title: Regional cerebral development at term relates to school-age social-emotional development in very preterm children.
abstract: OBJECTIVE
  Preterm children are at risk for social-emotional difficulties, including autism and attention-deficit/hyperactivity disorder. We assessed the relationship of regional brain development in preterm children, evaluated via magnetic resonance imaging (MRI) at term-equivalent postmenstrual age (TEA), to later social-emotional difficulties.
  
  
  METHODS
  MR images obtained at TEA from 184 very preterm infants (gestation <30 weeks or birth weight <1,250 g) were analyzed for white matter abnormalities, hippocampal volume, and brain metrics. A total of 111 infants underwent diffusion tensor imaging, which provided values for fractional anisotropy and apparent diffusion coefficient. Social-emotional development was assessed with the Infant Toddler Social and Emotional Assessment (ITSEA) at age 2 and the Strengths and Difficulties Questionnaire (SDQ) at age 5 years.
  
  
  RESULTS
  Higher apparent diffusion coefficient in the right orbitofrontal cortex was associated with social-emotional problems at age 5 years (peer problems, p < .01). In females, smaller hippocampal volume was associated with increased hyperactivity (p < .01), peer problems (p < .05), and SDQ total score (p < .01). In males, a smaller frontal region was associated with poorer prosocial (p < .05) scores. Many of the hippocampal findings remained significant after adjusting for birthweight z score, intelligence, social risk, immaturity at birth, and parental mental health. These associations were present in children who had social-emotional problems in similar domains at age 2 and those who did not.
  
  
  CONCLUSIONS
  Early alterations in regional cerebral development in very preterm infants relate to specific deficits in social-emotional performance by school-age. These results vary by gender. Our results provide further evidence for a neuroanatomical basis for behavioral challenges found in very preterm children.
authors.affiliation: Washington University, USA. rogersc@psychiatry.wustl.edu
authors.forename: Cynthia E
authors.initials: CE
authors.lastname: Rogers
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Anderson
authors.forename: Deanne K
authors.initials: DK
authors.lastname: Thompson
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Kidokoro
authors.forename: Michael
authors.initials: M
authors.lastname: Wallendorf
authors.forename: Karli
authors.initials: K
authors.lastname: Treyvaud
authors.forename: Gehan
authors.initials: G
authors.lastname: Roberts
authors.forename: Lex W
authors.initials: LW
authors.lastname: Doyle
authors.forename: Jeffrey J
authors.initials: JJ
authors.lastname: Neil
authors.forename: Terrie E
authors.initials: TE
authors.lastname: Inder
mesh_terms: D016880:Anisotropy; D001289:Attention Deficit Disorder with Hyperactivity / Q000175:diagnosis* / Q000503:physiopathology; D001321:Autistic Disorder / Q000175:diagnosis* / Q000503:physiopathology; D001921:Brain / Q000473:pathology* / Q000503:physiopathology; D002675:Child, Preschool; D038524:Diffusion Magnetic Resonance Imaging; D004292:Dominance, Cerebral / Q000502:physiology; D056348:Emotional Intelligence / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D005625:Frontal Lobe / Q000473:pathology / Q000503:physiopathology; D006624:Hippocampus / Q000473:pathology / Q000503:physiopathology; D006801:Humans; D007090:Image Interpretation, Computer-Assisted; D007223:Infant; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000503:physiopathology; D019102:Infant, Very Low Birth Weight; D008297:Male; D009929:Organ Size / Q000502:physiology; D010379:Peer Group; D012737:Sex Factors; D012919:Social Behavior