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Distinct neural mechanisms underlying cognitive difficulties in preterm children born at different stages of

Samson Nivins1, Nelly Padilla1, Hedvig Kvanta1

  • 1Department of Women's and Children's Health, Karolinska Institutet, Stockholm, Sweden.

Neuroimage. Clinical
|September 9, 2025
PubMed

Insights

Preterm birth is linked to brain differences and lower cognitive performance. These brain alterations may indicate compensatory mechanisms, suggesting tailored interventions are crucial for preterm children.

Area of Science:

  • Neuroscience
  • Developmental Pediatrics
  • Cognitive Science

Background:

  • Preterm birth is a significant global health concern, affecting neurodevelopment.
  • Understanding the long-term neurological consequences of prematurity is essential for early intervention.
  • Cognitive performance in childhood is a key indicator of neurodevelopmental outcomes.

Purpose of the Study:

  • To investigate the relationship between low cognitive performance and brain structure/network differences in preterm children.
  • To compare brain alterations in very-preterm, moderately-preterm, and full-term children.
  • To determine if these brain changes predict Autism Spectrum Disorder (ASD) or Attention-Deficit/Hyperactivity Disorder (ADHD) symptoms later in childhood.

Main Methods:

  • Longitudinal population-based study using data from the ABCD Study.
  • Brain imaging (cortical thickness, subcortical volumes) and cognitive assessments (NIH Toolbox) were performed on 9-10-year-old children.
  • Structural covariance networks were analyzed to examine brain connectivity patterns.

Main Results:

  • Low cognitive performance was more common in very-preterm (29.6%) and moderately-preterm (24.0%) children compared to full-term (16.2%) children.
  • Very-preterm children with low cognitive performance showed thinner inferior temporal cortex and fusiform gyrus, and larger amygdala volumes.
  • Moderately-preterm children with low cognitive performance exhibited smaller hippocampal volumes.
  • Structural covariance network analysis indicated altered connectivity in preterm children, potentially linked to ASD/ADHD symptoms.

Conclusions:

  • Preterm children with low cognitive performance exhibit distinct regional and network-level brain differences, varying by degree of prematurity.
  • Observed brain network alterations might represent compensatory mechanisms.
  • Findings underscore the necessity for interventions specifically tailored to the needs of preterm populations.
Abstract

Keywords:
ADHDASDAltered brain structuresBrain developmentLower cognitive performancePreterm birthSCN

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