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Resilience and Vulnerability: Neurodevelopment of Very Preterm Children at Four Years of Age

Julia M Young1,2,3, Marlee M Vandewouw1,2, Hilary E A Whyte2,4,5

  • 1Diagnostic Imaging, Hospital for Sick Children, Toronto, ON, Canada.

Frontiers in Human Neuroscience
|August 8, 2020
PubMed

Insights

Children born very preterm show altered brain development, with reduced white matter but increased gray matter and ventricles by age four. Some cases with ventriculomegaly had resilient outcomes, suggesting protective factors.

Area of Science:

  • Neuroscience
  • Developmental Pediatrics
  • Radiology

Background:

  • Children born very preterm (VPT) face risks for neurodevelopmental issues.
  • Brain development in VPT children is not well-studied before school age.
  • Ventriculomegaly in VPT infants can have varied outcomes.

Purpose of the Study:

  • To investigate structural brain differences in 4-year-old VPT children compared to full-term (FT) children.
  • To explore neurodevelopmental outcomes in relation to brain structure.
  • To examine unique VPT cases with ventriculomegaly and resilient outcomes.

Main Methods:

  • High-resolution structural magnetic resonance imaging (MRI) in 64 four-year-olds (37 VPT, 25 FT).
  • Assessment of brain volumes (white matter, gray matter, ventricles), cortical thickness, and surface area.
  • Standardized developmental and cognitive assessments.

Main Results:

  • VPT children had reduced white matter but increased gray matter, temporal/occipital lobes, and ventricle volumes.
  • VPT children exhibited greater cortical thickness across all lobes compared to FT.
  • VPT children scored lower on developmental assessments; two cases with ventriculomegaly had intact cognition and typical gray/increased white matter volumes.

Conclusions:

  • VPT children show distinct structural brain differences at age 4, suggesting delayed maturation.
  • Persistent ventriculomegaly with typical gray matter and increased white matter may be linked to preserved cognitive function in some VPT children.
  • These findings highlight potential protective mechanisms in brain development for VPT individuals.

Keywords:
brain developmentmagnetic resonance imagingneurodevelopmental outcomepretermventriculomegaly

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