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产前酒精暴露儿童和青少年的皮质变薄延迟

Delayed cortical thinning in children and adolescents with prenatal alcohol exposure.

作者信息

Gimbel Blake A, Roediger Donovan J, Ernst Abigail M, Anthony Mary E, de Water Erik, Mueller Bryon A, Rockhold Madeline N, Schumacher Moss J, Mattson Sarah N, Jones Kenneth L, Lim Kelvin O, Wozniak Jeffrey R

机构信息

Department of Psychiatry and Behavioral Sciences, University of Minnesota Twin Cities, Minneapolis, Minnesota, USA.

Great Lakes Neurobehavioral Center, Edina, Minnesota, USA.

出版信息

Alcohol Clin Exp Res (Hoboken). 2023 Jul;47(7):1312-1326. doi: 10.1111/acer.15096. Epub 2023 May 8.

Abstract

BACKGROUND

Prenatal alcohol exposure (PAE) is associated with abnormalities in cortical structure and maturation, including cortical thickness (CT), cortical volume, and surface area. This study provides a longitudinal context for the developmental trajectory and timing of abnormal cortical maturation in PAE.

METHODS

We studied 35 children with PAE and 30 nonexposed typically developing children (Comparisons), aged 8-17 at enrollment, who were recruited from the University of Minnesota FASD Program. Participants were matched on age and sex. They underwent a formal evaluation of growth and dysmorphic facial features associated with PAE and completed cognitive testing. MRI data were collected on a Siemens Prisma 3T scanner. Two sessions, each including MRI scans and cognitive testing, were spaced approximately 15 months apart on average. Change in CT and performance on tests of executive function (EF) were examined.

RESULTS

Significant age-by-group (PAE vs. Comparison) linear interaction effects in CT were observed in the parietal, temporal, occipital, and insular cortices suggesting altered developmental trajectories in the PAE vs. Comparison groups. Results suggest a pattern of delayed cortical thinning in PAE, with the Comparison group showing more rapid thinning at younger ages and those with PAE showing accelerated thinning at older ages. Overall, children in the PAE group showed reduced cortical thinning across time relative to the Comparison participants. Symmetrized percent change (SPC) in CT in several regions was significantly correlated with EF performance at 15-month follow-up for the Comparison group but not the group with PAE.

CONCLUSIONS

Regional differences were seen longitudinally in the trajectory and timing of CT change in children with PAE, suggesting delayed cortical maturation and an atypical pattern of development compared with typically developing individuals. In addition, exploratory correlation analyses of SPC and EF performance suggest the presence of atypical brain-behavior relationships in PAE. The findings highlight the potential role of altered developmental timing of cortical maturation in contributing to long-term functional impairment in PAE.

摘要

背景

产前酒精暴露(PAE)与皮质结构和成熟异常有关,包括皮质厚度(CT)、皮质体积和表面积。本研究为PAE中异常皮质成熟的发育轨迹和时间提供了纵向背景。

方法

我们研究了35名有PAE的儿童和30名未暴露的正常发育儿童(对照组),这些儿童在明尼苏达大学胎儿酒精谱系障碍项目中招募,入组时年龄在8至17岁之间。参与者在年龄和性别上进行了匹配。他们接受了与PAE相关的生长和面部畸形特征的正式评估,并完成了认知测试。MRI数据在西门子Prisma 3T扫描仪上收集。两次检查,每次包括MRI扫描和认知测试,平均间隔约15个月。检查了CT的变化和执行功能(EF)测试的表现。

结果

在顶叶、颞叶、枕叶和岛叶皮质中观察到CT上显著的年龄-组(PAE与对照组)线性交互作用,表明PAE组与对照组的发育轨迹不同。结果表明PAE中皮质变薄延迟,对照组在较年轻时皮质变薄更快,而有PAE的儿童在较年长时皮质变薄加速。总体而言,与对照组参与者相比,PAE组儿童随时间推移皮质变薄减少。在15个月随访时,对照组几个区域的CT对称百分比变化(SPC)与EF表现显著相关,而PAE组则不然。

结论

在有PAE的儿童中,纵向观察到CT变化的轨迹和时间存在区域差异,这表明与正常发育个体相比,皮质成熟延迟且发育模式不典型。此外,SPC与EF表现的探索性相关分析表明PAE中存在非典型的脑-行为关系。这些发现突出了皮质成熟发育时间改变在导致PAE长期功能损害中的潜在作用。

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