Extensive and interrelated subcortical white and gray matter alterations in preterm-born adults
- 493 Downloads
Preterm birth is a leading cause for impaired neurocognitive development with an increased risk for persistent cognitive deficits in adulthood. In newborns, preterm birth is associated with interrelated white matter (WM) alterations and deep gray matter (GM) loss; however, little is known about the persistence and relevance of these subcortical brain changes. We tested the hypothesis that the pattern of correspondent subcortical WM and GM changes is present in preterm-born adults and has a brain-injury-like nature, i.e., it predicts lowered general cognitive performance. Eighty-five preterm-born and 69 matched term-born adults were assessed by diffusion- and T1-weighted MRI and cognitive testing. Main outcome measures were fractional anisotropy of water diffusion for WM property, GM volume for GM property, and full-scale IQ for cognitive performance. In preterm-born adults, reduced fractional anisotropy was widely distributed ranging from cerebellum to brainstem to hemispheres. GM volume was reduced in the thalamus, striatum, temporal cortices, and increased in the cingulate cortices. Fractional anisotropy reductions were specifically associated with GM loss in thalamus and striatum, with correlation patterns for both regions extensively overlapping in the WM of brainstem and hemispheres. For overlap regions, fractional anisotropy was positively related with both gestational age and full-scale IQ. Results provide evidence for extensive, interrelated, and adverse WM and GM subcortical changes in preterm-born adults. Data suggest persistent brain-injury-like changes of subcortical–cortical connectivity after preterm delivery.
KeywordsPreterm-born adults Diffusion MRI White matter Voxel-based morphometry Gray matter IQ
We thank all current and former members of the Bavarian Longitudinal Study Group who contributed to general study organization, recruitment, and data collection, management and subsequent analyses, including (in alphabetical order): Stephan Czeschka, Claudia Grünzinger, Christian Koch, Diana Kurze, Sonja Perk, Andrea Schreier, Antje Strasser, Julia Trummer, and Eva van Rossum. We are grateful to the staff of the Department of Neuroradiology in Munich and the Department of Radiology in Bonn for their help in data collection. Most importantly, we thank all our study participants and their families for their efforts to take part in this study. This study was supported by Chinese Scholar Council (CSC, File No: 2010604026 to C.M.), German Federal Ministry of Education and Science (BMBF 01ER0801 to P.B. and D.W., BMBF 01EV0710 to A.M.W., BMBF 01ER0803 to C.S.) and the Kommission für Klinische Forschung, Technische Universität München (KKF 8765162 to C.S).
Conflict of interest
All authors report no biomedical financial interests or potential conflicts of interest.
- Anjari M, Srinivasan L, Allsop JM, Hajnal JV, Rutherford MA, Edwards AD, Counsell SJ (2007) Diffusion tensor imaging with tract-based spatial statistics reveals local white matter abnormalities in preterm infants. NeuroImage 35:1021–1027. doi: 10.1016/j.neuroimage.2007.01.035 CrossRefPubMedGoogle Scholar
- Nosarti C, Shergill SS, Allin MP, Walshe M, Rifkin L, Murray RM, McGuire PK (2009) Neural substrates of letter fluency processing in young adults who were born very preterm: alterations in frontal and striatal regions. NeuroImage 47:1904–1913. doi: 10.1016/j.neuroimage.2009.04.041 CrossRefPubMedGoogle Scholar
- Riegel K, Orth B, Wolke D, Osterlund K (1995) Die Entwicklung gefährdet geborener Kinder bis zum 5 Lebensjahr. Thieme, Stuttgart (Germany)Google Scholar
- Srinivasan L, Dutta R, Counsell SJ, Allsop JM, Boardman JP, Rutherford MA, Edwards AD (2007) Quantification of deep gray matter in preterm infants at term-equivalent age using manual volumetry of 3-tesla magnetic resonance images. Pediatrics 119:759–765. doi: 10.1542/peds.2006-2508 CrossRefPubMedGoogle Scholar
- Von Aster M, Neubauer A, Horn R (2006) Wechsler Intelligenztest für Erwachsene (WIE). Deutschsprachige Bearbeitung und Adaptation des WAIS-III von David Wechsler. Harcourt Test Services, Frankfurt/Main (Germany)Google Scholar