Early experience alters brain function and structure

被引:533
作者
Als, H
Duffy, FH
McAnulty, GB
Rivkin, MJ
Vajapeyam, S
Mulkern, RV
Warfield, SK
Huppi, PS
Butler, SC
Conneman, N
Fischer, C
Eichenwald, EC
机构
[1] Harvard Univ, Sch Med, Dept Psychiat, Boston, MA 02115 USA
[2] Harvard Univ, Sch Med, Dept Neurol, Boston, MA 02115 USA
[3] Harvard Univ, Sch Med, Dept Radiol, Boston, MA 02115 USA
[4] Harvard Univ, Sch Med, Dept Newborn Med, Boston, MA 02115 USA
[5] Childrens Hosp, Boston, MA 02115 USA
[6] Univ Geneva, Dept Newborn Med, Geneva, Switzerland
[7] Brigham & Womens Hosp, Newborn Intens Care Nursery, Boston, MA 02115 USA
关键词
preterm infants; NIDCAP; neurobehavior; spectral coherence; diffusion tensor imaging; transverse relaxation time; Bayley Scales of Infant Development; APIB;
D O I
10.1542/peds.113.4.846
中图分类号
R72 [儿科学];
学科分类号
100202 ;
摘要
Objective. To investigate the effects of early experience on brain function and structure. Methods. A randomized clinical trial tested the neurodevelopmental effectiveness of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Thirty preterm infants, 28 to 33 weeks' gestational age (GA) at birth and free of known developmental risk factors, participated in the trial. NIDCAP was initiated within 72 hours of intensive care unit admission and continued to the age of 2 weeks, corrected for prematurity. Control ( 14) and experimental ( 16) infants were assessed at 2 weeks' and 9 months' corrected age on health status, growth, and neurobehavior, and at 2 weeks' corrected age additionally on electroencephalogram spectral coherence, magnetic resonance diffusion tensor imaging, and measurements of transverse relaxation time. Results. The groups were medically and demographically comparable before as well as after the treatment. However, the experimental group showed significantly better neurobehavioral functioning, increased coherence between frontal and a broad spectrum of mainly occipital brain regions, and higher relative anisotropy in left internal capsule, with a trend for right internal capsule and frontal white matter. Transverse relaxation time showed no difference. Behavioral function was improved also at 9 months' corrected age. The relationship among the 3 neurodevelopmental domains was significant. The results indicated consistently better function and more mature fiber structure for experimental infants compared with their controls. Conclusions. This is the first in vivo evidence of enhanced brain function and structure due to the NIDCAP. The study demonstrates that quality of experience before term may influence brain development significantly.
引用
收藏
页码:846 / 857
页数:12
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