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Winter EL, Caemmerer JM, Trudel SM, deLeyer-Tiarks J, Bray MA, Dale BA, Kaufman AS. Does the Degree of Prematurity Relate to the Bayley-4 Scores Earned by Matched Samples of Infants and Toddlers across the Cognitive, Language, and Motor Domains? J Intell 2023; 11:213. [PMID: 37998712 PMCID: PMC10671985 DOI: 10.3390/jintelligence11110213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Revised: 09/30/2023] [Accepted: 11/03/2023] [Indexed: 11/25/2023] Open
Abstract
The literature on children born prematurely has consistently shown that full-term babies outperform preterm babies by about 12 IQ points, even when tested as adolescents, and this advantage for full-term infants extends to the language and motor domains as well. The results of comprehensive meta-analyses suggest that the degree of prematurity greatly influences later test performance, but these inferences are based on data from an array of separate studies with no control of potential confounding variables such as age. This study analyzed Bayley-4 data for 66 extremely premature infants and toddlers (<32 weeks), 70 moderately premature children (32-36 weeks), and 133 full-term children. All groups were carefully matched on key background variables by the test publisher during the standardization of the Bayley-4. This investigation analyzed data on the five subtests: cognitive, expressive communication, receptive communication, fine motor, and gross motor. A multivariate analysis of covariance (MANCOVA) assessed for group mean differences across the three subsamples, while controlling for the children's age. Extremely premature children scored significantly lower than moderately premature children on all subtests, and both preterm groups were significantly outscored by the full-term sample across all domains. In each set of comparisons, the cognitive and motor subtests yielded the largest differences, whereas language development, both expressive and receptive, appeared the least impacted by prematurity. A follow-up MANOVA was conducted to examine full-term versus preterm discrepancies on the five subtests for infants (2-17 months) vs. toddlers (18-42 months). For that analysis, the two preterm groups were combined into a single preterm sample, and a significant interaction between the age level and group (full-term vs. preterm) was found. Premature infants scored lower than premature toddlers on receptive communication, fine motor, and cognitive. Neither expressive communication nor gross motor produced significant discrepancies between age groups The findings of this study enrich the preterm literature on the degree of prematurity; the age-based interactions have implications for which abilities are most likely to improve as infants grow into toddlerhood.
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Affiliation(s)
- Emily L Winter
- School of Health Sciences Clinical PsyD Program, Touro University, New York, NY 10036, USA
| | | | - Sierra M Trudel
- Department of Occupational and Environmental Medicine, University of Connecticut School of Medicine, Farmington, CT 06030, USA
| | | | - Melissa A Bray
- Department of Educational Psychology, University of Connecticut, Storrs, CT 06268, USA
| | - Brittany A Dale
- Department of Special Education, Ball State University, Muncie, IN 47306, USA
| | - Alan S Kaufman
- Department of Educational Psychology, University of Connecticut, Storrs, CT 06268, USA
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2
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Serenius F, Kaul YF, Källén K, Hafström M, Ådén U, Stjernqvist K, Farooqi A. Neurobehavioral symptoms in children born extremely preterm: A Swedish National Study. Acta Paediatr 2023; 112:2387-2399. [PMID: 37551108 DOI: 10.1111/apa.16942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 08/03/2023] [Accepted: 08/07/2023] [Indexed: 08/09/2023]
Abstract
AIM To determine the prevalence of neurobehavioral symptoms at 6.5 years in children born extremely preterm (EPT, <27 weeks' gestation). METHODS Population-based cohort study of infants born EPT in Sweden from 2004 to 2007. Of 486 survivors 375 were assessed and compared with 369 matched term-born controls. EPT children free from neurosensory and intellectual disabilities (neurodevelopmental disabilities [NDD]-free, n = 236) were compared separately. Standardised questionnaires were used to assess parental ratings of hyperactivity and attention, emotional, peer-relation, conduct and social problems; and deficits in perception, language and memory. RESULTS EPT children had more reported problems in all assessed neurobehavioral domains than controls, with more than three times greater odds for most outcomes. Except for conduct problems, increased problems were identified also in NDD-free children. The odds of having neurobehavioral problems in ≥3 co-occurring domains were five (whole EPT group) and three (NDD-free group) times higher than in controls. CONCLUSION EPT children with or without NDD have more neurobehavioral problems in multiple domains than term peers. Ongoing assessments of behaviour until school age or beyond should recognise early symptoms of attention, everyday social problems, perceptual, emotional or language difficulties.
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Affiliation(s)
- Fredrik Serenius
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Department of Neonatology, Child and Adolescent Medicine, Umeå University Hospital, Umeå, Sweden
| | | | - Karin Källén
- Department of Obstetrics and Gynecology, Institute of Clinical Sciences, Lund, University of Lund, Lund, Sweden
| | - Maria Hafström
- Department of Paediatrics, Institute of Clinical Science, University of Gothenburg, Gothenburg, Sweden
- Angered Hospital, Gothenburg, Sweden
| | - Ulrika Ådén
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
| | - Karin Stjernqvist
- Department of Clinical Sciences, Pediatric Section, Lund University, Lund, Sweden
- Department of Neonatal Care and Pediatric Surgery, Skåne University Hospital, Lund, Sweden
| | - Aijaz Farooqi
- Department of Neonatology, Child and Adolescent Medicine, Umeå University Hospital, Umeå, Sweden
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3
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Boerma T, Ter Haar S, Ganga R, Wijnen F, Blom E, Wierenga CJ. What risk factors for Developmental Language Disorder can tell us about the neurobiological mechanisms of language development. Neurosci Biobehav Rev 2023; 154:105398. [PMID: 37741516 DOI: 10.1016/j.neubiorev.2023.105398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/03/2023] [Accepted: 09/17/2023] [Indexed: 09/25/2023]
Abstract
Language is a complex multidimensional cognitive system that is connected to many neurocognitive capacities. The development of language is therefore strongly intertwined with the development of these capacities and their neurobiological substrates. Consequently, language problems, for example those of children with Developmental Language Disorder (DLD), are explained by a variety of etiological pathways and each of these pathways will be associated with specific risk factors. In this review, we attempt to link previously described factors that may interfere with language development to putative underlying neurobiological mechanisms of language development, hoping to uncover openings for future therapeutical approaches or interventions that can help children to optimally develop their language skills.
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Affiliation(s)
- Tessel Boerma
- Institute for Language Sciences, Department of Languages, Literature and Communication, Utrecht University, Utrecht, the Netherlands
| | - Sita Ter Haar
- Institute for Language Sciences, Department of Languages, Literature and Communication, Utrecht University, Utrecht, the Netherlands; Cognitive Neurobiology and Helmholtz Institute, Department of Psychology, Utrecht University/Translational Neuroscience, University Medical Center Utrecht, the Netherlands
| | - Rachida Ganga
- Institute for Language Sciences, Department of Languages, Literature and Communication, Utrecht University, Utrecht, the Netherlands
| | - Frank Wijnen
- Institute for Language Sciences, Department of Languages, Literature and Communication, Utrecht University, Utrecht, the Netherlands
| | - Elma Blom
- Department of Development and Education of youth in Diverse Societies (DEEDS), Utrecht University, Utrecht, the Netherlands; Department of Language and Culture, The Arctic University of Norway UiT, Tromsø, Norway.
| | - Corette J Wierenga
- Biology Department, Faculty of Science, Utrecht University, the Netherlands; Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, the Netherlands.
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4
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Pretzel P, Wilke M, Tournier JD, Goelz R, Lidzba K, Hauser TK, Groeschel S. Reduced structural connectivity in non-motor networks in children born preterm and the influence of early postnatal human cytomegalovirus infection. Front Neurol 2023; 14:1241387. [PMID: 37849834 PMCID: PMC10577195 DOI: 10.3389/fneur.2023.1241387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2023] [Accepted: 09/13/2023] [Indexed: 10/19/2023] Open
Abstract
Introduction Preterm birth is increasingly recognized to cause lifelong functional deficits, which often show no correlate in conventional MRI. In addition, early postnatal infection with human cytomegalovirus (hCMV) is being discussed as a possible cause for further impairments. In the present work, we used fixel-based analysis of diffusion-weighted MRI to assess long-term white matter alterations associated with preterm birth and/or early postnatal hCMV infection. Materials and methods 36 former preterms (PT, median age 14.8 years, median gestational age 28 weeks) and 18 healthy term-born controls (HC, median age 11.1 years) underwent high angular resolution DWI scans (1.5 T, b = 2 000 s/mm2, 60 directions) as well as clinical assessment. All subjects showed normal conventional MRI and normal motor function. Early postnatal hCMV infection status (CMV+ and CMV-) had been determined from repeated screening, ruling out congenital infections. Whole-brain analysis was performed, yielding fixel-wise metrics for fiber density (FD), fiber cross-section (FC), and fiber density and cross-section (FDC). Group differences were identified in a whole-brain analysis, followed by an analysis of tract-averaged metrics within a priori selected tracts associated with cognitive function. Both analyses were repeated while differentiating for postnatal hCMV infection status. Results PT showed significant reductions of fixel metrics bilaterally in the cingulum, the genu corporis callosum and forceps minor, the capsula externa, and cerebellar and pontine structures. After including intracranial volume as a covariate, reductions remained significant in the cingulum. The tract-specific investigation revealed further reductions bilaterally in the superior longitudinal fasciculus and the uncinate fasciculus. When differentiating for hCMV infection status, no significant differences were found between CMV+ and CMV-. However, comparing CMV+ against HC, fixel metric reductions were of higher magnitude and of larger spatial extent than in CMV- against HC. Conclusion Preterm birth can lead to long-lasting alterations of WM micro- and macrostructure, not visible on conventional MRI. Alterations are located predominantly in WM structures associated with cognitive function, likely underlying the cognitive deficits observed in our cohort. These observed structural alterations were more pronounced in preterms who suffered from early postnatal hCMV infection, in line with previous studies suggesting an additive effect.
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Affiliation(s)
- Pablo Pretzel
- Department of Child Neurology and Developmental Medicine, University Children’s Hospital, Tübingen, Germany
- Experimental Pediatric Neuroimaging, Department of Child Neurology and Department of Neuroradiology, University Hospital, Tübingen, Germany
| | - Marko Wilke
- Department of Child Neurology and Developmental Medicine, University Children’s Hospital, Tübingen, Germany
- Experimental Pediatric Neuroimaging, Department of Child Neurology and Department of Neuroradiology, University Hospital, Tübingen, Germany
| | - J-Donald Tournier
- Centre for the Developing Brain, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
- Biomedical Engineering Department, School of Biomedical Engineering and Imaging Sciences, King’s College London, London, United Kingdom
| | - Rangmar Goelz
- Department of Neonatology, University Children’s Hospital, Tübingen, Germany
| | - Karen Lidzba
- Division of Neuropaediatrics, Development and Rehabilitation, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
| | | | - Samuel Groeschel
- Department of Child Neurology and Developmental Medicine, University Children’s Hospital, Tübingen, Germany
- Experimental Pediatric Neuroimaging, Department of Child Neurology and Department of Neuroradiology, University Hospital, Tübingen, Germany
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Cuervo S, Creaghead N, Vannest J, Hunter L, Ionio C, Altaye M, Parikh NA. Language Outcomes of Children Born Very Preterm in Relation to Early Maternal Depression and Anxiety. Brain Sci 2023; 13:1355. [PMID: 37891724 PMCID: PMC10605035 DOI: 10.3390/brainsci13101355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/15/2023] [Accepted: 09/20/2023] [Indexed: 10/29/2023] Open
Abstract
Unaddressed maternal psychological distress within the first year postpartum is known to have numerous negative consequences on the child's developmental outcomes, including language acquisition. This study examined the relationship between early maternal psychosocial factors and the language outcomes of children born very preterm (VPT; ≤32 weeks gestational age). It used data from the Cincinnati Infant Neurodevelopment Early Prediction Study, an ongoing National-Institutes-of-Health-funded prospective, multicenter cohort investigation of VPT infants. A total of 243 (125 boys; 118 girls) children born VPT (M = 29.03 weeks of gestation; SD = 2.47) and their corresponding 207 mothers (34 with multiple infants) were included in this study. We did not find an association between maternal depression or anxiety and Bayley-III (M = 92.3, SD = 18.9) language scores. Additionally, maternal grit and self-efficacy did not modify the relationship between depression and anxiety and language scores. A higher level of maternal education and infant female sex were significantly associated with higher language scores. While preterm birth typically results in higher rates of depression and anxiety for parents, the findings suggest that maternal depression, anxiety, and grit and the self-efficacy of the mothers in this sample did not relate to the language development of their children, independent of maternal education and infant female sex.
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Affiliation(s)
- Sisan Cuervo
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH 45267, USA; (S.C.); (N.C.); (J.V.)
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Nancy Creaghead
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH 45267, USA; (S.C.); (N.C.); (J.V.)
| | - Jennifer Vannest
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH 45267, USA; (S.C.); (N.C.); (J.V.)
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Center for Prevention of Neurodevelopmental Disorder, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.A.); (N.A.P.)
| | - Lisa Hunter
- Department of Communication Sciences and Disorders, University of Cincinnati, Cincinnati, OH 45267, USA; (S.C.); (N.C.); (J.V.)
- Communication Sciences Research Center, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Center for Prevention of Neurodevelopmental Disorder, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.A.); (N.A.P.)
| | - Chiara Ionio
- Department of Psychology, Catholic University of the Sacred Heart, 00168 Milano, Italy;
| | - Mekibib Altaye
- Center for Prevention of Neurodevelopmental Disorder, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.A.); (N.A.P.)
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
| | - Nehal A. Parikh
- Center for Prevention of Neurodevelopmental Disorder, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (M.A.); (N.A.P.)
