Decreased regional brain volume and cognitive impairment in preterm children at low risk.
OBJECTIVE
To investigate whether preterm children with low risk for neurodevelopmental deficits show long-term changes in gray matter (GM) and white matter (WM) volumes compared with term children and to relate these changes to cognitive outcome.


METHODS
MRI was used to evaluate 20 preterm children who were determined to be at low risk for neurodevelopmental deficits and were born between 30 and 34 weeks' gestational age without major neonatal morbidity or cerebral pathology in the neonatal period and 22 matched, term control subjects. Volumetric images were analyzed by means of voxel-based morphometry to identify regional cerebral alterations. Children also underwent cognitive and behavioral/emotional assessments.


RESULTS
Preterm children showed global and regional GM volume reductions in several brain areas, including temporal and parietal lobes and concomitant WM volume reductions in the same areas, although only the left temporal regions achieved statistical significance. Global intellectual performance in the preterm group was significantly decreased compared with control subjects. Neither behavioral nor emotional problems were found in the preterm group. In the whole sample, we found a positive correlation between GM volume bilaterally in the middle temporal and in the postcentral gyri with IQ. Positive correlations were observed between GM and gestational age at birth in parietal and temporal cerebral regions and with WM in parietal regions.


CONCLUSIONS
Preterm birth has an important impact on the neurodevelopmental and cognitive outcome of children at 9 years of age, being a risk factor for decreased regional cortical GM and WM even in preterm children with low risk for neurodevelopmental deficits.
Soria-Pastor
Sara
S
Department of Psychiatry and Clinical Psychobiology, Faculty of Medicine, University of Barcelona, Barcelona, Spain.
Padilla
Nelly
N
Zubiaurre-Elorza
Leire
L
Ibarretxe-Bilbao
Naroa
N
Botet
Francesc
F
Costas-Moragas
Carme
C
Falcon
Carles
C
Bargallo
Nuria
N
Mercader
Josep Maria
JM
Junqué
Carme
C
D001921:Brain / Q000473:pathology*; D001925:Brain Damage, Chronic / Q000175:diagnosis* / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology; D002648:Child; D002675:Child, Preschool; D003072:Cognition Disorders / Q000175:diagnosis* / Q000473:pathology; D002658:Developmental Disabilities / Q000175:diagnosis / Q000473:pathology; D005260:Female; D005865:Gestational Age; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000473:pathology; D007360:Intelligence; D008137:Longitudinal Studies; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D009929:Organ Size / Q000502:physiology; D012016:Reference Values; D012307:Risk Factors; D013223:Statistics as Topic; D014888:Wechsler Scales / Q000706:statistics & numerical data