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Gerstner T, Henning O, Løhaugen G, Skranes J. Reduced Interhemispheric Coherence and Cognition in Children with Fetal Alcohol Spectrum Disorder (FASD)-A Quantitative EEG Study. Neuropediatrics 2024. [PMID: 38320603 DOI: 10.1055/a-2262-7781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2024]
Abstract
BACKGROUND Magnetic resonance imaging in fetal alcohol spectrum disorder (FASD) children showed altered connectivity, suggesting underlying deficits in networks, which may be related to cognitive outcome. Functional connectivity has been of interest in neurophysiological research with quantitative electroencephalography (QEEG) as useful tool for measuring pathology, not detectable by normal EEG. The aim of this study was to investigate differences in the EEG interhemispheric coherence (ICoh) in children diagnosed with FASD compared with healthy controls and to relate the results to cognitive scores. METHOD Analysis of ICoh in 81 FASD children (4-Digit Code) compared with 31 controls. The children underwent cognitive assessment, and EEG was performed and used for analysis. Group comparisons and analysis of covariance interaction models were used to test for differences between FASD and controls but also to look for differences between FASD subgroups. Significant findings were correlated to cognitive scores. RESULTS Lower ICoh was found in the frontal and temporal derivations in the FASD group. When comparing FASD subgroups, children with fetal alcohol syndrome had lower ICoh occipital. Reduced ICoh in the temporal alpha band was correlated with lower performance IQ in the FASD group. CONCLUSION Our findings could imply hypoconnectivity between the hemispheres with impact on cognition. We suggest that EEG coherence analysis could be a sensitive parameter in the detection of electrophysiological abnormalities in FASD with possible clinical relevance. These results may indicate that QEEG could be used as biomarker for FASD. However, further research is needed to determine the role of QEEG analysis in the diagnosis of FASD.
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Affiliation(s)
- Thorsten Gerstner
- Department of Pediatrics, Regional Competence for Children with Prenatal Alcohol/Drug Exposure, Sørlandet Hospital, Arendal, Norway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Oliver Henning
- National Centre for Epilepsy, Oslo University Hospital, Oslo, Norway
| | - Gro Løhaugen
- Department of Pediatrics, Regional Competence for Children with Prenatal Alcohol/Drug Exposure, Sørlandet Hospital, Arendal, Norway
| | - Jon Skranes
- Department of Pediatrics, Regional Competence for Children with Prenatal Alcohol/Drug Exposure, Sørlandet Hospital, Arendal, Norway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Aslaksen AK, Hoem ML, Vikesdal GH, Voie MT, Haugen OH, Skranes J. Children had increased risks of impaired motor and visual-motor skills after prenatal exposure to opioid maintenance therapy. Acta Paediatr 2024. [PMID: 38415880 DOI: 10.1111/apa.17175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/15/2024] [Accepted: 02/19/2024] [Indexed: 02/29/2024]
Abstract
AIM Preschool children prenatally exposed to opioid maintenance therapy (OMT) have an increased risk of neurodevelopmental impairments. We aimed to investigate long-term motor and visual-motor integration outcome in children aged 5-13 Years, born to mothers in OMT. METHODS From January 2018 to June 2021, 63 children prenatally exposed to OMT and 63 comparison children matched for age and gender, were examined at two Norwegian hospitals. Motor skills were assessed by the Movement-ABC test and visual-motor integration by the Beery VMI test. A motor function neurological assessment test was used to examine neuromotor soft signs. RESULTS In the OMT-exposed group, 16% had motor impairment, 35% had motor problems and 19% had visual-motor integration problems. Forty-three percent of the exposed children had neuromotor soft signs. Strabismus had some influence on motor and visual-motor outcomes but could not explain the group differences. CONCLUSION Children prenatally exposed to opioid maintenance therapy have an increased risk of long-term motor impairment and visual-motor problems. In addition, they exhibit significantly more neuromotor soft signs, which may affect general well-being, leisure activities and school performance.
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Affiliation(s)
- Anne Kathinka Aslaksen
- Department of Pediatrics, Sørlandet Hospital, Kristiansand, Norway
- Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine K1, Faculty of Medicine, University of Bergen, Bergen, Norway
| | | | - Gro Horgen Vikesdal
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
| | | | - Olav H Haugen
- Department of Clinical Medicine K1, Faculty of Medicine, University of Bergen, Bergen, Norway
- Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway
| | - Jon Skranes
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Gerstner T, Henning O, Løhaugen G, Skranes J. Frequency of epilepsy and pathological EEG findings in a Norwegian sample of children with fetal alcohol spectrum disorder: Impact on cognition and adaptive functioning. Alcohol Clin Exp Res (Hoboken) 2024; 48:309-318. [PMID: 38105112 DOI: 10.1111/acer.15247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/19/2023] [Revised: 12/08/2023] [Accepted: 12/11/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) comprises a combination of developmental, cognitive, and behavioral disabilities that occur in children exposed to alcohol prenatally. A higher prevalence of epilepsy and pathological electroencephalographic (EEG) features have also been reported in individuals with FASD. We examined the frequency of epilepsy, pathological EEG findings, and their implications for cognitive and adaptive functioning in children with FASD. METHODS We conducted a cross-sectional study of 148 children with FASD who underwent a multidisciplinary assessment and a 120-min EEG recording. Group comparisons and regression analyses were performed to test the associations between epilepsy and pathological EEG findings, FASD subgroups and neurocognitive test results and adaptive functioning. RESULTS The frequency of epilepsy was 6%, which compares with 0.7% in Norway overall. Seventeen percent of children without epilepsy had pathological EEG findings. Attention-deficit hyperactivity disorder (ADHD) was diagnosed in 64% of the children. Children with epilepsy and/or pathological EEG findings had comparable cognitive and adaptive scores to those with normal EEG. However, children with frontal EEG pathology (without epilepsy) had significantly lower scores on the IQ indices Processing speed and Working memory than FASD children without such findings, irrespective of ADHD comorbidity. CONCLUSIONS There was a greater prevalence of epilepsy among children with FASD than in the general Norwegian population. A greater frequency of EEG pathology was also evident in children without epilepsy, across all FASD subgroups. Irrespective of epilepsy, ADHD comorbidity, and FASD subgroup, children with frontal EEG pathology, despite having a normal total IQ, showed significantly slower processing speed and poorer working memory, which may indicate specific executive function deficits that could affect learning and adaptive functioning.
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Affiliation(s)
- Thorsten Gerstner
- Regional Competence Center for Children with Prenatal Alcohol/Drug Exposure, Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Oliver Henning
- National Centre for Epilepsy, Oslo University Hospital, Oslo, Norway
| | - Gro Løhaugen
- Regional Competence Center for Children with Prenatal Alcohol/Drug Exposure, Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Jon Skranes
- Regional Competence Center for Children with Prenatal Alcohol/Drug Exposure, Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Aslaksen AK, Vikesdal GH, Voie MT, Rowlands M, Skranes J, Haugen OH. Visual function in Norwegian children aged 5-13 years with prenatal exposure to opioid maintenance therapy: A case-control study. Acta Ophthalmol 2023. [PMID: 37702266 DOI: 10.1111/aos.15764] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/04/2023] [Accepted: 08/29/2023] [Indexed: 09/14/2023]
Abstract
PURPOSE To assess various aspects of visual function in school children prenatally exposed to opioid maintenance therapy (OMT) and to explore possible outcome differences between prenatal methadone and buprenorphine exposure. METHODS In a cross-sectional case-control study, 63 children aged 5-13 years with prenatal OMT exposure were compared with 63 age- and gender-matched, non-exposed controls regarding important visual parameters, such as visual acuity, orthoptic status, refractive state, colour vision, and visual field. RESULTS The OMT-exposed children had significantly poorer visual acuity, both for the best eye, the worst eye and binocularly. Two children had mild visual impairment. Manifest strabismus was more frequent in the OMT group, 30%, vs. 4.8% in the control group. The most frequent types of strabismus were accommodative esotropia and intermittent exotropia. Manifest nystagmus was present in 10 (16%) of the exposed children compared to one among the non-exposed children. The accommodative amplitude was decreased in the OMT group compared to the controls. After adjusting for polydrug exposure and SGA (small-for-gestational-age), the between-group differences in visual acuity, strabismus, and nystagmus remained. The methadone-exposed children had poorer visual acuity, increased frequency of strabismus and a higher percentage of nystagmus, hypermetropia and astigmatism compared to the buprenorphine-exposed children. CONCLUSIONS School-age children exposed to methadone or buprenorphine in utero had a higher prevalence of strabismus and nystagmus, and a lower visual acuity and accommodation amplitude. Buprenorphine exposure was associated with more favourable results than methadone exposure on most visual outcome measures and should be the preferred substance in OMT.
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Affiliation(s)
- Anne Kathinka Aslaksen
- Department of Paediatrics, Sørlandet Hospital, Arendal, Norway
- Department of Paediatrics, Haukeland University Hospital, Bergen, Norway
- Department of Clinical Medicine K1, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Gro Horgen Vikesdal
- Department of Optometry, Radiography and Lighting Design, University of South-Eastern Norway, Kongsberg, Norway
| | | | - Megan Rowlands
- Department of Ophthalmology, Sørlandet Hospital, Arendal, Norway
| | - Jon Skranes
- Department of Paediatrics, Sørlandet Hospital, Arendal, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Olav H Haugen
- Department of Clinical Medicine K1, Faculty of Medicine, University of Bergen, Bergen, Norway
- Department of Ophthalmology, Haukeland University Hospital, Bergen, Norway
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Beneventi H, Løhaugen GC, Andersen GL, Sundberg C, Østgård HF, Bakkan E, Walther G, Vik T, Skranes J. Working Memory Training in Norwegian Children with Cerebral Palsy (CP) Show Minimal Evidence of Near and No Far Transfer Effects. Dev Neurorehabil 2023; 26:364-370. [PMID: 37740724 DOI: 10.1080/17518423.2023.2259985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 09/13/2023] [Indexed: 09/25/2023]
Abstract
In children with cerebral palsy (CP), learning disabilities are well documented, and impairments in executive functions, such as attention, inhibition, shifting and working memory, represent significant burdens on patients, their families and the society. The aim of this study was to evaluate whether Cogmed RM working memory training could improve working memory in children with CP and investigate whether increased working memory capacity would generalize to other cognitive functions. Twenty-eight children completed the training and the results were compared to a waitlist control group (n = 32). The results yielded three main findings. First, children with CP improved with practice on trained working memory tasks. Second, the intervention group showed minimal near transfer effects to non-trained working memory tasks. Third, no effects on cognitive and behavioral far transfer measures were found.
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Affiliation(s)
- Harald Beneventi
- Department of Paediatric Habilitation, Stavanger University Hospital, Stavanger, Norway
| | - Gro Cc Løhaugen
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
- Department of Clinical and Laboratory Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Guro L Andersen
- Department of Clinical and Laboratory Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Cerebral Palsy Register of Norway, Habilitation Center, Vestfold Hospital Trust, Tønsberg, Norway
| | - Cato Sundberg
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Heidi Furre Østgård
- Department of Clinical and Laboratory Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ellen Bakkan
- Department of Paediatric Habilitation, Stavanger University Hospital, Stavanger, Norway
| | - Geir Walther
- Department of Child and Adolescent Psychiatry, Vestfold Hospital Trust, Tønsberg, Norway
| | - Torstein Vik
- Department of Clinical and Laboratory Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jon Skranes
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
- Department of Clinical and Laboratory Medicine, Norwegian University of Science and Technology, Trondheim, Norway
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Gerstner T, Saevareid HI, Johnsen ÅR, Løhaugen G, Skranes J. Sleep disturbances in Norwegian children with fetal alcohol spectrum disorders (FASD) with and without a diagnosis of attention-deficit hyperactivity disorder or epilepsy. Alcohol Clin Exp Res 2023; 47:589-599. [PMID: 36811179 DOI: 10.1111/acer.15009] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 11/16/2022] [Accepted: 01/04/2023] [Indexed: 02/23/2023]
Abstract
BACKGROUND Fetal alcohol spectrum disorder (FASD) describes a combination of developmental, cognitive, and behavioral disabilities in children with prenatal exposure to alcohol. The literature suggests that there are higher rates of sleep disturbances in these children. Few studies have investigated sleep disturbances in relation to common comorbidities of FASD. We examined the prevalence of disturbed sleep and the relationship between parent-reported sleep problems in different FASD subgroups and comorbidities like epilepsy or attention-deficit hyperactivity disorder (ADHD) and impact on clinical functioning. METHODS In this prospective cross-sectional survey, caregivers of 53 children with FASD completed the Sleep Disturbance Scale for Children (SDSC). Information about comorbidities was collected, and EEG and assessment of IQ, daily-life executive and adaptive functioning were performed. Group comparisons and ANCOVA interaction models were used to test the associations between different sleep disturbances and clinical factors that could interfere with sleep. RESULTS An abnormal sleep score on the SDSC was very common, affecting 79% of children (n = 42) with equal prevalence in all FASD subgroups. Difficulty falling asleep was the most common sleep problem, followed by difficulty staying asleep and waking early. The incidence of epilepsy was 9.4%, with an abnormal EEG seen in 24.5%, and a diagnosis of ADHD in 47.2% of children. The distribution of these conditions was equal in all FASD subgroups. Children with signs of sleep disturbance had poorer working memory, executive function, and adaptive functioning. Children with ADHD had a greater prevalence of sleep disturbance than those without ADHD (OR 1.36; 95% CI 1.03 to 1.79). CONCLUSION Problems with sleep are very common in FASD children and seem independent of FASD subgroup and the presence of epilepsy or a pathological EEG finding, while those with ADHD had more sleep problems. The study underscores the importance of screening for sleep disturbances in all children with FASD as these problems may be treatable.
