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Published on: November 20, 2015
Patterns of cerebral white matter damage and cognitive impairment in adolescents born very preterm
Sara Soria-Pastor1, Monica Gimenez, Ana Narberhaus
1Department of Psychiatry and Clinical Psychobiology, Faculty of Medicine, University of Barcelona, C/ Casanova 143, 08036 Barcelona, Spain.
Insights
White matter damage is common in adolescents born prematurely, impacting intelligence and processing speed. This persistent damage, even in those with seemingly normal development, affects cognitive functions.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Radiology
Background:
- Premature birth is linked to white matter damage, even in individuals with outwardly normal development.
- Cognitive performance in preterm children is often lower than in term-born peers, despite appearing within normal limits.
Purpose of the Study:
- To investigate the association between reduced performance intelligence quotient (PIQ) and white matter abnormalities in adolescents with a history of preterm birth.
- To explore the relationship between specific cognitive functions, such as processing speed, and white matter integrity in this population.
Main Methods:
- Voxel-based morphometry (VBM) was used to analyze brain structure in preterm and term-born adolescents.
- Correlation analyses examined the relationship between white matter volume, grey matter volume, and PIQ scores.
- The Digit Symbol subtest was used to assess processing speed and its correlation with white matter integrity.
Main Results:
- Eighty percent (35/44) of preterm adolescents exhibited white matter abnormalities, primarily in the centrum semiovale and posterior periventricular regions.
- A significant correlation was found between whole-brain white matter volume and PIQ in preterm adolescents (r=0.32; P=0.036), but not with grey matter volume.
- Reduced white matter concentration correlated with lower scores on the Digit Symbol subtest, indicating impaired processing speed.
Conclusions:
- White matter damage is prevalent and persists into adolescence in individuals born very preterm.
- Diffuse white matter loss is a likely contributor to decrements in performance intelligence quotient and processing speed observed in very preterm-born adolescents.
Abstract:
There is increasing evidence about the presence of white matter damage in subjects with a history of premature birth, even in those classified as good outcome because of an apparently normal development. Although intellectual performance is within normal limits in premature children it is significantly decreased compared to paired controls. The purpose of this study was to investigate the relationship between a lower performance intelligence quotient and white matter damage in preterm adolescents. The sample comprised 44 adolescents (mean age+/-S.D.: 14.4+/-1.6 years) born before 32 weeks of gestational age and 43 term-born adolescents (14.5+/-2.1 years). Individual voxel-based morphometry analyses demonstrated that 35/44 (80%) preterm subjects had white matter abnormalities. The centrum semiovale and the posterior periventricular regions were the most frequently affected areas. Correlation analysis showed that in preterms the performance intelligence quotient correlated with the whole-brain white matter volume (r=0.32; P=0.036) but not with grey matter volume. Complementary analysis showed that low scores in the Digit Symbol subtest, a measure of processing speed, in the preterm group correlated with reductions in white matter concentration. These results suggest that white matter damage is highly common and that it persists until adolescence. Hence, diffuse white matter loss may be responsible for performance intelligence quotient and processing speed decrements in subjects with very preterm birth.
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