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与极低出生体重且胎儿生长不良的学龄儿童相关联的束路结构改变与语言能力

Microstructural alterations in association tracts and language abilities in schoolchildren born very preterm and with poor fetal growth.

机构信息

PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland.

Department of Child Neurology, Oulu University Hospital, University of Oulu, P.O. Box 5000, FIN-90014, Oulu, Finland.

出版信息

Pediatr Radiol. 2023 Jan;53(1):94-103. doi: 10.1007/s00247-022-05418-3. Epub 2022 Jul 1.

Abstract

BACKGROUND

Prematurity and perinatal risk factors may influence white matter microstructure. In turn, these maturational changes may influence language development in this high-risk population of children.

OBJECTIVE

To evaluate differences in the microstructure of association tracts between preterm and term children and between preterm children with appropriate growth and those with fetal growth restriction and to study whether the diffusion tensor metrics of these tracts correlate with language abilities in schoolchildren with no severe neurological impairment.

MATERIALS AND METHODS

This study prospectively followed 56 very preterm children (mean gestational age: 28.7 weeks) and 21 age- and gender-matched term children who underwent diffusion tensor imaging at a mean age of 9 years. We used automated probabilistic tractography and measured fractional anisotropy in seven bilateral association tracts known to belong to the white matter language network. Both groups participated in language assessment using five standardised tests at the same age.

RESULTS

Preterm children had lower fractional anisotropy in the right superior longitudinal fasciculus 1 compared to term children (P < 0.05). Preterm children with fetal growth restriction had lower fractional anisotropy in the left inferior longitudinal fasciculus compared to preterm children with appropriate fetal growth (P < 0.05). Fractional anisotropy in three dorsal tracts and in two dorsal and one ventral tract had a positive correlation with language assessments among preterm children and preterm children with fetal growth restriction, respectively (P < 0.05).

CONCLUSION

There were some microstructural differences in language-related tracts between preterm and term children and between preterm children with appropriate and those with restricted fetal growth. Children with better language abilities had a higher fractional anisotropy in distinct white matter tracts.

摘要

背景

早产儿和围产期的危险因素可能会影响白质的微观结构。反过来,这些成熟变化可能会影响高危儿童的语言发展。

目的

评估早产儿和足月儿之间、生长适当的早产儿和胎儿生长受限的早产儿之间的联络束微观结构差异,并研究这些束的弥散张量指标是否与无严重神经功能障碍的学龄儿童的语言能力相关。

材料和方法

本研究前瞻性随访了 56 名极早产儿(平均胎龄:28.7 周)和 21 名年龄和性别匹配的足月儿,他们在平均 9 岁时接受了弥散张量成像。我们使用自动概率追踪技术测量了 7 条已知属于白质语言网络的双侧联络束的各向异性分数。两组儿童在相同年龄时均接受了五项标准语言评估测试。

结果

与足月儿相比,早产儿右侧上纵束 1 的各向异性分数较低(P<0.05)。与生长适当的早产儿相比,胎儿生长受限的早产儿左侧下纵束的各向异性分数较低(P<0.05)。在早产儿和胎儿生长受限的早产儿中,三条背侧束和两条背侧及一条腹侧束的各向异性分数与语言评估呈正相关(P<0.05)。

结论

早产儿和足月儿之间、生长适当的早产儿和胎儿生长受限的早产儿之间存在一些与语言相关的束微观结构差异。语言能力较好的儿童在特定的白质束中具有较高的各向异性分数。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d6d7/9816217/1a00c683ac36/247_2022_5418_Fig1_HTML.jpg

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