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Affiliation(s)
- Thorsten Gerstner
- Regional Competence for Children with Prenatal Alcohol/Drug Exposure, Department of Pediatrics, Sørlandet Hospital, Arendal, Norway.,Department of clinical and molecular medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Hans Inge Saevareid
- Department of Health and Nursing Sciences, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Åse Ribe Johnsen
- Department of Health and Nursing Sciences, Faculty of Health and Sport Sciences, University of Agder, Grimstad, Norway
| | - Gro Løhaugen
- Regional Competence for Children with Prenatal Alcohol/Drug Exposure, Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Jon Skranes
- Regional Competence for Children with Prenatal Alcohol/Drug Exposure, Department of Pediatrics, Sørlandet Hospital, Arendal, Norway.,Department of clinical and molecular medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Rimol LM, Rise HH, Evensen KAI, Yendiki A, Løhaugen GC, Indredavik MS, Brubakk AM, Bjuland KJ, Eikenes L, Weider S, Håberg A, Skranes J. Atypical brain structure mediates reduced IQ in young adults born preterm with very low birth weight. Neuroimage 2023; 266:119816. [PMID: 36528311 DOI: 10.1016/j.neuroimage.2022.119816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 12/05/2022] [Accepted: 12/13/2022] [Indexed: 12/15/2022] Open
Abstract
Preterm birth with very low birth weight (VLBW) confers heightened risk for perinatal brain injury and long-term cognitive deficits, including a reduction in IQ of up to one standard deviation. Persisting gray and white matter aberrations have been documented well into adolescence and adulthood in preterm born individuals. What has not been documented so far is a plausible causal link between reductions in cortical surface area or subcortical brain structure volumes, and the observed reduction in IQ. The NTNU Low Birth Weight in a Lifetime Perspective study is a prospective longitudinal cohort study, including a preterm born VLBW group (birthweight ≤1500 g) and a term born control group. Structural magnetic resonance imaging data were obtained from 38 participants aged 19, born preterm with VLBW, and 59 term-born peers. The FreeSurfer software suite was used to obtain measures of cortical thickness, cortical surface area, and subcortical brain structure volumes. Cognitive ability was estimated using the Wechsler Adult Intelligence Scale, 3rd Edition, including four IQ-indices: Verbal comprehension, Working memory, Perceptual organization, and Processing speed. Statistical mediation analyses were employed to test for indirect effects of preterm birth with VLBW on IQ, mediated by atypical brain structure. The mediation analyses revealed negative effects of preterm birth with VLBW on IQ that were partially mediated by reduced surface area in multiple regions of frontal, temporal, parietal and insular cortex, and by reductions in several subcortical brain structure volumes. The analyses did not yield sufficient evidence of mediation effects of cortical thickness on IQ. This is, to our knowledge, the first time a plausible causal relationship has been established between regional cortical area reductions, as well as reductions in specific subcortical and cerebellar structures, and general cognitive ability in preterm born survivors with VLBW.
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Affiliation(s)
- Lars M Rimol
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Radiology and Nuclear Medicine, St. Olav University Hospital, Trondheim, Norway.
| | - Henning Hoel Rise
- Department of Radiology and Nuclear Medicine, St. Olav University Hospital, Trondheim, Norway
| | - Kari Anne I Evensen
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway; Department of Public Health and Nursing, NTNU, Trondheim, Norway
| | - Anastasia Yendiki
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, United States
| | - Gro C Løhaugen
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | | | - Ann-Mari Brubakk
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
| | | | - Live Eikenes
- Department of Neuromedicine and Movement Science, NTNU, Trondheim, Norway
| | - Siri Weider
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Asta Håberg
- Department of Radiology and Nuclear Medicine, St. Olav University Hospital, Trondheim, Norway; Department of Circulation and Medical Imaging, NTNU, Trondheim, Norway
| | - Jon Skranes
- Department of Radiology and Nuclear Medicine, St. Olav University Hospital, Trondheim, Norway; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
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Weider S, Lærum AMW, Evensen KAI, Reitan SK, Lydersen S, Brubakk AM, Skranes J, Indredavik MS. Neurocognitive function and associations with mental health in adults born preterm with very low birthweight or small for gestational age at term. Front Psychol 2023; 13:1078232. [PMID: 36743594 PMCID: PMC9890170 DOI: 10.3389/fpsyg.2022.1078232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 12/22/2022] [Indexed: 01/19/2023] Open
Abstract
Objectives To assess neurocognitive function in adults born with low birthweight compared with controls and to explore associations between neurocognitive function and psychopathology in these groups. Methods In this prospective cohort study, one group born preterm with very low birthweight (VLBW: birthweight <1,500 g, n = 53), one group born small for gestational age at term (SGA: birthweight <10th percentile, n = 63) and one term-born control group (birthweight ≥10th percentile, n = 81) were assessed with neurocognitive tests, diagnostic interviews, and self-report questionnaires at 26 years of age. Results The VLBW group scored significantly below the control group on several neurocognitive measures, including IQ measures, psychomotor speed, verbal fluency, aspects of visual learning and memory, attention, social cognition, working memory and fine motor speed. The SGA group consistently scored at an intermediate level between the VLBW and the control group and had significantly lower scores than controls on Performance IQ and psychomotor speed, including switching. In the VLBW group, associations were found between lower spatial working memory and the presence of anxiety disorders, internalizing and attention problems, and autistic traits. Furthermore, lower Full scale IQ was associated with attention problems when adjusting for sex and parental socioeconomic status. Conclusion Adults born preterm with VLBW or born term SGA displayed neurocognitive difficulties. Spatial working memory was associated with difficulties with attention, anxiety, and social function of VLBW adults. The finding and its clinical applicability should be further explored.
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Affiliation(s)
- Siri Weider
- Department of Psychology, Faculty of Social and Educational Sciences, Norwegian University of Science and Technology, Trondheim, Norway,*Correspondence: Siri Weider, ✉
| | - Astrid M. W. Lærum
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway,Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Kari Anne I. Evensen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway,Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway,Unit for Physiotherapy Services, Trondheim Municipality, Trondheim, Norway,Department of Physiotherapy, Oslo Metropolitan University, Oslo, Norway
| | - Solveig Klæbo Reitan
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway,Department of Psychiatry, Division of Mental Health Care, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Stian Lydersen
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ann Mari Brubakk
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jon Skranes
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway,Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Marit S. Indredavik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
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Evensen KAI, Aakvik KAD, Hollund IMH, Skranes J, Brubakk A, Indredavik MS. Multidisciplinary and neuroimaging findings in preterm born very low birthweight individuals from birth to 28 years of age: A systematic review of a Norwegian prospective cohort study. Paediatr Perinat Epidemiol 2022; 36:606-630. [PMID: 35867340 PMCID: PMC9542186 DOI: 10.1111/ppe.12890] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 04/04/2022] [Accepted: 04/11/2022] [Indexed: 12/20/2022]
Abstract
BACKGROUND Children born preterm with very low birthweight (VLBW) face long-lasting neurodevelopmental challenges, where multidisciplinary assessments are warranted. The International Classification of Functioning, Disability and Health (ICF) provides a framework for understanding and conceptualising these outcomes. OBJECTIVES We aimed to review clinical and neuroimaging findings from birth to adulthood in a Norwegian cohort of individuals born preterm with VLBW (gestational age <37 weeks, birthweight ≤1500 g) within the framework of ICF. DATA SOURCES We searched PubMed and Embase for articles reporting results of the Norwegian University of Science and Technology (NTNU) Low Birth Weight in a Lifetime Perspective study. STUDY SELECTION AND DATA EXTRACTION We included original articles reporting proportions of adverse outcomes, mean group differences, risk factors or associations between outcomes. Data were extracted according to ICF's two-level classification. Body functions and structures comprised outcomes of brain structures, cognition, mental health, vision, pain and physical health. Activities and participation comprised motor skills, general and social functioning, education, employment, and health-related quality of life. SYNTHESIS We performed a qualitative synthesis of included articles. Where mean (SD) was reported, we calculated group differences in SD units. RESULTS Fifty-eight publications were included. Within body functions and structures, increased prevalence of brain structure pathology, lower cognitive performance, mental health problems, visual and physical health impairments through childhood, adolescence and young adulthood were reported among preterm VLBW participants compared with controls. Within activities and participation, motor problems, lower general and social functioning, and lower academic attainment were found. Perinatal factors were associated with several outcomes, and longitudinal findings suggested persistent consequences of being born preterm with VLBW. CONCLUSIONS Being born preterm with VLBW has long-term influences on body functions and structures, activities and participation. The ICF is appropriate for assessing general domains of functioning and guiding the management of individuals born preterm with VLBW.
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Affiliation(s)
- Kari Anne I. Evensen
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway,Department of Physiotherapy, Faculty of Health SciencesOslo Metropolitan UniversityOsloNorway,Unit for Physiotherapy ServicesTrondheim MunicipalityTrondheimNorway
| | - Kristina Anna Djupvik Aakvik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
| | - Ingrid Marie Husby Hollund
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway,Department of Physical Medicine and RehabilitationSt. Olavs Hospital, Trondheim University HospitalTrondheimNorway
| | - Jon Skranes
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway,Department of PediatricsSørlandet HospitalArendalNorway
| | - Ann‐Mari Brubakk
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
| | - Marit S. Indredavik
- Department of Clinical and Molecular Medicine, Faculty of Medicine and Health SciencesNorwegian University of Science and TechnologyTrondheimNorway
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Hol HR, Flak MM, Chang L, Løhaugen GCC, Bjuland KJ, Rimol LM, Engvig A, Skranes J, Ernst T, Madsen BO, Hernes SS. Cortical Thickness Changes After Computerized Working Memory Training in Patients With Mild Cognitive Impairment. Front Aging Neurosci 2022; 14:796110. [PMID: 35444526 PMCID: PMC9014119 DOI: 10.3389/fnagi.2022.796110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Accepted: 02/21/2022] [Indexed: 11/13/2022] Open
Abstract
Background Adaptive computerized working memory (WM) training has shown favorable effects on cerebral cortical thickness as compared to non-adaptive training in healthy individuals. However, knowledge of WM training-related morphological changes in mild cognitive impairment (MCI) is limited. Objective The primary objective of this double-blind randomized study was to investigate differences in longitudinal cortical thickness trajectories after adaptive and non-adaptive WM training in patients with MCI. We also investigated the genotype effects on cortical thickness trajectories after WM training combining these two training groups using longitudinal structural magnetic resonance imaging (MRI) analysis in Freesurfer. Method Magnetic resonance imaging acquisition at 1.5 T were performed at baseline, and after four- and 16-weeks post training. A total of 81 individuals with MCI accepted invitations to undergo 25 training sessions over 5 weeks. Longitudinal Linear Mixed effect models investigated the effect of adaptive vs. non-adaptive WM training. The LME model was fitted for each location (vertex). On all statistical analyzes, a threshold was applied to yield an expected false discovery rate (FDR) of 5%. A secondary LME model investigated the effects of LMX1A and APOE-ε4 on cortical thickness trajectories after WM training. Results A total of 62 participants/patients completed the 25 training sessions. Structural MRI showed no group difference between the two training regimes in our MCI patients, contrary to previous reports in cognitively healthy adults. No significant structural cortical changes were found after training, regardless of training type, across all participants. However, LMX1A-AA carriers displayed increased cortical thickness trajectories or lack of decrease in two regions post-training compared to those with LMX1A-GG/GA. No training or training type effects were found in relation to the APOE-ε4 gene variants. Conclusion The MCI patients in our study, did not have improved cortical thickness after WM training with either adaptive or non-adaptive training. These results were derived from a heterogeneous population of MCI participants. The lack of changes in the cortical thickness trajectory after WM training may also suggest the lack of atrophy during this follow-up period. Our promising results of increased cortical thickness trajectory, suggesting greater neuroplasticity, in those with LMX1A-AA genotype need to be validated in future trials.
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Affiliation(s)
- Haakon R. Hol
- Department of Radiology, Sørlandet Hospital, Arendal, Norway
- Department of Radiology, Oslo University Hospital, Oslo, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
- *Correspondence: Haakon R. Hol,
| | | | - Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
- Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - Knut Jørgen Bjuland
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars M. Rimol
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Andreas Engvig
- Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | - Jon Skranes
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Thomas Ernst
- Department of Diagnostic Radiology and Nuclear Medicine, University of Maryland School of Medicine, Baltimore, MD, United States
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Bengt-Ove Madsen
- Department of Geriatric and Internal Medicine, Sørlandet Hospital, Arendal, Norway
| | - Susanne S. Hernes
- Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Geriatric and Internal Medicine, Sørlandet Hospital, Arendal, Norway
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11
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Hernes SS, Flak MM, Løhaugen GCC, Skranes J, Hol HR, Madsen BO, Knapskog AB, Engvig A, Pripp A, Ulstein I, Lona T, Zhang X, Chang L. Working Memory Training in Amnestic and Non-amnestic Patients With Mild Cognitive Impairment: Preliminary Findings From Genotype Variants on Training Effects. Front Aging Neurosci 2021; 13:624253. [PMID: 33658917 PMCID: PMC7917210 DOI: 10.3389/fnagi.2021.624253] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Accepted: 01/12/2021] [Indexed: 11/13/2022] Open
Abstract
Working memory training (WMT) effects may be modulated by mild cognitive impairment (MCI) subtypes, and variations in APOE-epsilon (APOE-ε) and LMX1A genotypes. Sixty-one individuals (41 men/20 women, mean age 66 years) diagnosed with MCI (31 amnestic/30 non-amnestic) and genotyped for APOE-ε and LMX1A completed 4 weeks/20-25 sessions of WMT. Cognitive functions were assessed before, 4 weeks and 16 weeks after WMT. Except for Processing Speed, the non-amnestic MCI group (naMCI) outperformed the amnestic MCI (aMCI) group in all cognitive domains across all time-points. At 4 weeks, working memory function improved in both groups (p < 0.0001), but at 16 weeks the effects only remained in the naMCI group. Better performance was found after training for the naMCI patients with LMX1A-AA genotype and for the APOE-ε4 carriers. Only the naMCI-APOE-ε4 group showed improved Executive Function at 16 weeks. WMT improved working memory and some non-trained cognitive functions in individuals with MCI. The naMCI group had greater training gain than aMCI group, especially in those with LMX1A-AA genotype and among APOE-ε4-carriers. Further research with larger sample sizes for the subgroups and longer follow-up evaluations is warranted.
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Affiliation(s)
- Susanne S Hernes
- Department of Geriatric and Internal Medicine, Sørlandet Hospital, Arendal, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Marianne M Flak
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, Sørlandet Hospital HF, Arendal, Norway
| | - Gro C C Løhaugen
- Department of Pediatrics, Sørlandet Hospital HF, Arendal, Norway
| | - Jon Skranes
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, Sørlandet Hospital HF, Arendal, Norway
| | - Haakon R Hol
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Radiology, Sørlandet Hospital HF, Arendal, Norway
| | - Bengt-Ove Madsen
- Department of Geriatric and Internal Medicine, Sørlandet Hospital, Arendal, Norway
| | - Anne-Brita Knapskog
- Department of Geriatric Medicine, The Memory Clinic, Oslo University Hospital, Oslo, Norway
| | - Andreas Engvig
- Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | - Are Pripp
- Oslo Centre of Biostatistics and Epidemiology Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Ingun Ulstein
- Department of Geriatric Medicine, The Memory Clinic, Oslo University Hospital, Oslo, Norway
| | - Trine Lona
- Department of Psychiatry, Age Psychiatry, The Hospital of Telemark, Skien, Norway
| | - Xin Zhang
- Department of Diagnostic Radiology and Nuclear Medicine, and Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
| | - Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, and Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Medicine, John A. Burns School of Medicine, The University of Hawai'i at Mānoa, Honolulu, HI, United States
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12
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Sørensen K, Vestrheim IE, Lerdal B, Skranes J. Functional Skills among Preschool Children with Cerebral Palsy - Assessment before and after Early Intervention. Dev Neurorehabil 2020; 23:519-525. [PMID: 31779501 DOI: 10.1080/17518423.2019.1698069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Objective: To assess and evaluate the change in functional skills among children with cerebral palsy (CP) who participated in an intensified habilitation program. Methods: In this prospective longitudinal study, a cohort of 39 preschool children (2-5 years) with cerebral palsy (Gross Motor Function Classification System levels I-V) together with their parents participated in an intensified multidimensional habilitation program for 1 year. Activities strengthening functional skills were among the main interventions. The children were evaluated with the Pediatric Evaluation of Disability Inventory before and after the program period. Results: Only children at GMFCS levels I-II showed improvements in mobility and social function on norm-referenced scales. After the intervention period, these children scored similar to the mean for typically developing children of the same age on the social function domain. Conclusions: Functional skills among preschool children with CP, GMFCS levels I-II, seems strengthened after participation in an intensified habilitation program.
