Very Low Birth Weight Young Adults Research Articles

Memory function and hippocampal volumes in preterm born very-low-birth-weight (VLBW) young adults

The hippocampi are regarded as core structures for learning and memory functions, which is important for daily functioning and educational achievements. Previous studies have linked reduction in hippocampal volume to working memory problems in very low birth weight (VLBW; ≤1500g) children and reduced general cognitive ability in VLBW adolescents. However, the relationship between memory function and hippocampal volume has not been described in VLBW subjects reaching adulthood. The aim of the study was to investigate memory function and hippocampal volume in VLBW young adults, both in relation to perinatal risk factors and compared to term born controls, and to look for structure–function relationships. Using Wechsler Memory Scale-III and MRI, we included 42 non-disabled VLBW and 61 control individuals at age 19–20years, and related our findings to perinatal risk factors in the VLBW-group. The VLBW young adults achieved lower scores on several subtests of the Wechsler Memory Scale-III, resulting in lower results in the immediate memory indices (visual and auditory), the working memory index, and in the visual delayed and general memory delayed indices, but not in the auditory delayed and auditory recognition delayed indices. The VLBW group had smaller absolute and relative hippocampal volumes than the controls. In the VLBW group inferior memory function, especially for the working memory index, was related to smaller hippocampal volume, and both correlated with lower birth weight and more days in the neonatal intensive care unit (NICU). Our results may indicate a structural–functional relationship in the VLBW group due to aberrant hippocampal development and functioning after preterm birth.

Brain volumes and cognitive function in very-low-birth-weight (VLBW) young adults

BackgroundPreterm born very-low-birth-weight (VLBW: birth weight ≤1500 g) survivors have increased risk of perinatal brain injury that may cause deviant brain development and later neuroimpairments, including reduced cognitive functioning. AimsIn this long-term follow up study of three year-cohorts (birth years 1986–88) of VLBW subjects and term born controls with normal birth weight, the aim was to examine differences in brain volumes at age 20 years. In addition, the relationships between brain volumes and cognitive abilities and perinatal variables were explored. MethodsForty-four VLBW subjects and 60 controls were assessed with cognitive testing (Wechsler Adult Intelligence Scale – WAIS-III) and structural MRI at 1.5 T, using the FreeSurfer 5.1 software for volumetric analysis. A subpopulation had MRI performed also at age 15, and for this group changes in brain volumes with age were examined. ResultsThe VLBW subjects had smaller brain volumes, especially of thalamus, globus pallidus and parts of the corpus callosum, and larger lateral ventricles than controls at age 20. However, no significant group differences in longitudinal change from age 15 to 20 were observed. The most immature and smallest VLBW subjects at birth, and those with the highest perinatal morbidity, showed most pronounced volume deviations. Positive associations between several brain volumes and full IQ, as well as three of four IQ indices in the VLBW group, were observed. ConclusionReduced volumes of grey and white matter and ventricular dilatation in VLBW young adults may indicate permanent effects on brain development from perinatal brain injury with influence on later cognitive function.

Psychosocial Outcomes of Young Adults Born Very Low Birth Weight

To assess the early adult health, education, and social functioning of a national cohort of very low birth weight (VLBW) infants born in 1986 in New Zealand compared with a control group of young adults born the same year. The impact of neurodevelopmental disability at age 7 to 8 years on young adult outcomes was examined. Participants underwent a comprehensive face-to-face interview that included standardized assessment tools and previously used custom written survey items. We interviewed 230 VLBW young adults (71% of survivors) and 69 controls at age 22 to 23 years. VLBW young adults were 5.6 kg lighter and 4.2 cm shorter than controls, had lower rates of tertiary education/training (percentage difference [95% confidence interval]: -13.1 [-21.6 to -1.8]) and university degree completion (-15.6 [-28.0 to -4.8]), had more often been welfare dependent (23.5 [10.2 to 35.0]), had few or no friends (20.5 [7.2 to 32.2]), and more often had wheeze in the past year (20.1 [9.0 to 28.6]). However, in many areas there were no differences between the VLBW cohort and controls, and VLBW adults rated their overall quality of life and behavioral functioning similarly to their peers. Those with previous disability had poorer social, occupational, and physical functioning than other VLBW young adults. Despite some evidence of health, educational, and social difficulties, former VLBW young adults obtained similar scores across many aspects of health and social functioning as their same age peers, with some differences largely confined to those with previous disability.

