Grey and white matter distribution in very preterm adolescents mediates neurodevelopmental outcome

Nosarti, Chiara; Γιουρούκου, Έλενα; Healy, Elaine; Rifkin, Larry; Walshe, Muriel; Reichenberg, Abraham; Chitnis, Xavier; Williams, Steven; Murray, Robin M.

doi:10.1093/brain/awm282

Cited by 366 publications

(399 citation statements)

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“…White matter increases have been demonstrated in adolescents born very preterm who had experienced severe perinatal brain injury. 9 Widespread developmental changes in white matter anisotropy (fractional anisotropy values) were found in adolescents, and the increased fractional anisotropy was likely caused by active development during this stage. 49,50 The above-mentioned facts suggest compensatory changes that permit function to be spared by white matter plasticity in the brains of individuals born preterm.…”

Section: Discussionmentioning

confidence: 99%

“…54 Moreover, correlations between Verbal and Non-verbal IQ 55,56 and the posterior corpus callosum have previously been reported in adolescents born preterm. 9,56 In the subgroup analysis of field strength, the difference in fractional anisotropy in the genu of the corpus callosum was significantly greater in the 3T group than in the 1.5T group, and heterogeneity was found in the 3T group in this subregion. However, no significant difference was demonstrated between subgroups in the splenium of the corpus callosum.…”

Section: Review 335mentioning

confidence: 92%

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Fractional anisotropy alterations in individuals born preterm: a diffusion tensor imaging meta‐analysis

Sun

Han

et al. 2014

Develop Med Child Neuro

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ALEActivation likelihood estimate DTI Diffusion tensor imaging SMD Standardized mean difference AIM This meta-analysis explored cerebral microstructural changes in individuals born preterm using fractional anisotropy from diffusion tensor imaging.METHOD We used the activation likelihood estimate (ALE) method for the meta-analysis to locate anatomical regions with white matter abnormalities in a group of individuals born preterm and in term-born comparison participants. A statistical analysis of fractional anisotropy was conducted to quantitatively explore the extent of fractional anisotropy changes in the three subregions of the corpus callosum in the preterm group.RESULTS ALE analysis identified 11 regions of decreased fractional anisotropy and four regions of increased fractional anisotropy. Analysis of the corpus callosum revealed the largest decrease in fractional anisotropy in the splenium (standardized mean difference [SMD]=À0.75, 95% confidence interval [CI] À0.93 to À0.57), followed by the body (SMD=À0.73, 95% CI À1.13 to À0.32) and the genu (SMD=À0.65, 95% CI À0.97 to À0.33). INTERPRETATION Significant changes in fractional anisotropy in individuals born pretermreflect white matter abnormalities from childhood to young adulthood, and the mechanism of fractional anisotropy alterations in preterm infants may vary during different stages of white matter development. Furthermore, the variability of fractional anisotropy between studies can primarily be attributed to the age of the individuals at scanning and to the field strength of magnetic resonance scanners.Preterm birth is frequently accompanied by a variety of disabilities, such as cerebral palsy, intellectual disability, deafness, or blindness. The incidence of preterm birth has increased significantly in the past decades, but is associated with higher survival rates 1 and a lower incidence of major disabilities than in the past.2 However, there is strong evidence that preterm survivors without brain malformations, congenital infection, or metabolic disease and with normal outcomes or mild abnormalities on structural brain magnetic resonance imaging (MRI) may experience more problems of motor, cognitive, language, and behavioural functioning throughout childhood and young adulthood. [3][4][5][6] These sequelae have been attributed to perinatal brain injuries, 7,8 which frequently involve white matter, 9 during normal brain maturation. 10 Nevertheless, the location, severity, and mechanism of white matter injuries on neurodevelopment and their impact on future function have not been conclusively determined.11 Additional neuroimaging evidence is necessary to explain the mechanism of white matter injuries and to predict the future influence of these impairments in individuals who are born preterm.Diffusion tensor imaging (DTI), a novel MRI technique, can quantify the fibre orientation and integrity of white matter pathways within neural networks. This technique is superior to conventional MRI methods for the detection of white matter abnormalities becaus...

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Section: Discussionmentioning

confidence: 99%

Section: Review 335mentioning

confidence: 92%

Fractional anisotropy alterations in individuals born preterm: a diffusion tensor imaging meta‐analysis

Sun

Han

et al. 2014

Develop Med Child Neuro

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“…43 There is growing evidence that higher-order cognition is based on cofunctioning of a set of cortical areas in a dynamic large-scale framework, highlighting the central role of cortical communication. 44 Absence of language disabilities or amelioration of skills could be interpreted as evidence of neural and functional plasticity in response to early brain damage.…”

Section: Figurementioning

confidence: 99%

Language Functions in Preterm-Born Children: A Systematic Review and Meta-analysis

