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Published on: August 25, 2014
Cortical thickness and behavior abnormalities in children born preterm
Leire Zubiaurre-Elorza1, Sara Soria-Pastor, Carme Junque
1Department of Psychiatry and Clinical Psychobiology, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
Insights
Preterm birth can alter cortical thickness (CTh) and is linked to behavioral issues. Periventricular leukomalacia (PVL) in preterm infants is associated with atypical CTh increases and behavioral problems.
Area of Science:
- Neuroscience
- Developmental Pediatrics
- Radiology
Background:
- Preterm birth is a leading cause of neurodevelopmental deficits.
- Periventricular leukomalacia (PVL) is a common brain injury in preterm infants.
- Long-term effects of PVL on brain structure and function require further investigation.
Purpose of the Study:
- To investigate the long-term effects of preterm birth and PVL on cortical thickness (CTh).
- To examine the relationship between CTh and cognitive-behavioral abnormalities in preterm children.
Main Methods:
- Brain MRI (T1-weighted images) analyzed with FreeSurfer software.
- Comparison of 22 preterm children with PVL, 14 preterm children without PVL, and 22 full-term controls.
- Cognitive and behavioral assessments using WISC-IV and CBCL.
Main Results:
- No global CTh differences were observed between groups.
- Preterm children without PVL showed thinner cortex in specific left-hemisphere regions compared to controls.
- PVL preterm children exhibited thicker cortex in right pericalcarine and left frontal areas.
- Internalizing/externalizing scores correlated with frontal CTh in the PVL group.
- Higher attentional scores in PVL correlated with right frontal CTh increments.
Conclusions:
- Preterm children without PVL display regional cortical gray matter thinning compared to full-term peers.
- PVL preterm children show atypical increases in CTh, potentially underlying behavioral issues.
- Regional CTh alterations are associated with cognitive and behavioral outcomes in preterm populations.
Aim:
To identify long-term effects of preterm birth and of periventricular leukomalacia (PVL) on cortical thickness (CTh). To study the relationship between CTh and cognitive-behavioral abnormalities.
Methods:
We performed brain magnetic resonance imaging on 22 preterm children with PVL, 14 preterm children with no evidence of PVL and 22 full-term peers. T1-weighted images were analyzed with FreeSurfer software. All participants underwent cognitive and behavioral assessments by means of the Wechsler Intelligence Scales for Children-Fourth Edition (WISC-IV) and the Child Behavior Checklist (CBCL).
Results:
We did not find global CTh differences between the groups. However, a thinner cortex was found in left postcentral, supramarginal, and caudal middle rostral gyri in preterm children with no evidence of PVL than in the full-term controls, while PVL preterm children showed thicker cortex in right pericalcarine and left rostral middle frontal areas than in preterm children with no evidence of PVL. In the PVL group, internalizing and externalizing scores correlated mainly with CTh in frontal areas. Attentional scores were found to be higher in PVL and correlated with CTh increments in right frontal areas.
Interpretation:
The preterm group with no evidence of PVL, when compared with full-term children, showed evidence of a different pattern of regional thinning in the cortical gray matter. In turn, PVL preterm children exhibited atypical increases in CTh that may underlie their prevalent behavioral problems.