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Affiliation(s)
| | | | | | - Jon Skranes
- Sørlandet Hospital HF , Arendal, Norway.,Norwegian University of Science and Technology (NTNU) , Trondheim, Norway
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13
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Melby L, Indredavik MS, Løhaugen G, Brubakk AM, Skranes J, Vik T. Is there an association between full IQ score and mental health problems in young adults? A study with a convenience sample. BMC Psychol 2020; 8:7. [PMID: 32000845 PMCID: PMC6993501 DOI: 10.1186/s40359-020-0372-2] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2018] [Accepted: 01/13/2020] [Indexed: 01/18/2023] Open
Abstract
Background Intelligence is the aggregate or global capacity of the individual to act purposefully, to think rationally and to deal effectively with the environment. Previous studies have shown that individuals with intellectual disability, IQ < 70, have increased risk of being diagnosed with one or more mental disorders. We wanted to investigate if this also applies to individuals with IQ between 70 and 85. Methods In this study, data was abstracted from a longitudinal follow-up study of individuals with low birth weight and a control group. In the present study, mental health of participants with borderline IQ, defined as a full IQ score 70–84, were compared with mental health of a reference group with full IQ scores ≥85. Mental health at age 19 was assessed using the Schedule for Affective Disorder and Schizophrenia for School-age Children Present and Lifetime (K-SADS P/L) whereby scores meeting the diagnostic criteria for a mental disorder were defined as having mental health problems. In addition the participants completed the ADHD-rating scale and the Autism Spectrum Quotient form (AQ). Logistic regression analyses were used to calculate odds ratio (OR) with 95% confidence intervals (CI) for high scores on the K-SADS. Results Thirty participants with borderline IQ and 146 controls were included. Sixteen (53%) of the participants with borderline IQ met the diagnostic criteria on the K-SADS for any diagnosis compared with 18 (12%) in the reference group (OR: 6.2; CI: 2.6–14.9). In particular the participants with borderline IQ had excess risk of ADHD and anxiety. These associations were slightly attenuated when adjusted for birth weight and parents’ socioeconomic status. Conclusions 53% of the participants with borderline IQ had increased risk for a research assessed psychiatric diagnosis compared to about one in ten in the reference group. The group with borderline IQ also had higher total scores and higher scores on some sub-scores included in the Autism Spectrum Quotient form. Our results points towards an increased vulnerability for mental illness in individuals with borderline low IQ. Trial registration The main study is recorded by the Regional Committee for Health Research Ethics in Mid-Norway (as project number 4.2005.2605).
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Affiliation(s)
- Linde Melby
- Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), 6630, Tingvoll, Norway.
| | - Marit S Indredavik
- Child and Adolescent Psychiatry, Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Gro Løhaugen
- Department of Pediatrics, Sørlandet Hospital Arendal, Arendal, Norway
| | - Ann Mari Brubakk
- Pediatrics, Department of Clinical and Molecular medicine, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Jon Skranes
- Department of Pediatrics, Sørlandet Hospital Arendal, Arendal, Norway.,Pediatrics, Department of Clinical and Molecular medicine, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway
| | - Torstein Vik
- Pediatrics, Department of Clinical and Molecular medicine, Faculty of Medicine and Health Sciences, NTNU, Trondheim, Norway.,St. Olavs Hospital, Trondheim, Norway
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14
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Skranes J, Kleiven O, Aakre KM, Skadberg O, Melberg TH, Omland T, Orn S. P2500The high-sensitivity cardiac troponin I and T response following strenuous activity is attenuated by smokeless tobacco:The North Sea Race Endurance Exercise Study (NEEDED) 2014. Eur Heart J 2019. [DOI: 10.1093/eurheartj/ehz748.0829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Use of snus, a smokeless oral tobacco product, is increasing among athletes and recreational exercisers in Scandinavia. Strenuous physical activity is associated with an acute increase in high-sensitivity cardiac troponins (hs-cTn) in healthy individuals. Current smoking is associated with lower baseline hs-cTn concentrations in current smokers in the general population, but whether tobacco affects the hs-cTn response to exercise remains unknown.
Methods
We measured serial cTnI and cTnT concentrations in 1002 healthy recreational athletes before, 3 and 24 h after a 91 km bicycle race. Self-reported snus habits were reported as: non-current (n=794) and current (n=118). The association between snus use and change in log hs-cTnI and hs-cTnT (differences between concentrations at baseline and 3 h (Δ3 h) and 24 h (Δ24 h)) were assessed by multivariable linear regression analysis.
Results
Current snus use was associated with lower cTnI (current users of snus vs non-current: median, 1.7 ng/l; interquartile range (IQR), 1.6–2.3 vs 2.0 ng/L; IQR 1.6–3.2; p=0.020) and cTnT (current users of snus vs non-current: median, 3.0 ng/L, IQR, 3.0–3.5 vs 3.0 ng/L, IQR 3.0–4.3; p=0.021) concentrations at baseline. Both in unadjusted and fully adjusted linear regression models, users of snus had significantly lower Δ3 h and Δ24 h cTnI and cTnT concentrations (Table).
Association between snus use and change in concentrations of hs-cTnI and hs-cTnT (95% CI) Model 1 Model 2 Model 3 Model 4 ΔcTnI 3 h Current snus −28% (−46% to −10%), p=0.003 −33% (−51% to −14%), p=0.001 −31% (−49% to −13%), p=0.001 −29% (−47% to −11%), p=0.002 ΔcTnI 24 h Current snus −38% (−62% to −15%), p=0.002 −36% (−59% to −12%), p=0.003 −32% (−56% to −9%), p=0.007 −30% (−54% to −7%), p=0.010 ΔcTnT 3 h Current snus −28% (−10% to −46%), p=0.003 −33% (−51% to −14%), p=0.001 −31% (−49% to −13%), p=0.001 −29% (−47% to −11%), p=0.002 ΔcTnT 24 h Current snus −20% (−4% to −36%), p=0.015 −23% (−39% to −8%), p=0.004 −21% (−36% to −5%), p=0.009 −19% (−34% to −14%), p=0.013 Model 1 unadjusted; Model 2 adjusted for sex and age; Model 3 adjusted for Model 2 and systolic blood pressure, body mass index, low-density lipoprotein and estimated glomerular filtration rate; Model 4 adjusted for the same variables as in Model 3 but also race duration and resting heart rate.
Conclusion
The exercise-induced cTn response in healthy recreational cyclist is attenuated in users of smokeless tobacco compared to never users. These findings extend observations of lower hs-cTn concentrations in tobacco smokers in the general population.
Acknowledgement/Funding
Operating grant from North Sea Race, Abbot Diagnostics, Lærdal Foundation. PhD fellowship from South-Eastern Norway Regional Health Authority.
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Affiliation(s)
- J Skranes
- Akershus University Hospital and Center for Heart Failure Research, Institute of Clinical Medicine,, Lorenskog, Norway
| | - O Kleiven
- Stavanger University Hospital, Cardiology Department, Stavanger, Norway
| | - K M Aakre
- Haukeland University Hospital, Hormone Laboratory, Bergen, Norway
| | - O Skadberg
- Stavanger University Hospital, Laboratory of Clinical Biochemistry, Stavanger, Norway
| | - T H Melberg
- Stavanger University Hospital, Cardiology Department, Stavanger, Norway
| | - T Omland
- Akershus University Hospital and Center for Heart Failure Research, Institute of Clinical Medicine,, Lorenskog, Norway
| | - S Orn
- Stavanger University Hospital, Cardiology Department, Stavanger, Norway
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Abstract
Recent findings indicate that retinopathy of prematurity (ROP), presently classified by clinical examinations of retinal vascular tissue, is associated with structural alterations of the central nervous system. Such alterations may be the correlate of the association between ROP and impaired long-term neurocognitive and visual development. The advent of imaging techniques such as structural and diffusion tensor magnetic resonance imaging of the brain, and optical coherence tomography of the retina, will allow the complete visual system to be characterized in greater detail. It has been suggested that ROP may be not only a vascular, but a neurovascular disease, being part of a spectrum that includes pathological development in both the retinal and cerebral neurovascular interphase. We review the present knowledge in the field and point to future directions for research to tackle these questions.
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Affiliation(s)
- Tora Sund Morken
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Norway and Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Olaf Dammann
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA; Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany
| | - Jon Skranes
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway; Department of Child Neurology and Rehabilitation and Regional Competence Center for children with prenatal alcohol/drug exposure, Sørlandet Hospital, Arendal, Norway
| | - Dordi Austeng
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Norway and Department of Ophthalmology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
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16
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Affiliation(s)
- Jon Skranes
- Department of Pediatrics Sørlandet Hospital Arendal HF Arendal Norway
- Department of Clinical and Molecular Medicine Faculty of Medicine and Health Sciences Norwegian University of Science and Technology Trondheim Norway
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17
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Lærum AMW, Reitan SK, Evensen KAI, Lydersen S, Brubakk AM, Skranes J, Indredavik MS. Psychiatric symptoms and risk factors in adults born preterm with very low birthweight or born small for gestational age at term. BMC Psychiatry 2019; 19:223. [PMID: 31315591 PMCID: PMC6636134 DOI: 10.1186/s12888-019-2202-8] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Accepted: 07/02/2019] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND We aimed to examine psychiatric symptoms in adults born preterm with very low birthweight or born at term small for gestational age compared with normal birthweight peers, and examine associations with perinatal factors and childhood motor and cognitive function. METHODS In this longitudinal cohort study, one preterm born group with very low birthweight (VLBW: birthweight ≤1500 g), one term-born Small for Gestational Age (SGA: birthweight <10th percentile) group and one term-born non-SGA control group, were assessed at 26 years of age. Primary outcomes were scores on self-reported questionnaires: Achenbach System of Empirically Based Assessment - Adult Self-Report, The Autism-Spectrum Quotient and Peters et al. Delusions Inventory. Exposure variables were perinatal data, while childhood motor and cognitive function were examined as possible early markers. RESULTS Both the preterm VLBW and the term SGA group reported higher levels of attention, internalizing and externalizing problems compared to the control group. In addition, the VLBW participants reported more critical items and a higher proportion had intermediate level autistic traits, while the SGA participants reported more intrusive behavior. Increasing length of respiratory support and hospital stay in the neonatal period, and motor problems in early adolescence, were associated with adult psychiatric symptoms in the VLBW group. CONCLUSIONS Psychiatric symptoms were frequent in the preterm VLBW group and also in the term-born SGA group. Those who were sickest as babies were most at risk. Motor problems can possibly serve as an early marker of adult psychiatric symptoms in low birthweight individuals.
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Affiliation(s)
- Astrid M. W. Lærum
- 0000 0001 1516 2393grid.5947.fDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Unit for Pediatrics, 6th floor, Kvinne-barn-senteret, Olav Kyrres gt. 11, 7030 Trondheim, Norway ,0000 0004 0627 3560grid.52522.32Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Solveig Klæbo Reitan
- 0000 0001 1516 2393grid.5947.fDepartment of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway ,0000 0004 0627 3560grid.52522.32Department of Mental Health, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Kari Anne I. Evensen
- 0000 0001 1516 2393grid.5947.fDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Unit for Pediatrics, 6th floor, Kvinne-barn-senteret, Olav Kyrres gt. 11, 7030 Trondheim, Norway ,0000 0001 1516 2393grid.5947.fDepartment of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway ,Unit for Physiotherapy Services, Trondheim Municipality, Norway ,Department of Physiotherapy, Faculty of Health Sciences, Oslo Metropolitan University, Oslo, Norway
| | - Stian Lydersen
- 0000 0001 1516 2393grid.5947.fDepartment of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ann-Mari Brubakk
- 0000 0001 1516 2393grid.5947.fDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Unit for Pediatrics, 6th floor, Kvinne-barn-senteret, Olav Kyrres gt. 11, 7030 Trondheim, Norway ,0000 0004 0627 3560grid.52522.32Children’s Clinic, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Jon Skranes
- 0000 0001 1516 2393grid.5947.fDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Unit for Pediatrics, 6th floor, Kvinne-barn-senteret, Olav Kyrres gt. 11, 7030 Trondheim, Norway ,0000 0004 0414 4503grid.414311.2Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Marit S. Indredavik
- 0000 0001 1516 2393grid.5947.fDepartment of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Unit for Pediatrics, 6th floor, Kvinne-barn-senteret, Olav Kyrres gt. 11, 7030 Trondheim, Norway
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18
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Affiliation(s)
- Jon Skranes
- Regional Competence Center for Children with Prenatal Alcohol/Drug Exposure, Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
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19
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Aanes S, Bjuland KJ, Sripada K, Sølsnes AE, Grunewaldt KH, Håberg A, Løhaugen GC, Skranes J. Reduced hippocampal subfield volumes and memory function in school-aged children born preterm with very low birthweight (VLBW). Neuroimage Clin 2019; 23:101857. [PMID: 31136968 PMCID: PMC6536855 DOI: 10.1016/j.nicl.2019.101857] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Revised: 05/07/2019] [Accepted: 05/09/2019] [Indexed: 01/31/2023]
Abstract
BACKGROUND The hippocampus, an essential structure for learning and memory, has a reduced volume in preterm born (gestational age < 37 weeks) individuals with very low birth weight (VLBW: birth weight < 1500 g), which may affect memory function. However, the hippocampus is a complex structure with distinct subfields related to specific memory functions. These subfields are differentially affected by a variety of neuropathological conditions, but it remains unclear how these subfields may be affected by medical complications following preterm birth which may cause aberrant brain development, and the consequences of this on learning and memory function in children with VLBW. METHODS Children born preterm with VLBW (n = 34) and term-born controls from the Norwegian Mother and Child Cohort Study (MoBa) (n = 104) underwent structural MRI and a neuropsychological assessment of memory function at primary school age. FreeSurfer 6.0 was used to analyze the volumes of hippocampal subfields which were compared between groups, as was memory performance. Correlations between abnormal hippocampal subfields and memory performance were explored in the VLBW group. RESULTS All absolute hippocampal subfield volumes were lower in the children with VLBW compared to MoBa term-born controls, and the volumes of the left and right dentate gyrus and the right subiculum remained significantly lower after correcting for total intracranial volume. The VLBW group had inferior working memory performance and the score on the subtest Spatial Span backwards was positively correlated to the volume of the right dentate gyrus. CONCLUSIONS Hippocampal subfield volumes seem to be differently affected by early brain development related to preterm birth. The dentate gyrus appears particularly susceptible to adverse effects of preterm birth. Reduced working memory function among children with VLBW was associated with smaller volume of right dentate gyrus. This finding demonstrates alterations in hippocampal structure-function relationships associated with early brain development related to preterm birth.