Spek¹,

Franken²,

2012

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BACKGROUND AND OBJECTIVE: Preterm-born children (,37 weeks' gestation) have higher rates of language function problems compared with term-born children. It is unknown whether these problems decrease, deteriorate, or remain stable over time. The goal of this research was to determine the developmental course of language functions in preterm-born children from 3 to 12 years of age. METHODS:Computerized databases Embase, PubMed, Web of Knowledge, and PsycInfo were searched for studies published between January 1995 and March 2011 reporting language functions in pretermborn children. Outcome measures were simple language function assessed by using the Peabody Picture Vocabulary Test and complex language function assessed by using the Clinical Evaluation of Language Fundamentals. Pooled effect sizes (in terms of Cohen's d) and 95% confidence intervals (CI) for simple and complex language functions were calculated by using random-effects models. Meta-regression was conducted with mean difference of effect size as the outcome variable and assessment age as the explanatory variable.RESULTS: Preterm-born children scored significantly lower compared with term-born children on simple (d = -0.45 [95% CI: -0.59 to -0.30]; P , .001) and on complex (d = -0.62 [95% CI: -0.82 to -0.43]; P , .001) language function tests, even in the absence of major disabilities and independent of social economic status. For complex language function (but not for simple language function), group differences between preterm-and term-born children increased significantly from 3 to 12 years of age (slope = -0.05; P = .03). CONCLUSIONS:

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“…8 Assessment of VLBW-related brain abnormalities and environmental characteristics has the potential to yield more accurate predictions of individual outcomes. 9 Measures of executive function and other skills frequently impaired in survivors of VLBW (but not comprehensively probed by IQ tests) will also be useful in clarifying the cognitive implications of variations in brain status and environmental-genetic background.Finally, little is known about the longer-term development of adults with VLBW or the relevance of cognitive weaknesses to problems in mental health, job performance, interpersonal and family relationships, and independent living skills. Although cognitive weaknesses may increase an individual's vulnerability to these problems, outcomes are also dependent…”

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confidence: 99%

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confidence: 99%

Persisting cognitive deficits in survivors of very low birthweight and their implications for adult functioning

Taylor

2010

Develop Med Child Neuro

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Survival rates among very-low-birthweight (VLBW, <1500g) infants increased dramatically during the 1980s and 1990s, especially among those born with more extreme preterm birth. 1 The survivors are now entering young adulthood and are facing challenges not encountered in their school-age years. They are enrolled in post-secondary education or vocational training programs, or are working or seeking employment. With varying degrees of success, they are also gaining independence from their parents in decision-making and selfcare, and are establishing adult relationships or even beginning families of their own.Review of outcomes of VLBW in young adulthood suggests that many survivors may encounter more problems in facing these challenges than their term-born, normal birthweight peers. As a group, young adults with VLBW perform less well on tests of cognition and achievement than age-matched controls. 2 Despite inconsistencies across studies, they also may be prone to inattention and internalizing symptoms. Studies examining functional outcomes in young adults with VLBW confirm lower or delayed educational attainment and difficulties in establishing social relationships. 3,4 A Norwegian national study of adult outcomes found that lower gestational age predicted lower income and a decreased likelihood of finding a life partner and having children, suggesting functional limitations for that portion of the VLBW population with more extreme prematurity. 5 Outcomes are nevertheless highly variable and many if not most VLBW survivors appear to lead normal adult lives. 2,6 Long-term follow-up studies such as that by Løhaugen et al. 7 provide information that is useful in identifying affected individuals with VLBW and in characterizing their cognitive deficits. A major strength of the study is the administration of the full form of the Wechsler Intelligence Test, which provides a broader and more reliable index of global cognitive ability. Use of the full form also sheds new light on the magnitude of group differences across subtests and ability indices. The observation of pronounced weaknesses on the Wechsler Adult Intelligence Scale Perceptual Organization Index in the VLBW group compared with controls is consistent with previous literature. 8 However, the fact that there were group differences on all ability indices and on multiple verbal as well as performance subtests suggests that cognitive impairment in early adulthood is more pervasive than suggested by past studies using shortened versions of IQ testing batteries. Another important finding is the much higher rate of low IQ scores (>1SD below the mean of the controls) in the VLBW group, indicating that reduced IQ is a relatively common finding among survivors. A higher rate of participation in vocational programs in the VLBW group also adds to other evidence for effects of VLBW on employment. 5 More research is needed to better understand factors related to variability in cognitive outcomes of VLBW, the pattern of cognitive strengths and weaknesses evident in adulthoo...

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Grey and white matter distribution in very preterm adolescents mediates neurodevelopmental outcome

Cited by 366 publications

References 39 publications

Fractional anisotropy alterations in individuals born preterm: a diffusion tensor imaging meta‐analysis

Fractional anisotropy alterations in individuals born preterm: a diffusion tensor imaging meta‐analysis

Language Functions in Preterm-Born Children: A Systematic Review and Meta-analysis

Persisting cognitive deficits in survivors of very low birthweight and their implications for adult functioning

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