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Language and reading skills in school-aged children and adolescents born preterm are associated with white matter
Heidi M Feldman1, Eliana S Lee, Jason D Yeatman
1Department of Pediatrics, Stanford University School of Medicine, CA 94304, USA. hfeldman@stanford.edu
Insights
Children born preterm may experience language and reading difficulties linked to white matter brain differences. This study found specific white matter properties associated with better language and reading skills in preterm children, unlike full-term peers.
Area of Science:
- Neuroscience
- Developmental Psychology
- Pediatric Medicine
Background:
- Children born preterm are at increased risk for language and reading deficits.
- White matter brain injury is a common complication in preterm infants.
- The relationship between white matter integrity and cognitive skills in preterm children requires further investigation.
Purpose of the Study:
- To investigate the association between white matter properties and language/reading skills in children born preterm.
- To compare these associations in preterm children versus full-term controls.
Main Methods:
- Diffusion tensor imaging (DTI) was used to assess white matter properties, specifically fractional anisotropy (FA).
- Participants included children born preterm (before 36 weeks gestation) and full-term controls.
- A comprehensive battery of language and reading tests was administered to all participants.
Main Results:
- In preterm children, white matter FA was significantly associated with verbal IQ, processing speed, syntactic comprehension, and decoding.
- These associations involved a distributed network of white matter tracts in both hemispheres.
- In contrast, no significant associations were found between white matter FA and language/reading skills in the full-term group.
Conclusions:
- Higher white matter integrity, indicated by FA, is linked to better language and reading performance in children born preterm.
- This relationship appears specific to the preterm group, suggesting unique developmental pathways.
- Findings highlight the importance of white matter network development for cognitive outcomes in preterm individuals.
Abstract:
Children born preterm are at risk for deficits in language and reading. They are also at risk for injury to the white matter of the brain. The goal of this study was to determine whether performance in language and reading skills would be associated with white matter properties in children born preterm and full-term. Children born before 36 weeks gestation (n=23, mean±SD age 12.5±2.0 years, gestational age 28.7±2.5 weeks, birth weight 1184±431 g) and controls born after 37 weeks gestation (n=19, 13.1±2.1 years, 39.3±1.0 weeks, 3178±413 g) underwent a battery of language and reading tests. Diffusion tensor imaging (DTI) scans were processed using tract-based spatial statistics to generate a core white matter skeleton that was anatomically comparable across participants. Fractional anisotropy (FA) was the diffusion property used in analyses. In the full-term group, no regions of the whole FA-skeleton were associated with language and reading. In the preterm group, regions of the FA-skeleton were significantly associated with verbal IQ, linguistic processing speed, syntactic comprehension, and decoding. Combined, the regions formed a composite map of 22 clusters on 15 tracts in both hemispheres and in the ventral and dorsal streams. ROI analyses in the preterm group found that several of these regions also showed positive associations with receptive vocabulary, verbal memory, and reading comprehension. Some of the same regions showed weak negative correlations within the full-term group. Exploratory multiple regression in the preterm group found that specific white matter pathways were related to different aspects of language processing and reading, accounting for 27-44% of the variance. The findings suggest that higher performance in language and reading in a group of preterm but not full-term children is associated with higher fractional anisotropy of a bilateral and distributed white matter network.
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