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Original Research ARTICLE Provisionally accepted The full-text will be published soon. Notify me

Front. Psychol. | doi: 10.3389/fpsyg.2019.01942

BORN TOO EARLY AND TOO SMALL: HIGHER ORDER COGNITIVE AND BRAIN AT RISK AT AGES 8-16

 Monica M. Lopez1, 2*,  Marta Córcoles-Parada3, Rocio Gimenez-Mateo4,  Victor Serrano-del-Pueblo4, Leidy Lopez5,  Elena Perez-Hernandez6*, Francisco Mansilla7, Andres Martinez8*, Ignacio Onsurbe9, Paloma San Román10,  Mar Ubero11, Jonathan Clayden12 and  Chris A. Clark12
  • 1Regional Centre for Biomedical Research (CRIB), Medical Sciences, Universidad de Castilla La Mancha Albacete, Spain
  • 2Centre for Discovery Brain Sciences, University of Edinburgh, United Kingdom
  • 3Regional Centre for Biomedical Research (CRIB), Medical School, Facultad de Medicina, Universidad de Castilla-La Mancha, Spain
  • 4Facultad de Medicina, Universidad de Castilla-La Mancha, Spain
  • 5Psicología, Fundación Universitaria del Área Andina, Colombia
  • 6Developmental and Educational Psychology, Autonomous University of Madrid, Spain
  • 7Complejo Hospitalario Universitario de Albacete (SESCAM), Radiologgía, Facultad de Medicina, Universidad de Castilla-La Mancha, Spain
  • 8Complejo Hospitalario Universitario de Albacete (SESCAM), Pediatría Intensivista, Facultad de Medicina, Universidad de Castilla-La Mancha, Spain
  • 9Complejo Hospitalario Universitario de Albacete (SESCAM), Pediatría Neurología, Facultad de Medicina, Universidad de Castilla-La Mancha, Spain
  • 10Complejo Hospitalario Universitario de Albacete (SESCAM), Psiquiatría infanto-juvenil, Facultad de Medicina, Universidad de Castilla-La Mancha, Spain
  • 11Facultad de Ciencias de la Salud, Universidad Católica San Antonio de Murcia (UCAM), Spain
  • 12Developmental Neurosciences Prog, Institute of Child Health, University College London, United Kingdom

Prematurity presents a risk for higher order cognitive functions. Some of these deficits manifest later in development, when these functions are expected to mature. However, the causes and consequences of prematurity are still unclear. We conducted a longitudinal study to first identify clinical predictors of ultrasound brain abnormalities in 196 children born very preterm (VP; gestational age≤32 weeks) and with very low birth weight (VLBW; birth weight≤1500g). At ages 8-16, the subset of VP-VLBW children without neurological findings (124) were invited for a neuropsychological assessment and an MRI scan (41 accepted). Of these, 29 met a rigorous criterion for MRI quality and an age, and gender-matched control group (n=14) was included in this study. The key findings in the VP-VLBW neonates were: a) 37% of the VP-VLBW neonates had ultrasound brain abnormalities; b) gestational age and birth weight collectively with hospital course (i.e. days in hospital, neonatal intensive care, mechanical ventilation and with oxygen therapy, surgeries, and retinopathy of prematurity) predicted ultrasound brain abnormalities. At ages 8-16, VP-VLBW children showed: a) lower intelligent quotient (IQ) and executive function; b) decreased grey and white matter integrity; c) IQ correlated negatively with cortical thickness in higher order processing cortical areas. In conclusion, our data indicate that facets of executive function and IQ are the most affected in VP-VLBW children likely due to altered higher order cortical areas and underlying white matter.

Keywords: preterm, perinatal clinical variables, High order cognition, higher order processing areas , Memory, Attention, Executive Function, cortical thickness, IQ, white matter, grey matter volume, DTI, Hippocampus, frontal cortex

Received: 05 Mar 2019; Accepted: 07 Aug 2019.

Edited by:

Federica Scarpina, Italian Auxological Institute (IRCCS), Italy

Reviewed by:

Serena Giunta, University of Palermo, Italy
Dustin Scheinost, Yale University, United States  

Copyright: © 2019 Lopez, Córcoles-Parada, Gimenez-Mateo, Serrano-del-Pueblo, Lopez, Perez-Hernandez, Mansilla, Martinez, Onsurbe, San Román, Ubero, Clayden and Clark. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

* Correspondence:
Dr. Monica M. Lopez, Universidad de Castilla La Mancha Albacete, Regional Centre for Biomedical Research (CRIB), Medical Sciences, Albacete, 02006, Albacete, Spain, monica.munozlopez@uclm.es
Dr. Elena Perez-Hernandez, Autonomous University of Madrid, Developmental and Educational Psychology, Madrid, 28049, Madrid, Spain, elena.perezh@uam.es
Dr. Andres Martinez, Facultad de Medicina, Universidad de Castilla-La Mancha, Complejo Hospitalario Universitario de Albacete (SESCAM), Pediatría Intensivista, Albacete, Castilla-La Mancha, Spain, aamg12@gmail.com