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Ultrarare Variants in DNA Damage Repair Genes in Pediatric Acute-Onset Neuropsychiatric Syndrome or Acute Behavioral Regression in Neurodevelopmental Disorders. 小儿急发神经精神综合征或神经发育障碍中的急性行为退行性病变中 DNA 损伤修复基因的超常变异。
IF 2 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2025-01-01 Epub Date: 2024-10-11 DOI: 10.1159/000541908
Janet L Cunningham, Jennifer Frankovich, Robert A Dubin, Erika Pedrosa, Refia Nur Baykara, Noelle Cathleen Schlenk, Shahina B Maqbool, Hedwig Dolstra, Jacqueline Marino, Jacob Edinger, Julia M Shea, Gonzalo Laje, Sigrid M A Swagemakers, Siamala Sinnadurai, Zhengdong D Zhang, Jhih-Rong Lin, Peter J van der Spek, Herbert M Lachman, Herbert M Lachman

Introduction: Acute onset of severe psychiatric symptoms or regression may occur in children with premorbid neurodevelopmental disorders, although typically developing children can also be affected. Infections or other stressors are likely triggers. The underlying causes are unclear, but a current hypothesis suggests the convergence of genes that influence neuronal and immunological function. We previously identified 11 genes in pediatric acute-onset neuropsychiatric syndrome (PANS), in which two classes of genes related to either synaptic function or the immune system were found. Among the latter, three affect the DNA damage response (DDR): PPM1D, CHK2, and RAG1. We now report an additional 17 cases with mutations in PPM1D and other DDR genes in patients with acute onset of psychiatric symptoms and/or regression that their clinicians classified as PANS or another inflammatory brain condition.

Methods: We analyzed genetic findings obtained from parents and carried out whole-exome sequencing on a total of 17 cases, which included 3 sibling pairs and a family with 4 affected children.

Results: The DDR genes include clusters affecting p53 DNA repair (PPM1D, ATM, ATR, 53BP1, and RMRP), and the Fanconi Anemia Complex (FANCE, SLX4/FANCP, FANCA, FANCI, and FANCC). We hypothesize that defects in DNA repair genes, in the context of infection or other stressors, could contribute to decompensated states through an increase in genomic instability with a concomitant accumulation of cytosolic DNA in immune cells triggering DNA sensors, such as cGAS-STING and AIM2 inflammasomes, as well as central deficits on neuroplasticity. In addition, increased senescence and defective apoptosis affecting immunological responses could be playing a role.

Conclusion: These compelling preliminary findings motivate further genetic and functional characterization as the downstream impact of DDR deficits may point to novel treatment strategies.

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虽然发育正常的儿童也可能受到影响,但有神经发育前期障碍的儿童可能会出现急性发作的严重精神症状或退行。感染或其他压力因素很可能是诱发因素。其根本原因尚不清楚,但目前有一种假说认为,影响神经元和免疫功能的基因趋于一致。我们先前在小儿急发神经精神综合征(PANS)中发现了 11 个基因,其中有两类基因与突触功能或免疫系统有关。在后者中,有三个影响 DNA 损伤反应(DDR):PPM1D、CHK2 和 RAG1。现在,我们又报告了另外 17 例 PPM1D 和其他 DDR 基因突变的病例,这些患者都有急性发作的精神症状和/或精神退化,临床医生将其归类为 PANS 或其他脑部炎症。这些基因包括影响 p53 DNA 修复的基因簇(PPM1D、ATM、ATR、53BP1 和 RMRP)以及范可尼贫血症复合体(FANCE、SLX4/FANCP、FANCA、FANCI 和 FANCC)。我们假设,在感染或其他应激因素的背景下,DNA 修复基因的缺陷可能会导致基因组不稳定性增加,同时免疫细胞中的细胞膜 DNA 积累触发 DNA 传感器,如 cGAS-STING 和 AIM2 炎性体,以及中枢神经可塑性缺陷,从而导致失代偿状态。此外,影响免疫反应的衰老增加和凋亡缺陷也可能在其中发挥作用。这些令人信服的初步研究结果促使人们进一步研究基因和功能特征,因为DDR缺陷的下游影响可能会为新型治疗策略提供方向。
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引用次数: 0
Pediatric Post-Infectious Neuroinflammatory Syndromes Come to the Fore. 儿童感染后神经炎症综合征是最重要的。
IF 2 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2025-01-01 Epub Date: 2025-04-26 DOI: 10.1159/000546082
Samuel J Pleasure, Samuel J Pleasure
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引用次数: 0
The Long-Term Behavioural Effects of Maternal Creatine Supplementation in a Spiny Mouse Model of Birth Asphyxia. 母体补充肌酸对分娩窒息小鼠模型的长期行为影响。
IF 2 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2025-01-01 Epub Date: 2025-02-18 DOI: 10.1159/000544756
Nhi T Tran, James Tran, Tamara Yawno, Rod J Snow, David W Walker, Stacey J Ellery

