Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia; Victorian Infant Brain Studies (VIBeS), Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Developmental Imaging, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
Developmental Imaging, Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
Neuroimage. 2022 Jul 1;254:119168. doi: 10.1016/j.neuroimage.2022.119168. Epub 2022 Apr 1.
There have been many studies demonstrating children born very preterm exhibit brain white matter microstructural alterations, which have been related to neurodevelopmental difficulties. These prior studies have often been based on diffusion MRI modelling and analysis techniques, which commonly focussed on white matter microstructural properties in children born very preterm. However, there have been relatively fewer studies investigating the free-water content of the white matter, and also the microstructure and free-water content of the cortical grey matter, in children born very preterm. These biophysical properties of the brain change rapidly during fetal and neonatal brain development, and therefore such properties are likely also adversely affected by very preterm birth. In this study, we investigated the relationship of very preterm birth (<30 weeks' gestation) to both white matter and cortical grey matter microstructure and free-water content in childhood using advanced diffusion MRI analyses. A total of 130 very preterm participants and 45 full-term control participants underwent diffusion MRI at age 13 years. Diffusion tissue signal fractions derived by Single-Shell 3-Tissue Constrained Spherical Deconvolution were used to investigate brain tissue microstructural and free-water composition. The tissue microstructural and free-water composition metrics were analysed using a voxel-based analysis and cortical region-of-interest analysis approach. Very preterm 13-year-olds exhibited reduced white matter microstructural density and increased free-water content across widespread regions of the white matter compared with controls. Additionally, very preterm 13-year-olds exhibited reduced microstructural density and increased free-water content in specific temporal, frontal, occipital and cingulate cortical regions. These brain tissue composition alterations were strongly associated with cerebral white matter abnormalities identified in the neonatal period, and concurrent adverse cognitive and motor outcomes in very preterm children. The findings demonstrate brain microstructural and free-water alterations up to thirteen years from neonatal brain abnormalities in very preterm children that relate to adverse neurodevelopmental outcomes.
已有许多研究表明，极早产儿出生时表现出脑白质微观结构改变，这与神经发育困难有关。这些先前的研究通常基于弥散磁共振成像建模和分析技术，这些技术通常集中在极早产儿的脑白质微观结构特性上。然而，研究极早产儿脑白质内自由水含量以及皮质灰质的微观结构和自由水含量的研究相对较少。脑的这些生物物理特性在胎儿和新生儿脑发育过程中迅速变化，因此这些特性也可能因极早产而受到不利影响。在这项研究中，我们使用先进的弥散磁共振成像分析方法，研究了极早产（<30 周妊娠）与儿童期脑白质和皮质灰质微观结构和自由水含量的关系。共有 130 名极早产儿参与者和 45 名足月对照组参与者在 13 岁时接受了弥散磁共振成像检查。通过单壳 3 组织约束球谐反卷积获得的弥散组织信号分数用于研究脑组织微观结构和自由水组成。使用基于体素的分析和皮质感兴趣区分析方法分析组织微观结构和自由水组成指标。与对照组相比，极早产儿 13 岁时的白质微观结构密度降低，广泛的白质区域的自由水含量增加。此外，极早产儿 13 岁时特定的颞叶、额叶、枕叶和扣带回皮质区域的微观结构密度降低，自由水含量增加。这些脑组织成分改变与新生儿期脑白质异常以及极早产儿认知和运动功能不良密切相关。这些发现表明，极早产儿在新生儿期脑异常后长达 13 年出现脑微观结构和自由水改变，与不良神经发育结局相关。