Deficits in episodic memory relate to reduced hippocampal volumes in very-low-birth-weight (VLBW) young adults

WCN 2013 No: 2302 Topic: 36 — Other Topic Deficits in episodic memory relate to reduced hippocampal volumes in very-low-birth-weight (VLBW) young adults G. Lohaugen, K.J. Bjuland, M. Martinussen, J. Skranes. Child Rehabilitation, Sorlandet Hospital, Arendal, Norway; Laboratory Medicine, Children's and Women's Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway Background and aims: The hippocampus is regarded as a core structure for learning and memory functions. Academic problems are commonly reported in VLBW (bw ≤ 1500 g) children and adolescents, and the aims of this hospital-based, long-term follow-up study were to perform a comprehensive memory assessment in VLBW young adults and investigate the relationship between hippocampal volume and episodic memory compared to age-matched term born controls. Methods: Forty-two non-disabled VLBW and 61 age-matched controls were examined at age 19 with the WAIS-III, Wechsler Memory Scale-III and cerebral MRI. An automated MRI technique (FreeSurfer ver. 5.1) at 1.5 Tesla for morphometric analysis of hippocampal volumes was applied. Results: The VLBW group was at a disadvantage compared to controls on tests assessing visual immediate/delayed memory and working memory. The VLBW group had similar relative left (mean 0.244 (SE 0.003) mm, p = 0.242) and smaller right (mean: 0.243 (SE 0.004) mm, p = 0.027) hippocampal volumes vs. controls (left 0.249 (SE 0.003) mm; right 0.253 (SE 0.003) mm). Significant correlations were found between left (r = 0.344, p = 0.030) and right (r = 0.038, p = 0.016) relative hippocampal volumes and visual immediate memory. Working memory function was associated with right hippocampal volume (r = 0.392, p = 0.015). Conclusion: We found that being born preterm with VLBW has longterm negative consequences regarding memory functions, persisting into young adulthood. The relative hippocampal volumes were reduced in VLBW young adults compared to term born controls. Positive correlations were found between hippocampal volume and immediate visual and working memory function in the VLBW group. doi:10.1016/j.jns.2013.07.2305 Abstract — WCN 2013 No: 2310 Topic: 36 — Other Topic Oculomotor changes in multiple system atrophy: Clinical, MRI and laboratory features in eight patients WCN 2013 No: 2310 Topic: 36 — Other Topic Oculomotor changes in multiple system atrophy: Clinical, MRI and laboratory features in eight patients G. Lucii, F. Rosini, P. Federighi, E. Pretegiani, F. Giannini, A. Federico, A. Rufa. Eye Tracking & Visual Application Lab EVALab, UOC Neurologia e Malattie Neurometaboliche Dipartimento di Medicina Chirurgia e Neuroscienze, Universita degli Studi di Siena, Siena, Italy; UOC Neurofisiologia Clinica Dipartimento diMedicina Chirurgia e Neuroscienze, Universita degli Studi di Siena, Siena, Italy; c UOC Neurologia e Malattie Neurometaboliche Dipartimento di Medicina Chirurgia e Neuroscienze, Universita degli Studi di Siena, Siena, Italy Background: Multiple system atrophy (MSA) is a progressive adultonset α-synucleinopathy characterized by dysautonomia associated with cerebellar symptoms (MSA-C) or parkinsonism (MSA-P). Ocular motor changes, including saccadic dysmetria, saccadic intrusions and nystagmus, have been reported. Objective: To determine the ocular motor changes in MSA that may differentiate these patients from other neurodegenerative diseases with overlapping clinical features. Methods: Eight patients, six MSA-C and two MSA-P, were recorded. Mean age was 60 ± 3; mean disease duration was 4.87 ± 1.45 years. Horizontal (±10°; ±18°) and vertical (up/down 8°) visually-guided saccades and antisaccades were tested and compared with EVAlab's normative data. Three minutes of steady fixation were performed. Saccadic parameters, antisaccade errors with relative corrections and fixation changes were evaluated. Results: All patients showed significant reduction of amplitude (6.73° ± 2.11° vs 8.3° ± 0.09°)(P value = 0.026), and accuracy (2.01 ± 1.44 vs 1.17 ± 0.49)(P value = 0.004) of downward saccades. Amplitude at 18° of horizontal eccentricity (15.44° ± 2.56° vs 18.3° ± 0.9°) (P value b 0.0001) and accuracy at 10° (2.37 ± 0,86 vs 0.88 ± 0.52) (P value b 0.001) and 18° (4.86 ± 2.21 vs 1.22 ± 0.09)(P value b 0.001) of horizontal saccades were also decreased. Direction error in antisaccade task was about 45% with a 96% of spontaneous fast correction. Steady fixation was interrupted by saccadic intrusions (square wave jerks subtype, average number of 12/min and mean amplitude of 1.52° ± 0.31°). Conclusions: Our findings substantiate peculiar changes of saccade dynamics in MSA. Downward saccades are more impaired than horizontal. Voluntary saccades and fixation are also impaired and lesser than in other similar neurodegenerative diseases. Oculomotor profile helps to differentiate MSA from other neurodegenerative diseases with overlapping clinical features. doi:10.1016/j.jns.2013.07.2306 Abstract — WCN 2013 No: 2272 Topic: 36 — Other Topic Serial magnetic resonance imaging of acute necrotizing myelitis WCN 2013 No: 2272 Topic: 36 — Other Topic Serial magnetic resonance imaging of acute necrotizing myelitis E. Papageorgiou, K. Psychogios, D. Tzanetakos, I. Markakis, I. Xydakis, G. Gekas. Neurology, ‘St. Panteleimon’ General State Hospital, Nikaia,