- Perinatal Institute, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH 45229, USA
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Varela-Moraga V, Diethelm-Varela B, Pérez-Pereira M. Effect of biomedical complications on very and extremely preterm children's language. Front Psychol 2023; 14:1163252. [PMID: 37484104 PMCID: PMC10361768 DOI: 10.3389/fpsyg.2023.1163252] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/05/2023] [Indexed: 07/25/2023] Open
Abstract
Introduction Very and extremely preterm children have been found to show delays in the development of language in early years. In some investigations, however, a rigorous control of biomedical complications, such as Periventricular Leukomalacia (PVL), Intraventricular Hemorrhage (IVH) or Bronchopulmonary Dysplasia (BPD), does not always exist. For that reason, a confounding effect of low gestational age and biomedical complications may lead to erroneous conclusions about the effect of gestational age. Methods In this investigation we compare language development [use of words, sentence complexity and mean length of the three longest utterances (MLU3)] of three groups of Chilean children at 24 months of age (corrected age for preterm children). The first group was composed of 42 healthy full-term children (Full term group: FT), the second group of 60 preterm children born below 32 gestational weeks without medical complications (low risk preterm group: LRPT), and the third group was composed of 64 children below 32 gestational weeks who had medical complications (High risk preterm group: HRPT). The three groups were similar in terms of gender distribution, maternal education, and socio-economic environment. The instrument used to assess language was the Communicative Development Inventories (CDI). In addition, the Ages and Stages Questionnaire-3 (ASQ-3) was also used to assess other developmental dimensions. Results The results indicate that HRPT and LRPT children obtained significantly lower results than the FT group in the three language measures obtained through the CDI. No significant differences were observed between the HRPT and the LRPT groups, although the HRPT obtained the lowest results in the three CDI measures. The results obtained through the administration of the ASQ-3 confirm the delay of both preterm groups in communicative development when compared to the FT group. No significant differences between the FT and the PT groups were observed in gross motor, fine motor and problem solving dimensions of the ASQ-3. The LRPT group obtained results that were significantly higher than those of the FT group and the HRPT group in gross motor development. Discussion These results seem to indicate that the area of language development is particularly influenced by very or extremely low gestational age.
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Affiliation(s)
- Virginia Varela-Moraga
- Departamento de Fonoaudiología, Facultad de Medicina, Universidad de Chile, Santiago, Chile
| | - Benjamín Diethelm-Varela
- Department of Molecular Genetics and Microbiology, School of Biological Sciences, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Miguel Pérez-Pereira
- Departamento de Psicoloxía Evolutiva e da Educación, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
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7
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Torres Y, Celis C, Acurio J, Escudero C. Language Impairment in Children of Mothers with Gestational Diabetes, Preeclampsia, and Preterm Delivery: Current Hypothesis and Potential Underlying Mechanisms : Language Impartment and Pregnancy Complications. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1428:245-267. [PMID: 37466777 DOI: 10.1007/978-3-031-32554-0_11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
Many conditions may impair or delay language development, including socioeconomic status, parent's education, or intrauterine environment. Accordingly, increasing evidence has described that pregnancy complications, including gestational diabetes mellitus (GDM), preeclampsia, and preterm delivery, are associated with the offspring's impaired neurodevelopment. Since language is one of the high brain functions, alterations in this function are another sign of neurodevelopment impairment. How these maternal conditions may generate language impairment has yet to be entirely understood. However, since language development requires adequate structural formation and function/connectivity of the brain, these processes must be affected by alterations in maternal conditions. However, the underlying mechanisms of these structural alterations are largely unknown. This manuscript critically analyzes the literature focused on the risk of developing language impairment in children of mothers with GDM, preeclampsia, and preterm delivery. Furthermore, we highlight potential underlying molecular mechanisms associated with these alterations, such as neuroinflammatory and metabolic and cerebrovascular alterations.
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Affiliation(s)
- Yesenia Torres
- Vascular Physiology Laboratory, Department of Basic Science, Faculty of Sciences, Universidad of Bio Bio, Chillán, Chile
- Brainlab-Cognitive Neuroscience Research Group, Department of Clinical Psychology and Psychobiology, University of Barcelona, Barcelona, Catalonia, Spain
| | - Cristian Celis
- Vascular Physiology Laboratory, Department of Basic Science, Faculty of Sciences, Universidad of Bio Bio, Chillán, Chile
- Centro terapéutico , ABCfonoaudiologia, Santiago, Chile
| | - Jesenia Acurio
- Vascular Physiology Laboratory, Department of Basic Science, Faculty of Sciences, Universidad of Bio Bio, Chillán, Chile
- Group of Research and Innovation in Vascular Health (GRIVAS Health), Chillán, Chile
| | - Carlos Escudero
- Vascular Physiology Laboratory, Department of Basic Science, Faculty of Sciences, Universidad of Bio Bio, Chillán, Chile.
- Group of Research and Innovation in Vascular Health (GRIVAS Health), Chillán, Chile.
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Taskila HL, Heikkinen M, Yliherva A, Välimaa T, Hallman M, Kaukola T, Kallankari H. Antenatal and neonatal risk factors in very preterm children were associated with language difficulties at nine years of age. Acta Paediatr 2022; 111:2100-2107. [PMID: 35896181 DOI: 10.1111/apa.16501] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2022] [Revised: 07/21/2022] [Accepted: 07/26/2022] [Indexed: 11/28/2022]
Abstract
AIM This Finnish study compared language and reading abilities between schoolchildren born at a very low gestational age (VLGA) of <32 weeks and at term and analysed any associations between antenatal and neonatal risk factors and language skills in the VLGA group. METHODS We prospectively followed 76 children born at a VLGA and 50 children born at term when they reached a mean age of 9.0 (8.1-10.0) years. They attended mainstream schools and had no severe neurosensory disabilities. Receptive language ability, rapid naming and word reading were evaluated using standardised tests. RESULTS Children in the VLGA group had lower scores for receptive language abilities (median 55.0 versus 57.0, p = 0.01) and word reading (mean 4.4 versus 5.1, p = 0.03) than the children in the term group. In the VLGA group, foetal growth restriction was associated with lower scores for rapid naming, early intraventricular haemorrhage was associated with poor word reading and respiratory distress syndrome was associated with poor rapid naming (p < 0.05). CONCLUSION Schoolchildren born at a VLGA had more difficulties with receptive language abilities and word reading than children born at term. Foetal growth restriction and early neonatal morbidities were associated with language difficulties.
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Affiliation(s)
- Hanna-Leena Taskila
- PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland.,Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
| | - Minna Heikkinen
- PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland.,Research Unit of Logopedics and Child Language Research Center, University of Oulu, Oulu, Finland
| | - Anneli Yliherva
- Research Unit of Logopedics and Child Language Research Center, University of Oulu, Oulu, Finland.,Logopedics, Faculty of Social Sciences, University of Tampere, Tampere, Finland
| | - Taina Välimaa
- Research Unit of Logopedics and Child Language Research Center, University of Oulu, Oulu, Finland
| | - Mikko Hallman
- PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland
| | - Tuula Kaukola
- PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland.,Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
| | - Hanna Kallankari
- PEDEGO Research Unit and Medical Research Center Oulu, University of Oulu, Oulu, Finland.,Department of Children and Adolescents, Oulu University Hospital, Oulu, Finland
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Gire C, Garbi A, Zahed M, Beltran Anzola A, Tosello B, Datin-Dorrière V. Neurobehavioral Phenotype and Dysexecutive Syndrome of Preterm Children: Comorbidity or Trigger? An Update. CHILDREN (BASEL, SWITZERLAND) 2022; 9:239. [PMID: 35204960 PMCID: PMC8870742 DOI: 10.3390/children9020239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 01/29/2022] [Accepted: 02/09/2022] [Indexed: 06/14/2023]
Abstract
Premature birth is a worldwide public health priority. One in ten children is born before 37 weeks of gestational age and, in developed countries, survival rates without major neonatal morbidity are increasing. Although severe sequelae associated with these births have decreased, their neurobehavioral difficulties, often associated in multiple fields, remain stable but still widespread. These neurobehavioral difficulties hamper the normal development of academic achievements and societal integration and intensify the children's needs for rehabilitation during their preschool and academic years. Severe sequelae increase when gestational age decreases. This is even truer if the socio-cultural background is impeded by low income, education and language skills as compared with defined averages. However, moderate and/or minor neurocognitive and/or behavioral difficulties are almost identical for a moderate or a late preterm birth. Obtaining a better clinical description of neurobehavioral characteristics of those pretermly born, once they reach preschool age, is essential to detect behavioral issues as well as early specific cognitive difficulties (working memory, planning, inhibition, language expression and reception, attention and fine motor skills, etc.). Such information would provide a better understanding of the executive functions' role in brain connectivity, neurodevelopment and neuroanatomical correlation with premature encephalopathy.
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Affiliation(s)
- Catherine Gire
- Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrelys, CEDEX 20, 13915 Marseille, France; (C.G.); (A.G.); (M.Z.); (A.B.A.)
- CEReSS—Health Service Research and Quality of Life Center, Faculty of Medicine, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Aurélie Garbi
- Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrelys, CEDEX 20, 13915 Marseille, France; (C.G.); (A.G.); (M.Z.); (A.B.A.)
| | - Meriem Zahed
- Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrelys, CEDEX 20, 13915 Marseille, France; (C.G.); (A.G.); (M.Z.); (A.B.A.)
| | - Any Beltran Anzola
- Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrelys, CEDEX 20, 13915 Marseille, France; (C.G.); (A.G.); (M.Z.); (A.B.A.)
- CEReSS—Health Service Research and Quality of Life Center, Faculty of Medicine, Aix-Marseille University, 27 Boulevard Jean Moulin, 13005 Marseille, France
| | - Barthélémy Tosello
- Department of Neonatology, North Hospital, University Hospital of Marseille, Chemin des Bourrelys, CEDEX 20, 13915 Marseille, France; (C.G.); (A.G.); (M.Z.); (A.B.A.)
- CNRS, EFS, ADES, Aix Marseille Universite, 13915 Marseille, France
| | - Valérie Datin-Dorrière
- Department of Neonatal Medicine, Caen University Hospital, Avenue Cote De Nacre, 14000 Caen, France;
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10
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Johnson TJ, Meier PP, Schoeny ME, Bucek A, Janes JE, Kwiek JJ, Zupancic JAF, Keim SA, Patel AL. Study protocol for reducing disparity in receipt of mother's own milk in very low birth weight infants (ReDiMOM): a randomized trial to improve adherence to sustained maternal breast pump use. BMC Pediatr 2022; 22:27. [PMID: 34996401 PMCID: PMC8739536 DOI: 10.1186/s12887-021-03088-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Accepted: 12/22/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Black very low birth weight (VLBW; < 1500 g birth weight) and very preterm (VP, < 32 weeks gestational age, inclusive of extremely preterm, < 28 weeks gestational age) infants are significantly less likely than other VLBW and VP infants to receive mother's own milk (MOM) through to discharge from the neonatal intensive care unit (NICU). The costs associated with adhering to pumping maternal breast milk are borne by mothers and contribute to this disparity. This randomized controlled trial tests the effectiveness and cost-effectiveness of an intervention to offset maternal costs associated with pumping. METHODS This randomized control trial will enroll 284 mothers and their VP infants to test an intervention (NICU acquires MOM) developed to facilitate maternal adherence to breast pump use by offsetting maternal costs that serve as barriers to sustaining MOM feedings and the receipt of MOM at NICU discharge. Compared to current standard of care (mother provides MOM), the intervention bundle includes three components: a) free hospital-grade electric breast pump, b) pickup of MOM, and c) payment for opportunity costs. The primary outcome is infant receipt of MOM at the time of NICU discharge, and secondary outcomes include infant receipt of any MOM during the NICU hospitalization, duration of MOM feedings (days), and cumulative dose of MOM feedings (total mL/kg of MOM) received by the infant during the NICU hospitalization; maternal duration of MOM pumping (days) and volume of MOM pumped (mLs); and total cost of NICU care. Additionally, we will compare the cost of the NICU acquiring MOM versus NICU acquiring donor human milk if MOM is not available and the cost-effectiveness of the intervention (NICU acquires MOM) versus standard of care (mother provides MOM). DISCUSSION This trial will determine the effectiveness of an economic intervention that transfers the costs of feeding VLBWand VP infants from mothers to the NICU to address the disparity in the receipt of MOM feedings at NICU discharge by Black infants. The cost-effectiveness analysis will provide data that inform the adoption and scalability of this intervention. TRIAL REGISTRATION ClinicalTrials.gov: NCT04540575 , registered September 7, 2020.
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Affiliation(s)
- Tricia J Johnson
- Department of Health Systems Management, Rush University, 1700 West Van Buren Street, TOB Suite 126B, Chicago, USA.
| | - Paula P Meier
- Department of Pediatrics, Rush University Medical Center, Chicago, USA.,College of Nursing, Rush University, Chicago, USA
| | - Michael E Schoeny
- Department of Community, Systems and Mental Health Nursing, Rush University, Chicago, USA
| | - Amelia Bucek
- Department of Pediatrics, Rush University Medical Center, Chicago, USA
| | - Judy E Janes
- Department of Pediatrics, Rush University Medical Center, Chicago, USA
| | - Jesse J Kwiek
- Department of Microbiology, The Center for Retrovirus Research and the Infectious Disease Institute, The Ohio State University, Columbus, USA
| | - John A F Zupancic
- Department of Neonatology, Beth Israel Deaconess Medical Center, Boston, USA.,Harvard Medical School, Boston, USA
| | - Sarah A Keim
- Center for Biobehavioral Health, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, USA.,Department of Pediatrics, The Ohio State University College of Medicine, Columbus, USA.,Division of Epidemiology, The Ohio State University College of Public Health, Columbus, USA
| | - Aloka L Patel
- Department of Pediatrics, Rush University Medical Center, Chicago, USA
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11
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Abstract
Extremely preterm birth is associated with increased risk for a spectrum of neurodevelopmental problems. This review describes the nature of cognitive and academic outcomes of extremely preterm survivors across childhood and adolescence. Evidence across meta-analyses and large prospective birth cohorts indicate that early developmental difficulties in children born extremely preterm do not resolve with age and are not improving over time despite advancements in neonatal care. While extremely preterm birth confers increased risk of widespread cognitive difficulties, considerable heterogeneity in outcomes is evident across individuals. There is a continued need for high-quality longitudinal studies to understand the developmental progression of cognitive and academic skills following extremely preterm birth, and greater focus on understanding contributing factors that may help to explain the individual variability in cognitive and academic outcomes of extremely preterm survivors.
