Individual Attention Patterns in Children Born Very Preterm and Full Term at 7 and 13 Years of Age

Abstract

Objective: To identify attention profiles at 7 and 13 years, and transitions in attention profiles over time in children born very preterm (VP; <30 weeks’ gestation) and full term (FT), and examine predictors of attention profiles and transitions. Methods: Participants were 167 VP and 60 FT children, evaluated on profiles across five attention domains (selective, shifting and divided attention, processing speed, and behavioral attention) at 7 and 13 years using latent profile analyses. Transitions in profiles were assessed with contingency tables. For VP children, biological and social risk factors were tested as predictors with a multinomial logistic regression. Results: At 7 and 13 years, three distinct profiles of attentional functioning were identified. VP children were 2–3 times more likely to show poorer attention profiles compared with FT children. Transition patterns between 7 and 13 years were stable average, stable low, improving, and declining attention. VP children were two times less likely to have a stable average attention pattern and three times more likely to have stable low or improving attention patterns compared with FT children. Groups did not differ in declining attention patterns. For VP children, brain abnormalities on neonatal MRI and greater social risk at 7 years predicted stable low or changing attention patterns over time. Conclusions: VP children show greater variability in attention profiles and transition patterns than FT children, with almost half of the VP children showing adverse attention patterns over time. Early brain pathology and social environment are markers for attentional functioning.

Parsing brain-behavior heterogeneity in very preterm born children using integrated similarity networks

“…However, it remains to be explored whether distinct multidimensional subgroups of VPT children could also be characterized by localized differences in early brain development using advanced quantitative measures of brain structure and function, such as log-Jacobians, tract based spatial statistics and degree centrality, which have previously been used in neonatal samples [29][30][31]. Conducting analyses at the whole-brain and voxel-wise level, allows for an enhanced spatial localization of potential structural and functional between-subgroup differences, thus extending previous research [8,27,28].…”

“…Alterations in brain volumes [21,22], white matter microstructure [23,24], and functional connectivity [25,26] at birth in regions and networks subserving social, emotional and attentional processes, have been associated with later behavioral difficulties in VPT samples. Differences between latent subgroups of VPT children and infants have been previously studied in relation to qualitative measures of brain abnormalities and/or high grade brain injury based on neonatal Magnetic Resonance Imaging (MRI), as well as quantitative differences in brain tissue volumes [8,27,28]. However, it remains to be explored whether distinct multidimensional subgroups of VPT children could also be characterized by localized differences in early brain development using advanced quantitative measures of brain structure and function, such as log-Jacobians, tract based spatial statistics and degree centrality, which have previously been used in neonatal samples [29][30][31].…”

Preterm birth alters the development of cortical microstructure and morphology at term-equivalent age

“…In this study, we aimed to describe typical cortical micro- and macrostructural maturation using in vivo structural and diffusion MRI in a large sample of term-born infants scanned during the neonatal period, to then test how preterm birth shapes the developing cortex. Early brain development is highly variable between individuals, and even those belonging to the same risk or clinical ‘group’ often show heterogeneous pattern of deviations from typical maturation ( Dimitrova et al., 2020 ) and follow diverse neurocognitive trajectories ( Johnson et al., 2018 ; Bogičević et al., 2021 ). Therefore, to offer a more precise understanding of the early cortical consequences of preterm birth, we not only characterize the group-average abnormality, but also capture the heterogeneity across the preterm population.…”

Exploring predictors at toddler age of distinct profiles of attentional functioning in 6-year-old children born moderate-to-late preterm and full term

“…Preterm birth is a well-known risk factor for poorer attentional functioning [9][10][11][12][13][14][15]. However, identification and treatment of children born preterm with attention difficulties is complicated, as they show heterogenous attentional outcomes [16][17][18]. In a previous study, we demonstrated variability in attentional functioning at 6 years in children born moderately-tolate preterm (MLPT; 32-36 weeks' gestation) and full term (FT; 37-41 weeks' gestation) [16].…”