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Published on: August 25, 2014
Cerebellar growth and behavioural & neuropsychological outcome in preterm adolescents
Jennifer Parker1, Ann Mitchell, Anastasia Kalpakidou
1King's College London, Division of Psychological Medicine and Psychiatry, Institute of Psychiatry, London, UK.
Insights
Very preterm adolescents show reduced cerebellar volume growth into adulthood, correlating with lower self-reported wellbeing and cognitive function. This study highlights the long-term impact of preterm birth on cerebellar development and mental health outcomes.
Area of Science:
- Neuroscience
- Developmental Psychology
- Medical Imaging
Background:
- Adolescence involves significant brain development, particularly in social and cognitive functions.
- Individuals born very preterm (VPT) may experience altered neurodevelopmental trajectories.
- The cerebellum's role in adolescent development and its association with VPT outcomes are not well understood.
Purpose of the Study:
- To investigate adolescent cerebellar growth in very preterm individuals.
- To examine the association between cerebellar developmental changes and cognitive/behavioral outcomes in VPT individuals.
- To compare cerebellar development in VPT individuals with term-born controls.
Main Methods:
- Structural magnetic resonance imaging (MRI) was used to measure cerebellar volumes in VPT and term-born adolescents at two time points (adolescence and young adulthood).
- Neuropsychological tests assessed intelligence (Wechsler Abbreviated Scale of Intelligence) and verbal fluency (Controlled Oral Word Association Test).
- The General Health Questionnaire-12 (GHQ-12) evaluated psychological wellbeing.
Main Results:
- A significant time-point by group interaction revealed reduced cerebellar growth in VPT individuals compared to controls.
- By young adulthood, VPT individuals showed a 3.11% smaller cerebellar volume than in adolescence, while controls showed no significant change.
- Reduced cerebellar volume change in VPT individuals correlated negatively with GHQ-12 scores (total and subscales) and positively with IQ measures.
Conclusions:
- Very preterm birth is associated with altered cerebellar volume development between adolescence and young adulthood.
- Diminished cerebellar growth in VPT individuals is linked to poorer psychological wellbeing and cognitive function.
- These findings underscore the importance of monitoring cerebellar development and associated outcomes in VPT populations.
Abstract:
Adolescence is a time of social and cognitive development associated with changes in brain structure and function. These developmental changes may show an altered path in individuals born before 33 weeks' gestation (very preterm; VPT). The cerebellum is affected by VPT birth, but no studies have yet assessed the adolescent development of this structure, or whether developmental changes in cerebellar structure are associated with cognitive and behavioural outcome. We measured cerebellar volumes on structural magnetic resonance images in 65 adolescents who were born before 33 weeks' gestation (VPT) and 34 term-born adolescents (mean age VPT = 15.09, SD = 1.43/mean age term-born = 15.43, SD = 0.56) and again in adulthood (mean age VPT = 18.61, SD = 1.02/mean age term-born = 19.17, SD = 0.95). Participants also underwent neuropsychological tests; the Wechsler Abbreviated Scale of Intelligence and the Controlled Oral Word Association Test and completed the General Health Questionnaire-12. Repeated measures ANOVA showed a main effect of time-point (F = 4.59, df = 1, P = 0.035) and a time-point by group interaction (F = 8.03, df = 1, P = 0.006) on cerebellar growth. By adulthood, cerebellar volumes were 3.11% smaller in the preterm group than they had been in early adolescence (P = 0.000). Cerebellar volume did not change significantly in the control group (P = 0.612). There were significant negative correlations between change in cerebellar volume and GHQ-12 in the VPT group; total score (r = -0.324 P = 0.028) and several subscales; concentration (r = -0.378 P = 0.010), feeling useful (r = -0.311 P = 0.035), decision-making capability (r = -0.348 P = 0.018), overcoming difficulties (r = -0.331 P = 0.025), feeling confident (r = -0.309 P = 0.037) and feeling worthless (r = -0.329 P = 0.026). In the VPT group there were positive correlations between cerebellar volume and full-scale IQ (adolescence; r = 0.471, P = 0.002/adulthood; r = 0.309, P = 0.047), performance IQ (adolescence; r = 0.434, P = 0.004/adulthood; r = 0.345, P = 0.025) and verbal IQ (adolescence; r = 0.401, P = 0.008) which were not maintained after controlling for white matter volume. We have demonstrated a reduction in cerebellar volume between adolescence and young adulthood in VPT individuals, which is correlated with reduced self-reported wellbeing.