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Affiliation(s)
- Synne Aanes
- Department of Clinical and Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway.
| | | | - Kam Sripada
- Department of Clinical and Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway
| | - Anne Elisabeth Sølsnes
- Department of Clinical and Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway
| | - Kristine H Grunewaldt
- Department of Clinical and Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway; Department of Pediatrics, St Olav University Hospital, Trondheim, Norway
| | - Asta Håberg
- Department of Neuromedicine and Movement Science, Norwegian University of Science & Technology, Trondheim, Norway
| | - Gro C Løhaugen
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Jon Skranes
- Department of Clinical and Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
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Winkler AM, Greve DN, Bjuland KJ, Nichols TE, Sabuncu MR, Håberg AK, Skranes J, Rimol LM. Joint Analysis of Cortical Area and Thickness as a Replacement for the Analysis of the Volume of the Cerebral Cortex. Cereb Cortex 2019; 28:738-749. [PMID: 29190325 PMCID: PMC5972607 DOI: 10.1093/cercor/bhx308] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2017] [Accepted: 10/27/2017] [Indexed: 12/21/2022] Open
Abstract
Cortical surface area is an increasingly used brain morphology metric that is ontogenetically and phylogenetically distinct from cortical thickness and offers a separate index of neurodevelopment and disease. However, the various existing methods for assessment of cortical surface area from magnetic resonance images have never been systematically compared. We show that the surface area method implemented in FreeSurfer corresponds closely to the exact, but computationally more demanding, mass-conservative (pycnophylactic) method, provided that images are smoothed. Thus, the data produced by this method can be interpreted as estimates of cortical surface area, as opposed to areal expansion. In addition, focusing on the joint analysis of thickness and area, we compare an improved, analytic method for measuring cortical volume to a permutation-based nonparametric combination (NPC) method. We use the methods to analyze area, thickness and volume in young adults born preterm with very low birth weight, and show that NPC analysis is a more sensitive option for studying joint effects on area and thickness, giving equal weight to variation in both of these 2 morphological features.
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Affiliation(s)
- Anderson M Winkler
- Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK.,Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06511, USA.,Big Data Analytics Group, Hospital Israelita Albert Einstein, São Paulo, SP 05652-900, Brazil
| | - Douglas N Greve
- Martinos Center for Biomedical Imaging, Massachusetts General Hospital/ Harvard Medical School, Charlestown, MA 02129, USA
| | - Knut J Bjuland
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim 7030, Norway
| | - Thomas E Nichols
- Oxford Centre for Functional MRI of the Brain, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford OX3 9DU, UK.,Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - Mert R Sabuncu
- School of Electrical and Computer Engineering, and Meinig School of Biomedical Engineering, Cornell University, Ithaca, NY 14853, USA
| | - Asta K Håberg
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim 7030, Norway.,Department of Radiology, St. Olav's Hospital, Trondheim University Hospital, Trondheim 7030, Norway
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim 7030, Norway.,Department of Pediatrics, Sørlandet Hospital, 4838 Arendal, Norway
| | - Lars M Rimol
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim 7030, Norway.,Norwegian Advisory Unit for Functional MRI, Department of Radiology, St. Olav's University Hospital, Trondheim 7006, Norway
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21
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Flak MM, Hol HR, Hernes SS, Chang L, Engvig A, Bjuland KJ, Pripp A, Madsen BO, Knapskog AB, Ulstein I, Lona T, Skranes J, Løhaugen GCC. Adaptive Computerized Working Memory Training in Patients With Mild Cognitive Impairment. A Randomized Double-Blind Active Controlled Trial. Front Psychol 2019; 10:807. [PMID: 31031677 PMCID: PMC6473070 DOI: 10.3389/fpsyg.2019.00807] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2019] [Accepted: 03/25/2019] [Indexed: 01/14/2023] Open
Abstract
Objective We investigated if a 5-week computerized adaptive working memory training program (Cogmed®) of 20 to 25 sessions would be effective in improving the working memory capacity and other neuropsychological functions compared to a non-adaptive working memory training program (active-controlled) in adult patients with mild cognitive impairment (MCI). Methods This randomized double-blinded active control trial included 68 individuals aged 43 to 88 years, 45 men and 23 women, who were diagnosed with MCI at four Memory clinics. The study sample was randomized by block randomization to either adaptive or non-adaptive computerized working memory training. All participants completed the training, and were assessed with a comprehensive neuropsychological test battery before the intervention, and at 1 and 4 months after training. Results Compared to the non-adaptive training group, the adaptive training group did not show significantly greater improvement on the main outcome of working memory performance at 1 and 4 months after training. Conclusion No difference were found between the two types of training on the primary outcome of working memory, or on secondary outcomes of cognitive function domains, in this sample of MCI patients. Hence, the hypothesis that the adaptive training program would lead to greater improvements compared to the non-adaptive training program was not supported. Within group analyses was not performed due to the stringent RCT design.
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Affiliation(s)
- Marianne M Flak
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, Sørlandet Hospital HF, Arendal, Norway
| | - Haakon R Hol
- Department of Radiology, Sørlandet Hospital HF, Arendal, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Susanne S Hernes
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Medicine, The Memory Clinic Geriatric Unit, Sørlandet Hospital, Arendal, Norway
| | - Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, and Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Andreas Engvig
- Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | | | - Are Pripp
- Oslo Centre of Biostatistics and Epidemiology Research Support Services, Oslo University Hospital, Oslo, Norway
| | - Bengt-Ove Madsen
- Department of Medicine, The Memory Clinic Geriatric Unit, Sørlandet Hospital, Arendal, Norway
| | - Anne-Brita Knapskog
- Department of Geriatric Medicine, The Memory Clinic, Oslo University Hospital, Oslo, Norway
| | - Ingun Ulstein
- Department of Geriatric Medicine, The Memory Clinic, Oslo University Hospital, Oslo, Norway
| | - Trine Lona
- Department of Psychiatry, Age Psychiatry, The Hospital of Telemark, Skien, Norway
| | - Jon Skranes
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, Sørlandet Hospital HF, Arendal, Norway
| | - Gro C C Løhaugen
- Department of Pediatrics, Sørlandet Hospital HF, Arendal, Norway
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22
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Flak MM, Hol HR, Hernes SS, Chang L, Ernst T, Engvig A, Bjuland KJ, Madsen BO, Lindland EMS, Knapskog AB, Ulstein ID, Lona TEE, Skranes J, Løhaugen GCC. Corrigendum: Cognitive Profiles and Atrophy Ratings on MRI in Senior Patients With Mild Cognitive Impairment. Front Aging Neurosci 2019; 11:37. [PMID: 30863303 PMCID: PMC6399656 DOI: 10.3389/fnagi.2019.00037] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 02/06/2019] [Indexed: 11/13/2022] Open
Affiliation(s)
- Marianne M Flak
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, Sørlandet Hospital HF, Arendal, Norway
| | - Haakon R Hol
- Department of Radiology, Sørlandet Hospital HF, Arendal, Norway.,Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Susanne S Hernes
- Department of Clinical Science, University of Bergen, Bergen, Norway.,The Memory Clinic Geriatric Unit, Department of Medicine, Sørlandet Hospital, Arendal, Norway
| | - Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, and Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Thomas Ernst
- Department of Diagnostic Radiology and Nuclear Medicine, and Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States.,Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Andreas Engvig
- Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | | | - Bengt-Ove Madsen
- The Memory Clinic Geriatric Unit, Department of Medicine, Sørlandet Hospital, Arendal, Norway
| | - Elisabeth M S Lindland
- Department of Radiology, Sørlandet Hospital HF, Arendal, Norway.,Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway.,Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne-Brita Knapskog
- Department of Geriatric Medicine, The Memory Clinic, Oslo University Hospital, Oslo, Norway
| | - Ingun D Ulstein
- Department of Geriatric Medicine, The Memory Clinic, Oslo University Hospital, Oslo, Norway
| | - Trine E E Lona
- Department of Psychiatry, Age Psychiatry, The Hospital of Telemark, Skien, Norway
| | - Jon Skranes
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, Sørlandet Hospital HF, Arendal, Norway
| | - Gro C C Løhaugen
- Department of Pediatrics, Sørlandet Hospital HF, Arendal, Norway
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23
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Flak MM, Hol HR, Hernes SS, Chang L, Ernst T, Engvig A, Bjuland KJ, Madsen BO, Lindland EMS, Knapskog AB, Ulstein ID, Lona TEE, Skranes J, Løhaugen GCC. Cognitive Profiles and Atrophy Ratings on MRI in Senior Patients With Mild Cognitive Impairment. Front Aging Neurosci 2018; 10:384. [PMID: 30519185 PMCID: PMC6258794 DOI: 10.3389/fnagi.2018.00384] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Accepted: 11/01/2018] [Indexed: 12/12/2022] Open
Abstract
In this cross-sectional study, we sought to describe cognitive and neuroimaging profiles of Memory clinic patients with Mild Cognitive Impairment (MCI). 51 MCI patients and 51 controls, matched on age, sex, and socio-economic status (SES), were assessed with an extensive neuropsychological test battery that included a measure of intelligence (General Ability Index, "GAI," from WAIS-IV), and structural magnetic resonance imaging (MRI). MCI subtypes were determined after inclusion, and z-scores normalized to our control group were generated for each cognitive domain in each MCI participant. MR-images were scored by visual rating scales. MCI patients performed significantly worse than controls on 23 of 31 cognitive measures (Bonferroni corrected p = 0.001), and on 8 of 31 measures after covarying for intelligence (GAI). Compared to nonamnestic MCI patients, amnestic MCI patients had lower test results in 13 of 31 measures, and 5 of 31 measures after co-varying for GAI. Compared to controls, the MCI patients had greater atrophy on Schelten's Medial temporal lobe atrophy score (MTA), especially in those with amnestic MCI. The only structure-function correlation that remained significant after correction for multiple comparisons was the MTA-long delay recall domain. Intelligence operationalized as GAI appears to be an important moderator of the neuropsychological outcomes. Atrophy of the medial temporal lobe, based on MTA scores, may be a sensitive biomarker for the functional episodic memory deficits associated with MCI.
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Affiliation(s)
- Marianne M. Flak
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pediatrics, Sørlandet Hospital HF, Arendal, Norway
| | - Haakon R. Hol
- Department of Radiology, Sørlandet Hospital HF, Arendal, Norway
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Susanne S. Hernes
- Department of Clinical Science, University of Bergen, Bergen, Norway
- The Memory Clinic Geriatric Unit, Department of Medicine, Sørlandet Hospital, Arendal, Norway
| | - Linda Chang
- Department of Diagnostic Radiology and Nuclear Medicine, and Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Thomas Ernst
- Department of Diagnostic Radiology and Nuclear Medicine, and Department of Neurology, University of Maryland School of Medicine, Baltimore, MD, United States
- Department of Neurology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI, United States
| | - Andreas Engvig
- Department of Medicine, Diakonhjemmet Hospital, Oslo, Norway
| | | | - Bengt-Ove Madsen
- The Memory Clinic Geriatric Unit, Department of Medicine, Sørlandet Hospital, Arendal, Norway
| | - Elisabeth M. S. Lindland
- Department of Radiology, Sørlandet Hospital HF, Arendal, Norway
- Department of Radiology and Nuclear Medicine, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Anne-Brita Knapskog
- Department of Geriatric Medicine, The Memory Clinic, Oslo University Hospital, Oslo, Norway
| | - Ingun D. Ulstein
- Department of Geriatric Medicine, The Memory Clinic, Oslo University Hospital, Oslo, Norway
| | - Trine E. E. Lona
- Department of Psychiatry, Age Psychiatry, The Hospital of Telemark, Skien, Norway
| | - Jon Skranes
- Department of Clinical and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Pediatrics, Sørlandet Hospital HF, Arendal, Norway
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24
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Sripada K, Bjuland KJ, Sølsnes AE, Håberg AK, Grunewaldt KH, Løhaugen GC, Rimol LM, Skranes J. Trajectories of brain development in school-age children born preterm with very low birth weight. Sci Rep 2018; 8:15553. [PMID: 30349084 PMCID: PMC6197262 DOI: 10.1038/s41598-018-33530-8] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/27/2018] [Indexed: 12/29/2022] Open
Abstract
Preterm birth (gestational age < 37 weeks) with very low birth weight (VLBW, birth weight ≤ 1500 g) is associated with lifelong cognitive deficits, including in executive function, and persistent alterations in cortical and subcortical structures. However, it remains unclear whether “catch-up” growth is possible in the preterm/VLBW brain. Longitudinal structural MRI was conducted with children born preterm with VLBW (n = 41) and term-born peers participating in the Norwegian Mother and Child Cohort Study (MoBa) (n = 128) at two timepoints in early school age (mean ages 8.0 and 9.3 years). Images were analyzed with the FreeSurfer 5.3.0 longitudinal stream to assess differences in development of cortical thickness, surface area, and brain structure volumes, as well as associations with executive function development (NEPSY Statue and WMS-III Spatial Span scores) and perinatal health markers. No longitudinal group × time effects in cortical thickness, surface area, or subcortical volumes were seen, indicating similar brain growth trajectories in the groups over an approximately 16-month period in middle childhood. Higher IQ scores within the VLBW group were associated with greater surface area in left parieto-occipital and inferior temporal regions. Among VLBW preterm-born children, cortical surface area was smaller across the cortical mantle, and cortical thickness was thicker occipitally and frontally and thinner in lateral parietal and posterior temporal areas. Smaller volumes of corpus callosum, right globus pallidus, and right thalamus persisted in the VLBW group from timepoint 1 to 2. VLBW children had on average IQ 1 SD below term-born MoBa peers and significantly worse scores on WMS-III Spatial Span. Executive function scores did not show differential associations with morphometry between groups cross-sectionally or longitudinally. This study investigated divergent or “catch-up” growth in terms of cortical thickness, surface area, and volumes of subcortical gray matter structures and corpus callosum in children born preterm/VLBW and did not find group × time interactions. Greater surface area at mean age 9.3 in left parieto-occipital and inferior temporal cortex was associated with higher IQ in the VLBW group. These results suggest that preterm VLBW children may have altered cognitive networks, yet have structural growth trajectories that appear generally similar to their term-born peers in this early school age window.
