胎龄相当早产儿伴 1 级脑室内出血的脑结构网络改变。
Altered structural brain networks at term-equivalent age in preterm infants with grade 1 intraventricular hemorrhage.
机构信息
Department of Pediatrics, Hanyang University College of Medicine, Seoul, Hospital, 222-1 Wangsimni-ro Seongdong-gu, Seoul, 04763, South Korea.
Department of Biomedical Engineering, Hanyang University, Seoul, South Korea.
出版信息
Ital J Pediatr. 2020 Apr 10;46(1):43. doi: 10.1186/s13052-020-0796-6.
BACKGROUND
Preterm infants are at risk for structural disruption of brain connectivity due to perinatal complications encountered during the fetal and neonatal periods. This study aimed to investigate the development of connectivity using diffusion tensor imaging at near-term age and the effect of grade 1 intraventricular hemorrhage on it.
METHODS
A total of 86 infants (55 preterm infants, 24 full-term infants) without apparent brain injury underwent diffusion magnetic resonance imaging (MRI) between 36 and 41 weeks post-menstrual age. The diffusion-MRI based connectomics were constructed from 64-segmented regions by using the Johns Hopkins University neonate atlas and were weighted with fractional anisotropy. The connectomes were quantified in the structural networks and investigated using network metrics, such as the clustering coefficient, local efficiency, characteristic path length, global efficiency, and small-worldness. We compared the differences in the brain networks of preterm infants with or without grade 1 intraventricular hemorrhage in binary and fractional anisotropy-weighted (wFA) connectomes.
RESULTS
The 55 preterm infants had a mean gestational age at birth of 29.3 ± 4.1 weeks and the 24 term-born infants, 38.1 ± 1.1 weeks. A total of 13 of the 55 preterm infants (23.6%) were diagnosed with grade 1 intraventricular hemorrhage. The development of connectivity of the brain network in preterm infants without intraventricular hemorrhage was comparable at near-term age to that in term infants. The preterm infants with germinal matrix hemorrhage exhibited higher clustering (0.093 ± 0.015 vs. 0.088 ± 0.007, p = 0.027) and local efficiency (0.151 ± 0.022 vs. 0.141 ± 0.010, p = 0.025), implying the potential for segregation. However, the preterm infants with intraventricular hemorrhage revealed a longer path length (0.291 ± 0.035 vs. 0.275 ± 0.019, p = 0.020) and lower global efficiency (3.998 ± 0.473 vs. 4.212 ± 0.281, p = 0.048), indicating a decreased integration in the wFA connectivity matrix than those without germinal matrix hemorrhage, after correcting for gestational age, sex, bronchopulmonary dysplasia, and age at scan.
CONCLUSION
Grade 1 intraventricular hemorrhage in preterm infants may enhance the capacity for local information transfer and the relative reinforcement of the segregation of networks at the expense of global integration capacity.
背景
早产儿由于胎儿期和新生儿期的围产期并发症，其脑连接结构可能会受到破坏。本研究旨在探讨近足月龄时使用弥散张量成像（DTI）评估连接性的发育情况，以及 1 级脑室内出血（IVH）对其的影响。
方法
共有 86 名婴儿（55 名早产儿，24 名足月儿），无明显脑损伤，在胎龄 36-41 周时进行弥散磁共振成像（MRI）检查。基于 Johns Hopkins 大学新生儿图谱，从 64 个分割区域构建弥散磁共振成像连接组学，并使用各向异性分数（fractional anisotropy，FA）进行加权。在结构网络中对连接组学进行量化，并使用聚类系数、局部效率、特征路径长度、全局效率和小世界性等网络指标进行研究。我们比较了有无 1 级 IVH 的早产儿脑网络之间的差异，比较内容包括二值和 FA 加权（weighted FA，wFA）连接组学。
结果
55 名早产儿的平均胎龄为 29.3±4.1 周，24 名足月儿的胎龄为 38.1±1.1 周。55 名早产儿中有 13 名（23.6%）被诊断为 1 级 IVH。无 IVH 的早产儿脑网络的连接发育在近足月龄时与足月儿相当。伴有脑室内出血的早产儿其聚类（0.093±0.015 比 0.088±0.007，p=0.027）和局部效率（0.151±0.022 比 0.141±0.010，p=0.025）更高，这表明可能存在隔离。然而，有 IVH 的早产儿的路径长度更长（0.291±0.035 比 0.275±0.019，p=0.020），全局效率更低（3.998±0.473 比 4.212±0.281，p=0.048），这表明 wFA 连接矩阵的整合度低于无脑室内出血的早产儿，这与校正胎龄、性别、支气管肺发育不良和扫描年龄后一致。
结论
早产儿 1 级 IVH 可能会增强局部信息传递能力，并增强网络的隔离程度，而牺牲整体整合能力。
Zotero 插件