Center for MR Research, University Children's Hospital Zurich, Zurich, Switzerland.
Department of Neonatology, University Hospital Zurich, Zurich, Switzerland.
Neuroimage Clin. 2019;22:101806. doi: 10.1016/j.nicl.2019.101806. Epub 2019 Apr 1.
Periventricular white matter injury is common in very preterm infants and it is associated with long term neurodevelopmental impairments. While evidence supports the protective effects of erythropoetin (EPO) in preventing injury, we currently lack the complete understanding of how EPO affects the emergence and maturation of anatomical brain connectivity and function. In this case-control study, connectomic analysis based on diffusion MRI tractography was applied to evaluate the effect of early high-dose EPO in preterm infants. A whole brain, network-level analysis revealed a sub-network of anatomical brain connections in which connectivity strengths were significantly stronger in the EPO group. This distributed network comprised connections predominantly in the frontal and temporal lobe bilaterally, and the effect of EPO was focused on peripheral and feeder connections of the core structural connectivity network. EPO resulted in a globally increased clustering coefficient, higher global and average local efficiency, while higher strength and increased clustering was found for regions in the frontal lobe and cingulate gyrus. The connectivity network most affected by the EPO treatment showed a steeper increase graph theoretical measures with age compared to the placebo group. Our results demonstrate a weak but widespread effect of EPO on the structural connectivity network and a possible trophic effect of EPO reflected by increasing network segregation, predominantly in local connections.
脑室周围白质损伤在极早产儿中很常见,并且与长期神经发育损伤有关。虽然有证据表明促红细胞生成素(EPO)在预防损伤方面具有保护作用,但我们目前还不完全了解 EPO 如何影响解剖脑连接和功能的出现和成熟。在这项病例对照研究中,我们应用基于弥散 MRI 轨迹的连接组学分析来评估早期高剂量 EPO 对早产儿的影响。全脑网络水平分析显示,EPO 组的脑连接连通性明显更强的特定脑连接子网络。该分布式网络主要包括双侧额颞叶的连接,EPO 的作用集中在核心结构连通性网络的外围和馈线连接上。EPO 导致全局聚类系数增加,全局和平均局部效率提高,而额叶和扣带回区域的强度和聚类增加。与安慰剂组相比,EPO 治疗最受影响的连接网络的图论测量值随年龄的增长呈更陡峭的增长趋势。我们的结果表明,EPO 对结构连接网络具有微弱但广泛的影响,以及 EPO 可能通过增加网络分离(主要是局部连接)来反映的营养作用。