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Published on: August 25, 2014
Regional brain volume abnormalities and long-term cognitive outcome in preterm infants
B S Peterson1, B Vohr, L H Staib
1Yale Child Study Center, 230 S Frontage Rd, New Haven, CT 06520, USA. bradley.peterson@yale.edu
Insights
Preterm birth is linked to smaller brain volumes in specific regions, impacting cognitive development. These brain structure differences in prematurely born children correlate with lower IQ scores.
Area of Science:
- Neuroscience
- Developmental Neuroscience
- Pediatric Neurology
Background:
- Preterm infants often experience long-term cognitive and behavioral issues.
- The impact of premature birth stress on brain maturation and structure is not fully understood.
- Abnormalities in brain structure may contribute to cognitive deficits in preterm children.
Purpose of the Study:
- To compare regional brain volumes between term-born and preterm-born children.
- To investigate the association between regional brain volumes and cognitive outcomes in preterm children.
Main Methods:
- A case-control study involving 25 eight-year-old preterm children and 39 term control children.
- Structural magnetic resonance imaging (MRI) was used to measure volumes of various brain regions.
- Regional brain volumes were correlated with cognitive measures and perinatal variables.
Main Results:
- Preterm children showed significantly smaller cortical volumes, particularly in sensorimotor and premotor areas.
- Enlarged ventricles and smaller volumes were observed in the cerebellum, basal ganglia, amygdala, hippocampus, and corpus callosum in preterm children.
- Smaller sensorimotor and midtemporal cortical volumes were associated with lower IQ scores in preterm children.
Conclusions:
- Preterm birth is associated with region-specific, long-term reductions in brain volume.
- Morphological brain abnormalities in preterm children correlate with poorer cognitive outcomes.
- These findings highlight the lasting impact of preterm birth on brain development and function.
Context:
Preterm infants have a high prevalence of long-term cognitive and behavioral disturbances. However, it is not known whether the stresses associated with premature birth disrupt regionally specific brain maturation or whether abnormalities in brain structure contribute to cognitive deficits.
Objective:
To determine whether regional brain volumes differ between term and preterm children and to examine the association of regional brain volumes in prematurely born children with long-term cognitive outcomes.
Design And Setting:
Case-control study conducted in 1998 and 1999 at 2 US university medical schools.
Participants:
A consecutive sample of 25 eight-year-old preterm children recruited from a longitudinal follow-up study of preterm infants and 39 term control children who were recruited from the community and who were comparable with the preterm children in age, sex, maternal education, and minority status.
Main Outcome Measures:
Volumes of cortical subdivisions, ventricular system, cerebellum, basal ganglia, corpus callosum, amygdala, and hippocampus, derived from structural magnetic resonance imaging scans and compared between preterm and term children; correlations of regional brain volumes with cognitive measures (at age 8 years) and perinatal variables among preterm children.
Results:
Regional cortical volumes were significantly smaller in the preterm children, most prominently in sensorimotor regions (difference: left, 14.6%; right, 14.3% [P<.001 for both]) but also in premotor (left, 11.2%; right, 12.6% [P<.001 for both]), midtemporal (left, 7.4% [P =.01]; right, 10.2% [P<.001]), parieto-occipital (left, 7.9% [P =.01]; right, 7.4% [P =.005]), and subgenual (left, 8.9% [P =.03]; right, 11.7% [P =.01]) cortices. Preterm children's brain volumes were significantly larger (by 105. 7%-271.6%) in the occipital and temporal horns of the ventricles (P<. 001 for all) and smaller in the cerebellum (6.7%; P =.02), basal ganglia (11.4%-13.8%; P=.005), amygdala (left, 20.2% [P =.001]; right, 30.0% [P<.001]), hippocampus (left, 16.0% [P =.001]; right, 12.0% [P =.007]), and corpus callosum (13.1%-35.2%; P=.01 for all). Volumes of sensorimotor and midtemporal cortices were associated positively with full-scale, verbal, and performance IQ scores (P<.01 for all).
Conclusions:
Our data indicate that preterm birth is associated with regionally specific, long-term reductions in brain volume and that morphological abnormalities are, in turn, associated with poorer cognitive outcome. JAMA. 2000;284:1939-1947.
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