Abstract

BackgroundPreterm birth at very low birth weight (VLBW) poses a risk for cerebellar abnormalities and increased psychiatric morbidity compared with reference populations. We aimed to study cerebellar volumes (grey and white matter; GM, WM) and mental health in VLBW individuals and controls at 15 and 19 years of age, as well as changes between the two time points.MethodsForty VLBW (≤1500 g) and 56 control adolescents were included in the study at 15 years of age, and 44 VLBW and 60 control adolescents at 19 years of age. We had longitudinal data for 30 VLBW participants and for 37 controls. Clinical diagnoses were assessed following the schedule for affective disorders and schizophrenia for school-age children (KSADS). Psychiatric symptoms and function were further investigated with the Achenbach System of Empirically Based Assessment (ASEBA), ADHD Rating Scale-IV and the children’s global assessment scale (CGAS). An automatic segmentation of cerebellar GM and WM volumes was performed in FreeSurfer. The MRI scans were obtained on the same 1.5T scanner at both ages.ResultsThe VLBW group had higher rates of psychiatric disorders at both ages. Cerebellar growth trajectories did not differ between VLBW adolescents and controls, regardless of psychiatric status. However, VLBW adolescents who had a psychiatric diagnosis at both ages or developed a psychiatric disorder from 15 to 19 years had maintained smaller cerebellar WM and GM volumes than controls and also smaller volumes than VLWB adolescents who were or became healthy in this period. Moreover, there were no differences in cerebellar WM and GM volumes between controls and those VLBW who were healthy or became healthy. In the VLBW group, cerebellar WM and GM volumes correlated positively with psycho-social function at both 15 and 19 years of age, and smaller GM volumes were associated with inattention at 15 years.ConclusionsSmaller cerebellar volume in adolescents born very preterm and with VLBW may be a biomarker of increased risk of psychiatric problems in young adulthood.Electronic supplementary materialThe online version of this article (doi:10.1186/s13034-016-0093-8) contains supplementary material, which is available to authorized users.

Highlights

  • Preterm birth at very low birth weight (VLBW) poses a risk for cerebellar abnormalities and increased psychiatric morbidity compared with reference populations

  • We investigated longitudinal differences in cerebellar white matter (WM) and gray matter (GM) volumes between VLBW adolescents divided according to diagnostic status during adolescence and controls

  • We studied if there were cerebellar WM and GM volumetric differences between the two VLBW groups and the control group at 15 and 19 years of age by using a general linear model (GLM), adjusting for age, sex and estimated intracranial volume (eICV)

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Summary

Introduction

Preterm birth at very low birth weight (VLBW) poses a risk for cerebellar abnormalities and increased psychiatric morbidity compared with reference populations. The cerebellum is of particular interest in the preterm born due to its extensive development during the third trimester of gestation. For the very preterm born infant, the extensive development of the cerebellum takes place in an extra uterine environment, where respiratory problems, infections and nutritional challenges may influence cerebellar development. Projections from the cerebellum to the cerebral cortex constitute the cerebello-thalamo-cortical (CTC) pathway [23, 24], and early disruption of the cerebellar circuitry development has been positively correlated with ASD, attention deficit and emotional problems [25].

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