Ruttorf Michaela, Filip Julia, Schaible Thomas, Weis Meike, Zöllner Frank G
Computer Assisted Clinical Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Mannheim Institute for Intelligent Systems in Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany.
Eur J Neurosci. 2025 Feb;61(4):e70026. doi: 10.1111/ejn.70026.
School-aged and adolescent survivors of neonatal extracorporeal membrane oxygenation (ECMO) treatment still suffer from neurodevelopmental delays such as verbal, visuo-spatial and working memory problems, motor dysfunction and sensorineural hearing loss, respectively, later in life, which is well-documented by neuropsychological testing within follow-up programs. In this study, we demonstrate that diffusion-weighted imaging (DWI) in 2-year-old survivors of neonatal ECMO treatment reveals white matter (WM) alterations in brain regions related to neurodevelopmental outcome seen later in life. From the DWI data of 56 children, fractional anisotropy (FA), first fibre partial volume fraction estimate (F1), radial diffusivity (RD) and mean diffusivity (MD) are calculated and compared using tract-based spatial statistics adapted to a paediatric brain atlas. Significant differences in FA, F1, RD and MD between the no-ECMO and ECMO groups are seen in major WM tracts. Additionally, we examine individual diffusion measures by looking at 50 regions supplied with the paediatric brain atlas. We find the following regions to have significantly different means in the no-ECMO compared with the ECMO group matching reports of neuropsychological delays found in behavioural tests: left anterior corona radiata, left anterior limb of internal capsule, left anterior commissure, left and right corpus callosum (genu, body and splenium), left and right crus of fornix and left tapetum. Analysing diffusion measures at an early stage of life serves as a good tool to detect structural WM changes in survivors of neonatal ECMO treatment. Compared with neuropsychological testing, DWI does not depend on the child's active participation.
接受过新生儿体外膜肺氧合（ECMO）治疗的学龄期及青少年幸存者，在其生命后期仍分别遭受神经发育迟缓问题，如言语、视觉空间和工作记忆问题、运动功能障碍以及感音神经性听力损失，这在随访项目中的神经心理学测试中有充分记录。在本研究中，我们证明，对接受过新生儿ECMO治疗的2岁幸存者进行扩散加权成像（DWI）检查，可发现与生命后期所见神经发育结果相关的脑区白质（WM）改变。根据56名儿童的DWI数据，计算分数各向异性（FA）、第一纤维部分体积分数估计值（F1）、径向扩散率（RD）和平均扩散率（MD），并使用适用于儿科脑图谱的基于轨迹的空间统计学方法进行比较。在主要的白质束中，未接受ECMO治疗组与接受ECMO治疗组之间的FA、F1、RD和MD存在显著差异。此外，我们通过查看儿科脑图谱所提供的50个区域来检查个体扩散测量值。我们发现，与接受ECMO治疗组相比，未接受ECMO治疗组在以下区域的平均值存在显著差异，这与行为测试中发现的神经心理学延迟报告相符：左侧放射冠前部、左侧内囊前肢、左侧前连合、左右胼胝体（膝部、体部和压部）、左右穹窿脚以及左侧毯状核。在生命早期分析扩散测量值是检测新生儿ECMO治疗幸存者脑白质结构变化的良好工具。与神经心理学测试相比，DWI不依赖于儿童的积极参与。
