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早产儿大脑皮质对体感输入的处理改变,这些早产儿曾患有高级别脑室内-脑室外出血。

Altered cortical processing of somatosensory input in pre-term infants who had high-grade germinal matrix-intraventricular haemorrhage.

机构信息

Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom.

Department of Neuroscience, Physiology and Pharmacology, University College London, London WC1E 6BT, United Kingdom; Elizabeth Garrett Anderson Wing, University College London Hospitals, London WC1E 6BD, United Kingdom.

出版信息

Neuroimage Clin. 2020;25:102095. doi: 10.1016/j.nicl.2019.102095. Epub 2019 Nov 28.

Abstract

High-grade (large) germinal matrix-intraventricular haemorrhage (GM-IVH) is one of the most common causes of somatomotor neurodisability in pre-term infants. GM-IVH presents during the first postnatal week and can impinge on somatosensory circuits resulting in aberrant somatosensory cortical events straight after injury. Subsequently, somatosensory circuits undergo significant plastic changes, sometimes allowing the reinstatement of a somatosensory cortical response. However, it is not known whether this restructuring results in a full recovery of somatosensory functions. To investigate this, we compared somatosensory responses to mechanical stimulation measured with 18-channels EEG between infants who had high-grade GM-IVH (with ventricular dilatation and/or intraparenchymal lesion; n = 7 studies from 6 infants; mean corrected gestational age = 33 weeks; mean postnatal age = 56 days) and age-matched controls (n = 9 studies from 8 infants; mean corrected gestational age = 32 weeks; mean postnatal age = 36 days). We showed that infants who had high-grade GM-IVH did not recruit the same cortical source configuration following stimulation of the foot, but their response to stimulation of the hand resembled that of controls. These results show that somatosensory cortical circuits are reinstated in infants who had GM-IVH, during the several weeks after injury, but remain different from those of infants without brain injury. An important next step will be to investigate whether these evidences of neural reorganisation predict neurodevelopmental outcome.

摘要

高级(大面积)脑室内生发基质-脑室内出血(GM-IVH)是早产儿运动神经功能障碍的最常见原因之一。GM-IVH 在出生后第一周内出现,并可能影响体感回路,导致损伤后立即出现异常体感皮质事件。随后,体感回路经历了显著的可塑性变化,有时允许体感皮质反应的恢复。然而,尚不清楚这种重构是否会导致体感功能的完全恢复。为了研究这一点,我们比较了接受机械刺激时的体感反应,使用 18 通道 EEG 测量了有高级 GM-IVH(伴有脑室扩张和/或脑实质病变;n = 6 名婴儿的 7 项研究;平均校正胎龄 = 33 周;平均生后年龄 = 56 天)和年龄匹配的对照组(n = 8 名婴儿的 9 项研究;平均校正胎龄 = 32 周;平均生后年龄 = 36 天)。我们表明,接受高级 GM-IVH 的婴儿在足部刺激后没有招募相同的皮质源配置,但他们对手部刺激的反应类似于对照组。这些结果表明,在损伤后数周内,GM-IVH 婴儿的体感皮质回路得到了恢复,但仍与无脑损伤婴儿的不同。下一步的重要步骤将是研究这些神经重组的证据是否可以预测神经发育结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8747/6920135/4010bfe8248f/gr1.jpg

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