Department of Clinical & Molecular Medicine, Norwegian University of Science & Technology, Trondheim, Norway.
Department of Pediatrics, Sørlandet Hospital, Arendal, Norway.
Sci Rep. 2018 Oct 22;8(1):15553. doi: 10.1038/s41598-018-33530-8.
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.
早产（胎龄 < 37 周）伴极低出生体重（VLBW，出生体重 ≤ 1500 克）与终生认知缺陷相关，包括执行功能，并持续改变皮质和皮质下结构。然而，早产儿/极低体重儿（VLBW）脑是否存在“追赶生长”仍不清楚。本研究使用纵向结构磁共振成像（MRI），对在挪威母婴队列研究（MoBa）中出生的早产儿/极低体重儿（n = 41）和足月出生的同龄儿（n = 128）进行了两次检测，检测时间分别为儿童早期（平均年龄 8.0 岁和 9.3 岁）。使用 FreeSurfer 5.3.0 纵向流分析图像，以评估皮质厚度、表面积和脑结构体积的发育差异，以及与执行功能发育（NEPSY Statue 和 WMS-III 空间跨度评分）和围产期健康标志物的相关性。在皮质厚度、表面积或皮质下体积方面，未观察到纵向组 × 时间效应，这表明在儿童中期大约 16 个月的时间内，两组的脑生长轨迹相似。VLBW 组内较高的智商分数与左顶枕和下颞区的更大表面积相关。在 VLBW 早产儿中，整个皮质表面的皮质表面积更小，枕叶和额叶的皮质厚度更厚，外侧顶叶和后颞叶的皮质厚度更薄。胼胝体、右侧苍白球和右侧丘脑的体积从时间点 1 到 2 在 VLBW 组中持续较小。VLBW 儿童的平均智商比足月 MoBa 同龄人低 1 个标准差，WMS-III 空间跨度的得分明显更差。执行功能评分在横断面或纵向均未显示与形态计量学之间的差异相关性。本研究调查了早产儿/极低体重儿皮质厚度、表面积和皮质下灰质结构及胼胝体体积的发散或“追赶生长”，未发现组 × 时间交互作用。VLBW 组在平均年龄 9.3 时左侧顶枕和下颞叶的更大表面积与更高的智商相关。这些结果表明，早产儿/极低体重儿可能具有改变的认知网络，但在这个早期学校年龄窗口中，他们的结构生长轨迹似乎与足月同龄人总体相似。