Motor skills at 23 years of age in young adults born preterm with very low birth weight

BackgroundMotor skills have previously not been reported in young adults born with very low birth weight (VLBW), although they are commonly reported in children and adolescents. AimTo compare fine and gross motor skills in VLBW young adults with matched term-born controls, and to study longitudinal changes in the VLBW group. Study designA geographically based follow-up study of a VLBW group and a control group. SubjectsThirty-six VLBW (birth weight≤1500g) young adults, including four participants with cerebral palsy (CP), and 37 matched controls (birth weight≥10th centile) were examined at 14 and 23years of age. Outcome measuresFine and gross motor skills were assessed using Grooved Pegboard test (GP), Trail Making Test-5 (TMT-5), Movement Assessment Battery for Children-2 (Movement ABC-2) and High-level Mobility Assessment Tool (HiMAT). ResultsVLBW young adults were slower than controls on GP (p=0.026) and TMT-5 (p<0.001). Mean total Movement ABC-2 score was 69.7±20.2 in the VLBW group compared with 74.1±14.4 in the control group (p=0.017). Differences were also seen in manual dexterity and balance. Additionally, HiMAT showed reduced balance and speed in gross motor skills in the VLBW group. The proportion of participants with motor problems did not change between age 14 and 23. After exclusion of participants with CP, scores were essentially the same. ConclusionVLBW young adults had overall poorer fine and gross motor skills compared with controls. Reduced speed seemed to be an underlying problem. Longitudinal findings indicate that VLBW children have not outgrown their motor problems when entering adulthood.

Cortical surface area and IQ in very-low-birth-weight (VLBW) young adults

IntroductionQuantitative MRI measurements have revealed abnormalities in cortical development in children born preterm with very-low-birth-weight (VLBW). These children also have increased risk of cognitive deficits that persist into adulthood. The aim of this study was to investigate cortical surface area in VLBW young adults at age 19 compared with controls and to see whether surface area change was associated with cognitive function in the VLBW group. MethodsThirty-eight VLBW (BW ≤ 1500 g) and 59 control participants were included in the study. Cognitive function was assessed by Wechsler Adult Intelligence Scale (WAIS)-III. The MRI scanning was performed at 1.5 T, and for the morphometric analyses of cortical surface area the FreeSurfer software was used. ResultsReduction in cortical surface area was seen in ventrolateral prefrontal, temporal and parietal regions in the VLBW group. Intelligence quotient (IQ) scores were reduced and correlated with surface area reduction in superior and inferior frontal gyri, and in medial temporal and occipital regions in the VLBW group. Brodmann areas (BAs) included in the group differences and in the IQ correlation in the VLBW group were located to the inferior frontal gyrus (BA 11, 12, 44, 45, 47), isthmus (BA 25), the superior parietal (BA 7), the inferior temporal (BA 20) and the parahippocampal gyri (BA 28, 34, 35, 36, 37). The IQ indices that made the largest contribution to the associations between IQ and surface areal change in the VLBW group were the Working Memory and the Processing Speed indices. ConclusionsOur study indicates that permanent deviations in cortical surface area still present in adulthood may explain the increased prevalence of cognitive impairments in preterm born VLBW individuals.