Introduction: Birth asphyxia-induced encephalopathy is a major cause of long-term neurological morbidity, including cognitive and motor deficits. A proposed treatment is maternal creatine supplementation for prophylactic neuroprotection. This study examined how maternal creatine supplementation with or without birth asphyxia affected the behaviour of spiny mice offspring.

Methods: On day 20 of gestation (mid-gestation; term = 39 days), dams were randomly allocated to either a daily diet containing 5% w/w creatine monohydrate or remained on standard rodent chow. On gestational day 38, dams underwent either control caesarean section where offspring were delivered and recovered immediately, or birth asphyxia whereby the pregnant uterus was excised and placed in a saline bath for 7.5 min, inducing global hypoxia. All offspring were then cross-fostered to a lactating dam. Behavioural assessments were then completed on recovered offspring from neonatal to adolescent/adult ages (postnatal day [PND] 3-41) using the open-field, elevated plus maze, and novel object recognition test.

Results: Offspring that underwent birth asphyxia displayed locomotor deficits and increased anxiety-like behaviour at PND 3-7 in the open-field test (p < 0.05) and impaired novel object discrimination at PND 18 (p < 0.05). Antenatal creatine exposure reduced anxiety-like behaviour irrespective of asphyxia in pups at PND 3, indicating an amelioration of the asphyxia-induced anxiety-like behaviour. In adolescence/adulthood, creatine and asphyxia-exposed offspring showed reduced object exploration (p < 0.0001). Antenatal creatine led to sustained reductions in anxiety-like behaviour in the elevated plus maze at adolescence and increased body weight, regardless of birth asphyxia exposure (p < 0.05).

Conclusion: Antenatal creatine exposure following maternal dietary creatine supplementation decreased anxiety-like behaviour in spiny mice offspring. This change negated behavioural abnormalities caused by birth asphyxia in the neonatal period, though it may have broader influences on long-term emotional and information processing in offspring which warrants further investigation.

出生窒息性脑病是长期神经系统疾病的主要原因,包括认知和运动缺陷。一种建议的治疗方法是补充母体肌酸以预防神经保护。本研究考察了母体肌酸补充有无出生窒息如何影响棘鼠后代的行为。方法:妊娠第20天(妊娠中期;试验期=39天),随机分为两组,一组饲喂含有5% w/w一水肌酸的日粮,另一组饲喂标准鼠粮。在妊娠第38天,母鼠要么接受对照剖宫产,分娩后立即恢复,要么接受分娩窒息,切除妊娠子宫,将其置于生理盐水浴中7.5分钟,诱导全身缺氧。然后,所有的后代被交叉饲养到一个哺乳的大坝。对康复后的幼鼠从新生儿至青春期/成年期(出生后3-41日)进行行为学评估,采用开放场、高架迷宫和新物体识别测试。结果:在野外测试中,经历出生窒息的后代在PND3-7上表现出运动缺陷和焦虑样行为的增加(结论:在母体饮食中补充肌酸后,产前肌酸暴露降低了棘鼠后代的焦虑样行为。这种变化否定了新生儿时期出生窒息引起的行为异常,尽管它可能对后代的长期情绪和信息处理有更广泛的影响,这需要进一步的研究。
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引用次数: 0
Region-Specific Brain Volume Changes Emerge in Adolescence in the Valproic Acid Model of Autism and Parallel Human Findings. 丙戊酸自闭症模型在青春期出现的特定区域脑容量变化与人类研究结果相似。
IF 2.3 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2025-01-01 Epub Date: 2024-04-26 DOI: 10.1159/000538932
Cole King, Ivina Mali, Hunter Strating, Elizabeth Fangman, Jenna Neyhard, Macy Payne, Stefan H Bossmann, Bethany Plakke

