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Brain Cogn. 2019 Sep 25;136:103615. doi: 10.1016/j.bandc.2019.103615. [Epub ahead of print]

Altered working memory-related brain responses and white matter microstructure in extremely preterm-born children at school age.

Author information

1
Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland.
2
Department of Child Neurology, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
3
Department of Clinical Neurophysiology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
4
Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland.
5
Department of Pediatrics, Children's Hospital, Pediatric Research Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland.
6
Department of Neuroscience and Biomedical Engineering, Aalto University School of Science, Espoo, Finland; Department of Physiology, Faculty of Medicine, University of Helsinki, Helsinki, Finland; Advanced Magnetic Imaging Centre, Aalto University School of Science, Espoo, Finland. Electronic address: synnove.carlson@aalto.fi.

Abstract

Preterm birth poses a risk for neurocognitive and behavioral development. Preterm children, who have not been diagnosed with neurological or cognitive deficits, enter normal schools and are expected to succeed as their term-born peers. Here we tested the hypotheses that despite an uneventful development after preterm birth, these children might exhibit subtle abnormalities in brain function and white-matter microstructure at school-age. We recruited 7.5-year-old children born extremely prematurely (<28 weeks' gestation), and age- and gender-matched term-born controls (≥37 weeks' gestation). We applied fMRI during working-memory (WM) tasks, and investigated white-matter microstructure with diffusion tensor imaging. Compared with controls, preterm-born children performed WM tasks less accurately, had reduced activation in several right prefrontal areas, and weaker deactivation of right temporal lobe areas. The weaker prefrontal activation correlated with poorer WM performance. Preterm-born children had higher fractional anisotropy (FA) and lower diffusivity than controls in several white-matter areas, and in the posterior cerebellum, the higher FA associated with poorer visuospatial test scores. In controls, higher FA and lower diffusivity correlated with faster WM performance. Together these findings demonstrate weaker WM-related brain activations and altered white matter microstructure in children born extremely preterm, who had normal global cognitive ability.

KEYWORDS:

Diffusion tensor imaging; Functional MRI; Pediatric imaging; Prematurity; Working memory

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