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Adolescents who were born very preterm have decreased brain volumes
Chiara Nosarti1, Mazin H S Al-Asady, Sophia Frangou
1Division of Psychological Medicine, Department of Psychiatry, Institute of Psychiatry, London, UK. c.nosarti@iop.kcl.ac.uk
Insights
Very preterm infants show persistent brain volume deficits and enlarged ventricles into adolescence. These brain abnormalities in extremely premature individuals warrant further study for functional implications.
Area of Science:
- Neuroscience
- Developmental Biology
- Medical Imaging
Background:
- Infants born very preterm face elevated risks of brain injury.
- Increased survival rates of very preterm infants necessitate understanding long-term neurological outcomes.
- Persistent brain abnormalities into adulthood require investigation.
Purpose of the Study:
- To assess persistent brain abnormalities in adolescents born very preterm.
- To compare brain volumes, ventricular size, and grey/white matter ratios between very preterm and full-term adolescents.
- To investigate the long-term structural impact of extreme prematurity on the brain.
Main Methods:
- Structural magnetic resonance imaging (MRI) was used.
- A cohort of 72 adolescents born before 33 weeks' gestation and 48 age-matched full-term controls were studied.
- Brain measurements, including whole brain, grey matter, white matter, and hippocampal volumes, were analyzed using stereological principles by blinded assessors.
Main Results:
- Very preterm adolescents exhibited a 6.0% reduction in whole brain volume.
- Cortical grey matter volume decreased by 11.8%, and hippocampal volumes were reduced by 15.6% (right) and 12.1% (left).
- A significant 42.0% increase in lateral ventricular volume was observed in the very preterm group.
Conclusions:
- Individuals born very preterm demonstrate persistent decrements in brain volumes into adolescence.
- Striking increases in lateral ventricular volume are evident in very preterm adolescents.
- The functional significance of these persistent structural brain abnormalities requires further research.
Abstract:
Infants born very preterm have an increased risk of brain injury. Given the great increase in the number of such infants that are surviving, it is important to establish whether any resultant brain abnormalities persist into adolescence and adult life. We therefore examined in vivo whole brain, grey matter, white matter and hippocampal volumes, ventricular size and grey/white matter ratios in a series of adolescents who had been born very preterm, and an age-matched full-term control group. Structural MRI was carried out on a cohort of 72 adolescents (mean age 15 years) who were born before 33 weeks, and 48 age-matched full-term controls. Brain measurements were made blind to group affiliation using stereological principles. After controlling for gender and height, the very preterm subjects showed a 6.0% decrease in whole brain volume, and an 11.8% decrease in cortical grey matter volume, as well as a 15.6% decrease in right and a 12.1% decrease in left hippocampal volumes; they also had a 42.0% increase in the size of the lateral ventricles. Therefore, individuals who were born very preterm continue to show noticeable decrements in brain volumes and striking increases in lateral ventricular volume into adolescence. The functional significance of these abnormalities merits further investigation.