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social and communication deficits, cognitive dysfunction, and stereotyped repetitive behaviors. Regional volume changes are commonly observed in individuals with ASD. To examine volumetric dysregulation across adolescence, the valproic acid (VPA) model was used to induce ASD-like phenotypes in rats.

Method: Regional volumes were obtained via magnetic resonance imaging at either postnatal day 28 or postnatal day 40 (P40), which correspond to early and late adolescence, respectively.

Results: Consistent with prior research, VPA animals had reduced total brain volume compared to control animals. A novel outcome was that VPA animals had overgrown right hippocampi at P40. Differences in the pattern of development of the anterior cingulate cortex were also observed in VPA animals. Differences for the posterior cingulate were only observed in males, but not females.

Conclusion: These results demonstrate differences in region-specific developmental trajectories between control and VPA animals and suggest that the VPA model may capture regional volume changes consistent with human ASD.

Introduction: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by social and communication deficits, cognitive dysfunction, and stereotyped repetitive behaviors. Regional volume changes are commonly observed in individuals with ASD. To examine volumetric dysregulation across adolescence, the valproic acid (VPA) model was used to induce ASD-like phenotypes in rats.

Method: Regional volumes were obtained via magnetic resonance imaging at either postnatal day 28 or postnatal day 40 (P40), which correspond to early and late adolescence, respectively.

Results: Consistent with prior research, VPA animals had reduced total brain volume compared to control animals. A novel outcome was that VPA animals had overgrown right hippocampi at P40. Differences in the pattern of development of the anterior cingulate cortex were also observed in VPA animals. Differences for the posterior cingulate were only observed in males, but not females.

Conclusion: These results demonstrate differences in region-specific developmental trajectories between control and VPA animals and suggest that the VPA model may capture regional volume changes consistent with human ASD.

自闭症谱系障碍(ASD)是一种神经发育障碍,以社交和沟通障碍、认知功能障碍和刻板重复行为为特征。自闭症谱系障碍患者通常会出现区域体积变化。为了研究整个青春期的体积失调,研究人员使用丙戊酸(VPA)模型诱导大鼠出现类似 ASD 的表型。在出生后第28天(P28)或出生后第40天(P40)(分别对应青春期早期和晚期),通过磁共振成像(MRI)获得区域体积。与之前的研究结果一致,与对照组动物相比,VPA动物的大脑总体积有所减少。一个新的结果是,VPA动物在P40时右侧海马过度生长。在VPA动物身上还观察到前扣带回皮层发育模式的差异。仅在雄性动物中观察到扣带回后部的差异,而在雌性动物中则没有观察到。这些结果表明,对照组和 VPA 动物的特定区域发育轨迹存在差异,并表明 VPA 模型可能捕捉到与人类 ASD 一致的区域体积变化。
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引用次数: 0
Acute Onset Neuropsychiatric Conditions in Children and Adolescents following SARS-CoV-2 Infection: A Case Series. 儿童和青少年感染 SARS-CoV-2 后出现的急性神经精神症状:病例系列。
IF 2 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2025-01-01 Epub Date: 2025-03-24 DOI: 10.1159/000545349
Mohamed T Jasser, Thomas Ferland, Thomas Bocian, Matthew Goff, Abigail Gauch, Michael V Heinz, Elizabeth Joffrey, Richard Morse, Daniel Albert, Jennifer Frankovich, Juliette C Madan, Mohamed Jasser

Introduction: Neuropsychiatric symptoms following SARS-CoV-2 infection have been described in a substantial proportion of patients, acute, subacute, and chronic. Understanding of the neurological and neuropsychiatric sequelae of this virus is an emerging field of study with rapidly evolving descriptions of its impact on the central and peripheral nervous system.

