Psychological findings in preterm children related to neurologic status and magnetic resonance imaging.
OBJECTIVE
Preterm children experience learning disabilities more often than full-term children, but detailed information on their neuropsychological and neurologic determinants is lacking. We therefore examined these problems more closely and also studied if clinical neurologic examination and/or magnetic resonance imaging (MRI) can be used as tools to screen the preterm children at risk for these problems.


METHODS
In a population-based study, the psychological performance of 42 preterm children with a birth weight <1750 g and of their matched controls was assessed at 8 years of age and the findings were then related to clinical neurologic examination and MRI. Learning disabilities of these children, reported by the teachers, were also studied.


RESULTS
The cognitive ability of the preterm children, although in the normal range, was significantly lower than that of the control children. They performed particularly poorly in tasks requiring spatial and visuoperceptual abilities, which were associated with the finding of periventricular leukomalacia in MRI, especially with posterior ventricular enlargement. The preterm children with minor neurodevelopmental dysfunction (MND) had the most problems in neuropsychological tests, whereas the clinically healthy preterm children and those with cerebral palsy had fewer problems. The problems of MND children emerged in the domain of attention. They also experienced the most problems at school.


CONCLUSIONS
Visuospatial problems were associated with periventricular leukomalacia in MRI, but learning disabilities were most frequent among the preterm children with minor neurologic abnormalities. We recommend closer follow-up of preterm children with MND.
Department of Pediatrics, University of Oulu, Oulu, Finland.
P
P
Olsén
L
L
Vainionpää
E
E
Pääkkö
M
M
Korkman
J
J
Pyhtinen
M R
MR
Järvelin
D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis / Q000523:psychology; D001724:Birth Weight; D001921:Brain / Q000473:pathology; D001925:Brain Damage, Chronic / Q000175:diagnosis* / Q000523:psychology; D002547:Cerebral Palsy / Q000175:diagnosis / Q000523:psychology; D002658:Developmental Disabilities / Q000175:diagnosis* / Q000523:psychology; D005500:Follow-Up Studies; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000523:psychology; D007859:Learning Disabilities / Q000175:diagnosis* / Q000523:psychology; D007969:Leukomalacia, Periventricular / Q000175:diagnosis / Q000523:psychology; D008279:Magnetic Resonance Imaging; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D012307:Risk Factors; D014888:Wechsler Scales