Murdoch Children's Research Institute, Melbourne, VIC, Australia.
Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia.
Pediatr Res. 2020 Jan;87(1):48-56. doi: 10.1038/s41390-019-0546-x. Epub 2019 Aug 27.
Altered basal ganglia and thalamic connectivity may be critical for cognitive, motor and behavioural impairments common to very preterm (<32 weeks' gestational age) children. This study aims to (1) compare corticostriatal and thalamocortical tract connectivity between very preterm and term-born children at 7 years of age; (2) explore tract connectivity associations with 7-year neurodevelopmental outcomes, and whether these relationships differed between groups.
Eighty-three very preterm and 19 term-born (≥37 weeks' gestational age) children underwent structural and diffusion magnetic resonance imaging and had a neuropsychological assessment at 7 years. Corticostriatal and thalamocortical tracts were reconstructed and white matter connectivity was estimated with apparent fibre density.
Compared with term-born controls, very preterm children had decreased connectivity in tracts linking the caudate to right motor areas (-10%, p = 0.03) and the thalamus with left motor areas (-5.7%, p = 0.03). Reduced connectivity in corticostriatal and thalamocortical tracts was associated with adverse motor functioning in both groups (p = 0.06). Decreased connectivity of the left caudate and putamen with the lateral prefrontal cortex was associated with lower reading performance for controls (p = 0.06).
Corticostriatal and thalamocortical tracts are vulnerable to very preterm birth. Poorer connectivity in these tracts may underlie the motor impairments observed in very preterm children.
基底节和丘脑连接的改变可能对非常早产儿(<32 周胎龄)常见的认知、运动和行为障碍至关重要。本研究旨在:(1) 比较 7 岁时非常早产儿和足月产儿的皮质纹状体和丘脑皮质束连接;(2) 探讨束连接与 7 岁神经发育结局的关系,以及这些关系在两组之间是否不同。
83 名非常早产儿和 19 名足月产儿(≥37 周胎龄)在 7 岁时接受了结构和弥散磁共振成像检查,并进行了神经心理学评估。重建皮质纹状体和丘脑皮质束,并使用表观纤维密度估计白质连接。
与足月产对照组相比,非常早产儿的右侧运动区与尾状核之间的连接(-10%,p=0.03)和丘脑与左侧运动区之间的连接(-5.7%,p=0.03)的连接减少。皮质纹状体和丘脑皮质束的连接减少与两组的运动功能障碍有关(p=0.06)。左侧尾状核和壳核与外侧前额叶皮质的连接减少与对照组的阅读成绩较低有关(p=0.06)。
皮质纹状体和丘脑皮质束易受非常早产儿出生的影响。这些束中连接减少可能是非常早产儿运动障碍的基础。