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Affiliation(s)
- K Sripada
- Department of Clinical & Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway.
| | - K J Bjuland
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - A E Sølsnes
- Department of Clinical & Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway
| | - A K Håberg
- Department of Neuromedicine & Movement Science, Norwegian University of Science & Technology, Trondheim, Norway.,Department of Radiology & Nuclear Medicine, St. Olav's Hospital, Trondheim, Norway
| | - K H Grunewaldt
- Department of Clinical & Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway.,Department of Pediatrics, St. Olav's Hospital, Trondheim, Norway
| | - G C Løhaugen
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - L M Rimol
- Department of Radiology & Nuclear Medicine, St. Olav's Hospital, Trondheim, Norway.,Department of Circulation & Medical Imaging, Norwegian University of Science & Technology, Trondheim, Norway
| | - J Skranes
- Department of Clinical & Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway.,Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
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25
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Bangstad HJ, Storrøsten OT, Skranes J. Helge Michalsen. Tidsskriftet 2018. [DOI: 10.4045/tidsskr.18.0049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022] Open
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26
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Jystad KP, Strand KM, Bjellmo S, Lydersen S, Klungsöyr K, Stoknes M, Skranes J, Andersen GL, Vik T. Congenital anomalies and the severity of impairments for cerebral palsy. Dev Med Child Neurol 2017; 59:1174-1180. [PMID: 28967231 DOI: 10.1111/dmcn.13552] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/29/2017] [Indexed: 11/29/2022]
Abstract
AIM To study the prevalence of congenital anomalies among children with cerebral palsy (CP) born at term or late preterm, and if CP subtypes and clinical manifestations differ between children with and without congenital anomalies. METHOD This was a cross-sectional study using data from the Cerebral Palsy Register of Norway and the Medical Birth Registry of Norway. All children with congenital CP born at and later than 34 weeks' gestation in Norway from 1999 to 2009 were included. Anomalies were classified according to the European Surveillance of Congenital Anomalies classification guidelines. Groups were compared using Fisher's exact test, Kruskal-Wallis test, and the Mann-Whitney U test. RESULTS Among 685 children with CP, 169 (25%) had a congenital anomaly; 125 within the central nervous system. Spastic bilateral CP was more prevalent in children with anomalies (42%) than in children without (34%; p=0.011). Children with anomalies less frequently had low Apgar scores (p<0.001), but more often had severe limitations in gross- and fine-motor function, speech impairments, epilepsy, severe vision, and hearing impairments than children without anomalies (p<0.03). INTERPRETATION Although children with CP and anomalies had low Apgar scores less frequently, they had more severe limitations in motor function and more associated problems than children with CP without anomalies. WHAT THIS PAPER ADDS One in four children with cerebral palsy (CP) born at term or late preterm has a congenital anomaly. The added value of neuroimaging to detect central nervous system anomalies in children with CP. Children with anomalies have more severe motor impairments. More severe clinical manifestations are not explained by perinatal complications as indicated by low Apgar scores.
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Affiliation(s)
- Kjersti P Jystad
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Clinic of Surgery, St Olav's University Hospital, Trondheim, Norway
| | - Kristin M Strand
- Department of Obstetrics and Gynecology, St Olav's University Hospital, Trondheim, Norway
| | - Solveig Bjellmo
- Department of Obstetrics and Gynecology, Møre and Romsdal Hospital Trust, Ålesund, Norway
| | - Stian Lydersen
- The Regional Centre for Child and Adolescent Mental Health, NTNU, Trondheim, Norway
| | - Kari Klungsöyr
- Department of Global Public Health and Primary Care, University of Bergen, Bergen, Norway.,Domain for Health Data and Digitalisation, Norwegian Institute of Public Health, Bergen, Norway
| | - Magne Stoknes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,Department of Paediatrics, Sørlandet Hospital, Arendal, Norway
| | - Guro L Andersen
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway.,The Cerebral Palsy Register of Norway, Vestfold Hospital Trust, Tønsberg, Norway
| | - Torstein Vik
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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27
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28
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Affiliation(s)
- Jon Skranes
- Department of Laboratory Medicine; Children's and Women's Health; Medical Faculty; Norwegian University of Science and Technology; Trondheim Norway
- Department of Pediatrics; Sørlandet Hospital Arendal HF; Arendal Norway
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29
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Botellero VL, Skranes J, Bjuland KJ, Håberg AK, Lydersen S, Brubakk AM, Indredavik MS, Martinussen M. A longitudinal study of associations between psychiatric symptoms and disorders and cerebral gray matter volumes in adolescents born very preterm. BMC Pediatr 2017; 17:45. [PMID: 28143492 PMCID: PMC5286868 DOI: 10.1186/s12887-017-0793-0] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2016] [Accepted: 01/17/2017] [Indexed: 12/13/2022] Open
Abstract
Background Being born preterm with very low birthweight (VLBW ≤ 1500 g) poses a risk for cortical and subcortical gray matter (GM) abnormalities, as well as for having more psychiatric problems during childhood and adolescence than term-born individuals. The aim of this study was to investigate the relationship between cortical and subcortical GM volumes and the course of psychiatric disorders during adolescence in VLBW individuals. Methods We followed VLBW individuals and term-born controls (birth weight ≥10th percentile) from 15 (VLBW;controls n = 40;56) to 19 (n = 44;60) years of age. Of these, 30;37 individuals were examined longitudinally. Cortical and subcortical GM volumes were extracted from MRPRAGE images obtained with the same 1.5 T MRI scanner at both time points and analyzed at each time point with the longitudinal stream of the FreeSurfer software package 5.3.0. All participants underwent clinical interviews and were assessed for psychiatric symptoms and diagnosis (Schedule for Affective Disorders and Schizophrenia for School-age Children, Children’s Global Assessment Scale, Attention-Deficit/Hyperactivity Disorder Rating Scale-IV). VLBW adolescents were divided into two groups according to diagnostic status from 15 to 19 years of age: persisting/developing psychiatric diagnosis or healthy/becoming healthy. Results Reduction in subcortical GM volume at 15 and 19 years, not including the thalamus, was limited to VLBW adolescents with persisting/developing diagnosis during adolescence, whereas VLBW adolescents in the healthy/becoming healthy group had similar subcortical GM volumes to controls. Moreover, across the entire VLBW group, poorer psychosocial functioning was predicted by smaller subcortical GM volumes at both time points and with reduced GM volume in the thalamus and the parietal and occipital cortex at 15 years. Inattention problems were predicted by smaller GM volumes in the parietal and occipital cortex. Conclusions GM volume reductions in the parietal and occipital cortex as well as smaller thalamic and subcortical GM volumes were associated with the higher rates of psychiatric symptoms found across the entire VLBW group. Significantly smaller subcortical GM volumes in VLBW individuals compared with term-born peers might pose a risk for developing and maintaining psychiatric diagnoses during adolescence. Future research should explore the possible role of reduced cortical and subcortical GM volumes in the pathogenesis of psychiatric illness in VLBW adolescents. Electronic supplementary material The online version of this article (doi:10.1186/s12887-017-0793-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Violeta L Botellero
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Medical Technology Research Center, P.O. Box 8905, NO-7491, Trondheim, Norway.
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Medical Technology Research Center, P.O. Box 8905, NO-7491, Trondheim, Norway.,Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Knut Jørgen Bjuland
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Medical Technology Research Center, P.O. Box 8905, NO-7491, Trondheim, Norway
| | - Asta Kristine Håberg
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Medical Imaging, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Stian Lydersen
- Regional Center for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ann-Mari Brubakk
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Medical Technology Research Center, P.O. Box 8905, NO-7491, Trondheim, Norway.,Department of Pediatrics, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Marit S Indredavik
- Regional Center for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Child and Adolescent Psychiatry, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Marit Martinussen
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Medical Technology Research Center, P.O. Box 8905, NO-7491, Trondheim, Norway.,Department of Gynecology and Obstetrics, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
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Lærum AMW, Reitan SK, Evensen KAI, Lydersen S, Brubakk AM, Skranes J, Indredavik MS. Psychiatric Disorders and General Functioning in Low Birth Weight Adults: A Longitudinal Study. Pediatrics 2017; 139:peds.2016-2135. [PMID: 28123043 DOI: 10.1542/peds.2016-2135] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/17/2016] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE To examine psychiatric morbidity and overall functioning in adults born with low birth weight compared with normal birth weight controls at age 26 years and to study longitudinal trajectories of psychiatric morbidity from early adolescence to adulthood. METHODS Prospective cohort study wherein 44 preterm very low birth weight (≤1500 g), 64 term small for gestational age (SGA; <10th percentile), and 81 control adults were examined using the MINI-International Neuropsychiatric Interview: M.I.N.I. Plus, Norwegian version, the Global Assessment of Functioning, and questions on daily occupation and level of education. Prevalence of psychiatric disorders from previous follow-ups at age 14 and 19 years were included for longitudinal analysis. RESULTS From adolescence to adulthood, the term SGA group had a marked increase in the estimated probability of psychiatric disorders from 9% (95% confidence interval, 4-19) to 39% (95% confidence interval, 28-51). At 26 years, psychiatric diagnoses were significantly more prevalent in the preterm very low birth weight group (n = 16, 36%; P = .003) and the term SGA group (n = 24, 38%; P = .019) compared with the control group (n = 11, 14%). Both low birth weight groups had lower educational level and functioning scores than controls and a higher frequency of unemployment and disability benefit. CONCLUSIONS Low birth weight was a substantial risk factor for adult psychiatric morbidity and lowered overall functioning. The results underscore the need for long-term follow-up of low birth weight survivors through adolescence and adulthood, focusing on mental health. The longitudinal increase in psychiatric morbidity in the term SGA group calls for additional investigation.
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Affiliation(s)
- Astrid M W Lærum
- Departments of Laboratory Medicine, Children's and Women's Health,
| | | | - Kari Anne I Evensen
- Departments of Laboratory Medicine, Children's and Women's Health.,Public Health and General Practice, and.,Department of Physiotherapy, Trondheim Municipality, Trondheim, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ann-Mari Brubakk
- Departments of Laboratory Medicine, Children's and Women's Health
| | - Jon Skranes
- Departments of Laboratory Medicine, Children's and Women's Health
| | - Marit S Indredavik
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Child and Adolescent Psychiatry, St. Olavs Hospital Trondheim University Hospital, Trondheim, Norway; and
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31
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Wu D, Chang L, Akazawa K, Oishi K, Skranes J, Ernst T, Oishi K. Mapping the critical gestational age at birth that alters brain development in preterm-born infants using multi-modal MRI. Neuroimage 2017; 149:33-43. [PMID: 28111189 DOI: 10.1016/j.neuroimage.2017.01.046] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2016] [Revised: 01/07/2017] [Accepted: 01/18/2017] [Indexed: 02/06/2023] Open
Abstract
Preterm birth adversely affects postnatal brain development. In order to investigate the critical gestational age at birth (GAB) that alters the developmental trajectory of gray and white matter structures in the brain, we investigated diffusion tensor and quantitative T2 mapping data in 43 term-born and 43 preterm-born infants. A novel multivariate linear model-the change point model, was applied to detect change points in fractional anisotropy, mean diffusivity, and T2 relaxation time. Change points captured the "critical" GAB value associated with a change in the linear relation between GAB and MRI measures. The analysis was performed in 126 regions across the whole brain using an atlas-based image quantification approach to investigate the spatial pattern of the critical GAB. Our results demonstrate that the critical GABs are region- and modality-specific, generally following a central-to-peripheral and bottom-to-top order of structural development. This study may offer unique insights into the postnatal neurological development associated with differential degrees of preterm birth.
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Affiliation(s)
- Dan Wu
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Linda Chang
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Kentaro Akazawa
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kumiko Oishi
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Thomas Ernst
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Kenichi Oishi
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Chang L, Løhaugen GC, Andres T, Jiang CS, Douet V, Tanizaki N, Walker C, Castillo D, Lim A, Skranes J, Otoshi C, Miller EN, Ernst TM. Adaptive working memory training improved brain function in human immunodeficiency virus-seropositive patients. Ann Neurol 2016; 81:17-34. [PMID: 27761943 PMCID: PMC5299494 DOI: 10.1002/ana.24805] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Revised: 10/14/2016] [Accepted: 10/14/2016] [Indexed: 12/28/2022]
Abstract
Objective We aimed to evaluate the effectiveness of an adaptive working memory (WM) training (WMT) program, the corresponding neural correlates, and LMX1A‐rs4657412 polymorphism on the adaptive WMT, in human immunodeficiency virus (HIV) participants compared to seronegative (SN) controls. Methods A total of 201 of 206 qualified participants completed baseline assessments before randomization to 25 sessions of adaptive WMT or nonadaptive WMT. A total of 74 of 76 (34 HIV, 42 SN) completed adaptive WMT and all 40 completed nonadaptive WMT (20 HIV, 20 SN) and were assessed after 1 month, and 55 adaptive WMT participants were also assessed after 6 months. Nontrained near‐transfer WM tests (Digit‐Span, Spatial‐Span), self‐reported executive functioning, and functional magnetic resonance images during 1‐back and 2‐back tasks were performed at baseline and each follow‐up visit, and LMX1A‐rs4657412 was genotyped in all participants. Results Although HIV participants had slightly lower cognitive performance and start index than SN at baseline, both groups improved on improvement index (>30%; false discovery rate [FDR] corrected p < 0.0008) and nontrained WM tests after adaptive WMT (FDR corrected, p ≤ 0.001), but not after nonadaptive WMT (training by training type corrected, p = 0.01 to p = 0.05) 1 month later. HIV participants (especially LMX1A‐G carriers) also had poorer self‐reported executive functioning than SN, but both groups reported improvements after adaptive WMT (Global: training FDR corrected, p = 0.004), and only HIV participants improved after nonadaptive WMT. HIV participants also had greater frontal activation than SN at baseline, but brain activation decreased in both groups at 1 and 6 months after adaptive WMT (FDR corrected, p < 0.0001), with normalization of brain activation in HIV participants, especially the LMX1A‐AA carriers (LMX1A genotype by HIV status, cluster‐corrected‐p < 0.0001). Interpretation Adaptive WMT, but not nonadaptive WMT, improved WM performance in both SN and HIV participants, and the accompanied decreased or normalized brain activation suggest improved neural efficiency, especially in HIV‐LMX1A‐AA carriers who might have greater dopaminergic reserve. These findings suggest that adaptive WMT may be an effective adjunctive therapy for WM deficits in HIV participants. ANN NEUROL 2017;81:17–34
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Affiliation(s)
- Linda Chang
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI.,The Queen's Medical Center, Honolulu, HI
| | - Gro C Løhaugen
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI.,Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Sykehus HF, HABU, Arendal, Norway, and Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, MTFS, Trondheim, Norway
| | - Tamara Andres
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Caroline S Jiang
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Vanessa Douet
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Naomi Tanizaki
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Christina Walker
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Deborrah Castillo
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Ahnate Lim
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Jon Skranes
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI.,Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Sykehus HF, HABU, Arendal, Norway, and Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, MTFS, Trondheim, Norway
| | - Chad Otoshi
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
| | - Eric N Miller
- Department of Psychiatry, University of California, Los Angeles, CA
| | - Thomas M Ernst
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu, HI
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Chang L, Oishi K, Skranes J, Buchthal S, Cunningham E, Yamakawa R, Hayama S, Jiang CS, Alicata D, Hernandez A, Cloak C, Wright T, Ernst T. Sex-Specific Alterations of White Matter Developmental Trajectories in Infants With Prenatal Exposure to Methamphetamine and Tobacco. JAMA Psychiatry 2016; 73:1217-1227. [PMID: 27829078 PMCID: PMC6467201 DOI: 10.1001/jamapsychiatry.2016.2794] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
IMPORTANCE Methamphetamine is a common illicit drug used worldwide. Methamphetamine and/or tobacco use by pregnant women remains prevalent. However, little is known about the effect of comorbid methamphetamine and tobacco use on human fetal brain development. OBJECTIVE To investigate whether microstructural brain abnormalities reported in children with prenatal methamphetamine and/or tobacco exposure are present at birth before childhood environmental influences. DESIGN, SETTING, AND PARTICIPANTS A prospective, longitudinal study was conducted between September 17, 2008, and February 28, 2015, at an ambulatory academic medical center. A total of 752 infant-mother dyads were screened and 139 of 195 qualified neonates were evaluated (36 methamphetamine/tobacco exposed, 32 tobacco exposed, and 71 unexposed controls). They were recruited consecutively from the community. EXPOSURES Prenatal methamphetamine and/or tobacco exposure. MAIN OUTCOMES AND MEASURES Quantitative neurologic examination and diffusion tensor imaging performed 1 to 3 times through age 4 months; diffusivities and fractional anisotropy (FA) assessed in 7 white matter tracts and 4 subcortical brain regions using an automated atlas-based method. RESULTS Of the 139 infants evaluated, 72 were female (51.8%); the mean (SE) postmenstrual age at baseline was 41.5 (0.27) weeks. Methamphetamine/tobacco-exposed infants showed delayed developmental trajectories on active muscle tone (group × age, P < .001) and total neurologic scores (group × age, P = .01) that normalized by ages 3 to 4 months. Only methamphetamine/tobacco-exposed boys had lower FA (group × age, P = .02) and higher diffusivities in superior (SCR) and posterior corona radiatae (PCR) (group × age × sex, P = .002; group × age × sex, P = .01) at baseline that normalized by age 3 months. Only methamphetamine/tobacco- and tobacco-exposed girls showed persistently lower FA in anterior corona radiata (ACR) (group, P = .04; group × age × sex, P = .01). Tobacco-exposed infants showed persistently lower axial diffusion in the thalamus and internal capsule across groups (P = .02). CONCLUSIONS AND RELEVANCE Prenatal methamphetamine/tobacco exposure may lead to delays in motor development, with less coherent fibers and less myelination in SCR and PCR only in male infants, but these abnormalities may normalize by ages 3 to 4 months after cessation of stimulant exposure. In contrast, persistently less coherent ACR fibers were observed in methamphetamine/tobacco- and tobacco-exposed girls, possibly from increased dendritic branching or spine density due to epigenetic influences. Persistently lower diffusivity in the thalamus and internal capsule of all tobacco-exposed infants suggests aberrant axonal development. Collectively, prenatal methamphetamine and/or tobacco exposure may lead to delayed motor development and white matter maturation in sex- and regional-specific manners.
