The relationship between late (≥ 7 days) systemic dexamethasone and functional network connectivity in very preterm infants

作者全名："Jia, Wen; Wang, Xiaodong; Chen, Guangxiang; Cao, Huilin; Yue, Guang; Luo, Mei; Luo, Lijuan; Liu, Dong; Lei, Xiaoping; Dong, Wenbin; Ma, Xueling; Shi, Yuan"

作者地址："[Jia, Wen; Cao, Huilin; Yue, Guang; Ma, Xueling; Shi, Yuan] Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Key Lab Child Dev & Disorders, Chongqing Key Lab Pediat,Minist Educ,Dept Neonatol, Chongqing, Peoples R China; [Jia, Wen; Luo, Mei; Luo, Lijuan; Lei, Xiaoping; Dong, Wenbin] Southwest Med Univ, Affiliated Hosp, Dept Neonatol, Luzhou, Peoples R China; [Wang, Xiaodong] Southwest Med Univ, Affiliated Hosp, Dept Med, Luzhou, Peoples R China; [Chen, Guangxiang] Southwest Med Univ, Affiliated Hosp, Dept Imaging, Luzhou, Peoples R China; [Liu, Dong] Southwest Med Univ, Affiliated Hosp, Dept Pediat, Luzhou, Peoples R China"

通信作者："Ma, XL; Shi, Y (通讯作者)，Chongqing Med Univ, Natl Clin Res Ctr Child Hlth & Disorders, Key Lab Child Dev & Disorders, Chongqing Key Lab Pediat,Minist Educ,Dept Neonatol, Chongqing, Peoples R China."

来源：HELIYON

ESI学科分类：　

WOS号：WOS:001128043500001

JCR分区：Q1

影响因子：3.4

年份：2023

卷号：9

期号：12

开始页：　

结束页：　

文献类型：Article

关键词：Very preterm infants; Dexamethasone; Bronchopulmonary dysplasia; Neurodevelopment; Rs-fMRI; Functional network connectivity

摘要："Background: Current evidence shows that systemic dexamethasone administration starting after the first week of age reduces bronchopulmonary dysplasia for very preterm (VPT) infants, but its neurological effects remain obscure. Using resting-state functional magnetic resonance imaging (rs-fMRI), we assessed the changes in functional network connectivity (FNC) in very preterm infants treated with late systemic dexamethasone (>= 7 days of age). Methods: VPT infants (GA <= 32 weeks) who needed to rely on mechanical ventilation for more than 7 days but fewer than 14 days to maintain vital signs were included in the study. The cohort was divided into two groups according to whether they were given systemic dexamethasone. In addition, 26 healthy term infants were recruited as controls. At term-equivalent age (TEA), rs-fMRI and 3D-T1 data from eligible infants were acquired with a 3.0-T MRI scanner. After the MRI data were preprocessed, group-level independent component analysis (ICA), a technique used for blind source separation, was used to identify the components of resting-state networks (RSNs). Then, the functional connectivity between components and RSNs was compared among different groups. Upon follow-up at 3 months of corrected age, the neurodevelopmental outcomes of enrolled infants were assessed with the Bayley Scales of Infant Development-Chinese Revision (BSID-CR), and the Motor Development Index (MDI) and Psychomotor Development Index (PDI) were measured. Finally, the correlations between resting-state FNC and BSID scores were analysed.Results: Ultimately, 59 infants were included in the final analysis, including 19 preterm infants who received dexamethasone, 20 who did not, and 20 healthy term infants as controls. Based on their data, 11 components were identified, belonging to 5 RSNs: the visual network (VN), the dorsal attention network (DAN), the auditory network (AN), the primary sensorimotor network (SMN), and the default-mode network (DMN). Compared with the term infants, the preterm in-fants showed significantly weakened functional connectivity between the DAN and VN, as well as the VN and AN (P < 0.05). Among preterm infants, those who were given dexamethasone showed significantly stronger functional connectivity between the DAN and VN, as well as the DMN and AN (P < 0.05), than those who were not. The correlation analysis demonstrated that the con-nectivity values between the DAN and VN and between the VN and AN were positively correlated with the MDI (r = 0.432, P<0.001, and r = 0.479, P<0.001, respectively) and the PDI (r = 0.436, P<0.001 and r = 0.516, P<0.001, respectively). Conclusions: Our investigation uncovers a noteworthy link between the administration of late systemic dexamethasone (>= 7 days of age) in VPT infants and distinct improvements in FNC. Furthermore, the observed positive correlation between inter-network connectivity and scores on the BSID-CR implies a plausible neuroprotective aspect of this therapeutic approach in this spe-cific group of children."

基金机构：National Key Research and Development Program of China [2022YFC2704803]

基金资助正文：This study was supported by the National Key Research and Development Program of China (2022YFC2704803) .