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Affiliation(s)
- Leona Pascoe
- Turner Institute for Brain and Mental Health, Monash University, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
| | - Alice C Burnett
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Newborn Research, The Royal Women's Hospital, Melbourne, Australia; Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Peter J Anderson
- Turner Institute for Brain and Mental Health, Monash University, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
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12
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Neri E, De Pascalis L, Agostini F, Genova F, Biasini A, Stella M, Trombini E. Parental Book-Reading to Preterm Born Infants in NICU: The Effects on Language Development in the First Two Years. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111361. [PMID: 34769878 PMCID: PMC8582730 DOI: 10.3390/ijerph182111361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 10/24/2021] [Accepted: 10/25/2021] [Indexed: 11/16/2022]
Abstract
Background: After preterm birth, infants are at high risk for delays in language development. A promising intervention to reduce this risk is represented by the exposure to parental voices through book-reading in Neonatal Intensive Care Units (NICU). This study investigated the possible advantages of book-reading to preterm neonates during their NICU stay on their subsequent language development. Methods: 100 families of preterm infants were recruited. The parents of 55 preterm infants (Reading Group) received a colored picture-book on NICU admission and were supported to read to their neonate as often as possible and to continue after hospital discharge. Forty-five infants (Control Group) were recruited before the beginning of the intervention. Infant language development was assessed with the Hearing and Language quotients of the Griffith Mental Development Scale at the corrected ages of 3, 6, 9, 12, 18 and 24 months. Results: Regardless of group membership, Hearing and Language mean quotients decreased between 9 and 18 months; nevertheless, this decrease was considerably reduced in the Reading group, compared to the Control Group. Conclusions: Reading in NICUs represents a suitable intervention that could positively influence language development and parent-infant relationships in preterm children. The study findings support its implementation as a preventive measure.
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Affiliation(s)
- Erica Neri
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (L.D.P.); (F.G.); (E.T.)
- Correspondence: (E.N.); (F.A.)
| | - Leonardo De Pascalis
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (L.D.P.); (F.G.); (E.T.)
| | - Francesca Agostini
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (L.D.P.); (F.G.); (E.T.)
- Correspondence: (E.N.); (F.A.)
| | - Federica Genova
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (L.D.P.); (F.G.); (E.T.)
| | - Augusto Biasini
- Donor Human Milk Bank Italian Association (AIBLUD), 20126 Milan, Italy;
| | - Marcello Stella
- Pediatric and Neonatal Intensive Care Unit, Maurizio Bufalini Hospital, 47521 Cesena, Italy;
| | - Elena Trombini
- Department of Psychology “Renzo Canestrari”, University of Bologna, 40127 Bologna, Italy; (L.D.P.); (F.G.); (E.T.)
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13
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Gire C, Beltran Anzola A, Kaminski M, Baumstarck K, Ancel PY, Berbis J. A randomized EPIREMED protocol study on the long-term visuo spatial effects of very preterm children with a working memory deficit. BMC Pediatr 2021; 21:402. [PMID: 34517869 PMCID: PMC8436542 DOI: 10.1186/s12887-021-02867-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Accepted: 08/18/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Very preterm children generally perform poorly in executive functions and particularly in working memory. Adaptive training tasks encouraging these children to work continuously on their personal working memory capacity can be very useful. Above all in preschool-age children, several cognitive training programs focused on improving working memory capacity. Cogmed is a computerized visuospatial cognitive training program that improves working memory in children and adolescents with attention-deficit/hyperactivity disorder. The main objective is to assess the long-term effects (18 months) of cognitive training (Cogmed) on visuospatial processing in preschool-age very preterm children with working memory impairment. METHODS The EPIREMED study is a prospective, randomized, controlled, multicentric trial nested in a population based epidemiological survey. An intervention group (Cogmed cognitive training) and a control group (standard care management) will compare children aged 5½ to 6 years, born between 24- and 34-weeks' gestational age, with a global intelligence quotient > 70 and a working memory index < 85. The study will include 166 children from national study EPIPAGE-2 (Epidemiological Study on Small Gestational Ages). The intervention consists of 25 sessions administered over a 5- to 8-week period. The primary endpoint will be the visuospatial processing, assessed by the score of the visuospatial index: score of the WPPSI-IV (Wechsler Preschool and Primary Scale of Intelligence). The secondary endpoints will allow to assess the executive functions, language and abilities, infant behavior, quality of life assessment, school performance and parental anxiety. DISCUSSION This project's primary goal is to demonstrate the necessity of early visuospatial memory assessment within the vulnerable population of very preterm children, and to prove the feasibility and efficacy of computerized cognitive training using online software programs. A better global neuropsychological development improvement (visuospatial processing and other far transfer) can be expected with an improvement in learning and decreased behavioral problems. In the long term, these improvements might also reduce those global costs linked to the consequences of extreme prematurity. TRIAL REGISTRATION NCT02757794 (registered on 2nd May 2016 at ClinicalTrial.gov).
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Affiliation(s)
- Catherine Gire
- Department of Neonatology, North Hospital, APHM University Hospital, Marseille, France.,CEReSS - Health Service Research and Quality of Life Center, Faculty of Medicine, Aix-Marseille University, 27 Bd Jean Moulin, 13385, Marseille, cedex 05, France
| | - Any Beltran Anzola
- Department of Neonatology, North Hospital, APHM University Hospital, Marseille, France. .,CEReSS - Health Service Research and Quality of Life Center, Faculty of Medicine, Aix-Marseille University, 27 Bd Jean Moulin, 13385, Marseille, cedex 05, France.
| | - Monique Kaminski
- University of Paris, CRESS, Obstetrical Perinatal and Pediatric Epidemiology Research Team, EPOPé, INSERM, INRAE, F-75004, Paris, France
| | - Karine Baumstarck
- CEReSS - Health Service Research and Quality of Life Center, Faculty of Medicine, Aix-Marseille University, 27 Bd Jean Moulin, 13385, Marseille, cedex 05, France
| | - Pierre-Yves Ancel
- Obstetrical, Perinatal, and Pediatric Epidemiology Team, Center of Research in Epidemiology and Statistics (U1153), Paris University, INSERM, Paris, France.,Clinical Research Unit, Center for Clinical Investigation P1419, CHU Cochin Broca Hôtel-Dieu, Paris, France
| | - Julie Berbis
- CEReSS - Health Service Research and Quality of Life Center, Faculty of Medicine, Aix-Marseille University, 27 Bd Jean Moulin, 13385, Marseille, cedex 05, France
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14
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Del Hoyo Soriano L, Rosser TC, Hamilton DR, Harvey DJ, Abbeduto L, Sherman SL. Relationship between Apgar scores and long-term cognitive outcomes in individuals with Down syndrome. Sci Rep 2021; 11:12707. [PMID: 34135349 PMCID: PMC8208985 DOI: 10.1038/s41598-021-90651-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2020] [Accepted: 05/12/2021] [Indexed: 11/20/2022] Open
Abstract
This study examined the contribution of the Apgar score at 1 and 5 min after birth to later cognitive functioning in 168 individuals with Down syndrome who were between 6 and 25 years of age at time of cognitive testing. Our results showed that a lower Apgar score at 1 min was related to a worse performance in later cognitive measures of receptive vocabulary, verbal comprehension and production, visual memory and working memory. Results also showed that a lower Apgar score at 5 min was only related to worse later outcomes of verbal comprehension and production and auditory working memory. Our findings suggest a need for future studies investigating how specific perinatal events reflected in the Apgar score are linked to later cognitive functioning in individuals with Down syndrome.
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Affiliation(s)
- Laura Del Hoyo Soriano
- Department of Psychiatry and Behavioral Sciences, MIND Institute University of California Davis, Sacramento, CA, USA.
| | - Tracie C Rosser
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Debra R Hamilton
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
| | - Danielle J Harvey
- Department of Psychiatry and Behavioral Sciences, MIND Institute University of California Davis, Sacramento, CA, USA
| | - Leonard Abbeduto
- Department of Psychiatry and Behavioral Sciences, MIND Institute University of California Davis, Sacramento, CA, USA
| | - Stephanie L Sherman
- Department of Human Genetics, Emory University School of Medicine, Atlanta, GA, USA
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15
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Guillot M, Sebastianski M, Lemyre B. Comparative performance of head ultrasound and MRI in detecting preterm brain injury and predicting outcomes: A systematic review. Acta Paediatr 2021; 110:1425-1432. [PMID: 33206399 DOI: 10.1111/apa.15670] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/05/2020] [Accepted: 11/13/2020] [Indexed: 11/28/2022]
Abstract
AIM To systematically review the literature to compare the performance of head ultrasound (HUS) and magnetic resonance imaging (MRI) in their ability to detect brain injury and their predictive value for neurodevelopmental outcomes. METHODS This was a systematic review based on literature search in three electronic databases (MEDLINE, EMBASE, Cochrane Library) and additional sources for studies on routine brain injury screening in preterm neonates published during 2000-May 2020. Studies were included if they reported on the comparative performance of HUS and MRI in detecting preterm brain injury and/or their predictive value for neurodevelopmental outcomes. Findings from the included studies underwent narrative synthesis. RESULTS Forty-six studies were included. In comparison with HUS, MRI detected more anomalies and provided more details on the severity and the extent of preterm brain injury, particularly for white matter injury and cerebellar haemorrhage. Neonatal neuroimaging predicted outcomes with high negative predictive value but relatively low positive predictive value. The prognostic value of neonatal neuroimaging varied according to several factors including modality and timing of imaging, and tools used for grading brain injury. CONCLUSION Compared with HUS, MRI offers a better characterisation of preterm brain injury and may enhance the ability to predict neurodevelopmental outcomes.
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Affiliation(s)
- Mireille Guillot
- Department of Pediatrics (Neurology) University of Toronto and the Hospital for Sick Children Toronto Ontario Canada
- Department of Pediatrics (Neonatology) Université Laval and Centre Hospitalier Universitaire de Québec Québec City Québec Canada
| | - Meghan Sebastianski
- Alberta Strategy for Patient‐Oriented Research (SPOR) SUPPORT Unit Knowledge Translation Platform University of Alberta Edmonton Alberta Canada
| | - Brigitte Lemyre
- Department of Pediatrics (Neonatology) University of Ottawa and the Children’s Hospital of Eastern Ontario Ottawa Ontario Canada
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16
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Pawełczyk A, Łojek E, Żurner N, Gawłowska-Sawosz M, Gębski P, Pawełczyk T. The correlation between white matter integrity and pragmatic language processing in first episode schizophrenia. Brain Imaging Behav 2021; 15:1068-1084. [PMID: 32710335 PMCID: PMC8032571 DOI: 10.1007/s11682-020-00314-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Objective: Higher-order language disturbances could be the result of white matter tract abnormalities. The study explores the relationship between white matter and pragmatic skills in first-episode schizophrenia. Methods: Thirty-four first-episode patients with schizophrenia and 32 healthy subjects participated in a pragmatic language and Diffusion Tensor Imaging study, where fractional anisotropy of the arcuate fasciculus, corpus callosum and cingulum was correlated with the Polish version of the Right Hemisphere Language Battery. Results: The patients showed reduced fractional anisotropy in the right arcuate fasciculus, left anterior cingulum bundle and left forceps minor. Among the first episode patients, reduced understanding of written metaphors correlated with reduced fractional anisotropy of left forceps minor, and greater explanation of written and picture metaphors correlated with reduced fractional anisotropy of the left anterior cingulum. Conclusions: The white matter dysfunctions may underlie the pragmatic language impairment in schizophrenia. Our results shed further light on the functional neuroanatomical basis of pragmatic language use by patients with schizophrenia.
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Affiliation(s)
- Agnieszka Pawełczyk
- Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland.
| | | | - Natalia Żurner
- Adolescent Ward, Central Clinical Hospital of Medical University of Łódź, Łódź, Poland
| | | | - Piotr Gębski
- Scanlab Diagnostyka Medyczna Księży Młyn, Medical Examination Centre, Medical University of Łódź, Łódź, Poland
| | - Tomasz Pawełczyk
- Department of Affective and Psychotic Disorders, Medical University of Łódź, Łódź, Poland
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17
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Heikkinen M, Kallankari H, Partanen L, Korkalainen N, Kaukola T, Yliherva A. Children born before 32 weeks of gestation displayed impaired reading fluency, comprehension and spelling skills at 9 years of age. Acta Paediatr 2021; 110:521-527. [PMID: 32609898 DOI: 10.1111/apa.15456] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Revised: 06/16/2020] [Accepted: 06/25/2020] [Indexed: 12/01/2022]
Abstract
AIM Our aim was to study whether prematurity, associated with prenatal and neonatal risk factors, affects specific literacy skills among school children born at a very low gestational age (VLGA) of <32 weeks. METHODS The study group comprised 76 prospectively followed VLGA children born between November 1998 and November 2002 at Oulu University Hospital, Finland, and 51 term controls. The median gestational age of the VLGA children was 29.0 (24.1-31.9) weeks. All children were examined at a median age of 8.9 (8.0-9.9) years in Oulu between November 2007 and November 2011. Reading fluency, comprehension and spelling skills were evaluated using standardised tests for Finnish-speaking children. RESULTS Very low gestational age children had significantly poorer test results in reading comprehension (median 6.9 vs 8.3, P = .014) and spelling (median 35.7 vs 38.0, P = .013) than term children. Furthermore, VLGA children more often performed below the 10th percentile normal values in spelling (P = .012) compared with term controls. Foetal growth restriction was associated with lower scoring in reading fluency (P = .023) and spelling (P = .004) among VLGA children. CONCLUSION Very low gestational age school children performed poorer in reading comprehension and spelling than term children. In addition, poor foetal growth in VLGA children was associated with literacy problems.
