Objectives-To use functional magnetic resonance imaging (fMRI) to test the hypothesis that subjects who were born prematurely develop alternative systems for processing language.Study design-Subjects who were born prematurely (n = 14; 600-1250 g birthweight) without neonatal brain injury and 10 matched term control subjects were examined with a fMRI passive listening task of language, the Clinical Evaluation of Language Fundamentals (CELF) and portions of the Comprehensive Test of Phonological Processing (CTOPP). The fMRI task was evaluated for both phonologic and semantic processing.Results-Although there were differences in CELF scores between the subjects born prematurely and control subjects, there were no significant differences in the CTOPP measures in the 2 groups. fMRI studies demonstrated that the groups differentially engaged neural systems known to process language. Children born at term were significantly more likely to activate systems for the semantic processing of language, whereas subjects born prematurely preferentially engaged regions that subserve phonology.Conclusions-At 12 years of age, children born prematurely and children born at term activate neural systems for the auditory processing of language differently. Subjects born prematurely engage different networks for phonologic processing; this strategy is associated with phonologic language scores that are similar to those of control subjects. These biologically based developmental strategies may provide the substrate for the improving language skills noted in children who are born prematurely.Magnetic resonance imaging (MRI) permits the investigation of structural aspects of the developing brain. 1,2 Volumetric, diffusion tensor imaging, and magnetic resonance spectroscopy studies suggest that preterm birth is associated with significant alterations in corticogenesis, and several investigators have suggested that those cortical regions that subserve language are particularly vulnerable to the injury associated with preterm birth. 3,4 In contrast, neural processing has been less well studied in subjects born prematurely, but may offer important insights into the functional aspects of brain development after preterm birth. 5Reprint requests: Laura R. Ment, MD, Department of Pediatrics, Yale University School of Medicine, 333 Cedar St, New Haven, CT 06520; E-mail: laura.ment@yale.edu. Functional MRI (fMRI) is used extensively to study language processing in adults and children with known developmental disorders. 6,7 Preliminary studies of auditory tasks in children who were born prematurely suggest the presence of aberrant systems for language at school age, 5,8 yet recent neuropsychological studies document improvement in testing scores and school performance with time in children who were born prematurely. 9-12
NIH Public AccessWe previously reported in a study of almost 300 children born weighing 600 to 1250 g that the median Peabody Picture Vocabulary Test-Revised (PPVT-R) score, a standard measure for receptive vocabulary, incre...