Case presentation: Here, we report a series of 8 pediatric patients presenting with acute onset neuropsychiatric symptoms following SARS-CoV-2 infection who received comprehensive medical and psychiatric evaluation and treatment in our research-based Neuroimmune Psychiatric Disorders Program. We provide a review of the research available to date regarding potential mechanisms underlying neuroinflammatory consequences of this endemic infection. Opportunities for further investigations of mechanisms, evaluations and impactful treatments following SARS-CoV-2 infection are described.

Conclusion: The pediatric cases presented share acute onset of obsessive-compulsive disorder, psychosis, tics, neurobehavioral and physiological symptoms, with significant response to treatments targeting inflammation in combination with psychiatric and psychological interventions. Ongoing study and identification of this phenomenon of abrupt neuropsychiatric changes following SARS-CoV-2 infection may lead to more effective treatments with potential application to broader populations.

相当一部分成年患者在感染 SARS-CoV-2 后出现了神经精神症状,包括急性、亚急性和慢性症状。对这种病毒的神经和神经精神后遗症的了解是一个新兴的研究领域,对其对中枢和外周神经系统的影响的描述也在迅速发展。在此,我们报告了一系列感染 SARS-CoV-2 后出现急性神经精神症状的儿童患者,他们在我们以研究为基础的神经免疫精神障碍项目中接受了全面的医学和精神评估与治疗。我们回顾了迄今为止有关这种地方性感染导致神经炎症后果的潜在机制的研究。我们还介绍了进一步研究 SARS-CoV-2 感染机制、评估和有影响的治疗方法的机会。所介绍的儿科病例都有急性发作的强迫症、精神病、抽搐、神经行为和生理症状,并对针对炎症的治疗结合精神和心理干预措施有显著反应。对 SARS-CoV-2 感染后神经精神突变现象的持续研究和鉴定可能会带来更有效的治疗方法,并有可能应用于更广泛的人群。
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引用次数: 0
Transferring Mouse Emx1 and Emx2 Lentiviruses into the Chicken Embryonic Brain and Their Implication to the Organization and Evolution of the Amniote Pallium. 小鼠Emx1和Emx2慢病毒转染鸡胚脑及其对羊膜组织和进化的影响。
IF 2 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2025-01-01 Epub Date: 2025-01-24 DOI: 10.1159/000543601
Rui Zhao, Yuanyuan Gao, Chao Xi, Ping Liu, Shiying Lin, Shan Lu, Jin Liu, Jie Bing, Xinwen Zhang, Shaoju Zeng

Introduction: Homeobox genes are highly conserved and play critical roles in brain development. Recently, we have found that mammals have an additional fragment of approximately 20 amino acids in Emx1 and a poly-(AL)6-7 in Emx2, compared to other amniotes. It has been shown that Emx1 and Emx2 have synergistic actions in the brain development. These reports raise an interesting issue whether the differences of Emx1 and Emx2 between mammals and non-mammals are concerned with the organization and evolution of amniote pallium.

Methods: Lentiviruses expressing mouse Emx1 and Emx2 (mEmx1/2) with additional fragments were injected into the ventricle of the chick telencephalon at embryonic day 3 to study the effects of mEmx1/2 on the development of chick pallium, whereas injections of lentiviruses containing chick Emx1 and Emx2 (cEmx1/2), no targeted gene insert or saline were as controls. The expressions of reelin, vimentin, GABA and MAP2, neurogenesis patterns for calbindin (CB) and parvalbumin (PV) neurons and the sizes of anterior commissure (AC) were then studied by immuohistochemical staining, and open-field tests were performed to assess locomotor activities and curious or exploratory behaviors of the chicks.

