Kinney H C, Brody B A, Kloman A S, Gilles F H
Department of Pathology, Children's Hospital, Boston, MA 02115.
J Neuropathol Exp Neurol. 1988 May;47(3):217-34. doi: 10.1097/00005072-198805000-00003.
The timing and synchronization of postnatal myelination in the human central nervous system (CNS) are complex. We found eight time-related patterns of CNS myelination during the first two postnatal years in autopsied infants. The intensity of myelination was graded in 162 infants with diverse diseases on an ordinal scale of degrees 0-4. The Ayer method for maximum likelihood estimates for censored data was utilized to generate curves of the temporal changes in the percent of infants with degrees 0 through 4 of myelin in 62 white matter sites. These sites fall into eight subgroups determined by the presence or absence of microscopic myelin (degree 1) at birth and the median age at which mature myelin (degree 3) is reached. There is variability in the timing of myelination within and across axonal systems, and early onset of myelination is not always followed by early myelin maturation. We reexamined general rules governing the timing of myelination proposed by previous investigators, and found that those rules are neither complete nor inviolate, and that there is a complex interplay among them. This study specifies distinct periods of maturation in which myelinating pathways are potentially vulnerable to insult during the first two postnatal years.
人类中枢神经系统（CNS）产后髓鞘形成的时间和同步性很复杂。我们在尸检婴儿出生后的头两年发现了CNS髓鞘形成的八种与时间相关的模式。在162名患有各种疾病的婴儿中，髓鞘形成强度按0至4级的顺序量表进行分级。利用Ayer方法对删失数据进行最大似然估计，以生成62个白质部位髓鞘分级为0至4级的婴儿百分比随时间变化的曲线。这些部位分为八个亚组，由出生时微观髓鞘（1级）的有无以及达到成熟髓鞘（3级）的中位年龄决定。轴突系统内和跨轴突系统的髓鞘形成时间存在差异，髓鞘形成的早期开始并不总是伴随着髓鞘的早期成熟。我们重新审视了先前研究者提出的关于髓鞘形成时间的一般规则，发现这些规则既不完整也不是不可侵犯的，而且它们之间存在复杂的相互作用。这项研究明确了产后头两年髓鞘形成途径可能易受损伤的不同成熟阶段。