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Affiliation(s)
- Minna Heikkinen
- Faculty of Humanities Child Language Research Center University of Oulu Oulu Finland
| | - Hanna Kallankari
- PEDEGO Research Unit and Medical Research Center Oulu University of Oulu Oulu Finland
- Department of Child Neurology Oulu University Hospital Oulu Finland
| | - Lea Partanen
- Faculty of Humanities Child Language Research Center University of Oulu Oulu Finland
| | - Noora Korkalainen
- PEDEGO Research Unit and Medical Research Center Oulu University of Oulu Oulu Finland
| | - Tuula Kaukola
- PEDEGO Research Unit and Medical Research Center Oulu University of Oulu Oulu Finland
- Department of Neonatology Oulu University Hospital Oulu Finland
| | - Anneli Yliherva
- Faculty of Humanities Child Language Research Center University of Oulu Oulu Finland
- Logopedics, Faculty of Social Sciences University of Tampere Tampere Finland
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18
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Panceri C, Valentini NC, Silveira RC, Smith BA, Procianoy RS. Neonatal Adverse Outcomes, Neonatal Birth Risks, and Socioeconomic Status: Combined Influence on Preterm Infants' Cognitive, Language, and Motor Development in Brazil. J Child Neurol 2020; 35:989-998. [PMID: 32787744 DOI: 10.1177/0883073820946206] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND This study extended previous research by investigating the combined effects of neonatal birth risks, neonatal adverse outcomes, and socioeconomic status on preterm neurodevelopment. METHOD A total of 184 preterm infants were assessed using the Bayley Scales of Infant Development III in a follow-up clinic in southern Brazil. Structural equation modeling was conducted with 3 latent variables (neonatal birth risks, neonatal adverse outcomes, and socioeconomic status) and 3 outcomes (cognitive, language, and motor development). RESULTS The analyses showed that neonatal adverse outcomes were associated with infants' cognitive (b = -0.45, P < .001), language (b = -0.23, P = .001), and motor (b = -0.51, P < .001) development. Socioeconomic status also explained the variances (cognitive: b = 0.20, P = .006; language: b = 0.28, P = .001; and motor: b = 0.21, P = .004), whereas neonatal birth risks remained significant only in the motor development (b = 0.15, P = .040). CONCLUSION This study suggests that the most evident contributors to poor neurodevelopment were adverse outcomes and socioeconomic risk factors.
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Affiliation(s)
| | | | - Rita C Silveira
- 28124Universidade Federal do Rio Grande do Sul (UFRGS), Brazil.,37895Hospital de Clínicas de Porto Alegre, Brazil
| | - Beth A Smith
- 5116University of Southern California, CA, USA.,Children's Hospital Los Angeles, CA, USA
| | - Renato S Procianoy
- 28124Universidade Federal do Rio Grande do Sul (UFRGS), Brazil.,37895Hospital de Clínicas de Porto Alegre, Brazil
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19
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Oosterom L, Bogičević L, Verhoeven M, van Baar AL. Parenting Behavior at 18 Months Predicts Internalizing and Externalizing Problems at 6 Years in Moderately Preterm and Full Term Children. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228679. [PMID: 33238382 PMCID: PMC7700126 DOI: 10.3390/ijerph17228679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 11/14/2020] [Accepted: 11/20/2020] [Indexed: 11/24/2022]
Abstract
Moderately preterm born children (MPT) are at increased risk for behavior problems compared to full term born (FT) children. MPT children may receive less optimal parenting, and in response, may develop behavior problems. Our aims were to examine whether parenting behavior and mother–child interaction quality mediate the association between birth status and child behavior problems. Participants were 120 MPT children and 100 FT children. At 18 months of age, mothers reported on their parenting behavior (support and structure), and mother–child interaction (sensitivity and limit-setting) was observed. At 6 years of age, mothers reported on children’s behavior problems. Using structural equation modeling, birth status was found to predict attention problems, but not internalizing and externalizing problems. Mothers of MPT children set less appropriate limits than mothers of FT children at 18 months of age. More maternal structure at 18 months predicted fewer internalizing and externalizing problems, but not attention problems, at 6 years. These associations between parenting behavior, mother–child interaction quality, and child behavior problems were similar for MPT and FT children. Our findings indicate that maternal structure in toddlerhood is an important predictor of later internalizing and externalizing problems for both MPT and FT children.
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20
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White matter injury and neurodevelopmental disabilities: A cross-disease (dis)connection. Prog Neurobiol 2020; 193:101845. [PMID: 32505757 DOI: 10.1016/j.pneurobio.2020.101845] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Revised: 05/19/2020] [Accepted: 06/01/2020] [Indexed: 12/13/2022]
Abstract
White matter (WM) injury, once known primarily in preterm newborns, is emerging in its non-focal (diffused), non-necrotic form as a critical component of subtle brain injuries in many early-life diseases like prematurity, intrauterine growth restriction, congenital heart defects, and hypoxic-ischemic encephalopathy. While advances in medical techniques have reduced the number of severe outcomes, the incidence of tardive impairments in complex cognitive functions or psychopathology remains high, with lifelong detrimental effects. The importance of WM in coordinating neuronal assemblies firing and neural groups synchronizing within multiple frequency bands through myelination, even mild alterations in WM structure, may interfere with the cognitive performance that increasing social and learning demands would exploit tardively during children growth. This phenomenon may contribute to explaining longitudinally the high incidence of late-appearing impairments that affect children with a history of perinatal insults. Furthermore, WM abnormalities have been highlighted in several neuropsychiatric disorders, such as autism and schizophrenia. In this review, we gather and organize evidence on how diffused WM injuries contribute to neurodevelopmental disorders through different perinatal diseases and insults. An insight into a possible common, cross-disease, mechanism, neuroimaging and monitoring, biomarkers, and neuroprotective strategies will also be presented.
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21
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Neri E, Genova F, Monti F, Trombini E, Biasini A, Stella M, Agostini F. Developmental Dimensions in Preterm Infants During the 1st Year of Life: The Influence of Severity of Prematurity and Maternal Generalized Anxiety. Front Psychol 2020; 11:455. [PMID: 32292365 PMCID: PMC7119226 DOI: 10.3389/fpsyg.2020.00455] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/26/2020] [Indexed: 01/16/2023] Open
Abstract
BACKGROUND The literature has recognized premature birth as a risk factor for infant development and maternal anxiety. This study investigated the impact of the severity of birth weight, as well as of maternal anxiety at 3 months of infants' corrected age, on infants' outcomes during the 1st year postpartum. Moreover, it described the longitudinal trajectories of developmental outcomes, additionally exploring the impact of anxiety. METHODS The study compared 147 mothers and their 147 newborns, differentiated in 25 Extremely Low Birth Weight (ELBW), 41 Very Low Birth Weight (VLBW), and 81 Full-Term (FT) infants. At 3, 9, and 12 months (corrected age in the case of preterm infants) the level of infants' development was investigated according to the 5 quotients (Locomotor, Personal and Social, Hearing and Language, Eye-hand Co-ordination and Performance) of the Griffiths Mental Development Scales (GMDS-R). During the assessment of 3 months, mothers fulfilled Penn State Worry Questionnaire (PSWQ) to evaluate the presence of generalized anxiety. RESULTS Among the 5 GMDS-R quotients, significant effect of severity of birth weight emerged only for Performance quotient: preterm infants (ELBW at 3 months; VLBW at 12 months) showed lower scores than FT ones. Moreover, this quotient decreased from 3 to 9 and to 12 months for VLBW and FT infants, while it was stable for ELBW ones. A significant interaction between severity of birth weight and maternal anxiety emerged for Hearing and Language and Locomotor quotients. In the first case, scores for ELBW infants, independently from maternal anxiety, decreased from 9 to 12 months. The same results emerged for VLBW infants, in the case of non-anxious mothers. Regarding Locomotor quotient, mean scores decreased from 3 to 9 and to 12 months for all groups in the case of non-anxious mothers. Conversely, when mothers were anxious, this decrease emerged only for VLBW infants. Lastly, ELBW, VLBW and FT showed difference in the growth and slope of the trajectories of different quotients. CONCLUSION The severity of birth weight for preterm infants, also in interaction with maternal anxiety, had significant and specific impact on different dimensions of infants' development. Clinical implications of these results underline the need for individualized interventions.
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Affiliation(s)
- Erica Neri
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Federica Genova
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Fiorella Monti
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Elena Trombini
- Department of Psychology, University of Bologna, Bologna, Italy
| | - Augusto Biasini
- Donor Human Milk Bank Italian Association (AIBLUD), Milan, Italy
| | - Marcello Stella
- Paediatric and Neonatal Intensive Care Unit, Maurizio Bufalini Hospital, Cesena, Italy
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22
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Nascimento GB, Kessler TM, Souza APRD, Costa I, Moraes ABD. Risk indicators for hearing loss and language acquisition and their relationship with socioeconomic, demographic and obstetric variables in preterm and term babies. Codas 2020; 32:e20180278. [PMID: 32049152 DOI: 10.1590/2317-1782/20192018278] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2018] [Accepted: 05/05/2019] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To compare the frequency of risk indicators in preterm and full-term babies; to analyze the possible relationships among the presence of risk for hearing loss with language acquisition and socioeconomic, demographic and obstetric variables. METHODS This is a longitudinal cohort study, with a sample of 87 babies. Gestational, obstetric and sociodemographic data were collected from mothers and babies. The socioeconomic classification status of the families were classified using the Brazilian Criteria for Economic Classification. The risk for language was assessed using the Language Acquisition Enunciation Signs and the Denver II test. The data were analyzed using the STATISTICA 9.1 software, using the chi-square and the Mann-Whitney U tests and simple and multiple linear regression models. RESULTS Permanence in a neonatal intensive care (65.52%), ototoxic (48.28%), mechanical ventilation (39.66%) and hyperbilirubinemia (46.55%) were the more frequent risk indicators in the sample. Regarding socioeconomic, demographic and obstetric factors, there was a correlation among prenatal care, gestational age, birth weight, feeding with hearing risk. Acquisition and development of language showed statistical significance with varicella, HIV, Apgar score and birth weight >1500 grams. CONCLUSION Preterm babies showed higher frequency of risk indicators compared to full-term babies. Among environmental factors, prenatal care, which interferes in the outcome of gestational age, birth weight, Apgar score and presence of infectious diseases, as well as feeding, emerged as significant factors related to hearing and language acquisition. Prematurity was the relevant biological factor related to hearing and language risk.
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Affiliation(s)
| | | | | | - Inaê Costa
- Universidade Federal de Santa Maria - UFSM - Santa Maria (RS), Brasil
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23
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Wallois F, Routier L, Bourel-Ponchel E. Impact of prematurity on neurodevelopment. HANDBOOK OF CLINICAL NEUROLOGY 2020; 173:341-375. [PMID: 32958184 DOI: 10.1016/b978-0-444-64150-2.00026-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The consequences of prematurity on brain functional development are numerous and diverse, and impact all brain functions at different levels. Prematurity occurs between 22 and 36 weeks of gestation. This period is marked by extreme dynamics in the physiologic maturation, structural, and functional processes. These different processes appear sequentially or simultaneously. They are dependent on genetic and/or environmental factors. Disturbance of these processes or of the fine-tuning between them, when caring for premature children, is likely to induce disturbances in the structural and functional development of the immature neural networks. These will appear as impairments in learning skills progress and are likely to have a lasting impact on the development of children born prematurely. The level of severity depends on the initial alteration, whether structural or functional. In this chapter, after having briefly reviewed the neurodevelopmental, structural, and functional processes, we describe, in a nonexhaustive manner, the impact of prematurity on the different brain, motor, sensory, and cognitive functions.
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Affiliation(s)
- Fabrice Wallois
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France.
| | - Laura Routier
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France
| | - Emilie Bourel-Ponchel
- Research Group on Multimodal Analysis of Brain Function, Jules Verne Picardie University, Amiens, France; Department of Pediatric Functional Exploration of the Nervous System, University Hospital, Picardie, Amiens, France
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24
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De Stefano P, Marchignoli M, Pisani F, Cossu G. Uneven Linguistic Outcome in Extremely Preterm Children. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2019; 48:1363-1375. [PMID: 31407217 DOI: 10.1007/s10936-019-09662-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
One primary problem in extremely preterm children is the occurrence of atypical language development. The aim of this study was to explore the components of language (articulatory phonetics, lexicon and syntax) in comprehension and production in extremely preterm children between the 4th and 5th year of age. The language section of the Preschool Neuropsychological Test was administered to 20 extremely preterm monolingual Italian children (GA < 28 weeks) and to a control sample of 40 full term children (GA > 37 weeks), matched for age and non-verbal IQ. Language comprehension was fully efficient in all of the components that we assessed. In the tasks of language production the clinical sample fared much worse than their age and IQ matched controls and the differences were highly significant (p < .001). Language acquisition in extremely preterm children may follow uneven developmental trajectories: language comprehension can be spared in the face of a selective impairment of language production at the level of articulatory phonetics and syntax.
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Affiliation(s)
- P De Stefano
- Physiology Unit, Department of Neuroscience, University of Parma, Parma, Italy.
- Neurology Unit, University Hospitals of Geneva (HUG), Geneva, Switzerland.
| | - M Marchignoli
- Child Neuropsychiatry Unit, Medicine and Surgery Department, University of Parma, Parma, Italy
- Child Neuropsychiatry Unit, AUSL Parma, Sud-East District, Fidenza, Italy
| | - F Pisani
- Child Neuropsychiatry Unit, Medicine and Surgery Department, University of Parma, Parma, Italy
| | - G Cossu
- Physiology Unit, Department of Neuroscience, University of Parma, Parma, Italy
- Child Neuropsychiatry Unit, Medicine and Surgery Department, University of Parma, Parma, Italy
- Unit of Cognitive Neurorehabilitation for Children, Phoniatric Medical Center, Padua, Italy
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25
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Language Skills in Children Born Preterm (<30 Wks' Gestation) Throughout Childhood: Associations With Biological and Socioenvironmental Factors. J Dev Behav Pediatr 2019; 40:735-742. [PMID: 31613841 DOI: 10.1097/dbp.0000000000000742] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVE To examine the individual and collective contribution of biological and socioenvironmental factors associated with language function at 2, 5, 7, and 13 years in children born preterm (<30 weeks' gestation or <1250 g birth weight). METHODS Language function was assessed as part of a prospective longitudinal study of 224 children born preterm at 2, 5, 7, and 13 years using age-appropriate tools. Language Z-scores were generated based on a contemporaneous term-born control group. A selection of biological factors (sex, small for gestational age, bronchopulmonary dysplasia, infection, and qualitatively defined brain injury) and early socioenvironmental factors at age 2 years (primary income earner employment status and type, primary caregiver education level, English as a second language, parental mental health history, parent sensitivity and facilitation, and parent-child synchrony) was chosen a priori. Associations were assessed using univariable and multivariable linear regression models applied to outcomes at each time point. RESULTS Higher primary caregiver education level, greater parent-child synchrony, and parent sensitivity were independently associated with better language function across childhood. Socioenvironmental factors together explained an increasing percentage of the variance (9%-18%) in language function from 2 to 13 years of age. In comparison, there was little evidence for associations between biological factors and language function, even during early childhood years. CONCLUSION This study highlights the importance of socioenvironmental factors over biological factors for language development throughout childhood. Some of these socioenvironmental factors are potentially modifiable, and parent-based interventions addressing parenting practices and education may benefit preterm children's language development.
