Paules Cristina, Pérez Roche María Teresa, Marin Miguel Angel, Fayed Nicolás, García-Martí Gracián, Pisón Javier López, Oros Daniel, Pueyo Victoria
Obstetrics Department, Hospital Clínico Universitario Lozano Blesa, Avenida San Juan Bosco 15, 50009 Zaragoza, Spain.
Aragon Institute of Health Research (IIS Aragon), Avenida San Juan Bosco 13, 50009 Zaragoza, Spain.
Diagnostics (Basel). 2022 Nov 10;12(11):2748. doi: 10.3390/diagnostics12112748.
In this study, we used magnetic resonance imaging (MRI) to identify the different brain phenotypes within apparently healthy children and to evaluate whether these phenotypes had different prenatal characteristics. We included 65 healthy children (mean age, 10 years old) with normal neurological examinations and without structural abnormalities. We performed cluster analyses to identify the different brain phenotypes in the brain MRI images. We performed descriptive analyses, including demographic and perinatal characteristics, to assess the differences between the clusters. We identified two clusters: Cluster 1, or the “small brain phenotype” (n = 44), which was characterized by a global reduction in the brain volumes, with smaller total intracranial volumes (1044.53 ± 68.37 vs. 1200.87 ± 65.92 cm3 (p < 0.001)), total grey-matter volumes (644.65 ± 38.85 vs. 746.79 ± 39.37 cm3 (p < 0.001)), and total white-matter volumes (383.68 ± 40.17 vs. 443.55 ± 36.27 cm3 (p < 0.001)), compared with Cluster 2, or the “normal brain phenotype” (n = 21). Moreover, almost all the brain areas had decreased volumes, except for the ventricles, caudate nuclei, and pallidum areas. The risk of belonging to “the small phenotype” was 82% if the child was preterm, 76% if he/she was born small for his/her gestational age and up to 80% if the mother smoked during the pregnancy. However, preterm birth appears to be the only substantially significant risk factor associated with decreased brain volumes.
在本研究中,我们使用磁共振成像(MRI)来识别表面健康儿童的不同脑表型,并评估这些表型是否具有不同的产前特征。我们纳入了65名健康儿童(平均年龄10岁),他们的神经系统检查正常且无结构异常。我们进行聚类分析以识别脑MRI图像中的不同脑表型。我们进行描述性分析,包括人口统计学和围产期特征,以评估各聚类之间的差异。我们识别出两个聚类:聚类1,即“小脑表型”(n = 44),其特征是脑容量整体减小,总颅内体积(1044.53 ± 68.37 vs. 1200.87 ± 65.92 cm³(p < 0.001))、总灰质体积(644.65 ± 38.85 vs. 746.79 ± 39.37 cm³(p < 0.001))和总白质体积(383.68 ± 40.17 vs. 443.55 ± 36.27 cm³(p < 0.001))均小于聚类2,即“正常脑表型”(n = 21)。此外,除脑室、尾状核和苍白球区域外,几乎所有脑区的体积均减小。如果孩子早产,属于“小表型”的风险为82%;如果其出生时低于胎龄,该风险为76%;如果母亲在孕期吸烟,该风险高达80%。然而,早产似乎是与脑体积减小相关的唯一具有显著统计学意义的风险因素。