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Affiliation(s)
- Linda Chang
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Kenichi Oishi
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jon Skranes
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway, Department of Laboratory Medicine, Children’s and Women’s Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Steven Buchthal
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Eric Cunningham
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Robyn Yamakawa
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Sara Hayama
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Caroline S. Jiang
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Daniel Alicata
- Department of Psychiatry, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Antonette Hernandez
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Christine Cloak
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Tricia Wright
- Department of Obstetrics, Gynecology and Women’s Health, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
| | - Thomas Ernst
- Department of Medicine, John A. Burns School of Medicine, University of Hawaii at Manoa, Honolulu
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Skranes J, Løhaugen GCC. Reduction in general intelligence and executive function persists into adulthood among very preterm or very low birthweight children. Evid Based Ment Health 2016; 19:e28. [PMID: 27555641 PMCID: PMC10699516 DOI: 10.1136/eb-2015-102249] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2016] [Revised: 07/04/2016] [Accepted: 08/02/2016] [Indexed: 11/03/2022]
Affiliation(s)
- Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway;
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
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35
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Sørensen K, Liverød JR, Lerdal B, Vestrheim IE, Skranes J. Executive functions in preschool children with cerebral palsy--Assessment and early intervention--A pilot study. Dev Neurorehabil 2016; 19:111-6. [PMID: 24840746 DOI: 10.3109/17518423.2014.916761] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To assess the level of executive functioning among preschool children with cerebral palsy (CP) and evaluate effects of the Program Intensified habilitation (PIH). METHODS In this non-randomized, prospective study, 15 preschool children with CP, and their parents attended the PIH for a 1-year period. Executive functions were evaluated using the Behavior Rating Inventory of Executive functions-Preschool version (BRIEF-P), filled out by parents and preschool teachers. RESULTS Before PIH, scores of executive function difficulties were close to the general population mean. After PIH, fathers and preschool teachers reported reduced levels of executive difficulties on, respectively, the Emergent Metacognition Index and the Flexibility Index on the BRIEF-P. Mothers reported no changes. CONCLUSION The children in our sample showed age-appropriate levels of executive functions before attending PIH. Some aspects of executive skills difficulties were reduced after PIH. Using BRIEF-P contributed to the differentiation of cognitive strengths and weaknesses among the children.
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Affiliation(s)
- Kristian Sørensen
- a Child Habilitation Unit, Department of Pediatrics , Sørlandet Hospital HF , Kristiansand , Norway
| | - Janne Risholm Liverød
- b Adult Habilitation Unit, Department of Rehabilitation , Sørlandet Hospital HF , Kristiansand , Norway , and
| | - Bjørn Lerdal
- a Child Habilitation Unit, Department of Pediatrics , Sørlandet Hospital HF , Kristiansand , Norway
| | - Ida E Vestrheim
- a Child Habilitation Unit, Department of Pediatrics , Sørlandet Hospital HF , Kristiansand , Norway
| | - Jon Skranes
- a Child Habilitation Unit, Department of Pediatrics , Sørlandet Hospital HF , Kristiansand , Norway .,c Department of Laboratory Medicine, Children's and Women's Health, Medical Faculty , Norwegian University of Science and Technology (NTNU) , Trondheim , Norway
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36
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Holm M, Skranes J, Dammann O, Fichorova RN, Allred EN, Leviton A. Systemic endogenous erythropoietin and associated disorders in extremely preterm newborns. Arch Dis Child Fetal Neonatal Ed 2016; 101:F458-63. [PMID: 27173415 DOI: 10.1136/archdischild-2015-309127] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 01/10/2016] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To explore the association between concentrations of endogenous erythropoietin (EPO) in blood the first 2 weeks of life and neonatal disorders in extremely low gestational age newborns (ELGANs). DESIGN Prospective cohort study. SETTING Neonatal care units at 14 participating hospitals in the USA. PATIENTS 867 children born before the 28th week of gestation from the ELGAN study cohort. MAIN OUTCOME MEASURES EPO blood concentrations were measured on postnatal days 1, 7 and 14. The following neonatal characteristics and disorders were registered: blood gases, early and late respiratory dysfunction, pulmonary deterioration, retinopathy of prematurity (ROP), necrotising enterocolitis (NEC) and bronchopulmonary dysplasia (BPD). We calculated the gestational age-adjusted ORs for having each disorder associated with an EPO blood concentration in the highest or lowest quartile, compared with infants whose EPO concentration was in the middle two quartiles on the corresponding day. RESULTS Newborns whose day-1 EPO was in the highest quartile were at increased risk for early and persistent respiratory dysfunction during the first 2 weeks of life, and NEC requiring surgery. The lowest EPO quartile on day 1 was associated with a decreased risk of moderate BPD. The association between low EPO and decreased risk of respiratory complications persisted on day 7. On day 14, being in the highest EPO quartile was associated with increased risk of ROP, and BPD not requiring ventilation assistance. CONCLUSIONS EPO blood concentrations in extremely preterm newborns during the first 2 weeks of life convey information about increased risks of bowel, lung and retinal diseases.
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Affiliation(s)
- Mari Holm
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Olaf Dammann
- Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, Massachusetts, USA Perinatal Neuroepidemiology Unit, Hannover School of Medicine, Hannover, Germany
| | - Raina N Fichorova
- Laboratory of Genital Tract Biology, Department of Obstetrics, Gynecology, and Reproductive Biology, Brigham and Women's Hospital and Harvard Medical School, Boston, USA
| | | | - Alan Leviton
- Neuroepidemiology Unit, Department of Neurology, Boston Children's Hospital, and Harvard Medical School, Boston, Massachusetts, USA
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Aasen IE, Håberg AK, Olsen A, Brubakk AM, Evensen KAI, Sølsnes AE, Skranes J, Brunner JF. The relevance of the irrelevant: Attention and task-set adaptation in prematurely born adults. Clin Neurophysiol 2016; 127:3225-33. [PMID: 27522488 DOI: 10.1016/j.clinph.2016.07.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2016] [Revised: 06/28/2016] [Accepted: 07/13/2016] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To investigate attention and task-set adaptation in a preterm born very low birth weight (PT/VLBW) population by means of event-related potential components from an adapted cued go/no-go task. METHODS P3 components after target and non-target cues, as well as target, no-go and non-target imperative stimuli were compared in 30 PT/VLBW young adults and 33 term-born controls. Changes in P3 amplitudes as a function of time-on-task were also investigated. RESULTS The PT/VLBW group had larger P3 amplitudes to non-target cues and non-targets compared with controls. There were no significant group differences in the P3s to target or no-go stimuli. Moreover, the amplitude of the P3 to non-target cues and non-targets decreased significantly over time in the control group but not in the PT/VLBW group. CONCLUSIONS PT/VLBW young adults allocate more attention to behaviorally irrelevant information than term-born controls, and persist in attending to this information over time. SIGNIFICANCE This is the first study to investigate ERP components in an adult population born preterm with very low birth weight.
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Affiliation(s)
- Ida Emilia Aasen
- Department of Medical Imaging, St. Olavs Hospital, Trondheim University Hospital, Norway; Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neuropsychology, Helgeland Hospital, Mosjøen, Norway.
| | - Asta Kristine Håberg
- Department of Medical Imaging, St. Olavs Hospital, Trondheim University Hospital, Norway; Department of Neuroscience, NTNU, Trondheim, Norway
| | - Alexander Olsen
- MI Lab and Department of Circulation and Medical Imaging, NTNU, Trondheim, Norway; Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Norway
| | - Ann-Mari Brubakk
- Department of Laboratory Medicine, Children's and Women's Health, NTNU, Trondheim, Norway
| | - Kari Anne I Evensen
- Department of Laboratory Medicine, Children's and Women's Health, NTNU, Trondheim, Norway; Department of Public Health and General Practice, NTNU, Trondheim, Norway; Department of Physiotherapy, Trondheim Municipality, Norway
| | - Anne Elisabeth Sølsnes
- Department of Laboratory Medicine, Children's and Women's Health, NTNU, Trondheim, Norway
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, NTNU, Trondheim, Norway; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Jan Ferenc Brunner
- Department of Psychology, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Neuropsychology, Helgeland Hospital, Mosjøen, Norway; Department of Neuroscience, NTNU, Trondheim, Norway; Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Norway
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Husby IM, Stray KMT, Olsen A, Lydersen S, Indredavik MS, Brubakk AM, Skranes J, Evensen KAI. Long-term follow-up of mental health, health-related quality of life and associations with motor skills in young adults born preterm with very low birth weight. Health Qual Life Outcomes 2016; 14:56. [PMID: 27052007 PMCID: PMC4823914 DOI: 10.1186/s12955-016-0458-y] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 03/29/2016] [Indexed: 11/13/2022] Open
Abstract
Background Being born with very low birth weight (VLBW: ≤1500 g) is related to long-term disability and neurodevelopmental problems, possibly affecting mental health and health-related quality of life (HRQoL). However, studies in young adulthood yield mixed findings. The aim of this study was to examine mental health and HRQoL at 23 years, including changes from 20 to 23 years and associations with motor skills in VLBW young adults compared with controls. Methods In a geographically based follow-up study, 35 VLBW and 37 term-born young adults were assessed at 23 years by using Achenbach Adult Self-Report (ASR), Short Form 36 Health Survey (SF-36), Beck Depression Inventory (BDI) and various motor tests. The ASR and SF-36 were also used at 20 years. Longitudinal changes in ASR and SF-36 from 20 to 23 years were analysed by linear mixed models and associations with motor skills at 23 years by linear regression. Results At 23 years, total ASR score was 38.6 (SD: 21.7) in the VLBW group compared with 29.0 (SD: 18.6) in the control group (p = 0.048). VLBW participants had higher scores for attention problems, internalizing problems and critical items, and they reported to drink less alcohol than controls. BDI total score did not differ between groups. On SF-36, VLBW participants reported significantly poorer physical and social functioning, more role-limitations due to physical and emotional problems, more bodily pain and lower physical and mental component summaries than controls. In the VLBW group, total ASR score increased by 9.0 (95 % CI: 3.3 to 14.7) points from 20 to 23 years (p = 0.009 vs controls), physical and mental component summaries of SF-36 decreased by 2.9 (95 % CI: -4.8 to -1.1) and 4.4 (95 % CI: -7.1 to -1.7) points, respectively (p = 0.012 and p = 0.022 vs controls). Among VLBW participants, more mental health problems and lower physical and mental HRQoL were associated with poorer motor skills at 23 years. Conclusions VLBW young adults reported poorer and declining mental health and HRQoL in the transitional phase into adulthood. They seemed to have a cautious lifestyle with more internalizing problems and less alcohol use. The associations of mental health problems and HRQoL with motor skills are likely to reflect a shared aetiology. Electronic supplementary material The online version of this article (doi:10.1186/s12955-016-0458-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ingrid Marie Husby
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
| | | | - Alexander Olsen
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Physical Medicine and Rehabilitation, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.,MI Lab and Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Stian Lydersen
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Marit Sæbø Indredavik
- Regional Centre for Child and Youth Mental Health and Child Welfare, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Child and Adolescent Psychiatry, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ann-Mari Brubakk
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Kari Anne I Evensen
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Public Health and General Practice, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Physiotherapy, Trondheim Municipality, Trondheim, Norway
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Østgård HF, Sølsnes AE, Bjuland KJ, Rimol LM, Martinussen M, Brubakk AM, Håberg AK, Skranes J, Løhaugen GCC. Executive function relates to surface area of frontal and temporal cortex in very-low-birth-weight late teenagers. Early Hum Dev 2016; 95:47-53. [PMID: 26939083 DOI: 10.1016/j.earlhumdev.2016.01.023] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 01/25/2016] [Accepted: 01/29/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Being born with very low birth weight (VLBW; birth weight (BW) ≤1500 g) is associated with increased risk of maldevelopment of the immature brain which may affect neurological functioning. Deficits in attention and executive function problems have been reported in VLBW survivors compared with healthy subjects. AIMS The aim of this study was to evaluate attention and executive functions and to relate the clinical test results to cortical morphometry findings in VLBW young adults compared with term-born controls. STUDY DESIGN Prospective follow-up study of three year cohorts of VLBW and control children from birth to adulthood. OUTCOME MEASURES A comprehensive neuropsychological test battery was administered to 55 VLBW subjects born preterm (mean BW: 1217 g) and 81 term-born controls (mean BW: 3707 g) at age 19-20. Cerebral MRI was successfully obtained in 46 VLBW subjects and 61 controls. The FreeSurfer software package was applied for the cortical analyses based on T1-weighted MRI images. RESULTS The VLBW group obtained inferior scores on 15 of the 29 neuropsychological measures assessing attention and executive function and on both the attention and executive function domain scores. We found positive correlations between the executive function domain score and cortical surface area, especially in the antero-medial frontal and the temporal lobes of the brain in the VLBW group. CONCLUSION Young adults born with VLBW show deficits in attention and executive function compared with controls. The executive problems were related to smaller cortical surface area in brain regions known to be involved in higher order cognitive functioning.