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26
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Bartha-Doering L, Alexopoulos J, Giordano V, Stelzer L, Kainz T, Benavides-Varela S, Wartenburger I, Klebermass-Schrehof K, Olischar M, Seidl R, Berger A. Absence of neural speech discrimination in preterm infants at term-equivalent age. Dev Cogn Neurosci 2019; 39:100679. [PMID: 31437736 PMCID: PMC6969359 DOI: 10.1016/j.dcn.2019.100679] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 04/29/2019] [Accepted: 07/01/2019] [Indexed: 02/08/2023] Open
Abstract
Children born preterm are at higher risk to develop language deficits. Auditory speech discrimination deficits may be early signs for language developmental problems. The present study used functional near-infrared spectroscopy to investigate neural speech discrimination in 15 preterm infants at term-equivalent age compared to 15 full term neonates. The full term group revealed a significantly greater hemodynamic response to forward compared to backward speech within the left hemisphere extending from superior temporal to inferior parietal and middle and inferior frontal areas. In contrast, the preterm group did not show differences in their hemodynamic responses during forward versus backward speech, thus, they did not discriminate speech from non-speech. Groups differed significantly in their responses to forward speech, whereas they did not differ in their responses to backward speech. The significant differences between groups point to an altered development of the functional network underlying language acquisition in preterm infants as early as in term-equivalent age.
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Affiliation(s)
- Lisa Bartha-Doering
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria; Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria.
| | - Johanna Alexopoulos
- Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria; Department of Psychoanalysis and Psychotherapy, Medical University Vienna, Vienna, Austria
| | - Vito Giordano
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria; Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Lisa Stelzer
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria; Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Theresa Kainz
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria; Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Silvia Benavides-Varela
- Department of Developmental Psychology and Socialization, University of Padova, Padova, Italy
| | - Isabell Wartenburger
- Cognitive Sciences, Department of Linguistics, University of Potsdam, Potsdam, Germany
| | - Katrin Klebermass-Schrehof
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria; Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Monika Olischar
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria; Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Rainer Seidl
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria; Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
| | - Angelika Berger
- Department of Pediatrics and Adolescent Medicine, Medical University Vienna, Vienna, Austria; Comprehensive Center for Pediatrics, Medical University of Vienna, Vienna, Austria
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27
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Moran MM, Gunn-Charlton JK, Walsh JM, Cheong JLY, Anderson PJ, Doyle LW, Greaves S, Hunt RW. Associations of Neonatal Noncardiac Surgery with Brain Structure and Neurodevelopment: A Prospective Case-Control Study. J Pediatr 2019; 212:93-101.e2. [PMID: 31235385 DOI: 10.1016/j.jpeds.2019.05.050] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Revised: 04/18/2019] [Accepted: 05/20/2019] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To examine the associations of neonatal noncardiac surgery with newborn brain structure and neurodevelopment at 2 years of age. STUDY DESIGN Infants requiring neonatal noncardiac surgery for congenital diaphragmatic hernia, esophageal atresia, or anterior abdominal wall defect were compared with infants who did not require surgery, matched for sex, gestation at birth, and postmenstrual age at magnetic resonance imaging. Cerebral magnetic resonance imaging was performed at a mean (SD) postmenstrual age of 41.6 (1.7) weeks. Images were assessed qualitatively for brain maturation and injury and quantitatively for measures of brain size, cerebrospinal fluid spaces, and global abnormality. Neurodevelopment was then assessed at 2 years using the Bayley Scales of Infant and Toddler Development, 3rd edition. RESULTS Infants requiring surgery (n = 39) were 5.9 times (95% CI, 1.9-19.5; P < .01) more likely to have delayed gyral maturation and 9.8 times (95% CI, 1.2-446; P = .01) more likely to have white matter signal abnormalities compared with controls (n = 39). Cases were more likely to have higher global abnormality scores, smaller biparietal diameters, and larger ventricular sizes than controls. Infants who had surgery had lower mean composite scores in the language (mean difference, -12.5; 95% CI, -22.4 to -2.7) and motor domains (mean difference, -13.4; 95% CI, -21.1 to -5.6) compared with controls. CONCLUSIONS Infants requiring neonatal noncardiac surgery have smaller brains with more abnormalities compared with matched controls and have associated neurodevelopmental impairment at 2 years of age. Prospective studies with preoperative and postoperative imaging would assist in determining the timing of brain injury.
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Affiliation(s)
- Margaret M Moran
- Department of Neonatology, Children's University Hospital, Dublin, Ireland; Department of Neonatology, The Rotunda Hospital, Dublin, Ireland; Department of Pediatrics, University of Melbourne, Melbourne, Australia
| | - Julia K Gunn-Charlton
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Neonatal Medicine, The Royal Children's Hospital, Melbourne, Australia; Newborn Services, The Royal Women's Hospital, Melbourne, Australia
| | - Jennifer M Walsh
- Newborn Services, The Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynecology, The University of Melbourne, Melbourne, Australia
| | - Jeanie L Y Cheong
- Newborn Services, The Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynecology, The University of Melbourne, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Peter J Anderson
- Newborn Services, The Royal Women's Hospital, Melbourne, Australia; Turner Institute of Brain and Mental Health, Monash University, Melbourne, Australia
| | - Lex W Doyle
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Newborn Services, The Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynecology, The University of Melbourne, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Susan Greaves
- Department of Occupational Therapy, The Royal Children's Hospital, Melbourne, Australia
| | - Rod W Hunt
- Department of Pediatrics, University of Melbourne, Melbourne, Australia; Neonatal Medicine, The Royal Children's Hospital, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
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Sanchez K, Spittle AJ, Cheong JL, Thompson DK, Doyle LW, Anderson PJ, Morgan AT. Language in 2-year-old children born preterm and term: a cohort study. Arch Dis Child 2019; 104:647-652. [PMID: 30470685 DOI: 10.1136/archdischild-2018-315843] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2018] [Revised: 09/26/2018] [Accepted: 11/06/2018] [Indexed: 11/03/2022]
Abstract
PURPOSE Language skills are critical. Children born very preterm are vulnerable to language problems, but further work is needed to determine characteristics and specific predictors of language problems in this population. We aimed to compare language outcomes between 2-year-old children born <30 weeks and their term-born peers; and to explore risk factors for language difficulties in this cohort. DESIGN Language at 2 years was examined in 134 children born <30 weeks and 133 children born at term using the Bayley Scales of Infant and Toddler Development - 3rd Edition (Bayley-3) and the Communication and Symbolic Behaviour Scale: Developmental Profile (Infant Toddler Checklist) (CSBS:DP). Outcomes were compared between groups. Factors hypothesised to predict language outcome were examined in the preterm group: gestational age at birth, birth weight z-score, sex, hearing loss, multilingualism, maternal education, brain abnormality on MRI, medical risk and oromotor concerns at 12 months. RESULTS Children born <30 weeks performed more poorly on the CSBS:DP (particularly the social and symbolic composites) and the language scale of the Bayley-3 at 2 years than term-born peers. Lower gestational age at birth, male sex, hearing loss and multilingualism predicted poorer language scores. CONCLUSIONS Despite improvements in medical management, children born very preterm exhibit language delays at 2 years of age, with specific deficits in social communication and symbolic skills. Significant predictors of poorer language outcomes were similar to those in the general population (male sex, hearing loss, multilingualism), suggesting that further work is needed to establish which specific factors place preterm-born children at heightened risk.
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Affiliation(s)
- Katherine Sanchez
- Victorian Infant Brain Study, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Speech and Language, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Audiology and Speech Pathology, University of Melbourne, Parkville, Victoria, Australia
| | - Alicia J Spittle
- Victorian Infant Brain Study, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Physiotherapy, University of Melbourne, Parkville, Victoria, Australia.,Newborn Research, The Royal Women's Hospital, Parkville, Victoria, Australia
| | - Jeanie Ly Cheong
- Victorian Infant Brain Study, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Newborn Research, The Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Obstetrics and Gynecology, University of Melbourne, Parkville, Victoria, Australia
| | - Deanne K Thompson
- Victorian Infant Brain Study, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Obstetrics and Gynecology, University of Melbourne, Parkville, Victoria, Australia.,Neuroimaging and Neuroinformatics, Florey Institute of Neuroscience and Mental Health, Parkville, Victoria, Australia
| | - Lex W Doyle
- Victorian Infant Brain Study, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Newborn Research, The Royal Women's Hospital, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia
| | - Peter J Anderson
- Victorian Infant Brain Study, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Paediatrics, University of Melbourne, Parkville, Victoria, Australia.,Monash Institute of Cognitive and Clinical Neuroscience, Monash University, Clayton, Victoria, Australia
| | - Angela T Morgan
- Speech and Language, Murdoch Children's Research Institute, Parkville, Victoria, Australia.,Department of Audiology and Speech Pathology, University of Melbourne, Parkville, Victoria, Australia.,Department of Speech Pathology, the Royal Children's Hospital, Parkville, Victoria, Australia
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29
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Álvarez-Bueno C, Cavero-Redondo I, Díez-Fernández A, Pardo-Guijarro MJ, Sánchez-López M, Martínez-Vizcaíno V. Cardiorespiratory fitness as a mediator of the relationship between birth weight and cognition in school children. Psychol Res Behav Manag 2019; 12:255-262. [PMID: 31114408 PMCID: PMC6497506 DOI: 10.2147/prbm.s197945] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2018] [Accepted: 02/21/2019] [Indexed: 01/03/2023] Open
Abstract
Objectives: To examine differences in cognition parameters by birth weight categories and to analyze whether the relationships between birth weight and cognitive functions are mediated by cardiorespiratory fitness (CRF) in schoolchildren. Methods: A cross-sectional study using a sample of 664 school children from the MOVI-Kids study. Variables: i) cognitive function measured by the Battery of General and Differential Aptitudes (BADyG); ii) birth weight, reported by parents; and iii) CRF (20-m shuttle run test). ANCOVA models were estimated to assess differences in cognitive function categories across birth weight and CRF categories. Mediation analysis was conducted with Hayes' PROCESS macro. Results: CRF is a full mediator of the association between birth weight with the verbal and numerical factors, and general intelligence; and is a partial mediator when logical reasoning and the spatial factor were the dependent variables. The available data suggest that, in schoolchildren, the influence of birth weight on cognitive function is mediated by CRF. Conclusions: These findings highlight that children with lower birth weight values and lower fitness levels should be target subgroups to improve children's cognition, in which long-life physical activity interventions at early ages are a priority.
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Affiliation(s)
- Celia Álvarez-Bueno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Castilla-La Mancha, Spain
| | - Iván Cavero-Redondo
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Castilla-La Mancha, Spain
| | - Ana Díez-Fernández
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Castilla-La Mancha, Spain
| | - Maria Jesús Pardo-Guijarro
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Castilla-La Mancha, Spain.,School of Education, Universidad de Castilla-La Mancha, Cuenca, Castilla-La Mancha, Spain
| | - Mairena Sánchez-López
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Castilla-La Mancha, Spain.,School of Education, Universidad de Castilla-La Mancha, Ciudad Real, Castilla-La Mancha, Spain
| | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Castilla-La Mancha, Spain.,Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
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30
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McNally S, McCrory C, Quigley J, Murray A. Decomposing the social gradient in children's vocabulary skills at 3 years of age: A mediation analysis using data from a large representative cohort study. Infant Behav Dev 2019; 57:101326. [PMID: 31125856 DOI: 10.1016/j.infbeh.2019.04.008] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2018] [Revised: 04/18/2019] [Accepted: 04/22/2019] [Indexed: 12/30/2022]
Abstract
Disparities in children's expressive language by socio-economic status are evident early in childhood and impact children's development and educational attainment. This study investigated the processes by which maternal education, as a powerful indicator for socio-economic status, affects early expressive language. A nationally representative cohort study of 8,062 children resident in the Republic of Ireland were assessed on the British Ability Scales (BAS) Naming Vocabulary Test at 36 months. A significant difference of almost six points was found between the mean vocabulary test scores of children whose mothers had completed the minimum level of educational attainment compared with children whose mothers had a degree-level qualification. Mediation analysis revealed that 78% of the difference was explained by mediating variables, with differences in household income, parental practice, and material resources accounting for most of the variation. The findings support interventions which redress gaps in maternal education, income, and caregiving.
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Affiliation(s)
- Sinéad McNally
- Institute of Education, Dublin City University, Ireland.
| | - Cathal McCrory
- The Irish Longitudinal Study on Ageing, Department of Medical Gerontology, Trinity College Dublin, Ireland.
| | - Jean Quigley
- School of Psychology, Trinity College Dublin, Ireland.
| | - Aisling Murray
- Economic and Social Research Institute, Dublin, Ireland.
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31
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Language in Preterm Born Children: Atypical Development and Effects of Early Interventions on Neuroplasticity. Neural Plast 2019; 2019:6873270. [PMID: 30930944 PMCID: PMC6410465 DOI: 10.1155/2019/6873270] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 12/23/2018] [Indexed: 01/28/2023] Open
Abstract
Predicting language performances after preterm birth is challenging. It is described in the literature that early exposure to the extrauterine environment can be either detrimental or advantageous for neurodevelopment. However, the emphasis mostly lies on the fact that preterm birth may have an unfavorable effect on numerous aspects of development such as cognition, language, and behavior. Various studies reported atypical language development in preterm born children in the preschool years but also in school-aged children and adolescents. This review gives an overview of the course of language development and examines how prematurity can lead to atypical linguistic performances. In this paper, we mainly focus on environmental and neurophysiological factors influencing preterm infant neuroplasticity with potential short- and long-term effects on language development. Further research, however, should focus on examining the possible benefits that early exposure might entail.
