Edgin Jamie O, Inder Terrie E, Anderson Peter J, Hood Kelly M, Clark Caron A C, Woodward Lianne J
Department of Psychology, University of Canterbury & Van der Veer Institute for Parkinson's and Brain Research, Christchurch, New Zealand.
J Int Neuropsychol Soc. 2008 Jan;14(1):90-101. doi: 10.1017/S1355617708080053.
Despite evidence for executive dysfunction in school-aged preterm children, less is known about the early development of these difficulties or their underlying neuropathology. This study used prospective longitudinal data from a regional cohort of 88 very preterm and 98 full-term comparison children to examine the executive functioning (EF) of preschool children born very preterm. The relationship between the severity of neonatal cerebral white matter (WM) abnormalities on magnetic resonance imaging (MRI) at term equivalent and children's EF at ages two and four years (corrected age) was examined. At age four, very preterm children with WM abnormalities performed less well than full-term children on the Detour Reaching Box, a measure of behavioral inhibition and cognitive flexibility, even after controlling for child IQ, SES, and medical background. Examination of patterns of EF performance between the ages of 2 and 4 years showed that the performance of all groups improved with age. However, very preterm children with mild and moderate-severe WM abnormalities were characterized by higher rates of consistent performance impairments. These findings support the presence of early and persistent executive difficulties in preschool children born very preterm, and highlight the importance of white matter pathology in the development of executive impairments.
尽管有证据表明学龄期早产儿存在执行功能障碍，但对于这些困难的早期发展及其潜在的神经病理学了解较少。本研究使用了来自一个地区队列的前瞻性纵向数据，该队列包括88名极早产儿和98名足月儿作为对照，以研究极早产儿出生后学龄前儿童的执行功能（EF）。研究了足月时磁共振成像（MRI）上新生儿脑白质（WM）异常的严重程度与儿童在2岁和4岁（矫正年龄）时的EF之间的关系。在4岁时，即使在控制了儿童智商、社会经济地位（SES）和医学背景后，患有WM异常的极早产儿在绕道取物箱测试（一种行为抑制和认知灵活性的测量方法）中的表现仍不如足月儿。对2岁至4岁期间EF表现模式的检查表明，所有组的表现都随着年龄的增长而改善。然而，患有轻度和中度 - 重度WM异常的极早产儿的特点是持续表现受损的发生率较高。这些发现支持极早产儿出生后学龄前儿童存在早期且持续的执行功能困难，并强调了白质病理学在执行功能障碍发展中的重要性。
