Neonatal brain abnormalities and brain volumes associated with goal setting outcomes in very preterm 13-year-olds
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Executive dysfunction including impaired goal setting (i.e., planning, organization skills, strategic reasoning) is documented in children born very preterm (VP; <30 weeks/<1250 g), however the neurological basis for this impairment is unknown. This study sought to examine the relationship between brain abnormalities and brain volumes on neonatal magnetic resonance imaging (MRI) and goal setting abilities of VP 13-year-olds. Participants were 159 children born VP in a prospective longitudinal study. Qualitative brain abnormality scores and quantitative brain volumes were derived from neonatal MRI brain scans (40 weeks’ gestational age ± 2 weeks). Goal setting at 13 years was assessed using the Delis-Kaplan Executive Function Systems Tower Test, the Rey Complex Figure, and the Behavioural Assessment of the Dysexecutive System for Children Zoo Map and Six Part Test. A composite score was generated denoting overall performance on these goal setting measures. Separate regression models examined the association of neonatal brain abnormality scores and brain volumes with goal setting performance. There was evidence that higher neonatal white matter, deep grey matter and cerebellum abnormality scores were associated with poorer goal setting scores at 13 years. There was also evidence of positive associations between total brain volume, cerebellum, thalamic and cortical grey matter volumes and goal setting performance. Evidence for the associations largely persisted after controlling for potential confounders. Neonatal brain abnormality and brain volumes are associated with goal setting outcome in VP 13-year-olds. Used in conjunction with other clinical indicators, neonatal MRI may help to identify VP children at risk for later executive dysfunction.
KeywordsPremature birth Brain injury Executive function Magnetic resonance imaging (MRI)
We would like to acknowledge the input of the entire VIBeS research team, and all the families who participated in this study.
This study was funded by Australia’s National Health & Medical Research Council (Centre for Research Excellence 1060733 to L.W. Doyle, P.J. Anderson, and D. K. Thompson; Project Grant 1066555 to P.J. Anderson, L.W. Doyle, M. Spencer-Smith, D. K. Thompson; Senior Research Fellowship 1081288 to P.J. Anderson; Career Development Fellowship 1085754 to D. K. Thompson), the Murdoch Children’s Research Institute, The Royal Children’s Hospital, The Royal Children’s Hospital Foundation, Department of Paediatrics, The University of Melbourne and the Victorian Government’s Operational Infrastructure Support Program.
Compliance with ethical standards
Conflict of interest
Author Kristina M. Haebich declares that she has no conflict of interest. Author Catherine Willmott declares that she has no conflict of interest. Author Shannon E. Scratch declares that she has no conflict of interest. Author Leona Pascoe declares that she has no conflict of interest. Author Katherine J. Lee declares that she has no conflict of interest. Author Megan M. Spencer-Smith declares that she has no conflict of interest. Author Jeanie L.Y. Cheong declares that she has no conflict of interest. Author Terrie E. Inder declares that she has no conflict of interest. Author Lex W. Doyle declares that he has no conflict of interest. Author Deanne K. Thompson declares that she has no conflict of interest. Author Peter J. Anderson declares that he has no conflict of interest. This manuscript has never been published elsewhere.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
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