Can Cortical and White Matter Deviations Explain Deficits in Working Memory and Processing Speed in VLBW Young Adults?

Background and aims: Perinatal brain injury in very low birth weight (VLBW) children affecting grey and white matter damage is associated with neurocognitive deficits that persist into adulthood. The aim of study was to investigate the relationship between cognitive deficits and cortical surface area and white matter deviations in VLBW young adults.Methods: 49 VLBW (birth weight ≤ 1500 grams) and 59 term born controls were examined at the age of 19 with Wechsler Adult Intelligence Scale WAIS-III and MRI. An automated MRI technique at 1.5 Tesla for morphometric analyses of cortical surface area and DTI to investigate fractional anisotropy in white matter tracts were performed in both groups.Results: IQ was associated with reduced surface area in specific cortical regions of the brain of the VLBW young adults. The IQ indices that corresponded the most to the associations were the Working Memory Index and the Processing Speed Index (Figure 1). These indices were also related with FA reduction in central white matter tracts like corpus callosum, capsula externa and sup. long. fasciculus.Conclusions: Cognitive deficits in young adults born with VLBW were related with both grey and white matter abnormalities indicating perinatal brain injury with permanent consequences for brain development and functioning.

196 Widespread White Matter Damage is Seen on DTI in Young Adults Born Preterm with Very Low Birth Weight (VLBW)

Background and aims: Perinatal brain injury in very low birth weight (VLBW) preterms is associated with permanent changes in white matter integrity and connectivity, and to neurodevelopmental problems including cognitive deficits. The aim of study was to investigate whether being born with VLBW leads to white matter damage that persist into adulthood, and to examine the relationship between white matter integrity and perinatal data and IQ in the VLBW group. Methods: Forty-nine VLBW young adults and 59 term controls were scanned at 1.5 T at ages 18-22 with DTI. Voxelwise maps of fractional anisotropy (FA) were calculated and Tract-Based Spatial Statistics was carried out to test for voxelwise differences between groups. Cognitive function was assessed with WAIS-III. The relationships between FA and total IQ and perinatal variables were explored. Results: In VLBW adults all major central and posterior white matter tracts had reduced FA, mainly caused by an increase in the two lowest eigenvalues. FA correlated positively with birth weight and negatively with number of days on mechanical ventilator and in NICU. More than half of the VLBW subjects obtained a subnormal IQ score. The FA-IQ correlation analyses demonstrated positive correlations between FA and IQ in regions including corpus callosum and long and short association tracts. Conclusions: Preterm birth with VLBW results in long-term irreversible changes in white matter microstructure that relate to inferior IQ in VLBW young adults. Lower birth weight and perinatal problems seem to have permanent negative effects on white matter integrity.

167 Regional Cortical Surface Area Relates to Iq in Young Adults Born Preterm with Very Low Birth Weight (VLBW)

Background and aims: Perinatal brain injury in very low birth weight (VLBW) preterms includes grey and white matter damage that affects brain development, and is associated with neurocognitive deficits that persist into adulthood. The aim of study was to investigate the relationship between cortical surface area expansion and different IQ indices in VLBW young adults. Methods: 49 VLBW (birth weight ≤ 1500 grams) and 59 term born controls were examined at the age of 19 with Wechsler Adult Intelligence Scale WAIS-III and MRI. An automated MRI technique at 1.5 Tesla for morphometric analyses of regional cortical expansion was performed. Results: Reduced cortical surface area in the VLBW young adults compared with controls were seen mainly in the dorsolateral frontal, temporal and parietal regions, with a strong influence from birth weight, far less from gestational age. The variability in Full IQ in the VLBW group was associated with reduced surface area in specific cortical regions of the brain, with a pattern similar to the localization of the group differences. The IQ indices that corresponded the most to the associations were the Working Memory Index and the Processing Speed Index. No associations were seen between surface area and IQ indices in the control group. Conclusions: This is the first study that links cognitive deficits to deviations in regional cortical development seen as significantly reduced brain surface area in young adults born with VLBW compared to term born controls.

Quality of life in young adults with very low birth weight

OBJECTIVESTo assess quality of life (QoL) in a group of young adults born in 1980–1982 with very low birth weight (VLBW) and to compare this with a reference group and...