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32
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Resch M, Bresele S, Kager K, Pupp Peglow U, Griesmaier E, Kiechl-Kohlendorfer U. Predictors for delayed linguistic skills in very preterm infants. J Neonatal Perinatal Med 2019; 12:465-472. [PMID: 31561396 DOI: 10.3233/npm-1838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
BACKGROUND Preterm-born children are at higher risk for impaired linguistic abilities than are their term-born peers. The aim of the current study was to determine early predictors for delayed linguistic skills in very preterm-born preschool children. METHODS Between January 2005 and November 2010 all very preterm infants born at < 32 weeks gestation in Tyrol were prospectively enrolled (n = 421); 248 of them had a detailed examination at the age of five years including cognitive assessment (Wechsler Preschool and Primary Scale of Intelligence, third edition (WPPSI-III) or Snijders-Oomen Nonverbal Intelligence Tests (SON-R)) as well as a screening test for language skills (Bielefelder screening for early diagnosis of reading problems and weak spelling (BISC)). The association between pre-and postnatal factors and poor performance on the BISC assessment was analyzed by means of logistic regression analysis. RESULTS Of the 248 children 79 (31.8%) showed delayed literacy precursor skills. Male sex, gestational age, retinopathy of prematurity (ROP) grades 3-4 and low maternal education were predictive for delayed linguistic skills at 5 years of age in the multivariate analysis. CONCLUSION This study identified predictors for delayed literacy precursor skills. These data support the finding that in very preterm infants pre-and perinatal as well as sociodemographic factors account for linguistic skills in the preschool period.
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Affiliation(s)
- M Resch
- Department of Pediatrics, Division of Neonatology, Medical University of Innsbruck, Innsbruck, Austria
| | - S Bresele
- Department of Pediatrics, Division of Neonatology, Medical University of Innsbruck, Innsbruck, Austria
| | - K Kager
- Department of Pediatrics, Division of Neonatology, Medical University of Innsbruck, Innsbruck, Austria
| | - U Pupp Peglow
- Department of Pediatrics, Division of Neonatology, Medical University of Innsbruck, Innsbruck, Austria
| | - E Griesmaier
- Department of Pediatrics, Division of Neonatology, Medical University of Innsbruck, Innsbruck, Austria
| | - U Kiechl-Kohlendorfer
- Department of Pediatrics, Division of Neonatology, Medical University of Innsbruck, Innsbruck, Austria
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Souza ACFDSE, Casais-e-Silva LL, Sena EPD. The influence of prematurity on the development of phonological skills. REVISTA CEFAC 2019. [DOI: 10.1590/1982-0216/201921413118] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
ABSTRACT Purpose: to check the use of phonological processes in preterm infants. Methods: phonological evaluation was performed through the ABFW Child Language Test in 40 children, aged two to four years, i.e., 20 preterm and 20 full-term children, matched according to age, gender and socioeconomic level. Preterm children were evaluated at the State Center for Prevention and Rehabilitation of People with Disabilities - CEPRED; full-term children were selected and evaluated in a municipal nursery in the city of Salvador, BA, Brazil. The pertinent statistical tests were applied adopting the level of significance lower than 0.05%. Results: in the phonology test, the number of productive phonological processes not expected for the chronological age was statistically significant in the preterm group, especially syllable reduction, consonantal harmony, velar backing and liquid reduction. The high prevalence of cluster reduction and final consonant deletion, though still compatible with chronological age, shows the need to follow up the language acquisition of these children, after the age of four. Conclusion: the results evidenced the difficulty found by preterm infants in the development of phonological skills, emphasizing the importance of early diagnosis and speech-language monitoring in language acquisition.
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34
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Rogers CE, Lean RE, Wheelock MD, Smyser CD. Aberrant structural and functional connectivity and neurodevelopmental impairment in preterm children. J Neurodev Disord 2018; 10:38. [PMID: 30541449 PMCID: PMC6291944 DOI: 10.1186/s11689-018-9253-x] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2017] [Accepted: 11/14/2018] [Indexed: 12/15/2022] Open
Abstract
Background Despite advances in antenatal and neonatal care, preterm birth remains a leading cause of neurological disabilities in children. Infants born prematurely, particularly those delivered at the earliest gestational ages, commonly demonstrate increased rates of impairment across multiple neurodevelopmental domains. Indeed, the current literature establishes that preterm birth is a leading risk factor for cerebral palsy, is associated with executive function deficits, increases risk for impaired receptive and expressive language skills, and is linked with higher rates of co-occurring attention deficit hyperactivity disorder, anxiety, and autism spectrum disorders. These same infants also demonstrate elevated rates of aberrant cerebral structural and functional connectivity, with persistent changes evident across advanced magnetic resonance imaging modalities as early as the neonatal period. Emerging findings from cross-sectional and longitudinal investigations increasingly suggest that aberrant connectivity within key functional networks and white matter tracts may underlie the neurodevelopmental impairments common in this population. Main body This review begins by highlighting the elevated rates of neurodevelopmental disorders across domains in this clinical population, describes the patterns of aberrant structural and functional connectivity common in prematurely-born infants and children, and then reviews the increasingly established body of literature delineating the relationship between these brain abnormalities and adverse neurodevelopmental outcomes. We also detail important, typically understudied, clinical, and social variables that may influence these relationships among preterm children, including heritability and psychosocial risks. Conclusion Future work in this domain should continue to leverage longitudinal evaluations of preterm infants which include both neuroimaging and detailed serial neurodevelopmental assessments to further characterize relationships between imaging measures and impairment, information necessary for advancing our understanding of modifiable risk factors underlying these disorders and best practices for improving neurodevelopmental trajectories in this high-risk clinical population.
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Affiliation(s)
- Cynthia E Rogers
- Departments of Psychiatry and Pediatrics, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8504, St. Louis, MO, 63110, USA.
| | - Rachel E Lean
- Departments of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8504, St. Louis, MO, 63110, USA
| | - Muriah D Wheelock
- Departments of Psychiatry, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8504, St. Louis, MO, 63110, USA
| | - Christopher D Smyser
- Departments of Neurology, Pediatrics and Mallinckrodt Institute of Radiology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8111, St. Louis, MO, 63110, USA
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Developmental Disorders Among Very Preterm Children. CURRENT DEVELOPMENTAL DISORDERS REPORTS 2018. [DOI: 10.1007/s40474-018-0151-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Nguyen TNN, Spencer-Smith M, Haebich KM, Burnett A, Scratch SE, Cheong JLY, Doyle LW, Wiley JF, Anderson PJ. Language Trajectories of Children Born Very Preterm and Full Term from Early to Late Childhood. J Pediatr 2018; 202:86-91.e1. [PMID: 30054166 DOI: 10.1016/j.jpeds.2018.06.036] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Revised: 05/10/2018] [Accepted: 06/13/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVE To identify distinct language trajectories of children born very preterm and full term from 2 to 13 years of age and examine predictors for the identified trajectories. STUDY DESIGN A cohort of 224 children born very preterm and 77 full term controls recruited at birth were followed up at ages 2, 5, 7, and 13 years. The number of distinct language trajectories was examined using latent growth mixture modeling allowing for linear and quadratic time trends. Potential predictors in the neonatal period (eg, birth group, sex, and medical risk) and at 2 years (ie, social risk and use of allied health services) for the language trajectories were tested using multinomial logistic regression. RESULTS Five distinct language trajectories were identified across childhood: stable normal (32% of study cohort), resilient development showing catch-up (36%), precocious language skills (7%), stable low (17%), and high-risk (5%) development. The very preterm group was 8 times more likely to have a language trajectory that represented poorer language development compared with full term controls (very preterm, 40%; full term, 6%). Greater social risk and use of allied health services were associated with poorer language development. CONCLUSIONS Variable language trajectories were observed, with a substantial proportion of children born very preterm exhibiting adverse language development. These findings highlight the need for monitoring language skills in children born very preterm before school entry and across middle childhood.
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Affiliation(s)
- Thi-Nhu-Ngoc Nguyen
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Megan Spencer-Smith
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Kristina M Haebich
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia
| | - Alice Burnett
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia; Newborn Research, Royal Women's Hospital, Melbourne, Australia; Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Australia
| | - Shannon E Scratch
- Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada; Department of Pediatrics, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Jeanie L Y Cheong
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Australia; Department of Obstetrics and Gynecology, Royal Women's Hospital, Melbourne, Australia
| | - Lex W Doyle
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia; Department of Pediatrics, University of Melbourne, Melbourne, Australia; Newborn Research, Royal Women's Hospital, Melbourne, Australia; Department of Obstetrics and Gynecology, Royal Women's Hospital, Melbourne, Australia
| | - Joshua F Wiley
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia
| | - Peter J Anderson
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Australia; Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.
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Mürner-Lavanchy IM, Kelly CE, Reidy N, Doyle LW, Lee KJ, Inder T, Thompson DK, Morgan AT, Anderson PJ. White matter microstructure is associated with language in children born very preterm. Neuroimage Clin 2018; 20:808-822. [PMID: 30268990 PMCID: PMC6169247 DOI: 10.1016/j.nicl.2018.09.020] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 08/23/2018] [Accepted: 09/21/2018] [Indexed: 12/21/2022]
Abstract
Very preterm birth is associated with altered white matter microstructure and language difficulties, which may compromise communication, social function and academic achievement, but the relationship between these two factors is unclear. The aim of this study was to explore associations between white matter microstructure and language domains of semantics, grammar and phonological awareness at 7-years of age on a whole-brain level and within the arcuate fasciculus, an important language pathway, in very preterm and term-born children. Language was assessed in 145 very preterm-born (<30 weeks' gestation and/or <1250 g birth weight) and 33 term-born children aged 7 years. Fractional anisotropy (FA), axial diffusivity (AD), radial diffusivity (RD), mean diffusivity (MD), axon orientation dispersion and axon density were estimated from diffusion magnetic resonance images also obtained at 7 years. The correlation between diffusion values and language was assessed using Tract-Based Spatial Statistics (TBSS). The arcuate fasciculus was delineated using constrained spherical deconvolution tractography and diffusion parameters from this tract were related to language measures using linear regression. While there was evidence for widespread associations between white matter microstructure and language, there was little evidence of differences in these associations between very preterm and term-born groups. TBSS analyses revealed that higher FA and lower AD, RD, and MD in major fibre tracts, including those subserving language, were associated with better semantic, grammar and phonological awareness performance. Higher axon density in widespread fibre tracts was also associated with better semantic performance. The tractography analyses of the arcuate fasciculus showed some evidence for associations between white matter microstructure and language outcomes. White matter microstructural organisation in widespread fibre tracts, including language-relevant pathways, was associated with language performance in whole-brain and tract-based analyses. The associations were similar for very preterm and term-born groups, despite very preterm children performing more poorly across language domains.
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Affiliation(s)
- Ines M Mürner-Lavanchy
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Australia; Murdoch Children's Research Institute, Melbourne, Australia; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland..
| | - Claire E Kelly
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Natalie Reidy
- Murdoch Children's Research Institute, Melbourne, Australia
| | - Lex W Doyle
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Victoria, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Research Office, The Royal Women's Hospital, Melbourne, Australia
| | - Katherine J Lee
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | | | - Deanne K Thompson
- Murdoch Children's Research Institute, Melbourne, Australia; Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Angela T Morgan
- Murdoch Children's Research Institute, Melbourne, Australia; Department of Paediatrics, University of Melbourne, Melbourne, Australia; Department of Audiology and Speech Pathology, University of Melbourne, Melbourne, Australia
| | - Peter J Anderson
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Australia; Murdoch Children's Research Institute, Melbourne, Australia.
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Fouché LC, Kritzinger A, Le Roux T. Gestational age and birth weight variations in young children with language impairment at an early communication intervention clinic. SOUTH AFRICAN JOURNAL OF COMMUNICATION DISORDERS 2018; 65:e1-e9. [PMID: 30326710 PMCID: PMC6191671 DOI: 10.4102/sajcd.v65i1.584] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2017] [Revised: 04/30/2018] [Accepted: 06/01/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND South Africa presents with high preterm birth (PTB) and low birth weight (LBW) rates (14.17%). Numerous conditions characterised by language impairment are associated with LBW and/or PTB. Speech-language therapists may fail to identify older children whose language impairment may have originated from LBW and/or PTB. OBJECTIVE To describe the frequency of LBW and/or PTB, in comparison with full-term birth, and associated conditions in children at an early communication intervention (ECI) clinic. METHODS Retrospective data of 530 children aged 3-74 months were analysed, with 91.9% presenting with language impairment. RESULTS Almost 40% had LBW and/or PTB, and late PTB was the largest category. Factors associated with LBW and/or PTB were prenatal risks, including small-for-gestational age, perinatal risks, including caesarean section, and primary developmental conditions. Secondary language impairment was prevalent, associated with genetic conditions and global developmental delay. CONCLUSION The frequency of LBW and/or PTB was unexpectedly high, drawing attention to the origins of language impairment in almost 40% of the caseload at the ECI clinic.
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Affiliation(s)
- Lauren C Fouché
- Department of Speech-Language Pathology and Audiology, University of Pretoria.
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Abstract
Predicting neurodevelopmental outcomes in high-risk neonates remains challenging despite advances in neonatal care. Early and accurate characterization of infants at risk for neurodevelopmental delays is necessary to best identify those who may benefit from existing early interventions and novel therapies that become available. Although neuroimaging is a promising biomarker in the prediction of neurodevelopmental outcomes in high-risk infants, it requires additional resources and expertise. Despite many advances in neonatal neuroimaging, there remain limitations in relating early neuroimaging findings with long-term outcomes; further studies are necessary to determine the optimal protocols to best identify high-risk patients and improve neurodevelopmental outcome prediction.