Results: Following the injections of lentiviruses expressing mEmx1/2, the expressions of reelin, vimentin, GABA, and MAP2 increased in most parts of Wulst (W) and mesopallium (M), but not most of nidopallium (N). Neurogenesis patterns for CB and PV neurons changed toward mammalian inside-out one, and the sizes of AC staining for neurofilament were significantly larger. In addition, post-hatchling chicks showed higher rates of passive avoidance after training, but no significant differences in the total distance traveled and the percentage of time spent in the central rectangle, compared to those in the control groups.

Conclusion: The present study indicated that mEmx1/2 had effects on the development of chick pallium, suggesting that they are probably involved in the organization and evolution of amniote pallium.

同源盒基因是高度保守的基因,在大脑发育中起着至关重要的作用。最近我们发现,与其他羊膜动物相比,哺乳动物在Emx1中有大约20个氨基酸的额外片段,在Emx2中有一个多(Ala)6-7。研究表明,Emx1和Emx2在大脑发育中具有协同作用。这些报道提出了一个有趣的问题,即哺乳动物和非哺乳动物之间Emx1和Emx2的差异是否与羊膜白膜的组织和进化有关。方法:在胚胎第3天将表达小鼠Emx1和Emx2的慢病毒(mEmx1/2)和附加片段注射到鸡端脑室,研究mEmx1/2对鸡pallium发育的影响,而将含有鸡Emx1和Emx2的慢病毒(cEmx1/2)、不插入靶向基因或注射生理盐水作为对照。免疫组化染色观察鸡的reelin、vimentin、GABA和MAP2的表达、calbindin和parvalbumin神经元的神经发生模式和前连合的大小,并进行野外实验评估鸡的运动活动和好奇或探索行为。结果:在注射表达mEmx1/2的慢病毒后,Wulst (W)和mesopallium (M)的大部分组织中reelin、vimentin、GABA和MAP2的表达增加,而nidopallium (N)的表达没有增加。calbindin (CB)和parvalbumin (PV)神经元的神经发生模式转变为哺乳动物的内向外模式,神经丝的前连合染色明显变大。此外,与对照组相比,孵育后的雏鸡在训练后表现出更高的被动回避率,但在总行走距离和在中心矩形中停留的时间百分比方面没有显著差异。结论:本研究提示mEmx1/2对雏鸡苍白膜发育有影响,可能参与了羊膜苍白膜的组织和进化。
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引用次数: 0
Erratum. 勘误表。
IF 2 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2025-01-01 Epub Date: 2025-05-15 DOI: 10.1159/000545780
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引用次数: 0
Erratum. 勘误表。
IF 2 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2025-01-01 Epub Date: 2025-05-19 DOI: 10.1159/000545723
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引用次数: 0
Long-Term Neurologic Consequences following Fetal Growth Restriction: The Impact on Brain Reserve. 胎儿生长受限的长期神经后果;对大脑储备的影响。
IF 2.3 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2025-01-01 Epub Date: 2024-05-14 DOI: 10.1159/000539266
Divyen K Shah, Susana Pereira, Gregory A Lodygensky

Background: Fetal growth restriction (FGR) corresponds to the fetus's inability to achieve an adequate weight gain based on genetic potential and gestational age. It is an important cause of morbidity and mortality.

Summary: In this review, we address the challenges of diagnosis and classification of FGR. We review how chronic fetal hypoxia impacts brain development. We describe recent advances on placental and fetal brain imaging using magnetic resonance imaging and how they offer new noninvasive means to study growth restriction in humans. We go on to review the impact of FGR on brain integrity in the neonatal period, later childhood, and adulthood and review available therapies.

Key messages: FGR consequences are not limited to the perinatal period. We hypothesize that impaired brain reserve, as defined by structure and size, may predict some concerning epidemiological data of impaired cognitive outcomes and dementia with aging in this group of patients.

Background: Fetal growth restriction (FGR) corresponds to the fetus's inability to achieve an adequate weight gain based on genetic potential and gestational age. It is an important cause of morbidity and mortality.

