产前酒精暴露与生命最初 6-7 年的白质微结构变化:南非出生队列的纵向弥散张量成像研究

IF 3.4 2区 医学 Q2 NEUROIMAGING
K.A. Donald , C.J. Hendrikse , A. Roos , C.J. Wedderburn , S. Subramoney , J.E. Ringshaw , L. Bradford , N. Hoffman , T. Burd , K.L. Narr , R.P. Woods , H.J. Zar , S.H. Joshi , D.J. Stein
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引用次数: 0

摘要

产前酒精暴露(PAE)会影响生命早期的大脑发育,但很少有研究调查 PAE 对幼儿白质束成熟轨迹的影响。在此,我们使用扩散加权成像(DWI)重复三个时间点,测量 PAE 对学龄前白质微结构发育模式的影响。研究对象来自德拉肯斯坦儿童健康研究(Drakenstein Child Health Study,DCHS),这是一项在南非西开普省近郊社区进行的出生队列研究。该研究共采集了 237 名新生儿(N = 82 次扫描:30 PAE;52 次对照)、2-3 岁(N = 121 次扫描:27 PAE;94 次对照)和 6-7 岁(N = 139 次扫描:45 PAE;94 次对照)儿童的 342 次扫描结果。在妊娠 28 至 32 周期间收集了母亲在怀孕期间的饮酒情况和其他产前协变量。采用线性混合效应模型和限制最大似然法(restricted maxium likelihood)来处理缺失数据,以研究 PAE 对特定白质束的分数各向异性(FA)和平均扩散率(MD)随时间变化的影响,同时对儿童性别和母亲教育程度进行调整。我们发现 PAE 对左侧小脑上梗(SCP-L:p = 0.001;经 FDR 校正后存活)和右侧上纵束(SLF-R:p = 0.046)的分数各向异性(FA)和平均扩散率(MD)的发展轨迹有明显的随时间变化的影响,这表明 PAE 患儿的白质发展发生了改变。与对照组相比,PAE 患儿从新生儿期到 2-3 岁期间,这些束的 FA 值变化更快,随后从 2-3 岁到 6-7 岁期间,这些束的 FA 值变化轨迹更趋于平缓,这些轨迹与未接触 PAE 的对照组儿童不同。鉴于SCP和SLF在神经认知功能的各个方面(即运动调节、学习、记忆、语言)起着辅助作用,它们成熟模式的改变可能会导致PAE患儿经常出现的一系列身体、社交、情感和认知障碍。本研究强调了在 PAE 纵向研究中反复进行早期成像的价值,并重点指出幼儿期是潜在易感性的关键窗口期,也是早期干预的机会。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Prenatal alcohol exposure and white matter microstructural changes across the first 6–7 years of life: A longitudinal diffusion tensor imaging study of a South African birth cohort

Prenatal alcohol exposure and white matter microstructural changes across the first 6–7 years of life: A longitudinal diffusion tensor imaging study of a South African birth cohort

Prenatal alcohol exposure and white matter microstructural changes across the first 6–7 years of life: A longitudinal diffusion tensor imaging study of a South African birth cohort

Prenatal alcohol exposure (PAE) can affect brain development in early life, but few studies have investigated the effects of PAE on trajectories of white matter tract maturation in young children. Here we used diffusion weighted imaging (DWI) repeated over three time points, to measure the effects of PAE on patterns of white matter microstructural development during the pre-school years. Participants were drawn from the Drakenstein Child Health Study (DCHS), an ongoing birth cohort study conducted in a peri-urban community in the Western Cape, South Africa. A total of 342 scans acquired from 237 children as neonates (N = 82 scans: 30 PAE; 52 controls) and at ages 2–3 (N = 121 scans: 27 PAE; 94 controls) and 6–7 years (N = 139 scans: 45 PAE; 94 controls) were included. Maternal alcohol use during pregnancy and other antenatal covariates were collected from 28 to 32 weeks’ gestation. Linear mixed effects models with restricted maxium likelihood to accommodate missing data were implemented to investigate the effects of PAE on fractional anisotropy (FA) and mean diffusivity (MD) in specific white matter tracts over time, while adjusting for child sex and maternal education. We found significant PAE-by-time effects on trajectories of FA development in the left superior cerebellar peduncle (SCP-L: p = 0.001; survived FDR correction) and right superior longitudinal fasciculus (SLF-R: p = 0.046), suggesting altered white matter development among children with PAE. Compared with controls, children with PAE demonstrated a more rapid change in FA in these tracts from the neonatal period to 2–3 years of age, followed by a more tapered trajectory for the period from 2–3 to 6–7 years of age, with these trajectories differing from unexposed control children. Given their supporting roles in various aspects of neurocognitive functioning (i.e., motor regulation, learning, memory, language), altered patterns of maturation in the SCP and SLF may contribute to a spectrum of physical, social, emotional, and cognitive difficulties often experienced by children with PAE. This study highlights the value of repeated early imaging in longitudinal studies of PAE, and focus for early childhood as a critical window of potential susceptibility as well as an opportunity for early intervention.

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来源期刊
Neuroimage-Clinical
Neuroimage-Clinical NEUROIMAGING-
CiteScore
7.50
自引率
4.80%
发文量
368
审稿时长
52 days
期刊介绍: NeuroImage: Clinical, a journal of diseases, disorders and syndromes involving the Nervous System, provides a vehicle for communicating important advances in the study of abnormal structure-function relationships of the human nervous system based on imaging. The focus of NeuroImage: Clinical is on defining changes to the brain associated with primary neurologic and psychiatric diseases and disorders of the nervous system as well as behavioral syndromes and developmental conditions. The main criterion for judging papers is the extent of scientific advancement in the understanding of the pathophysiologic mechanisms of diseases and disorders, in identification of functional models that link clinical signs and symptoms with brain function and in the creation of image based tools applicable to a broad range of clinical needs including diagnosis, monitoring and tracking of illness, predicting therapeutic response and development of new treatments. Papers dealing with structure and function in animal models will also be considered if they reveal mechanisms that can be readily translated to human conditions.
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