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40
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Nguyen TNN, Spencer-Smith M, Zannino D, Burnett A, Scratch SE, Pascoe L, Ellis R, Cheong J, Thompson D, Inder T, Doyle LW, Anderson PJ. Developmental Trajectory of Language From 2 to 13 Years in Children Born Very Preterm. Pediatrics 2018; 141:peds.2017-2831. [PMID: 29632253 PMCID: PMC5914491 DOI: 10.1542/peds.2017-2831] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/31/2018] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVES The objective of this study was to describe language functioning at 13 years of age and examine its developmental trajectory from 2 to 13 years of age in children born very preterm (VP) compared with term controls. METHODS Two hundred and twenty-four children born VP (<30 weeks' gestation) and 77 term controls had language skills assessed by using performance-based and/or parent-report measures at 2, 5, 7, and 13 years of age. Regression models were used to compare verbal memory, grammar, semantics, and pragmatic skills between the VP and term groups at 13 years of age. Linear mixed effects regression models were used to assess language trajectories from 2 to 13 years of age. RESULTS Compared with term controls, children born VP had poorer functioning across all components of language (mean group differences ranged from -0.5 SD to -1 SD; all P < .05) at 13 years of age. At each follow-up age, the VP group displayed poorer language functioning than the term controls, with the groups exhibiting similar developmental trajectories (slope difference = -0.01 SD per year; P = .55). CONCLUSIONS Children born VP continue to display language difficulties compared with term controls at 13 years of age, with no evidence of developmental "catch-up." Given the functional implications associated with language deficits, early language-based interventions should be considered for children born VP.
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Affiliation(s)
- Thi-Nhu-Ngoc Nguyen
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia;,Murdoch Children’s Research Institute, Melbourne, Australia
| | - Megan Spencer-Smith
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia;,Murdoch Children’s Research Institute, Melbourne, Australia
| | - Diana Zannino
- Murdoch Children’s Research Institute, Melbourne, Australia
| | - Alice Burnett
- Murdoch Children’s Research Institute, Melbourne, Australia;,Departments of Paediatrics and,Department of Neonatal Medicine, The Royal Children's Hospital, Melbourne, Australia;,Newborn Research Centre, The Royal Women’s Hospital and University of Melbourne, Melbourne, Australia
| | - Shannon E. Scratch
- Murdoch Children’s Research Institute, Melbourne, Australia;,Bloorview Research Institute, Holland Bloorview Kids Rehabilitation Hospital, Toronto, Canada;,Department of Paediatrics, Rehabilitation Sciences Institute, University of Toronto, Toronto, Canada
| | - Leona Pascoe
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia;,Murdoch Children’s Research Institute, Melbourne, Australia
| | - Rachel Ellis
- Murdoch Children’s Research Institute, Melbourne, Australia
| | - Jeanie Cheong
- Murdoch Children’s Research Institute, Melbourne, Australia;,Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia;,Newborn Research Centre, The Royal Women’s Hospital and University of Melbourne, Melbourne, Australia
| | - Deanne Thompson
- Murdoch Children’s Research Institute, Melbourne, Australia;,Departments of Paediatrics and,Florey Institute of Neuroscience and Mental Health, Melbourne, Australia; and
| | - Terrie Inder
- Department of Pediatrics Newborn Medicine, Brigham and Women’s Hospital, Boston, Massachusetts
| | - Lex W. Doyle
- Departments of Paediatrics and,Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia;,Newborn Research Centre, The Royal Women’s Hospital and University of Melbourne, Melbourne, Australia
| | - Peter J. Anderson
- Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia;,Murdoch Children’s Research Institute, Melbourne, Australia
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Brown L, Burns YR, Watter P, Gray PH, Gibbons KS. Behaviour of 4- to 5-year-old nondisabled ELBW children: Outcomes following group-based physiotherapy intervention. Child Care Health Dev 2018; 44:227-233. [PMID: 28752669 DOI: 10.1111/cch.12495] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Revised: 06/13/2017] [Accepted: 06/21/2017] [Indexed: 11/28/2022]
Abstract
BACKGROUND Extreme prematurity or extremely low birth weight (ELBW) can adversely affect behaviour. Nondisabled ELBW children are at risk of behavioural problems, which may become a particular concern after commencement of formal education. This study explored the frequency of behavioural and emotional problems amongst nondisabled ELBW children at 4 to 5 years of age and whether intervention had a positive influence on behaviour. The relationship between behaviour, gender, and other areas of performance at 5 years was explored. METHODS Fifty 4-year-old children (born <28 weeks gestation or birth weight <1,000 g) with minimal/mild motor impairment were randomly allocated to intervention (n = 24) or standard care (n = 26). Intervention was 6 group-based physiotherapy weekly sessions and home programme. Standard care was best practice advice. The Child Behavior Checklist (CBCL) for preschool children was completed at baseline and at 1-year post-baseline. Other measures at follow-up included Movement Assessment Battery for Children Second Edition, Beery Visual-Motor Integration Test 5th Edition, and Peabody Picture Vocabulary Test 4th Edition. RESULTS The whole cohort improved on CBCL total problems score between baseline (mean 50.0, SD 11.1) and 1-year follow-up (mean 45.2, SD 10.3), p = .004. There were no significant differences between groups over time on CBCL internalizing, externalizing, or total problems scores. The intervention group showed a mean difference in total problems score of -3.8 (CI [1.5, 9.1]) between times, with standard care group values being -4.4 (CI [1.6, 7.1]). Males had higher total problems scores than females (p = .026), although still performed within the "normal" range. CBCL scores did not correlate with other scores. CONCLUSIONS The behaviour of nondisabled ELBW children was within the "normal" range at 4 to 5 years, and both intervention and standard care may have contributed to improved behavioural outcomes. Behaviour was not related to performance in other developmental domains.
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Affiliation(s)
- L Brown
- Growth and Development Unit, Mater Mothers' Hospital, Raymond Terrace, South Brisbane, QLD, Australia.,Sydney Children's Hospital, Randwick, NSW, Australia
| | - Y R Burns
- Growth and Development Unit, Mater Mothers' Hospital, Raymond Terrace, South Brisbane, QLD, Australia.,School of Health and Rehabilitation, University of Queensland, St Lucia, QLD, Australia
| | - P Watter
- School of Health and Rehabilitation, University of Queensland, St Lucia, QLD, Australia
| | - P H Gray
- Growth and Development Unit, Mater Mothers' Hospital, Raymond Terrace, South Brisbane, QLD, Australia.,Mater Research Institute, University of Queensland, Raymond Terrace, South Brisbane, QLD, Australia
| | - K S Gibbons
- Mater Research Institute, University of Queensland, Raymond Terrace, South Brisbane, QLD, Australia
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42
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Zimmerman E. Do Infants Born Very Premature and Who Have Very Low Birth Weight Catch Up With Their Full Term Peers in Their Language Abilities by Early School Age? JOURNAL OF SPEECH, LANGUAGE, AND HEARING RESEARCH : JSLHR 2018; 61:53-65. [PMID: 29255846 DOI: 10.1044/2017_jslhr-l-16-0150] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Accepted: 08/03/2017] [Indexed: 06/07/2023]
Abstract
PURPOSE This study examined the extent to which children born preterm (< 37 weeks) and/or who have low birth weight (< 2,500 g) catch up with their full term peers in terms of their language abilities at early school age (≥ 5 to < 9 years). METHOD A systematic literature search identified empirical studies that fit the inclusion criteria. Data from the tests/questionnaires used for meta-analysis spanned the following language categories: total language score, expressive language, receptive language, pragmatics, phonological awareness, and grammar. The means (standard deviations) were extracted from the studies and were converted to mean difference and 95% confidence intervals to test for overall effect. RESULTS Sixteen studies met the inclusionary criteria, for a total of 2,739 participants, of which 1,224 were born full term and 1,515 were born preterm. It is important to note that the preterm cohort represented very preterm infants who have a very low birth weight. The meta-analysis found that preterm infants scored significantly worse on total language (p < .001), receptive language (p < .001), expressive language (p < .001), phonological awareness (p < .001), and grammar (p = .03) than their full term peers. However, preterm infants did not score significantly worse than their peers on their pragmatics (p = .19). CONCLUSIONS Children born VPT and who have VLBW perform worse than their peers on their total language, receptive language, expressive language, phonological awareness, and grammar abilities by early school age. This information is important for speech-language pathologists to consider as children born prematurely reach school age.
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Affiliation(s)
- Emily Zimmerman
- Department of Communication Sciences and Disorders, Northeastern University, Boston, MA
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Spittle AJ, Treyvaud K, Lee KJ, Anderson PJ, Doyle LW. The role of social risk in an early preventative care programme for infants born very preterm: a randomized controlled trial. Dev Med Child Neurol 2018; 60:54-62. [PMID: 29058313 DOI: 10.1111/dmcn.13594] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/09/2017] [Indexed: 12/01/2022]
Abstract
AIM To examine the differential effects of an early intervention programme for infants born preterm on neurodevelopment and parental mental health according to family social risk. METHOD One hundred and twenty infants born earlier than 30 weeks' gestation were randomized to early intervention (n=61) or control groups (n=59). Cognitive, language, and motor outcomes were assessed by blinded assessors at 2 years, 4 years, and 8 years, and primary caregivers completed questionnaires on their anxiety and depression. Outcomes at each time point were compared between groups using linear regression with an interaction term for social risk (higher/lower). RESULTS There was evidence of interactions between intervention group and social risk for cognition at 2 years and 4 years, motor function at 4 years, and language at 8 years, with a greater intervention effect in children from higher social risk environments. In contrast, the impact of early intervention on parental depressive symptoms was greater for parents of lower social risk than for those of higher social risk. INTERPRETATION Effects of early intervention on outcomes for children born preterm and their caregivers varied according to family social risk. Family social risk should be considered when implementing early intervention programmes for children born preterm and their families. WHAT THIS PAPER ADDS Intervention is associated with better early cognitive functioning for children in higher social risk families. Positive effects of intervention for the high risk group were not sustained at school-age. Intervention has a greater effect on primary caregiver mental health in the lower social risk group compared with higher social risk.
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Affiliation(s)
- Alicia J Spittle
- Department of Physiotherapy, University of Melbourne, Melbourne, Australia.,Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Newborn Research, Royal Women's Hospital, Melbourne, Australia
| | - Karli Treyvaud
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Newborn Research, Royal Women's Hospital, Melbourne, Australia.,Department of Psychology and Counselling, La Trobe University, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Katherine J Lee
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Peter J Anderson
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Monash Institute of Cognitive and Clinical Neurosciences, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Lex W Doyle
- Clinical Sciences, Murdoch Children's Research Institute, Melbourne, Australia.,Newborn Research, Royal Women's Hospital, Melbourne, Australia.,Department of Paediatrics, University of Melbourne, Melbourne, Australia.,Department of Obstetrics and Gynaecology, University of Melbourne, Melbourne, Australia
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Monson BB, Eaton-Rosen Z, Kapur K, Liebenthal E, Brownell A, Smyser CD, Rogers CE, Inder TE, Warfield SK, Neil JJ. Differential Rates of Perinatal Maturation of Human Primary and Nonprimary Auditory Cortex. eNeuro 2018; 5:ENEURO.0380-17.2017. [PMID: 29354680 PMCID: PMC5773280 DOI: 10.1523/eneuro.0380-17.2017] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 12/11/2017] [Indexed: 12/22/2022] Open
Abstract
Primary and nonprimary cerebral cortex mature along different timescales; however, the differences between the rates of maturation of primary and nonprimary cortex are unclear. Cortical maturation can be measured through changes in tissue microstructure detectable by diffusion magnetic resonance imaging (MRI). In this study, diffusion tensor imaging (DTI) was used to characterize the maturation of Heschl's gyrus (HG), which contains both primary auditory cortex (pAC) and nonprimary auditory cortex (nAC), in 90 preterm infants between 26 and 42 weeks postmenstrual age (PMA). The preterm infants were in different acoustical environments during their hospitalization: 46 in open ward beds and 44 in single rooms. A control group consisted of 15 term-born infants. Diffusion parameters revealed that (1) changes in cortical microstructure that accompany cortical maturation had largely already occurred in pAC by 28 weeks PMA, and (2) rapid changes were taking place in nAC between 26 and 42 weeks PMA. At term equivalent PMA, diffusion parameters for auditory cortex were different between preterm infants and term control infants, reflecting either delayed maturation or injury. No effect of room type was observed. For the preterm group, disturbed maturation of nonprimary (but not primary) auditory cortex was associated with poorer language performance at age two years.
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Affiliation(s)
- Brian B. Monson
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
- Department of Radiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Zach Eaton-Rosen
- Translational Imaging Group, University College London, London, WC1E 7JE United Kingdom
| | - Kush Kapur
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Einat Liebenthal
- Department of Psychiatry, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Abraham Brownell
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Christopher D. Smyser
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63130
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63130
| | - Cynthia E. Rogers
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63130
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63130
| | - Terrie E. Inder
- Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Simon K. Warfield
- Department of Radiology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115
| | - Jeffrey J. Neil
- Department of Neurology, Boston Children’s Hospital, Harvard Medical School, Boston, MA 02115
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van Ettinger-Veenstra H, Widén C, Engström M, Karlsson T, Leijon I, Nelson N. Neuroimaging of decoding and language comprehension in young very low birth weight (VLBW) adolescents: Indications for compensatory mechanisms. PLoS One 2017; 12:e0185571. [PMID: 28968426 PMCID: PMC5624616 DOI: 10.1371/journal.pone.0185571] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Accepted: 09/15/2017] [Indexed: 01/25/2023] Open
Abstract
In preterm children with very low birth weight (VLBW ≤ 1500 g), reading problems are often observed. Reading comprehension is dependent on word decoding and language comprehension. We investigated neural activation–within brain regions important for reading–related to components of reading comprehension in young VLBW adolescents in direct comparison to normal birth weight (NBW) term-born peers, with the use of functional magnetic resonance imaging (fMRI). We hypothesized that the decoding mechanisms will be affected by VLBW, and expect to see increased neural activity for VLBW which may be modulated by task performance and cognitive ability. The study investigated 13 (11 included in fMRI) young adolescents (ages 12 to 14 years) born preterm with VLBW and in 13 NBW controls (ages 12–14 years) for performance on the Block Design and Vocabulary subtests of the Wechsler Intelligence Scale for Children; and for semantic, orthographic, and phonological processing during an fMRI paradigm. The VLBW group showed increased phonological activation in left inferior frontal gyrus, decreased orthographic activation in right supramarginal gyrus, and decreased semantic activation in left inferior frontal gyrus. Block Design was related to altered right-hemispheric activation, and VLBW showed lower WISC Block Design scores. Left angular gyrus showed activation increase specific for VLBW with high accuracy on the semantic test. Young VLBW adolescents showed no accuracy and reaction time performance differences on our fMRI language tasks, but they did exhibit altered neural activation during these tasks. This altered activation for VLBW was observed as increased activation during phonological decoding, and as mainly decreased activation during orthographic and semantic processing. Correlations of neural activation with accuracy on the semantic fMRI task and with decreased WISC Block Design performance were specific for the VLBW group. Together, results suggest compensatory mechanisms by recruiting additional brain regions upon altered neural development of decoding for VLBW.
