Abstract
AimTo identify long-term effects of preterm birth and of periventricular leukomalacia (PVL) on cortical thickness (CTh). To study the relationship between CTh and cognitive-behavioral abnormalities.MethodsWe performed brain magnetic resonance imaging on 22 preterm children with PVL, 14 preterm children with no evidence of PVL and 22 full-term peers. T1-weighted images were analyzed with FreeSurfer software. All participants underwent cognitive and behavioral assessments by means of the Wechsler Intelligence Scales for Children-Fourth Edition (WISC-IV) and the Child Behavior Checklist (CBCL).ResultsWe did not find global CTh differences between the groups. However, a thinner cortex was found in left postcentral, supramarginal, and caudal middle rostral gyri in preterm children with no evidence of PVL than in the full-term controls, while PVL preterm children showed thicker cortex in right pericalcarine and left rostral middle frontal areas than in preterm children with no evidence of PVL. In the PVL group, internalizing and externalizing scores correlated mainly with CTh in frontal areas. Attentional scores were found to be higher in PVL and correlated with CTh increments in right frontal areas.InterpretationThe preterm group with no evidence of PVL, when compared with full-term children, showed evidence of a different pattern of regional thinning in the cortical gray matter. In turn, PVL preterm children exhibited atypical increases in CTh that may underlie their prevalent behavioral problems.
Highlights
Neonates born preterm have a high risk of developing long-term psychiatric and behavioral disorders [1,2,3]
Selection criteria included: gestational age (GA),37 weeks, full intelligence quotient (FIQ) .70, neonatal diagnosis of periventricular leukomalacia (PVL), and signs of PVL in the current magnetic resonance imaging (MRI) according to the criteria proposed by Flodmark et al [22]
Cortical Thickness Differences Analysis of global cortical thickness (CTh) revealed no statistical differences between groups
Summary
Neonates born preterm have a high risk of developing long-term psychiatric and behavioral disorders [1,2,3]. Preterm birth has been related to attention/hyperactivity symptoms [4,5,6], a high prevalence of autism [7], and higher scores in other behavioral disorders [8,9,10]. Normal development in childhood is accompanied by an increase in cortical thickness (CTh) in almost all brain areas, whereas there is a progressive cortical thinning during adolescence [11]. Cortical thickening has been described in autism [12,13], whereas cortical thinning has been found in attention deficit hyperactivity disorder [14]
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