Left Dorsolateral Prefrontal Cortical Functional Connectivity in Former Term and Very Preterm-Born Children

Introduction Children born very preterm (VP) are at increased risk for brain injury resulting from both destructive and developmental disturbance. This has been associated with adverse cognitive and neuropsychological outcome. The aim of this study is to identify resting state functional connectivity and correlation with neuropsychological function at early school age of former VP compared with full-term (FT) control.

Materials and Methods This is a retrospective, historical cohorts, control-matched study. Several 30 VP children, born before 32 weeks’ gestational age weighing <1,000 g, admitted to Seoul National University Hospital neonatal intensive care unit between 2008 and 2009 were selected. Thirty-three age matched FT controls were recruited. All participants underwent a resting state functional magnetic resonance imaging scan, and were assessed for cognitive function (Korean-Wechsler Intelligence Scale for Children-IV or Korean Educational Development Institute-Wechsler Intelligence scale for children), executive function (advanced test for attention, Children’s color trail tests, Stroop color-word tests and Wisconsin card sorting test) and behavioral problems (Korean-Attention-Deficit Hyperactivity Disorder-Rating Score and Korean-Child behavior checklists).

Results Full scale intelligence quotient was higher in FT control than in VP children (109.3 vs. 90.97, p < 0.001, respectively).

The cortical thickness (CT) of VP children was thinner than that of FT controls at both supramarginal/inferior parietal cortex and superior parietal lobule of right hemisphere. In contrast, the CTs at medial orbitofrontal cortex, frontal pole, right dorsolateral prefrontal cortex (DLPFC), and occipital cortex were all thinner in FT than in VP patients ([Fig. A015]). The CT of left supramarginal and inferior parietal cortex showed positive correlation with STROOP test in VP group.

Seed-based analyses were performed using regions of interests as left DLPFC, the resting state functional connectivity was weaker in VP children than that of FT control to left superior frontal gyrus, left parietal lobe, left angular gyrus, left occipital cuneus, right medial frontal gyrus, right cingulate gyrus, right cerebellum, and right superior frontal gyrus. In voxel-based analysis, VP children with exposure to systemic inflammation had reduced right middle temporal cortex volume than without inflammation.

Fig. A015

Conclusion Prematurity was associated with reduced corticocortical connectivity around left DLPFC which is correlated with poor executive function in VP children at 10 to 11 years of age.

Conflict of Interest

None declared.