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Affiliation(s)
- Helene van Ettinger-Veenstra
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- * E-mail:
| | - Carin Widén
- Department of Clinical and Experimental Medicine, Pediatrics, Linköping University, Linköping, Sweden
| | - Maria Engström
- Department of Medical and Health Sciences, Linköping University, Linköping, Sweden
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Thomas Karlsson
- Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
- Department of Behavioral Science and Learning, and Linnaeus Centre HEAD, Linköping University, Linköping, Sweden
| | - Ingemar Leijon
- Department of Clinical and Experimental Medicine, Pediatrics, Linköping University, Linköping, Sweden
| | - Nina Nelson
- Department of Clinical and Experimental Medicine, Pediatrics, Linköping University, Linköping, Sweden
- Department of Quality and Patient Safety, Karolinska University Hospital, Stockholm, Sweden
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46
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Herzmann C, Zubiaurre-Elorza L, Wild CJ, Linke AC, Han VK, Lee DSC, Cusack R. Using Functional Magnetic Resonance Imaging to Detect Preserved Function in a Preterm Infant with Brain Injury. J Pediatr 2017; 189:213-217.e1. [PMID: 28735979 DOI: 10.1016/j.jpeds.2017.06.063] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Revised: 05/15/2017] [Accepted: 06/26/2017] [Indexed: 02/07/2023]
Abstract
We studied developmental plasticity using functional magnetic resonance imaging (fMRI) in a preterm infant with brain injury on structural MRI. fMRI showed preserved brain function and subsequent neurodevelopment was within the normal range. Multimodal neuroimaging including fMRI can improve understanding of neural plasticity after preterm birth and brain injury.
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Affiliation(s)
| | | | - Conor J Wild
- Brain and Mind Institute, Western University, London, Ontario, Canada
| | - Annika C Linke
- Brain and Mind Institute, Western University, London, Ontario, Canada
| | - Victor K Han
- Children's Health Research Institute, London, Ontario, Canada
| | - David S C Lee
- Children's Health Research Institute, London, Ontario, Canada; Pediatrics, Western University, London, Ontario, Canada
| | - Rhodri Cusack
- Brain and Mind Institute, Western University, London, Ontario, Canada; Children's Health Research Institute, London, Ontario, Canada
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47
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Hinojosa-Rodríguez M, Harmony T, Carrillo-Prado C, Van Horn JD, Irimia A, Torgerson C, Jacokes Z. Clinical neuroimaging in the preterm infant: Diagnosis and prognosis. Neuroimage Clin 2017; 16:355-368. [PMID: 28861337 PMCID: PMC5568883 DOI: 10.1016/j.nicl.2017.08.015] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 08/11/2017] [Accepted: 08/12/2017] [Indexed: 01/30/2023]
Abstract
Perinatal care advances emerging over the past twenty years have helped to diminish the mortality and severe neurological morbidity of extremely and very preterm neonates (e.g., cystic Periventricular Leukomalacia [c-PVL] and Germinal Matrix Hemorrhage - Intraventricular Hemorrhage [GMH-IVH grade 3-4/4]; 22 to < 32 weeks of gestational age, GA). However, motor and/or cognitive disabilities associated with mild-to-moderate white and gray matter injury are frequently present in this population (e.g., non-cystic Periventricular Leukomalacia [non-cystic PVL], neuronal-axonal injury and GMH-IVH grade 1-2/4). Brain research studies using magnetic resonance imaging (MRI) report that 50% to 80% of extremely and very preterm neonates have diffuse white matter abnormalities (WMA) which correspond to only the minimum grade of severity. Nevertheless, mild-to-moderate diffuse WMA has also been associated with significant affectations of motor and cognitive activities. Due to increased neonatal survival and the intrinsic characteristics of diffuse WMA, there is a growing need to study the brain of the premature infant using non-invasive neuroimaging techniques sensitive to microscopic and/or diffuse lesions. This emerging need has led the scientific community to try to bridge the gap between concepts or ideas from different methodologies and approaches; for instance, neuropathology, neuroimaging and clinical findings. This is evident from the combination of intense pre-clinical and clinicopathologic research along with neonatal neurology and quantitative neuroimaging research. In the following review, we explore literature relating the most frequently observed neuropathological patterns with the recent neuroimaging findings in preterm newborns and infants with perinatal brain injury. Specifically, we focus our discussions on the use of neuroimaging to aid diagnosis, measure morphometric brain damage, and track long-term neurodevelopmental outcomes.
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Affiliation(s)
- Manuel Hinojosa-Rodríguez
- Unidad de Investigación en Neurodesarrollo, Departamento de Neurobiología Conductual y Cognitiva, Instituto de Neurobiología, Universidad Nacional Autónoma de México (UNAM), Campus Juriquilla, Mexico
| | - Thalía Harmony
- Unidad de Investigación en Neurodesarrollo, Departamento de Neurobiología Conductual y Cognitiva, Instituto de Neurobiología, Universidad Nacional Autónoma de México (UNAM), Campus Juriquilla, Mexico
| | - Cristina Carrillo-Prado
- Unidad de Investigación en Neurodesarrollo, Departamento de Neurobiología Conductual y Cognitiva, Instituto de Neurobiología, Universidad Nacional Autónoma de México (UNAM), Campus Juriquilla, Mexico
| | - John Darrell Van Horn
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, 2025 Zonal Avenue, SHN, Los Angeles, California 90033, USA
| | - Andrei Irimia
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, 2025 Zonal Avenue, SHN, Los Angeles, California 90033, USA
| | - Carinna Torgerson
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, 2025 Zonal Avenue, SHN, Los Angeles, California 90033, USA
| | - Zachary Jacokes
- USC Mark and Mary Stevens Neuroimaging and Informatics Institute, 2025 Zonal Avenue, SHN, Los Angeles, California 90033, USA
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48
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Wolthuis-Stigter MI, Da Costa SP, Bos AF, Krijnen WP, Van Der Schans CP, Luinge MR. Sucking behaviour in infants born preterm and developmental outcomes at primary school age. Dev Med Child Neurol 2017; 59:871-877. [PMID: 28432690 DOI: 10.1111/dmcn.13438] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/03/2017] [Indexed: 11/29/2022]
Abstract
AIM To determine the association between sucking in infants born preterm and developmental outcomes at 5 years. METHOD Thirty-four infants were included (mean gestational age 30wks 4d, mean birthweight 1407g). The Neonatal Oral-Motor Assessment Scale was used longitudinally from 37 to 50 weeks postmenstrual age. At 5 years, we assessed motor skills, intelligence, language, verbal memory, and behavioural problems. Linear regression analyses were performed to test whether aspects of sucking behaviour predicted these developmental outcomes. Where linear regression was not appropriate, Spearman's correlation coefficients were calculated between sucking and developmental outcomes. RESULTS Sucking was associated with total motor skills (B [unstandardized correlation coefficient for normally distributed data]=22.66, 95% confidence interval [CI] 6.61 to 38.71), balance (Spearman's ρ=0.64, p<0.001), total intelligence (B=-1.16, 95% CI -1.89 to -0.44, B=10.48, 95% CI 0.39 to 20.71, B=-2.22, 95% CI -3.42 to -1.02), verbal intelligence (B=-0.95; 95% CI -1.83 to -0.07, B=-2.02; 95% CI -3.55 to -0.49), performance intelligence (B=-1.34, 95% CI -2.13 to -0.54, B=12.36, 95% CI 1.13 to 23.60, B=-2.37, 95% CI -3.75 to -0.96), and language (B=-1.78, 95% CI -3.36 to -0.19). All associations were in the same direction: the better the sucking, the higher the test scores. Verbal memory and behavioural problems were not associated with sucking. INTERPRETATION Abnormal sucking between 42 weeks and 50 weeks postmenstrual age may reflect abnormal neurological functioning in children born preterm.
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Affiliation(s)
- Mechteld I Wolthuis-Stigter
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
| | - Saakje P Da Costa
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
| | - Arend F Bos
- Department of Pediatrics, Neonatology, Beatrix Children's Hospital, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Wim P Krijnen
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
| | - Cees P Van Der Schans
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands.,Department of Rehabilitation Medicine, Center for Rehabilitation, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Margreet R Luinge
- Research Group Healthy Ageing, Allied Health Care and Nursing, Hanze University of Applied Sciences, Groningen, the Netherlands
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49
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Anderson PJ, Treyvaud K, Neil JJ, Cheong JLY, Hunt RW, Thompson DK, Lee KJ, Doyle LW, Inder TE. Associations of Newborn Brain Magnetic Resonance Imaging with Long-Term Neurodevelopmental Impairments in Very Preterm Children. J Pediatr 2017; 187:58-65.e1. [PMID: 28583705 PMCID: PMC5533625 DOI: 10.1016/j.jpeds.2017.04.059] [Citation(s) in RCA: 93] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2016] [Revised: 03/23/2017] [Accepted: 04/26/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To determine the relationship between brain abnormalities on newborn magnetic resonance imaging (MRI) and neurodevelopmental impairment at 7 years of age in very preterm children. STUDY DESIGN A total of 223 very preterm infants (<30 weeks of gestation or <1250 g) born at Melbourne's Royal Women's Hospital had a brain MRI scan at term equivalent age. Scans were scored using a standardized system that assessed structural abnormality of cerebral white matter, cortical gray matter, deep gray matter, and cerebellum. Children were assessed at 7 years on measures of general intelligence, motor functioning, academic achievement, and behavior. RESULTS One hundred eighty-six very preterm children (83%) had both an MRI at term equivalent age and a 7-year follow-up assessment. Higher global brain, cerebral white matter, and deep gray matter abnormality scores were related to poorer intelligence quotient (IQ) (Ps < .01), spelling (Ps < .05), math computation (Ps < .01), and motor function (Ps < .001). Higher cerebellum abnormality scores were related to poorer IQ (P = .001), math computation (P = .018), and motor outcomes (P = .001). Perinatal, neonatal, and social confounders had little effect on the relationships between the MRI abnormality scores and outcomes. Moderate-severe global abnormality on newborn MRI was associated with a reduction in IQ (-6.9 points), math computation (-7.1 points), and motor (-1.9 points) scores independent of the other potential confounders. CONCLUSIONS Structured evaluation of brain MRI at term equivalent is predictive of outcome at 7 years of age, independent of clinical and social factors.
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Affiliation(s)
- Peter J Anderson
- Monash Institute of Cognitive and Clinical Neurosciences, Monash University, Melbourne, Victoria, Australia; Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia.
| | - Karli Treyvaud
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia,Department of Psychology & Counselling, La Trobe University, Melbourne, Victoria, Australia
| | - Jeffrey J Neil
- Department of Neurology, Boston Children’s Hospital, Boston, USA,Harvard Medical School, Harvard University, Boston, USA
| | - Jeanie LY Cheong
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia,Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia,Newborn Intensive Care, The Royal Women’s Hospital, Melbourne, Victoria, Australia
| | - Rodney W Hunt
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia,Neonatal Medicine, The Royal Children’s Hospital, Melbourne, Victoria, Australia
| | - Deanne K Thompson
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Katherine J Lee
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lex W Doyle
- Clinical Sciences, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia,Department of Paediatrics, The University of Melbourne, Melbourne, Victoria, Australia,Department of Obstetrics and Gynaecology, The University of Melbourne, Melbourne, Victoria, Australia,Newborn Intensive Care, The Royal Women’s Hospital, Melbourne, Victoria, Australia
| | - Terrie E Inder
- Harvard Medical School, Harvard University, Boston, USA,Pediatric Newborn Medicine, The Brigham and Women’s Hospital, Boston, USA
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50
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Fenoglio A, Georgieff MK, Elison JT. Social brain circuitry and social cognition in infants born preterm. J Neurodev Disord 2017; 9:27. [PMID: 28728548 PMCID: PMC5516343 DOI: 10.1186/s11689-017-9206-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2016] [Accepted: 05/30/2017] [Indexed: 12/17/2022] Open
Abstract
Preterm birth is associated with an increased risk of adverse neurologic, psychiatric, and cognitive outcomes. The brain circuits involved in processing social information are critical to all of these domains, but little work has been done to examine whether and how these circuits may be especially sensitive to prematurity. This paper contains a brief summary of some of the cognitive, psychiatric, and social outcomes associated with prematurity, followed by a description of findings from the modest body of research into social-cognitive development in infants and children born preterm. Next, findings from studies of structural and functional brain development in infants born preterm are reviewed, with an eye toward the distinctive role of the brain circuits implicated in social functioning. The goal of this review is to investigate the extent to which the putative "social brain" may have particular developmental susceptibilities to the insults associated with preterm birth, and the role of early social-cognitive development in later neurodevelopmental outcomes. Much work has been done to characterize neurobehavioral outcomes in the preterm population, but future research must incorporate both brain and behavioral measures to identify early biomarkers linked to later emerging social-cognitive clinical impairment in order to guide effective, targeted intervention.
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Affiliation(s)
- Angela Fenoglio
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455 USA
| | - Michael K. Georgieff
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455 USA
- Department of Pediatrics, Division of Pediatric Neonatology, University of Minnesota, 6th Floor East Building, MB630, 2450 Riverside Ave, Minneapolis, MN 55454 USA
| | - Jed T. Elison
- Institute of Child Development, University of Minnesota, 51 East River Parkway, Minneapolis, MN 55455 USA
- Department of Pediatrics, Division of Pediatric Neonatology, University of Minnesota, 6th Floor East Building, MB630, 2450 Riverside Ave, Minneapolis, MN 55454 USA
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