Vo Van Philippe, Alison Marianne, Morel Baptiste, Beck Jonathan, Bednarek Nathalie, Hertz-Pannier Lucie, Loron Gauthier
Department of Neonatology, Hospices Civils de Lyon, Femme Mère Enfant Hospital, 59 Boulevard Pinel, 69500 Bron, France.
Service d'Imagerie Pédiatrique, Hôpital Robert Debré, APHP, 75019 Paris, France.
Children (Basel). 2022 Mar 4;9(3):356. doi: 10.3390/children9030356.
Preterm birth disrupts the in utero environment, preventing the brain from fully developing, thereby causing later cognitive and behavioral disorders. Such cerebral alteration occurs beneath an anatomical scale, and is therefore undetectable by conventional imagery. Prematurity impairs the microstructure and thus the histological process responsible for the maturation, including the myelination. Cerebral MRI diffusion tensor imaging sequences, based on water's motion into the brain, allows a representation of this maturation process. Similarly, the brain's connections become disorganized. The connectome gathers structural and anatomical white matter fibers, as well as functional networks referring to remote brain regions connected one over another. Structural and functional connectivity is illustrated by tractography and functional MRI, respectively. Their organizations consist of core nodes connected by edges. This basic distribution is already established in the fetal brain. It evolves greatly over time but is compromised by prematurity. Finally, cerebral plasticity is nurtured by a lifetime experience at microstructural and macrostructural scales. A preterm birth causes a negative and early disruption, though it can be partly mitigated by positive stimuli based on developmental neonatal care.
早产会破坏子宫内环境，阻碍大脑充分发育，从而导致日后出现认知和行为障碍。这种大脑改变发生在解剖学尺度之下，因此传统成像手段无法检测到。早产会损害微观结构，进而影响负责成熟过程的组织学进程，包括髓鞘形成。基于水分子在大脑中运动的脑磁共振成像扩散张量成像序列，能够呈现这一成熟过程。同样，大脑的连接也会变得紊乱。连接组汇集了结构性和解剖学上的白质纤维，以及涉及相互连接的远程脑区的功能网络。结构和功能连接分别通过纤维束成像和功能磁共振成像来显示。它们的组织由通过边连接的核心节点组成。这种基本分布在胎儿大脑中就已确立。它会随着时间大幅演变，但会因早产而受到损害。最后，大脑可塑性在微观结构和宏观结构层面受一生经历的影响。早产会造成负面的早期干扰，不过基于新生儿发育护理的积极刺激可以部分减轻这种干扰。
