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产前接触化疗对执行功能的长期影响:一项 ERP 研究。

Long-term impact of prenatal exposure to chemotherapy on executive functioning: An ERP study.

机构信息

Department of Oncology, KU Leuven, Leuven, Belgium.

Department of Electrical Engineering (ESAT), KU Leuven, Leuven, Belgium.

出版信息

Clin Neurophysiol. 2019 Sep;130(9):1655-1664. doi: 10.1016/j.clinph.2019.06.012. Epub 2019 Jul 9.

Abstract

OBJECTIVE

This study examines the long-term impact of prenatal exposure to chemotherapy on executive functioning and the contribution of late-prematurity to this effect, using event-related potentials.

METHODS

Mothers of the prenatal-exposed children (n = 20) were diagnosed with cancer and received chemotherapeutic treatment during pregnancy. We recruited healthy controls (n = 20) who were matched on a 1:1 ratio regarding prematurity, age and sex. We assessed executive functioning at the age of nine, using two event-related potential paradigms: a Go/Nogo paradigm to investigate processes of response inhibition and conflict monitoring, as well as a Posner paradigm to investigate spatial attention.

RESULTS

Lower potentials were found in prenatal-exposed children compared to controls in the Go/Nogo P3 and Posner positive slow wave. Moreover, prenatal-exposed children responded slower on the Posner paradigm compared to controls (p < .033), with more incorrect responses (p = .023). In the control group, the N2 Go/Nogo wave was more pronounced in children born after a longer gestation.

CONCLUSIONS

This is the first study that demonstrates an effect of prenatal exposure to chemotherapy on the development of executive functioning, not limited to the effect of late-prematurity.

SIGNIFICANCE

This study emphasizes the necessity of a long-term follow-up of prenatal-exposed children to re-inform clinical practice on the costs and benefits of late-premature induction over treatment during pregnancy.

摘要

目的

本研究使用事件相关电位技术,考察产前接触化疗对执行功能的长期影响,以及晚发性早产对此影响的贡献。

方法

接受化疗治疗的母亲(n=20)为患有癌症的孕妇。我们招募了 20 名健康对照组,他们在早产、年龄和性别方面与对照组 1:1 匹配。我们在 9 岁时使用两种事件相关电位范式评估执行功能:Go/Nogo 范式用于研究反应抑制和冲突监测过程,Posner 范式用于研究空间注意力。

结果

与对照组相比,产前暴露组的 Go/Nogo P3 和 Posner 正慢波的电位较低。此外,与对照组相比,产前暴露组在 Posner 范式上的反应较慢(p<.033),且错误反应更多(p=.023)。在对照组中,出生后胎龄较长的儿童 Go/Nogo N2 波更明显。

结论

这是第一项表明产前接触化疗会影响执行功能发展的研究,不仅限于晚发性早产的影响。

意义

这项研究强调了对产前暴露儿童进行长期随访的必要性,以便重新告知临床实践中晚期早产儿的诱导分娩相对于孕期治疗的利弊。

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