Division of Neonatal and Developmental Medicine, Department of Pediatrics, Stanford University School of Medicine, Palo Alto, CA, USA.
J Pediatr. 2012 Sep;161(3):427-433.e1. doi: 10.1016/j.jpeds.2012.02.037. Epub 2012 Apr 4.
To use objective, nonverbal oculomotor tasks to assess executive function and infer the neural basis of impairments in preterm children.
Cross-sectional study of preterm children age 9-16 years (n = 69; mean gestational age 29 weeks) and full-term controls (n = 43). Tasks assessed sensorimotor function (reflexive prosaccades); resistance to peripheral distracters (fixation); response inhibition, response preparation, and execution of a voluntary saccade (antisaccades); and spatial working memory (memory-guided saccades). Group differences were analyzed using ANOVA. We used linear regression to analyze the contributions of age, sex, gestational age, and white matter category to task performance.
Preterm children did not differ from controls on basic sensorimotor function, response inhibition, and working memory. Compared with controls, preterm children showed greater susceptibility to peripheral distracters (P = .008) and were slower to initiate an inhibitory response (P = .003). Regression models showed contributions of age and white matter category to task performance.
Preterm children show intact basic sensorimotor function and demonstrate difficulties in processes underlying executive control, including increased distractibility and prolonged response preparation. These limitations may reflect specific neural abnormalities in fronto-subcortical executive control of behavior.
使用客观、非言语性的眼动任务来评估执行功能,并推断早产儿执行功能障碍的神经基础。
对 9-16 岁的早产儿(n=69;平均胎龄 29 周)和足月对照组(n=43)进行的横断面研究。任务评估了感觉运动功能(反射性注视性眼球运动);对外周分心物的抵抗(注视);反应抑制、反应准备和自愿性眼球运动(反注视)的执行;以及空间工作记忆(记忆引导性眼球运动)。使用方差分析分析组间差异。我们使用线性回归分析年龄、性别、胎龄和白质类别对任务表现的贡献。
早产儿在基本感觉运动功能、反应抑制和工作记忆方面与对照组无差异。与对照组相比,早产儿对周围分心物的敏感性更高(P=0.008),抑制性反应的启动速度较慢(P=0.003)。回归模型显示年龄和白质类别对任务表现有贡献。
早产儿表现出完整的基本感觉运动功能,并表现出执行控制过程中的困难,包括注意力分散增加和反应准备时间延长。这些局限性可能反映了额叶-皮质下执行控制行为的特定神经异常。