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Affiliation(s)
- Heidi Furre Østgård
- Department of Laboratory Medicine, Children's and Women's Health, Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway
| | - Anne Elisabeth Sølsnes
- Department of Laboratory Medicine, Children's and Women's Health, Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Knut Jørgen Bjuland
- Department of Laboratory Medicine, Children's and Women's Health, Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway
| | - Lars Morten Rimol
- Department of Laboratory Medicine, Children's and Women's Health, Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway; Department of Medicine, University of Haw, ai'i, Honolulu, HI, USA
| | - Marit Martinussen
- Department of Laboratory Medicine, Children's and Women's Health, Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway; Department of Obstetrics, St Olav University Hospital, Trondheim, Norway
| | - Ann-Mari Brubakk
- Department of Laboratory Medicine, Children's and Women's Health, Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, St Olav University Hospital, Trondheim, Norway
| | - Asta Kristine Håberg
- Department of Circulation and Medical Imaging, Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience, Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway; Department of Medical Imaging, St Olav University Hospital, Trondheim, Norway
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Gro Christine Christensen Løhaugen
- Department of Laboratory Medicine, Children's and Women's Health, Medical Faculty, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
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Botellero VL, Skranes J, Bjuland KJ, Løhaugen GC, Håberg AK, Lydersen S, Brubakk AM, Indredavik MS, Martinussen M. Mental health and cerebellar volume during adolescence in very-low-birth-weight infants: a longitudinal study. Child Adolesc Psychiatry Ment Health 2016; 10:6. [PMID: 26985236 PMCID: PMC4793750 DOI: 10.1186/s13034-016-0093-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 02/11/2016] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Preterm birth at very low birth weight (VLBW) poses a risk for cerebellar abnormalities and increased psychiatric morbidity compared with reference populations. We aimed to study cerebellar volumes (grey and white matter; GM, WM) and mental health in VLBW individuals and controls at 15 and 19 years of age, as well as changes between the two time points. METHODS Forty VLBW (≤1500 g) and 56 control adolescents were included in the study at 15 years of age, and 44 VLBW and 60 control adolescents at 19 years of age. We had longitudinal data for 30 VLBW participants and for 37 controls. Clinical diagnoses were assessed following the schedule for affective disorders and schizophrenia for school-age children (KSADS). Psychiatric symptoms and function were further investigated with the Achenbach System of Empirically Based Assessment (ASEBA), ADHD Rating Scale-IV and the children's global assessment scale (CGAS). An automatic segmentation of cerebellar GM and WM volumes was performed in FreeSurfer. The MRI scans were obtained on the same 1.5T scanner at both ages. RESULTS The VLBW group had higher rates of psychiatric disorders at both ages. Cerebellar growth trajectories did not differ between VLBW adolescents and controls, regardless of psychiatric status. However, VLBW adolescents who had a psychiatric diagnosis at both ages or developed a psychiatric disorder from 15 to 19 years had maintained smaller cerebellar WM and GM volumes than controls and also smaller volumes than VLWB adolescents who were or became healthy in this period. Moreover, there were no differences in cerebellar WM and GM volumes between controls and those VLBW who were healthy or became healthy. In the VLBW group, cerebellar WM and GM volumes correlated positively with psycho-social function at both 15 and 19 years of age, and smaller GM volumes were associated with inattention at 15 years. CONCLUSIONS Smaller cerebellar volume in adolescents born very preterm and with VLBW may be a biomarker of increased risk of psychiatric problems in young adulthood.
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Affiliation(s)
- Violeta L. Botellero
- Department of Laboratory Medicine, Children’s and Women’s Health, Faculty of Medicine, Medical Technology Research Center, Norwegian University of Science and Technology, P.O. Box 8905, 7491 Trondheim, Norway
| | - Jon Skranes
- Department of Laboratory Medicine, Children’s and Women’s Health, Faculty of Medicine, Medical Technology Research Center, Norwegian University of Science and Technology, P.O. Box 8905, 7491 Trondheim, Norway ,Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Knut Jørgen Bjuland
- Department of Laboratory Medicine, Children’s and Women’s Health, Faculty of Medicine, Medical Technology Research Center, Norwegian University of Science and Technology, P.O. Box 8905, 7491 Trondheim, Norway
| | - Gro C. Løhaugen
- Department of Laboratory Medicine, Children’s and Women’s Health, Faculty of Medicine, Medical Technology Research Center, Norwegian University of Science and Technology, P.O. Box 8905, 7491 Trondheim, Norway ,Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Asta Kristine Håberg
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway ,Department of Medical Imaging, St. Olav’s University Hospital, Trondheim, Norway
| | - Stian Lydersen
- Regional Center for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ann-Mari Brubakk
- Department of Laboratory Medicine, Children’s and Women’s Health, Faculty of Medicine, Medical Technology Research Center, Norwegian University of Science and Technology, P.O. Box 8905, 7491 Trondheim, Norway ,Department of Pediatrics, St. Olav’s University Hospital, Trondheim, Norway
| | - Marit S. Indredavik
- Regional Center for Child and Youth Mental Health and Child Welfare, Norwegian University of Science and Technology, Trondheim, Norway ,Department of Child and Adolescent Psychiatry, St. Olav’s University Hospital, Trondheim, Norway
| | - Marit Martinussen
- Department of Laboratory Medicine, Children’s and Women’s Health, Faculty of Medicine, Medical Technology Research Center, Norwegian University of Science and Technology, P.O. Box 8905, 7491 Trondheim, Norway ,Department of Gynecology and Obstetrics, St. Olav’s University Hospital, Trondheim, Norway
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Chang L, Akazawa K, Yamakawa R, Hayama S, Buchthal S, Alicata D, Andres T, Castillo D, Oishi K, Skranes J, Ernst T, Oishi K. Delayed early developmental trajectories of white matter tracts of functional pathways in preterm-born infants: Longitudinal diffusion tensor imaging data. Data Brief 2016; 6:1007-15. [PMID: 26958632 PMCID: PMC4763104 DOI: 10.1016/j.dib.2016.01.064] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Revised: 01/12/2016] [Accepted: 01/27/2016] [Indexed: 11/19/2022] Open
Abstract
Probabilistic maps of white matter pathways related to motor, somatosensory, auditory, visual, and limbic functions, and major white matter tracts (the corpus callosum, the inferior fronto-occipital fasciculus, and the middle cerebellar peduncle) were applied to evaluate the developmental trajectories of these tracts, using longitudinal diffusion tensor imaging (DTI) obtained in term-born and preterm-born healthy infants. Nineteen term-born and 30 preterm-born infants completed MR scans at three time points: Time-point 1, 41.6±2.7 postmenstrual weeks; Time-point 2, 46.0±2.9 postmenstrual weeks; and Time-point 3, 50.8±3.7 postmenstrual weeks. The DTI-derived scalar values (fractional anisotropy, eigenvalues, and radial diffusivity) of the three time points are available in this Data article.
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Affiliation(s)
- Linda Chang
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Kentaro Akazawa
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Robyn Yamakawa
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Sara Hayama
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Steven Buchthal
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Daniel Alicata
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Tamara Andres
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Deborrah Castillo
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Kumiko Oishi
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Jon Skranes
- Department of Laboratory Medicine, Children׳s and Women׳s Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Thomas Ernst
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Kenichi Oishi
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Corresponding author at: The Russell H. Morgan Department of Radiology and Radiological Science, The Johns Hopkins University School of Medicine, 208 Traylor Building, 720 Rutland Avenue, Baltimore, MD 21205, USA.
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Chang L, Løhaugen GC, Douet V, Miller EN, Skranes J, Ernst T. Neural correlates of working memory training in HIV patients: study protocol for a randomized controlled trial. Trials 2016; 17:62. [PMID: 26833223 PMCID: PMC4736265 DOI: 10.1186/s13063-016-1160-4] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2015] [Accepted: 01/07/2016] [Indexed: 12/31/2022] Open
Abstract
Background Potent combined antiretroviral therapy decreased the incidence and severity of HIV-associated neurocognitive disorders (HAND); however, no specific effective pharmacotherapy exists for HAND. Patients with HIV commonly have deficits in working memory and attention, which may negatively impact many other cognitive domains, leading to HAND. Since HAND may lead to loss of independence in activities of daily living and negative emotional well-being, and incur a high economic burden, effective treatments for HAND are urgently needed. This study aims to determine whether adaptive working memory training might improve cognitive functions and neural network efficiency and possibly decrease neuroinflammation. This study also aims to assess whether subjects with the LMX1A-rs4657412 TT(AA) genotype show greater training effects from working memory training than TC(AG) or CC(GG)-carriers. Methods/Design 60 HIV-infected and 60 seronegative control participants will be randomized to a double-blind active-controlled study, using adaptive versus non-adaptive Cogmed Working Memory Training® (CWMT), 20–25 sessions over 5–8 weeks. Each subject will be assessed with near- and far-transfer cognitive tasks, self-reported mood and executive function questionnaires, and blood-oxygenation level-dependent functional MRI during working memory (n-back) and visual attention (ball tracking) tasks, at baseline, 1-month, and 6-months after CWMT. Furthermore, genotyping for LMX1A-rs4657412 will be performed to identify whether subjects with the TT(AA)-genotype show greater gain or neural efficiency after CWMT than those with other genotypes. Lastly, cerebrospinal fluid will be obtained before and after CWMT to explore changes in levels of inflammatory proteins (cytokines and chemokines) and monoamines. Discussion Improving working memory in HIV patients, using CWMT, might slow the progression or delay the onset of HAND. Observation of decreased brain activation or normalized neural networks, using fMRI, after CWMT would lead to a better understanding of how neural networks are modulated by CWMT. Moreover, validating the greater training gain in subjects with the LMX1A-TT(AA) genotype could lead to a personalized approach for future working memory training studies. Demonstrating and understanding the neural correlates of the efficacy of CWMT in HIV patients could lead to a safe adjunctive therapy for HAND, and possibly other brain disorders. Trial registration ClinicalTrial.gov, NCT02602418.
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Affiliation(s)
- L Chang
- Department of Medicine, John A. Burns School of Medicine, The Queen's Medical Center, University of Hawaii at Manoa, 1356 Lusitana Street, 7th Floor UH Tower, Honolulu, HI, USA.
| | - G C Løhaugen
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway. .,Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
| | - V Douet
- Department of Medicine, John A. Burns School of Medicine, The Queen's Medical Center, University of Hawaii at Manoa, 1356 Lusitana Street, 7th Floor UH Tower, Honolulu, HI, USA.
| | - E N Miller
- UCLA Psychiatry and Biobehavioral Sciences, Los Angeles, CA, USA.
| | - J Skranes
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway. .,Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
| | - T Ernst
- Department of Medicine, John A. Burns School of Medicine, The Queen's Medical Center, University of Hawaii at Manoa, 1356 Lusitana Street, 7th Floor UH Tower, Honolulu, HI, USA.
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Rimol LM, Bjuland KJ, Løhaugen GC, Martinussen M, Evensen KAI, Indredavik MS, Brubakk AM, Eikenes L, Håberg AK, Skranes J. Cortical trajectories during adolescence in preterm born teenagers with very low birthweight. Cortex 2016; 75:120-131. [DOI: 10.1016/j.cortex.2015.12.001] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Revised: 10/19/2015] [Accepted: 12/07/2015] [Indexed: 01/01/2023]
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Grunewaldt KH, Skranes J, Brubakk AM, Lähaugen GCC. Computerized working memory training has positive long-term effect in very low birthweight preschool children. Dev Med Child Neurol 2016; 58:195-201. [PMID: 26140426 DOI: 10.1111/dmcn.12841] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/05/2015] [Indexed: 12/01/2022]
Abstract
AIM Working memory deficits are frequently found in children born preterm and have been linked to learning disabilities, and cognitive and behavioural problems. Our aim was to evaluate if a computerized working memory training program has long-term positive effects on memory, learning, and behaviour in very-low-birthweight (VLBW) children at age 5 to 6 years. METHOD This prospective, intervention study included 20 VLBW preschool children in the intervention group and 17 age-matched, non-training VLBW children in the comparison group. The intervention group trained with the Cogmed JM working memory training program daily for 5 weeks (25 training sessions). Extensive neuropsychological assessment and parental questionnaires were performed 4 weeks after intervention and at follow-up 7 months later. For most of the statistical analyses, general linear models were applied. RESULTS At follow-up, higher scores and increased or equal performance gain were found in the intervention group than the comparison group on memory for faces (p=0.012), narrative memory (p=0.002), and spatial span (p=0.003). No group differences in performance gain were found for attention and behaviour. INTERPRETATION Computerized working memory training seems to have positive and persisting effects on working memory, and visual and verbal learning, at 7-month follow-up in VLBW preschool children. We speculate that such training is beneficial by improving the ability to learn from the teaching at school and for further cognitive development.
