Altered working memory-related brain responses and white matter microstructure in extremely preterm-born children at school age

Abstract

Preterm birth poses a risk for neurocognitive and behavioral development. Preterm children, who have not been diagnosed with neurological or cognitive deficits, enter normal schools and are expected to succeed as their term-born peers. Here we tested the hypotheses that despite an uneventful development after preterm birth, these children might exhibit subtle abnormalities in brain function and white-matter microstructure at school-age. We recruited 7.5-year-old children born extremely prematurely (< 28 weeks' gestation), and age-and gender-matched term-born controls (≥ 37 weeks' gestation). We applied fMRI during working-memory (WM) tasks, and investigated white-matter microstructure with diffusion tensor imaging. Compared with controls, preterm-born children performed WM tasks less accurately, had reduced activation in several right prefrontal areas, and weaker deactivation of right temporal lobe areas. The weaker prefrontal activation correlated with poorer WM performance. Preterm-born children had higher fractional anisotropy (FA) and lower diffusivity than controls in several white-matter areas, and in the posterior cerebellum, the higher FA associated with poorer visuospatial test scores. In controls, higher FA and lower diffusivity correlated with faster WM performance. Together these findings demonstrate weaker WM-related brain activations and altered white matter microstructure in children born extremely preterm, who had normal global cognitive ability.

Systemic Maternal Human sFLT1 Overexpression Leads to an Impaired Foetal Brain Development of Growth-Restricted Foetuses upon Experimental Preeclampsia

“…In humans, preterm infants are at high risk to develop cognitive deficits or other neurological complications in later life. This association was also observed in preterm infants of PE pregnancies, with FGR seen as an additional risk factor [ 1 , 16 , 41 – 46 ]. In a study of Córcoles-Parada et al, with 196 children born very preterm combined with very low birth weight, children revealed a lower intelligence quotient, decreased grey and white matter integrity, and reduced cortical thickness at the age of 8-16 years [ 45 ].…”

“…In a study of Córcoles-Parada et al, with 196 children born very preterm combined with very low birth weight, children revealed a lower intelligence quotient, decreased grey and white matter integrity, and reduced cortical thickness at the age of 8-16 years [ 45 ]. In another study by Tokariev et al, with children of about 7 years old and born before 28 weeks of gestation, showed weaker memory-related brain activations in functional magnet resonance imaging and altered white matter microstructure in diffusion tensor imaging even with normally appearing cognitive abilities [ 44 , 46 ].…”