Pavy Carlton L, Shaw Julia C, Moloney Roisin A, Palliser Hannah K, Hirst Jonathon J
School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, NSW, Australia.
Hunter Medical Research Institute, Mothers and Babies Research Centre, Newcastle, NSW, Australia.
Front Pediatr. 2024 Jan 26;12:1336137. doi: 10.3389/fped.2024.1336137. eCollection 2024.
Preterm birth is known to cause impaired cerebellar development, and this is associated with the development of neurobehavioral disorders. This review aims to identify the mechanisms through which preterm birth impairs cerebellar development and consequently, increases the risk of developing neurobehavioral disorders. The severity of these disorders is directly related to the degree of prematurity, but it is also evident that even late preterm births are at significantly increased risk of developing serious neurobehavioral disorders. Preterm birth is associated with hypoxic events and increased glutamatergic tone within the neonatal brain which contribute to excitotoxic damage. The cerebellum is a dense glutamatergic region which undergoes relatively late neurodevelopment up to and beyond birth. Evidence indicates that the cerebellum forms reciprocal connections to regions important in behaviour regulation such as the limbic system and frontal cortex. Studies using fMRI (functional magnetic resonance Imaging), BOLD (blood oxygen level dependent) response and morphology studies in humans show the cerebellum is often involved in disorders such as attention deficit hyperactivity disorder (ADHD) and anxiety. The vulnerability of the cerebellum to preterm birth insult and its connections to behaviour associated brain regions implicates it in the development of neurobehavioral disorders. Protection against preterm associated insults on the cerebellum may provide a novel avenue through which ADHD and anxiety can be reduced in children born preterm.
众所周知,早产会导致小脑发育受损,这与神经行为障碍的发生有关。本综述旨在确定早产损害小脑发育并因此增加神经行为障碍发生风险的机制。这些障碍的严重程度与早产程度直接相关,但很明显,即使是晚期早产也会显著增加患严重神经行为障碍的风险。早产与新生儿脑内的缺氧事件以及谷氨酸能张力增加有关,这会导致兴奋性毒性损伤。小脑是一个密集的谷氨酸能区域,其神经发育相对较晚,直至出生后仍在继续。有证据表明,小脑与行为调节重要区域(如边缘系统和额叶皮质)形成相互连接。在人类中使用功能磁共振成像(fMRI)、血氧水平依赖(BOLD)反应和形态学研究表明,小脑常常参与诸如注意力缺陷多动障碍(ADHD)和焦虑等疾病。小脑对早产损伤的易感性及其与行为相关脑区的连接表明它在神经行为障碍的发生中起作用。预防早产对小脑的相关损伤可能为降低早产儿童患ADHD和焦虑症提供一条新途径。