Children born very preterm experience altered cortical expansion over the first decade of life.

IF 4.1 Q1 CLINICAL NEUROLOGY Brain communications Pub Date : 2024-09-17 eCollection Date: 2024-01-01 DOI:10.1093/braincomms/fcae318
Lisa S Gorham, Aidan R Latham, Dimitrios Alexopoulos, Jeanette K Kenley, Emily Iannopollo, Rachel E Lean, David Loseille, Tara A Smyser, Jeffrey J Neil, Cynthia E Rogers, Christopher D Smyser, Kara Garcia
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Abstract

The brain develops rapidly from the final trimester of gestation through childhood, with cortical surface area expanding greatly in the first decade of life. However, it is unclear exactly where and how cortical surface area changes after birth, or how prematurity affects these developmental trajectories. Fifty-two very preterm (gestational age at birth = 26 ± 1.6 weeks) and 41 full-term (gestational age at birth = 39 ± 1.2 weeks) infants were scanned using structural magnetic resonance imaging at term-equivalent age and again at 9/10 years of age. Individual cortical surface reconstructions were extracted for each scan. Infant and 9/10 cortical surfaces were aligned using anatomically constrained Multimodal Surface Matching (aMSM), a technique that allows calculation of local expansion gradients across the cortical surface for each individual subject. At the neonatal time point, very preterm infants had significantly smaller surface area than their full-term peers (P < 0.001), but at the age 9/10-year time point, very preterm and full-term children had comparable surface area (P > 0.05). Across all subjects, cortical expansion by age 9/10 years was most pronounced in frontal, temporal, and supramarginal/inferior parietal junction areas, which are key association cortices (P Spin < 0.001). Very preterm children showed greater cortical surface area expansion between term-equivalent age and age 9/10 compared to their full-term peers in the medial and lateral frontal areas, precuneus, and middle temporal/banks of the superior sulcus junction (P < 0.05). Furthermore, within the very preterm group, expansion was highly variable within the orbitofrontal cortex and posterior regions of the brain. By mapping these patterns across the cortex, we identify differences in association cortices that are known to be important for executive functioning, emotion processing, and social cognition. Additional longitudinal work will be needed to understand if increased expansion in very preterm children is adaptive, or if differences persist into adulthood.

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早产儿在出生后的头十年里,大脑皮层的扩张会发生变化。
从妊娠的最后三个月到童年,大脑发育迅速,皮质表面积在生命的头十年大幅扩大。然而,目前还不清楚大脑皮层表面积在出生后的确切位置和如何变化,也不清楚早产对这些发育轨迹有何影响。研究人员对 52 名极度早产儿(出生时胎龄 = 26 ± 1.6 周)和 41 名足月儿(出生时胎龄 = 39 ± 1.2 周)进行了结构性磁共振成像扫描,结果显示,这些婴儿在足月儿和 9/10 岁时的皮层表面积都发生了变化。每次扫描均提取单个皮层表面重建。使用解剖约束多模态表面匹配(aMSM)技术对婴儿和 9/10 岁儿童的皮层表面进行对齐,该技术可计算出每个受试者皮层表面的局部扩张梯度。在新生儿期,早产儿的表面积明显小于足月儿(P < 0.001),但在 9/10 岁时,早产儿和足月儿的表面积相当(P > 0.05)。在所有受试者中,9/10 岁时皮质扩张最明显的是额叶、颞叶和上边缘/下顶叶交界区,这些区域是关键的关联皮质(P<0.001)。与足月儿童相比,极早产儿在足月至 9/10 岁期间的额叶内侧和外侧区域、楔前区和颞中部/上沟交界处的皮质表面积扩张更大(P < 0.05)。此外,在早产儿组中,眶额叶皮层和大脑后部区域的扩展差异很大。通过绘制大脑皮层的这些模式图,我们发现了联想皮层的差异,而众所周知,联想皮层对执行功能、情绪处理和社会认知非常重要。我们还需要进行更多的纵向研究,以了解早产儿大脑皮层的扩张是否具有适应性,或者这种差异是否会持续到成年期。
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