Department of Pediatrics, University of Calgary, Calgary, AB, Canada.
Departments of Community Health Sciences, University of Calgary, Calgary, AB, Canada.
Acta Paediatr. 2019 Sep;108(9):1649-1660. doi: 10.1111/apa.14786. Epub 2019 Apr 9.
Brain alterations in very preterm children at risk for developmental coordination disorder were investigated.
Infants born very preterm with gestation age <30 weeks or birthweight <1250 g were recruited from Royal Women's Hospital Melbourne from 2001 to 2003. Volumetric imaging was performed at term equivalent age; at seven years, volumetric imaging and diffusion tensor imaging were performed. At seven years, 53 of 162 children without cerebral palsy had scores ≤16th percentile on the Movement Assessment Battery for Children-Second Edition and were considered at risk for developmental coordination disorder.
At term equivalent age, smaller brain volumes were found for total brain tissue, cortical grey matter, cerebellum, caudate accumbens, pallidum and thalamus in children at risk for developmental coordination disorder (p < 0.05); similar patterns were present at seven years. There was no evidence for catch-up brain growth in at-risk children. At seven years, at-risk children displayed altered microstructural organisation in many white matter tracts (p < 0.05).
Infants born very preterm at risk for developmental coordination disorder displayed smaller brain volumes at term equivalent age and seven years, and altered white matter microstructure at seven years, particularly in motor areas. There was no catch-up growth from infancy to seven years.
研究有发展性协调障碍风险的极早产儿的大脑变化。
本研究于 2001 年至 2003 年从墨尔本皇家妇女医院招募了胎龄<30 周或出生体重<1250g 的极早产儿。在胎龄相等时进行容积成像；在 7 岁时，进行容积成像和弥散张量成像。在 7 岁时，162 名无脑瘫儿童中有 53 名儿童的运动评估儿童第二版（Movement Assessment Battery for Children-Second Edition）评分≤第 16 百分位数，被认为有发展性协调障碍的风险。
在胎龄相等时，有发展性协调障碍风险的儿童的全脑组织、皮质灰质、小脑、尾状核、苍白球和丘脑的脑体积较小（p<0.05）；在 7 岁时也存在类似的模式。在有风险的儿童中，没有发现大脑生长的追赶现象。在 7 岁时，有风险的儿童的许多白质束的微观结构组织发生了改变（p<0.05）。
有发展性协调障碍风险的极早产儿在胎龄相等和 7 岁时的脑体积较小，7 岁时的白质微观结构发生改变，特别是在运动区。从婴儿期到 7 岁时没有追赶性生长。
