中国神经再生研究(英文版)

中国神经再生研究(英文版) ›› 2019, Vol. 14 ›› Issue (4): 642-648.doi: 10.4103/1673-5374.247468

• 原著:脑损伤修复保护与再生 • 上一篇    下一篇

重度缺氧缺血性脑病新生儿静息态网络的复杂性及其幅度变化

  

  • 出版日期:2019-04-15 发布日期:2019-04-15
  • 基金资助:

    江苏省妇幼健康研究项目（F201612），常州市科技支撑项目（CE20165027），常州市重点科研项目（ZD201515），常州市高层次人才培养（卫生专业）项目（2016CZBJ028）

Resting-state network complexity and magnitude changes in neonates with severe hypoxic ischemic encephalopathy

Hong-Xin Li 1 , Min Yu 2 , Ai-Bin Zheng 3 , Qin-Fen Zhang 1 , Guo-Wei Hua 1 , Wen-Juan Tu 1 , Li-Chi Zhang 4, 5   

  1. 1 Department of Neonatology, Changzhou Children’s Hospital, Changzhou, Jiangsu Province, China
    2 Graduate Student, Nantong University, Nantong, Jiangsu Province, China
    3 Department of Children’s Health Research Center, Changzhou Children’s Hospital, Changzhou, Jiangsu Province, China
    4 Institute for Medical Imaging Technology, School of Biomedical Engineering, Shanghai Jiao Tong University, Shanghai, China
    5 Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
  • Online:2019-04-15 Published:2019-04-15
  • Contact: Li-Chi Zhang, MD, lichizhang@sjtu.edu.cn.
  • Supported by:

    This study was supported by the Jiangsu Maternal and Child Health Research Project of China, No. F201612 (to HXL); the Chang¬zhou Science and Technology Support Plan of China, No. CE20165027 (to HXL); the Changzhou City Planning Commission Major Science and Technology Projects of China, No. ZD201515 (to HXL); the Changzhou High Level Training Fund for Health Professionals of China, No. 2016CZBJ028 (to HXL).

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摘要：

以静息态功能磁共振成像对脑性瘫痪成人和青少年的研究发现，部分脑区存在脑网络连接中断，而对新生儿脑病患者脑网络的相应研究较少。试验在中国常州市儿童医院招募了28例缺氧缺血性脑病足月新生儿，其中14例为轻度缺氧缺血性脑病，另14例为重度缺氧缺血性脑病。通过静息态功能磁共振成像检测发现，轻度和重度缺氧缺血性脑病新生儿在全脑网络中都具有小世界特征，而与轻度缺氧缺血性脑病新生儿相比，重度缺氧缺血性脑病新生儿局部效率和聚散系数均明显降低，功能网络中枢区域分布的节点数量较少，且左侧罗兰迪克岛盖、左侧边缘回、两侧颞上回和右侧颞中回的节点效率降低。说明重度缺氧缺血性脑病患儿大脑静息态功能网络拓扑结构较轻度患儿明显落后，且可能与其语言、运动和认知功能异常有关。结果可为早期预测重度缺氧缺血性脑病患儿脑发育结果和制定早期干预方向在脑功能层面提供一定的指导意义。试验已于2013年1月经常州市儿童医院伦理审查委员会批准（批准号2013-001），并获得患儿家属的书面知情同意。试验已于2018-05-31在中国临床试验中心注册，注册号：ChiCTR1800016409，版本号为1.0。

orcid: 0000-0003-4396-4566(Li-Chi Zhang)

关键词: 新生儿, 缺氧缺血性脑病, 静息态功能磁共振成像, 脑网络, 小世界组织, 脑功能连接, 局部效率, 聚散系数, 神经再生

Abstract:

Resting-state functional magnetic resonance imaging has revealed disrupted brain network connectivity in adults and teenagers with cere¬bral palsy. However, the specific brain networks implicated in neonatal cases remain poorly understood. In this study, we recruited 14 term-born infants with mild hypoxic ischemic encephalopathy and 14 term-born infants with severe hypoxic ischemic encephalopathy from Changzhou Children’s Hospital, China. Resting-state functional magnetic resonance imaging data showed efficient small-world organization in whole-brain networks in both the mild and severe hypoxic ischemic encephalopathy groups. However, compared with the mild hypoxic ischemic encephalopathy group, the severe hypoxic ischemic encephalopathy group exhibited decreased local efficiency and a low clustering coefficient. The distribution of hub regions in the functional networks had fewer nodes in the severe hypoxic ischemic encephalopathy group compared with the mild hypoxic ischemic encephalopathy group. Moreover, nodal efficiency was reduced in the left rolandic operculum, left supramarginal gyrus, bilateral superior temporal gyrus, and right middle temporal gyrus. These results suggest that the topological structure of the resting state functional network in children with severe hypoxic ischemic encephalopathy is clearly distinct from that in children with mild hypoxic ischemic encephalopathy, and may be associated with impaired language, motion, and cognition. These data indicate that it may be possible to make early predictions regarding brain development in children with severe hypoxic ischemic encephalopathy, enabling early interventions targeting brain function. This study was approved by the Regional Ethics Review Boards of the Changzhou Children’s Hospital (approval No. 2013-001) on January 31, 2013. Informed consent was obtained from the family members of the children. The trial was registered with the Chinese Clinical Trial Registry (registration number: ChiCTR1800016409) and the protocol version is 1.0.

Key words: nerve regeneration, neonates, hypoxic ischemic encephalopathy, resting-state functional magnetic resonance imaging, brain networks, small-world organization, brain functional connectivity, local efficiency, clustering coefficient, neural regeneration