TY - JOUR
T1 - Regional cerebral development at term relates to school-age social-emotional development in very preterm children
AU - Rogers, Cynthia E.
AU - Anderson, Peter J.
AU - Thompson, Deanne K.
AU - Kidokoro, Hiroyuki
AU - Wallendorf, Michael
AU - Treyvaud, Karli
AU - Roberts, Gehan
AU - Doyle, Lex W.
AU - Neil, Jeffrey J.
AU - Inder, Terrie E.
PY - 2012/2
Y1 - 2012/2
N2 - Objective: Preterm children are at risk for socialemotional difficulties, including autism and attention-deficit/hyperactivity disorder. We assessed the relationship of regional brain development in preterm children, evaluated via magnetic resonance imaging (MRI) at term-equivalent postmenstrual age (TEA), to later socialemotional difficulties. Method: MR images obtained at TEA from 184 very preterm infants (gestation <30 weeks or birth weight <1,250 g) were analyzed for white matter abnormalities, hippocampal volume, and brain metrics. A total of 111 infants underwent diffusion tensor imaging, which provided values for fractional anisotropy and apparent diffusion coefficient. Socialemotional development was assessed with the Infant Toddler Social and Emotional Assessment (ITSEA) at age 2 and the Strengths and Difficulties Questionnaire (SDQ) at age 5 years. Results: Higher apparent diffusion coefficient in the right orbitofrontal cortex was associated with socialemotional problems at age 5 years (peer problems, p <.01). In females, smaller hippocampal volume was associated with increased hyperactivity (p <.01), peer problems (p <.05), and SDQ total score (p <.01). In males, a smaller frontal region was associated with poorer prosocial (p <.05) scores. Many of the hippocampal findings remained significant after adjusting for birthweight z score, intelligence, social risk, immaturity at birth, and parental mental health. These associations were present in children who had socialemotional problems in similar domains at age 2 and those who did not. Conclusions: Early alterations in regional cerebral development in very preterm infants relate to specific deficits in socialemotional performance by school-age. These results vary by gender. Our results provide further evidence for a neuroanatomical basis for behavioral challenges found in very preterm children.
AB - Objective: Preterm children are at risk for socialemotional difficulties, including autism and attention-deficit/hyperactivity disorder. We assessed the relationship of regional brain development in preterm children, evaluated via magnetic resonance imaging (MRI) at term-equivalent postmenstrual age (TEA), to later socialemotional difficulties. Method: MR images obtained at TEA from 184 very preterm infants (gestation <30 weeks or birth weight <1,250 g) were analyzed for white matter abnormalities, hippocampal volume, and brain metrics. A total of 111 infants underwent diffusion tensor imaging, which provided values for fractional anisotropy and apparent diffusion coefficient. Socialemotional development was assessed with the Infant Toddler Social and Emotional Assessment (ITSEA) at age 2 and the Strengths and Difficulties Questionnaire (SDQ) at age 5 years. Results: Higher apparent diffusion coefficient in the right orbitofrontal cortex was associated with socialemotional problems at age 5 years (peer problems, p <.01). In females, smaller hippocampal volume was associated with increased hyperactivity (p <.01), peer problems (p <.05), and SDQ total score (p <.01). In males, a smaller frontal region was associated with poorer prosocial (p <.05) scores. Many of the hippocampal findings remained significant after adjusting for birthweight z score, intelligence, social risk, immaturity at birth, and parental mental health. These associations were present in children who had socialemotional problems in similar domains at age 2 and those who did not. Conclusions: Early alterations in regional cerebral development in very preterm infants relate to specific deficits in socialemotional performance by school-age. These results vary by gender. Our results provide further evidence for a neuroanatomical basis for behavioral challenges found in very preterm children.
KW - hippocampus
KW - neurodevelopment
KW - orbitofrontal cortex
KW - preterm infant
KW - socialemotional development
UR - http://www.scopus.com/inward/record.url?scp=84855986709&partnerID=8YFLogxK
U2 - 10.1016/j.jaac.2011.11.009
DO - 10.1016/j.jaac.2011.11.009
M3 - Article
C2 - 22265364
AN - SCOPUS:84855986709
SN - 0890-8567
VL - 51
SP - 181
EP - 191
JO - Journal of the American Academy of Child and Adolescent Psychiatry
JF - Journal of the American Academy of Child and Adolescent Psychiatry
IS - 2
ER -