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在产前接受阿片类药物维持治疗后,儿童的脑容量和皮质表面积较小。

Children had smaller brain volumes and cortical surface areas after prenatal opioid maintenance therapy exposure.

作者信息

Aslaksen Anne Kathinka, Bjuland Knut Jørgen, Hoem Mari Leirdal, Horgen Gro, Haugen Olav H, Skranes Jon, Aukland Stein Magnus

机构信息

Department of Pediatrics, Sørlandet Hospital, Arendal and Kristiansand, Norway.

Department of Pediatrics, Haukeland University Hospital, Bergen, Norway.

出版信息

Acta Paediatr. 2025 Feb;114(2):398-409. doi: 10.1111/apa.17448. Epub 2024 Oct 8.

Abstract

AIM

The studies have shown that infants with prenatal OMT exposure had smaller brain volumes than non-exposed controls, but long-term outcome data are lacking. We examined 5-13-year-old OMT-exposed children with brain MRI and tested motor and visual-motor functions and possible associations between brain morphology and outcome.

METHODS

To this retrospective cohort study, we recruited 55 children with prenatal OMT exposure and 59 age- and gender-matched controls. They were examined with brain MRI, Movement-ABC and Beery-VMI. MRI images were processed with the Free Surfer® software to obtain volumetrics and estimates of cortical surface area and thickness. We used a general linear regression model (GLM) to calculate group differences.

RESULTS

The children in the OMT group had smaller mean total intracranial volume (ICV), 1407 cm (CI 95% 1379-1434) versus 1450 cm (CI 95% 1423-1476) in the control group (p = 0.026). After adjusting for ICV, significant group differences persisted for volumes of amygdala, basal ganglia and mid-posterior part of corpus callosum. Cortical surface area was smaller in the left caudal middle frontal gyrus and the right inferior parietal lobule in the OMT-group. Visual-motor function was significantly correlated with ICV.

CONCLUSION

Prenatal OMT exposure may alter early brain development with possible negative long-term functional consequences.

摘要

目的

研究表明,产前接触过氧甲基三嗪(OMT)的婴儿脑容量小于未接触过的对照组婴儿,但缺乏长期预后数据。我们对5至13岁接触过OMT的儿童进行了脑部磁共振成像(MRI)检查,并测试了运动和视觉运动功能,以及脑形态与预后之间可能存在的关联。

方法

在这项回顾性队列研究中,我们招募了55名产前接触过OMT的儿童和59名年龄及性别匹配的对照组儿童。他们接受了脑部MRI、运动能力评估量表(Movement-ABC)和贝利视觉运动整合发展测验(Beery-VMI)检查。MRI图像使用Free Surfer®软件进行处理,以获得体积测量值以及皮质表面积和厚度的估计值。我们使用一般线性回归模型(GLM)来计算组间差异。

结果

OMT组儿童的平均总颅内体积(ICV)较小,为1407立方厘米(95%置信区间为1379 - 1434),而对照组为1450立方厘米(95%置信区间为1423 - 1476)(p = 0.026)。在对ICV进行校正后,杏仁核、基底神经节和胼胝体中后部的体积在两组间仍存在显著差异。OMT组左侧尾侧中额回和右侧顶下小叶的皮质表面积较小。视觉运动功能与ICV显著相关。

结论

产前接触OMT可能会改变早期脑发育,并可能产生长期的负面功能后果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/270d/11706743/07728393f816/APA-114-398-g003.jpg

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