Altered Gray Matter Volume and School Age Anxiety in Children Born Late Preterm

Abstract

Objectives To determine if late preterm (LP) children differ from full term (FT) children in volumes of the cortex, hippocampus, corpus callosum, or amygdala and whether these differences are associated with anxiety symptoms at school-age. Study design LP children born between 34 and 36 weeks gestation and FT children born between 39 and 41 weeks gestation from a larger longitudinal cohort had MRI scans at school-age. Brain volumes, cortical surface area and thickness measures were obtained. Anxiety symptoms were assessed using a structured diagnostic interview annually beginning at preschool-age and following the MRI. Results LP children (n=21) had a smaller percentage of total, right parietal, and right temporal lobe gray matter volume than FT children (n=87). There were no differences in hippocampal, callosal, or amygdala volumes or cortical thickness. LP children also had a relative decrease in right parietal lobe cortical surface area. LP children had greater anxiety symptoms over all assessments. The relationship between late prematurity and school-age anxiety symptoms was mediated by the relative decrease in right temporal lobe volume. Conclusion LP children, comprising 70% of preterm children, are also at increased risk for altered brain development particularly in the right temporal and parietal cortices. Alterations in the right temporal lobe cortical volume may underlie the increased rate of anxiety symptoms among these LP children. These findings suggest that LP delivery may disrupt temporal and parietal cortical development that persists until school-age with the right temporal lobe conferring risk for elevated anxiety symptoms.

Altered resting-state functional connectivity in emotion-processing brain regions in adults who were born very preterm

“…Most notably, increased connectivity was found between the left superficial amygdala and the STS in this group but not in controls. Structural alterations in the STS have been previously reported in VPT samples (Nosarti et al 2008; Rogers et al 2014). This region – and in particular its posterior portion (Hein & Knight, 2008)- is well known as a face-sensitive region specialized for dynamic feature recognition (Haxby et al 2000; Andrews & Ewbank, 2004; Engell & Haxby, 2007), including eye and mouth movements (Puce et al 1998; Hoffman & Haxby, 2000) and emotional expressions (LaBar et al 2003).…”

“…Volumetric alterations have been shown in VPT samples in brain regions thought to subserve emotion processing, such as the amygdala (Peterson et al 2000), orbitofrontal cortex (Giménez et al 2006), fusiform gyrus (Nosarti et al 2008; Gousias et al 2012), hippocampus (Rogers et al 2012; Omizzolo et al 2013; Aanes et al 2015) and insula (Nosarti et al 2014). Moreover, both structural magnetic resonance imaging (MRI) and diffusion MRI studies, have found significant associations between brain alterations in regions typically implicated in socio-emotion processing and specific social and emotional outcomes in VPT samples (Rogers et al 2012, 2014; Healy et al 2013; Fischi-Gómez et al 2015). However, to our knowledge, no neuroimaging study to date has investigated resting-state functional connectivity (rs-fc) in emotion-processing networks and performance on emotional processing tasks in individuals born VPT.…”

Developmental Outcomes of Late Preterm Infants From Infancy to Kindergarten

“…Compared with infants born full term, the late preterm brain manifests neurodevelopmental immaturity, characterized by lower brain volume and less differentiated patterns of myelination and neural connectivity. 34 -37 These structural differences in the brains of children born late preterm, including lower gray matter volume present in infancy and school age, 38,39 may be associated with the suboptimal development in early reading and math skills we identified, similar to that which has been observed in children born full term. 40,41 The lack of developmental differences in children born late preterm observed at 24 months and the reemergence of suboptimal development at preschool may also be related to limitations in the instruments used at the 24-month timepoint and to subtle differences in brain development that become apparent with advancing age.…”

17OHP‐C in patients with spontaneous preterm labor and intact membranes: is there an effect according to the presence of intra‐amniotic inflammation?

“…[64][65][66] Rapid white matter development occurs over the late gestation period, with most fetal brain development occurring after 36 weeks of gestation. [64][65][66] Rapid white matter development occurs over the late gestation period, with most fetal brain development occurring after 36 weeks of gestation.…”

“…The brain size of moderate and late preterm infants was smaller than that of term infants. [64][65][66] Rapid white matter development occurs over the late gestation period, with most fetal brain development occurring after 36 weeks of gestation. [67][68][69][70] Because of this physical development of the fetal brain, there are various risks in late preterm babies compared with in term babies, such as cerebral palsy, attention deficit hyperactivity disorder, mental retardation, and learning disabilities.…”