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Published on: November 20, 2015
Reduced Cholinergic Basal Forebrain Integrity Links Neonatal Complications and Adult Cognitive Deficits After
Michel J Grothe1, Lukas Scheef2, Josef Bäuml3
1Germater for Neurodegenerative Diseases, Rostockn Cen.
Insights
Premature birth can impair the cholinergic basal forebrain (cBF), leading to long-term cognitive deficits in adults. This study shows reduced cBF volume in preterm individuals, linking neonatal complications to adult IQ.
Area of Science:
- Neuroscience
- Developmental Neuroscience
- Cognitive Neuroscience
Background:
- Premature birth increases risk for long-term neurocognitive impairments.
- The cholinergic basal forebrain (cBF) is vulnerable to perinatal stressors, with impaired integrity linked to cognitive deficits.
- This study investigates cBF integrity in adults born preterm and its role in cognitive outcomes.
Purpose of the Study:
- To determine if cBF integrity is impaired in adults born very preterm.
- To investigate the association between cBF integrity, neonatal complications, and adult cognitive function.
- To examine the mediating role of cBF volume in the relationship between neonatal complications and cognitive deficits.
Main Methods:
- Used magnetic resonance imaging (MRI) to assess cBF volume in adults born very preterm/low birth weight and term-born controls.
- Analyzed the relationship between cBF volume, neonatal complications, and adult intelligence (IQ).
- Employed path analysis to model the mediating effect of cBF volume.
Main Results:
- Adults born very preterm/low birth weight had significantly reduced cBF volumes (-4.5%) compared to controls.
- Lower cBF volume was associated with increased neonatal complications and lower adult IQ, independent of global brain volumes.
- Path analysis confirmed that cBF volume mediates the link between neonatal complications and adult cognitive deficits.
Conclusions:
- Provides the first human evidence that impaired cBF integrity after premature birth connects neonatal complications to long-term cognitive outcomes.
- Suggests that cholinergic system abnormalities may be a key factor in neurocognitive impairments following premature delivery.
- Highlights the importance of the cholinergic basal forebrain in mediating the effects of prematurity on cognitive function.
Background:
Prematurely born individuals have an increased risk for long-term neurocognitive impairments. In animal models, development of the cholinergic basal forebrain (cBF) is selectively vulnerable to adverse effects of perinatal stressors, and impaired cBF integrity results in lasting cognitive deficits. We hypothesized that cBF integrity is impaired in prematurely born individuals and mediates adult cognitive impairments associated with prematurity.
Methods:
We used magnetic resonance imaging-based volumetric assessments of a cytoarchitectonically defined cBF region of interest to determine differences in cBF integrity between 99 adults who were born very preterm and/or with very low birth weight and 106 term-born control subjects from the same birth cohort. Magnetic resonance imaging-derived cBF volumes were studied in relation to neonatal clinical complications after delivery and intelligence measures (IQ) in adulthood.
Results:
In adults who were born very preterm and/or with very low birth weight, cBF volumes were significantly reduced compared with term-born adults (-4.5% [F1,202 = 11.82, p = .001]). Lower cBF volume in adults who were born very preterm and/or with very low birth weight was specifically associated with both neonatal complications (rpart,92 = -.35, p < .001) and adult IQ (rpart,88 = .33, p = .001) even after controlling for global gray matter and white matter volume. In a path analytic model, cBF volume significantly mediated the association between neonatal complications and adult cognitive deficits.
Conclusions:
We provide first-time evidence in humans that cBF integrity is impaired after premature birth and links neonatal complications with long-term cognitive outcome. Data suggest that cholinergic system abnormalities may play a relevant role for long-term neurocognitive impairments associated with premature delivery.
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