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Affiliation(s)
- Kristine Hermansen Grunewaldt
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, St. Olav University Hospital, Trondheim, Norway
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Ann-Mari Brubakk
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, St. Olav University Hospital, Trondheim, Norway
| | - Gro C C Lähaugen
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
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Flak MM, Hernes SS, Chang L, Ernst T, Douet V, Skranes J, Løhaugen GCC. Erratum to: 'The Memory Aid study: protocol for a randomized controlled clinical trial evaluating the effect of computer-based working memory training in elderly patients with mild cognitive impairment (MCI)'. Trials 2016; 17:40. [PMID: 26790720 PMCID: PMC4721053 DOI: 10.1186/s13063-016-1180-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Marianne M Flak
- Department of Medicine, Geriatric Unit, The Memory Clinic, Sørlandet Hospital, Arendal, Norway. .,Department of Medicine, John A. Burns School of Medicine, The Queen's Medical Center, Honolulu, HI, USA.
| | - Susanne S Hernes
- Department of Medicine, Geriatric Unit, The Memory Clinic, Sørlandet Hospital, Arendal, Norway
| | - Linda Chang
- Department of Medicine, John A. Burns School of Medicine, The Queen's Medical Center, Honolulu, HI, USA
| | - Thomas Ernst
- Department of Medicine, John A. Burns School of Medicine, The Queen's Medical Center, Honolulu, HI, USA
| | - Vanessa Douet
- Department of Medicine, John A. Burns School of Medicine, The Queen's Medical Center, Honolulu, HI, USA
| | - Jon Skranes
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway.,Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gro C C Løhaugen
- Department of Pediatrics, Sørlandet Hospital, Arendal, Norway.,Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
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Løhaugen GCC, Flak MM, Gerstner T, Sundberg C, Lerdal B, Skranes J. Establishment of the South-Eastern Norway Regional Health Authority Resource Center for Children with Prenatal Alcohol/Drug Exposure. Subst Abuse 2015; 9:67-75. [PMID: 26692762 PMCID: PMC4671549 DOI: 10.4137/sart.s23542] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Revised: 09/29/2015] [Accepted: 10/07/2015] [Indexed: 11/24/2022]
Abstract
This paper presents a new initiative in the South-Eastern Health Region of Norway to establish a regional resource center focusing on services for children and adolescents aged 2–18 years with prenatal exposure to alcohol or other drugs. In Norway, the prevalence of fetal alcohol spectrum (FAS) is not known but has been estimated to be between 1 and 2 children per 1000 births, while the prevalence of prenatal exposure to illicit drugs is unknown. The resource center is the first of its kind in Scandinavia and will have three main objectives: (1) provide hospital staff, community health and child welfare personnel, and special educators with information, educational courses, and seminars focused on the identification, diagnosis, and treatment of children with a history of prenatal alcohol/drug exposure; (2) provide specialized health services, such as diagnostic services and intervention planning, for children referred from hospitals in the South-Eastern Health Region of Norway; and (3) initiate multicenter studies focusing on the diagnostic process and evaluation of interventions.
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Affiliation(s)
- Gro C C Løhaugen
- Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Hospital HF, HABU, Arendal, Norway. ; Department of Laboratory Medicine, Children's and Women's Health (LBK), Faculty of Medicine, Norwegian University of Science and Technology, MTFS, Trondheim, Norway
| | - Marianne Møretrø Flak
- Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Hospital HF, HABU, Arendal, Norway. ; Addiction Unit (ARA-K), Sørlandet Sykehus HF, Kristiansand, Norway
| | - Thorsten Gerstner
- Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Hospital HF, HABU, Arendal, Norway
| | - Cato Sundberg
- Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Hospital HF, HABU, Arendal, Norway
| | - Bjørn Lerdal
- Department of Child Neurology and Rehabilitation (HABU-K), Sørlandet Hospital HF, HABU, Kristiansand, Norway
| | - Jon Skranes
- Department of Child Neurology and Rehabilitation (HABU-A), Sørlandet Hospital HF, HABU, Arendal, Norway. ; Department of Laboratory Medicine, Children's and Women's Health (LBK), Faculty of Medicine, Norwegian University of Science and Technology, MTFS, Trondheim, Norway
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Sølsnes AE, Sripada K, Yendiki A, Bjuland KJ, Østgård HF, Aanes S, Grunewaldt KH, Løhaugen GC, Eikenes L, Håberg AK, Rimol LM, Skranes J. Limited microstructural and connectivity deficits despite subcortical volume reductions in school-aged children born preterm with very low birth weight. Neuroimage 2015; 130:24-34. [PMID: 26712340 DOI: 10.1016/j.neuroimage.2015.12.029] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2015] [Revised: 11/24/2015] [Accepted: 12/16/2015] [Indexed: 12/14/2022] Open
Abstract
Preterm birth and very low birth weight (VLBW, ≤1500 g) are worldwide problems that burden survivors with lifelong cognitive, psychological, and physical challenges. In this multimodal structural magnetic resonance imaging (MRI) and diffusion MRI (dMRI) study, we investigated differences in subcortical brain volumes and white matter tract properties in children born preterm with VLBW compared to term-born controls (mean age=8 years). Subcortical brain structure volumes and cortical thickness estimates were obtained, and fractional anisotropy (FA), mean diffusivity (MD), radial diffusivity (RD), and axial diffusivity (AD) were generated for 18 white matter tracts. We also assessed structural relationships between white matter tracts and cortical thickness of the tract endpoints. Compared to controls, the VLBW group had reduced volumes of thalamus, globus pallidus, corpus callosum, cerebral white matter, ventral diencephalon, and brain stem, while the ventricular system was larger in VLBW subjects, after controlling for age, sex, IQ, and estimated total intracranial volume. For the dMRI parameters, group differences were not significant at the whole-tract level, though pointwise analysis found shorter segments affected in forceps minor and left superior longitudinal fasciculus - temporal bundle. IQ did not correlate with subcortical volumes or dMRI measures in the VLBW group. While the deviations in subcortical volumes were substantial, there were few differences in dMRI measures between the two groups, which may reflect the influence of advances in perinatal care on white matter development.
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Affiliation(s)
- Anne Elisabeth Sølsnes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kam Sripada
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.
| | - Anastasia Yendiki
- Department of Radiology, Athinoula A. Martinos Center for Biomedical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Knut Jørgen Bjuland
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Heidi Furre Østgård
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Synne Aanes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kristine Hermansen Grunewaldt
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, St. Olav's Hospital, Trondheim, Norway
| | - Gro C Løhaugen
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Live Eikenes
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway
| | - Asta K Håberg
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway; Department of Medical Imaging, St. Olav's Hospital, Trondheim, Norway
| | - Lars M Rimol
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
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Akazawa K, Chang L, Yamakawa R, Hayama S, Buchthal S, Alicata D, Andres T, Castillo D, Oishi K, Skranes J, Ernst T, Oishi K. Probabilistic maps of the white matter tracts with known associated functions on the neonatal brain atlas: Application to evaluate longitudinal developmental trajectories in term-born and preterm-born infants. Neuroimage 2015; 128:167-179. [PMID: 26712341 DOI: 10.1016/j.neuroimage.2015.12.026] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2015] [Revised: 12/08/2015] [Accepted: 12/16/2015] [Indexed: 01/23/2023] Open
Abstract
Diffusion tensor imaging (DTI) has been widely used to investigate the development of the neonatal and infant brain, and deviations related to various diseases or medical conditions like preterm birth. In this study, we created a probabilistic map of fiber pathways with known associated functions, on a published neonatal multimodal atlas. The pathways-of-interest include the superficial white matter (SWM) fibers just beneath the specific cytoarchitectonically defined cortical areas, which were difficult to evaluate with existing DTI analysis methods. The Jülich cytoarchitectonic atlas was applied to define cortical areas related to specific brain functions, and the Dynamic Programming (DP) method was applied to delineate the white matter pathways traversing through the SWM. Probabilistic maps were created for pathways related to motor, somatosensory, auditory, visual, and limbic functions, as well as major white matter tracts, such as the corpus callosum, the inferior fronto-occipital fasciculus, and the middle cerebellar peduncle, by delineating these structures in eleven healthy term-born neonates. In order to characterize maturation-related changes in diffusivity measures of these pathways, the probabilistic maps were then applied to DTIs of 49 healthy infants who were longitudinally scanned at three time-points, approximately five weeks apart. First, we investigated the normal developmental pattern based on 19 term-born infants. Next, we analyzed 30 preterm-born infants to identify developmental patterns related to preterm birth. Last, we investigated the difference in diffusion measures between these groups to evaluate the effects of preterm birth on the development of these functional pathways. Term-born and preterm-born infants both demonstrated a time-dependent decrease in diffusivity, indicating postnatal maturation in these pathways, with laterality seen in the corticospinal tract and the optic radiation. The comparison between term- and preterm-born infants indicated higher diffusivity in the preterm-born infants than in the term-born infants in three of these pathways: the body of the corpus callosum; the left inferior longitudinal fasciculus; and the pathway connecting the left primary/secondary visual cortices and the motion-sensitive area in the occipitotemporal visual cortex (V5/MT+). Probabilistic maps provided an opportunity to investigate developmental changes of each white matter pathway. Whether alterations in white matter pathways can predict functional outcomes will be further investigated in a follow-up study.
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Affiliation(s)
- Kentaro Akazawa
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Linda Chang
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Robyn Yamakawa
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Sara Hayama
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Steven Buchthal
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Daniel Alicata
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Tamara Andres
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Deborrah Castillo
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Kumiko Oishi
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Thomas Ernst
- Department of Medicine, School of Medicine, University of Hawaii at Manoa, Honolulu, HI, USA
| | - Kenichi Oishi
- Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Finbråten AK, Martins C, Andersen GL, Skranes J, Brannsether B, Júlíusson PB, Syversen U, Stevenson RD, Vik T. Assessment of body composition in children with cerebral palsy: a cross-sectional study in Norway. Dev Med Child Neurol 2015; 57:858-64. [PMID: 25827868 DOI: 10.1111/dmcn.12752] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/09/2015] [Indexed: 11/26/2022]
Abstract
AIM The assessment of growth and body composition is challenging in children with cerebral palsy (CP). The aim of this study was to compare clinical assessments of body composition with measurements obtained using dual-energy X-ray absorptiometry (DXA) in this population. METHOD Knee height, weight, and triceps and subscapular skinfold thickness (SFT) were measured in 47 children with CP (age range 8-18y; 18 females, 29 males). Height was estimated from knee height, and used to calculate body mass index (BMI). Using SFT measurements, body fat percentage was calculated by standard ('Slaughter') and CP-modified ('Gurka') equations and compared with results obtained using DXA. RESULTS Children with severe gross motor function impairments (Gross Motor Function Classification System [GMFCS] level III or IV) exhibited stunted growth and had higher fat percentages and lower lean body mass than children classified in GMFCS level I or II. In 10 children classified as 'thin' according to their BMI (five of whom were assigned thinness grade of 2 or lower), percentage of body fat, as determined by DXA, was normal or high. The Slaughter equations significantly underestimated body fat percentages, whereas the precision of the CP-modified Gurka equations was excellent. INTERPRETATION In this study, children with CP and severe motor impairments displayed stunted growth, but were not undernourished. Relying solely upon BMIs may be misleading in children with CP. Therefore, clinicians should be encouraged to measure SFT and to calculate body fat percentages using the CP-modified version of the Slaughter equation.
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Affiliation(s)
- Ane-Kristine Finbråten
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Pediatrics, St. Olav's University Hospital, Trondheim, Norway
| | - Catia Martins
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - Guro Lillemoen Andersen
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway.,The Cerebral Palsy Register of Norway, Habilitation Center, Vestfold Hospital Trust, Tønsberg, Norway
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Bente Brannsether
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Pediatrics, Stavanger University Hospital, Stavanger, Norway
| | - Pétur Benedikt Júlíusson
- Department of Clinical Science, University of Bergen, Bergen, Norway.,Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Unni Syversen
- Department of Cancer Research and Molecular Medicine, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Endocrinology, St. Olav's University Hospital, Trondheim, Norway
| | - Richard D Stevenson
- Department of Pediatrics, Division of Developmental Pediatrics, Kluge Children's Rehabilitation Center and Research Institute, University of Virginia, Charlottesville, VA, USA
| | - Torstein Vik
- Department of Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology, Trondheim, Norway
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Sølsnes AE, Grunewaldt KH, Bjuland KJ, Stavnes EM, Bastholm IA, Aanes S, Østgård HF, Håberg A, Løhaugen GCC, Skranes J, Rimol LM. Cortical morphometry and IQ in VLBW children without cerebral palsy born in 2003-2007. Neuroimage Clin 2015; 8:193-201. [PMID: 26106543 PMCID: PMC4473819 DOI: 10.1016/j.nicl.2015.04.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 03/19/2015] [Accepted: 04/07/2015] [Indexed: 11/26/2022]
Abstract
Children born prematurely with very low birth weight (VLBW: bw ≤ 1500 g) have an increased risk of preterm perinatal brain injury, which may subsequently alter the maturation of the brain, including the cerebral cortex. The aim of study was to assess cortical thickness and surface area in VLBW children compared with term-born controls, and to investigate possible relationships between cortical morphology and Full IQ. In this cross-sectional study, 37 VLBW and 104 term children born between the years 2003–2007 were assessed cognitively at 5–10 years of age, using age appropriate Wechsler tests. The FreeSurfer software was used to obtain estimates of cortical thickness and surface area based on T1-weighted MRI images at 1.5 Tesla. The VLBW children had smaller cortical surface area bilaterally in the frontal, temporal, and parietal lobes. A thicker cortex in the frontal and occipital regions and a thinner cortex in posterior parietal areas were observed in the VLBW group. There were significant differences in Full IQ between groups (VLBW M = 98, SD = 9.71; controls M = 108, SD = 13.57; p < 0.001). There was a positive relationship between IQ and surface area in both groups, albeit significant only in the larger control group. In the VLBW group, reduced IQ was associated with frontal cortical thickening and temporo-parietal thinning. We conclude that cortical deviations are evident in childhood even in VLBW children born in 2003–2007 who have received state of the art medical treatment in the perinatal period and who did not present with focal brain injuries on neonatal ultrasonography. The cortical deviations were associated with reduced cognitive functioning. Cortical deviations are evident even in VLBW children born in 2003–2007 A smaller surface area was observed in widespread cortical regions in VLBW children VLBW children had frontal and occipital cortical thickening and parietal thinning VLBW children had reduced Full IQ compared to term born peers The cortical deviations were partially associated with reduced cognitive functioning
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Affiliation(s)
| | - Kristine H Grunewaldt
- Department of Laboratory Medicine, Children's and Women's Health, Trondheim, Norway ; Department of Pediatrics, St. Olav University Hospital, Trondheim, Norway
| | - Knut J Bjuland
- Department of Laboratory Medicine, Children's and Women's Health, Trondheim, Norway
| | - Elisabeth M Stavnes
- Department of Laboratory Medicine, Children's and Women's Health, Trondheim, Norway
| | - Irén A Bastholm
- Department of Laboratory Medicine, Children's and Women's Health, Trondheim, Norway
| | - Synne Aanes
- Department of Laboratory Medicine, Children's and Women's Health, Trondheim, Norway
| | - Heidi F Østgård
- Department of Laboratory Medicine, Children's and Women's Health, Trondheim, Norway
| | - Asta Håberg
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
| | - Gro C C Løhaugen
- Department of Laboratory Medicine, Children's and Women's Health, Trondheim, Norway ; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Jon Skranes
- Department of Laboratory Medicine, Children's and Women's Health, Trondheim, Norway ; Department of Pediatrics, Sørlandet Hospital, Arendal, Norway
| | - Lars M Rimol
- Department of Laboratory Medicine, Children's and Women's Health, Trondheim, Norway
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