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. 2012 Feb;51(2):181-91.
doi: 10.1016/j.jaac.2011.11.009.

Regional cerebral development at term relates to school-age social-emotional development in very preterm children

Cynthia E Rogers  1 , Peter J Anderson, Deanne K Thompson, Hiroyuki Kidokoro, Michael Wallendorf, Karli Treyvaud, Gehan Roberts, Lex W Doyle, Jeffrey J Neil, Terrie E Inder
Affiliations

Regional cerebral development at term relates to school-age social-emotional development in very preterm children

Cynthia E Rogers et al. J Am Acad Child Adolesc Psychiatry. 2012 Feb.

Abstract

Objective: Preterm children are at risk for social-emotional difficulties, including autism and attention-deficit/hyperactivity disorder. We assessed the relationship of regional brain development in preterm children, evaluated via magnetic resonance imaging (MRI) at term-equivalent postmenstrual age (TEA), to later social-emotional difficulties.

Method: MR images obtained at TEA from 184 very preterm infants (gestation <30 weeks or birth weight <1,250 g) were analyzed for white matter abnormalities, hippocampal volume, and brain metrics. A total of 111 infants underwent diffusion tensor imaging, which provided values for fractional anisotropy and apparent diffusion coefficient. Social-emotional development was assessed with the Infant Toddler Social and Emotional Assessment (ITSEA) at age 2 and the Strengths and Difficulties Questionnaire (SDQ) at age 5 years.

Results: Higher apparent diffusion coefficient in the right orbitofrontal cortex was associated with social-emotional problems at age 5 years (peer problems, p < .01). In females, smaller hippocampal volume was associated with increased hyperactivity (p < .01), peer problems (p < .05), and SDQ total score (p < .01). In males, a smaller frontal region was associated with poorer prosocial (p < .05) scores. Many of the hippocampal findings remained significant after adjusting for birthweight z score, intelligence, social risk, immaturity at birth, and parental mental health. These associations were present in children who had social-emotional problems in similar domains at age 2 and those who did not.

Conclusions: Early alterations in regional cerebral development in very preterm infants relate to specific deficits in social-emotional performance by school-age. These results vary by gender. Our results provide further evidence for a neuroanatomical basis for behavioral challenges found in very preterm children.

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Conflict of interest statement

Disclosure: Drs. Rogers, Anderson, Thompson, Kidokoro, Wallendorf, Treyvaud, Roberts, Doyle, and Neil, and Inder report no biomedical financial interests or potential conflicts of interest.

Figures

Figure 1
Figure 1
Left: Axial Apparent Diffusion Coefficient (ADC) image at the level of the orbits with Regions of interest (ROIs) placed in the bilateral Orbital Frontal Cortices. Middle: Superior Axial ADC image with ROIs placed in the bilateral temporal lobes. Right: Axial ADC image with ROIs placed in the bilateral temporal lobes where bilateral amygdalae first visible.
Figure 2
Figure 2
Scatterplots of Hippocampal Volume and Strength and Difficulties Questionnaire (SDQ) Hyperactivity-Inattention Scale. Note: Left panels represent females and right panels represent males.
Figure 3
Figure 3
A: Mean z-scores of labeled brain measures and Strength and Difficulties Questionnaire (SDQ) scales with fitted regression lines for those above (left panel) and below (right panel) the term 80th percentile for the labeled Infant Toddler Social Emotional Assessment (ITSEA) domain at age 2. B: Mean of brain measures for those who were above and below the 80th percentile of the labeled ITSEA domains for the Very Preterm (VPT) subgroup scoring above the term 80th percentile for the SDQ peer problems (top row) and SDQ hyperactivity/inattention (bottom row) scales at age 5. ADC = Apparent Diffusion Coefficient
See this image and copyright information in PMC

References

    1. Anderson P, Doyle LW. Neurobehavioral outcomes of school-age children born extremely low birth weight or very preterm in the 1990s. JAMA. 2003;289(24):3264–3272. - PubMed
    1. Taylor HG, Minich NM, Klein N, Hack M. Longitudinal outcomes of very low birth weight: neuropsychological findings. J Int Neuropsychol Soc. 2004;10(2):149–163. - PubMed
    1. Johnson S, Hollis C, Kochhar P, et al. Psychiatric disorders in extremely preterm children: longitudinal finding at age 11 years in the EPICure study. J Am Acad Child Adolesc Psychiatry. 2010;49(5):453–463.e1. - PubMed
    1. Botting N, Powls A, Cooke RW, Marlow N. Attention deficit hyperactivity disorders and other psychiatric outcomes in very low birthweight children at 12 years. J Child Psychol Psychiatry. 1997;38(8):931–941. - PubMed
    1. Limperopoulos C. Autism spectrum disorders in survivors of extreme prematurity. Clin Perinatol. 2009;36(4):791–805. vi. - PubMed

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