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Published on: May 19, 2015
Brain tissue microstructure in a prospective, longitudinal, population-based cohort of preterm and term-born young
Bradley S Peterson1,2, Sahar Delavari1,2, Jonathan Sadik1,2
1Institute for the Developing Mind, Children's Hospital Los Angeles, Los Angeles, CA, USA.
Insights
Preterm birth causes brain tissue abnormalities that persist into adulthood, increasing the risk of psychiatric disorders. These effects are worse with earlier birth and complications, impacting cognitive function.
Area of Science:
- Neuroscience
- Developmental Neuroscience
- Medical Imaging
Background:
- Preterm birth affects 15 million infants annually, posing risks for lifelong neurodevelopmental issues.
- Long-term persistence of brain abnormalities and their association with cognitive/psychiatric outcomes post-preterm birth remain unclear.
Purpose of the Study:
- To investigate if brain tissue abnormalities from preterm birth persist into young adulthood.
- To determine the association between these persistent abnormalities and long-term cognitive and psychiatric outcomes.
Main Methods:
- A population-based sample of preterm infants and term controls was followed from infancy to young adulthood (mean age 19 years).
- Diffusion Tensor Imaging (DTI) was used to assess brain microstructure.
- Cognitive and psychiatric outcomes were evaluated in young adulthood.
Main Results:
- Preterm birth was linked to altered white matter integrity (lower fractional anisotropy, higher average diffusion coefficient) and grey matter abnormalities.
- Lower gestational age and perinatal complications (e.g., bronchopulmonary dysplasia, oxygen use) exacerbated these brain tissue changes.
- Preterm individuals showed lower full-scale IQ and higher rates of psychiatric disorders, with brain tissue abnormalities correlating with psychiatric illness.
Conclusions:
- Brain tissue microstructure abnormalities associated with preterm birth persist into young adulthood, indicating disordered myelination and axonal pathology.
- These persistent disturbances increase the likelihood of developing psychiatric disorders by young adulthood.
- Adverse effects were more pronounced in individuals born at younger gestational ages and those with perinatal complications linked to infection/inflammation.
Background:
Fifteen million infants annually are born prematurely, placing them at high risk for life-long adverse neurodevelopmental outcomes. Whether brain tissue abnormalities that accompany preterm birth persist into young adulthood and are associated with long-term cognitive or psychiatric outcomes is not known.
Methods:
From infancy into young adulthood, we followed a population-based sample of consecutively identified preterm infants and their matched term controls. The preterm group was born at an average gestational age of 31.5 ± 2.6 weeks. We obtained Diffusion Tensor Imaging scans and assessed cognitive and psychiatric outcomes in young adulthood, at a mean age of 19 (range 17.6-20.8) years. Usable data were acquired from 180 participants (89 preterm, 91 term).
Results:
Preterm birth was associated with lower fractional anisotropy (FA) and higher average diffusion coefficient (ADC) values in deep white matter tracts of the internal capsule, cerebral peduncles, inferior frontal-occipital fasciculus, sagittal stratum and splenium of the corpus callosum, as well as in grey matter of the caudate, putamen and thalamus. A younger gestational age at birth accentuated these tissue abnormalities. Perinatal characteristics, including lower 5-min APGAR score, history of bronchopulmonary dysplasia, more days of oxygen supplementation and multiple births all increased ADC values in deep white matter tracts and grey matter throughout the brain. Preterm individuals had significantly lower full-scale IQ and more frequent lifetime psychiatric disorders. Those with psychiatric illnesses had significantly higher ADC and lower FA values throughout the deep posterior white matter.
Conclusions:
Abnormalities in brain tissue microstructure associated with preterm birth persist into young adulthood and likely represent disordered myelination and accompanying axonal pathology. These disturbances are associated with a higher likelihood of developing a psychiatric disorder by young adulthood. Brain tissue disturbances were accentuated in those born at younger gestational ages and in those with a history of perinatal complications associated with infection and inflammation.