Summary: In this review, we address the challenges of diagnosis and classification of FGR. We review how chronic fetal hypoxia impacts brain development. We describe recent advances on placental and fetal brain imaging using magnetic resonance imaging and how they offer new noninvasive means to study growth restriction in humans. We go on to review the impact of FGR on brain integrity in the neonatal period, later childhood, and adulthood and review available therapies.

Key messages: FGR consequences are not limited to the perinatal period. We hypothesize that impaired brain reserve, as defined by structure and size, may predict some concerning epidemiological data of impaired cognitive outcomes and dementia with aging in this group of patients.

背景:胎儿生长受限(FGR)是指胎儿无法根据遗传潜能和胎龄获得足够的体重增长。摘要:在这篇综述中,我们探讨了 FGR 诊断和分类所面临的挑战。我们回顾了胎儿长期缺氧对大脑发育的影响。我们介绍了使用核磁共振成像技术进行胎盘和胎儿大脑成像的最新进展,以及这些技术如何为研究人类生长受限提供新的非侵入性手段。接下来,我们将回顾胎儿生长受限对新生儿期、儿童后期和成年期大脑完整性的影响,并回顾现有的治疗方法:关键信息:胎儿生长受限的后果不仅限于围产期。我们假设,根据结构和大小定义的大脑储备受损可能预示着这组患者认知能力受损和老年痴呆症的一些流行病学数据。
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引用次数: 0
The Association between Ventricle Ratio in Preterm Infants and Motor Developmental Delay. 早产儿脑室比率与运动发育迟缓之间的关系。
IF 2 4区 医学 Q2 DEVELOPMENTAL BIOLOGY Pub Date : 2025-01-01 Epub Date: 2024-09-02 DOI: 10.1159/000540754
Hyun Iee Shin, Na Mi Lee, Sun Mi Kim, Hyunchan Hwang, Gangta Choi, Doug Hyun Han, Don-Kyu Kim

Introduction: Early prediction and timely intervention are particularly essential for high-risk preterm infants. Brain magnetic resonance imaging (BMRI) is frequently used alongside functional evaluations to improve predictions of developmental outcomes. This study aimed to assess voxel-based brain volumetry in extremely preterm infants using BMRI at term equivalent age (TEA) and investigate its association with developmental outcomes.

Methods: From March 2016 to December 2019, high-risk preterm infants (birth weight <1,500 g or gestational age <32 weeks) with BMRI at TEA and follow-up developmental data assessed by Bayley-III were included. For BMRI volumetry, manual tracing and segmentation were performed on T1-weighted scans, and after smoothing, voxels were calculated for each brain segment. Forty-seven subjects were enrolled and categorized into typical/delayed motor groups.

Results: Results revealed a significant difference in ventricle size and ventricle ratio in BMRI at TEA between the groups. Even after controlling for other factors that could influence developmental outcomes, ventricle ratio emerged as a robust, single predictor for future motor development.

Conclusion: This study suggests the potential clinical utility of BMRI volumetry in predicting motor development outcomes.

导言 早期预测和及时干预对高风险早产儿尤为重要。脑磁共振成像(BMRI)经常与功能评估一起使用,以改善对发育结果的预测。本研究旨在使用 BMRI 评估极早产儿在足月等效年龄(TEA)时基于体素的脑容量,并调查其与发育结果的关联。方法 从2016年3月至2019年12月,纳入了在足月等效年龄(TEA)进行BMRI检查并通过Bayley-III评估后续发育数据的高风险早产儿(出生体重< 1500克或胎龄< 32周)。在进行 BMRI 容积测量时,对 T1 加权扫描进行手动追踪和分割,平滑后计算每个脑区的体素。47 名受试者被纳入研究,并被分为典型/延迟运动组 结果 结果显示,在 TEA 时,各组间的脑室大小和脑室比率在 BMRI 中存在显著差异。即使在控制了可能影响发育结果的其他因素后,心室比仍是预测未来运动发育的唯一可靠指标。结论 本研究表明,BMRI 容积测量法在预测运动发育结果方面具有潜在的临床实用性。
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引用次数: 0
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Developmental Neuroscience
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