Vestibular and Oculomotor Research Group, Department of Neuroscience, Erasmus Medical Center, Rotterdam, the Netherlands.
Department of Neonatology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, the Netherlands.
Pediatr Neurol. 2020 Aug;109:63-71. doi: 10.1016/j.pediatrneurol.2019.12.010. Epub 2020 Jan 28.
To provide insight into early neurosensory development in children born very preterm, we assessed the association between early structural brain damage and functional visuospatial attention and motion processing from one to two years corrected age.
In 112 children born at less than 32 weeks gestational age, we assessed brain damage and growth with a standardized scoring system on magnetic resonance imaging (MRI; 1.5 Tesla) scans performed at 29 to 35 weeks gestational age. Of the children with an MRI scan, 82 participated in an eye tracking-based assessment of visuospatial attention and motion processing (Tobii T60XL) at one year corrected age and 59 at two years corrected age.
MRI scoring showed good intra- and inter-rater reproducibility. At one year, 10% children had delayed attentional reaction times and 23% had delayed motion reaction times. Moderate to severe brain damage significantly correlated with slower visuospatial reaction times. At two years, despite attention and motion reaction times becoming significantly faster, 20% had delayed attentional reaction times and 35% had delayed motion reaction times, but no correlations with MRI scores were found. The presence of structural brain damage was associated with abnormal functional performance over age.
The present study indicates an association between moderate to severe brain damage and visuospatial attention and motion processing dysfunction at one year corrected age. This provides a new perspective on comprehensive MRI scoring and quantitative functional visuospatial assessments and their applicability in children born very preterm in their first years of life.
为了深入了解极早产儿的早期神经感觉发育情况,我们评估了从校正后 1 至 2 岁期间早期结构性脑损伤与功能性视空间注意力和运动处理之间的关联。
在 112 名胎龄小于 32 周的婴儿中,我们使用标准化评分系统对 29 至 35 周胎龄的磁共振成像(MRI;1.5 特斯拉)扫描进行了脑损伤和生长评估。在有 MRI 扫描的儿童中,有 82 名儿童在校正后 1 岁时接受了基于眼动追踪的视空间注意力和运动处理评估(Tobii T60XL),59 名儿童在校正后 2 岁时接受了评估。
MRI 评分显示出良好的内部和内部评分者之间的可重复性。在 1 岁时,10%的儿童注意力反应时间延迟,23%的儿童运动反应时间延迟。中度至重度脑损伤与较慢的视空间反应时间显著相关。在 2 岁时,尽管注意力和运动反应时间明显加快,但仍有 20%的儿童注意力反应时间延迟,35%的儿童运动反应时间延迟,但与 MRI 评分无相关性。结构性脑损伤的存在与功能表现异常有关。
本研究表明,中度至重度脑损伤与校正后 1 岁时的视空间注意力和运动处理功能障碍之间存在关联。这为全面的 MRI 评分以及定量的功能性视空间评估及其在极早产儿生命最初几年的应用提供了新的视角。