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Language outcome related to brain structures in school-aged preterm children: A systematic review.

ABSTRACT: Preterm children often have language problems. This atypical language development is probably due to atypical brain development. We conducted a systematic review to provide an overview of the extensive and diverse scientific literature on the relations between language outcome and underlying brain structures in school-aged preterm-born children. Embase, Medline Ovid, Web of Science, Cochrane central and Google scholar were searched for relevant studies. Inclusion criteria were: cases are school-aged preterm children; structural MRI (T1- and T2-weighted sequences) or DTI used in combination with a neurocognitive language test; publication in an English-language peer-reviewed journal. Correlational measures between language scores and brain volume or fractional anisotropy of a brain structure were extracted. 23 studies were included. The relations between oral language, verbal fluency and/or written language and MRI/DTI measurements of white matter, gray matter, cerebellum, corpus callosum and/or the fasciculi are presented. Oral language skills and verbal fluency appear to be related to the corpus callosum. Oral language skills are also related to the uncinate fasciculus. There seems to be no clear relation between cerebellar development and verbal fluency skills. Not one single brain area is responsible for atypical language development, but several brain areas and their connections are essential. For future research it is recommended to relate brain areas to oral language skills on a microstructural level in preterm children. We also recommend to use language tests in which it is possible to distinguish between several language domains, such as perceptive and expressive language.

SUBMITTER: Stipdonk LW

PROVIDER: S-EPMC5986152 | biostudies-literature | 2018

REPOSITORIES: biostudies-literature

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Language outcome related to brain structures in school-aged preterm children: A systematic review.

Stipdonk Lottie W LW Franken Marie-Christine J P MJP Dudink Jeroen J

PloS one 20180604 6

Preterm children often have language problems. This atypical language development is probably due to atypical brain development. We conducted a systematic review to provide an overview of the extensive and diverse scientific literature on the relations between language outcome and underlying brain structures in school-aged preterm-born children. Embase, Medline Ovid, Web of Science, Cochrane central and Google scholar were searched for relevant studies. Inclusion criteria were: cases are school- ...[more]

PMID: 29864120

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Project description:Importance:Children born preterm are at an elevated risk of academic underachievement. However, the extent to which performance across domain-specific subskills in reading and mathematics is associated with preterm birth remains unclear. Objective:To conduct a systematic review and meta-analysis of academic outcomes of school-aged children born preterm, compared with children born at term, appraising evidence for higher- and lower-order subskills in reading and mathematics. Data Sources:PubMed/MEDLINE, PsycINFO, and the Cumulative Index of Nursing and Allied Health Literature electronic databases from January 1, 1980, to July 30, 2018, were searched for population, exposure, and outcome terms such as child (population), preterm birth (exposure), and education* (outcome). Study Selection:Peer-reviewed English-language publications that included preterm-born children and a comparison group of term-born children aged 5 to 18 years and born during or after 1980 and that reported outcomes on standardized assessments from cohort or cross-sectional studies were screened. Of the 9833 articles screened, 33 unique studies met the inclusion criteria. Data Extraction and Synthesis:Data were analyzed from August 1 to September 29, 2018. The Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines were followed. Two reviewers independently screened the databases and extracted sample characteristics and outcomes scores. Pooled mean differences (MDs) were analyzed using random-effects models. Main Outcomes and Measures:Performance on standardized assessment of higher-order subskills of reading comprehension and applied mathematics problems; lower-order reading subskills of decoding, pseudoword decoding, and word identification; and lower-order mathematics subskills of knowledge, calculation, and fluency. Results:Outcomes data were extracted for 4006 preterm and 3317 term-born children, totaling 7323 participants from 33 unique studies. Relative to children born at term, children born preterm scored significantly lower in reading comprehension (mean difference [MD], -7.96; 95% CI, -12.15 to -3.76; I2?=?81%) and applied mathematical problems (MD, -11.41; 95% CI, -17.57 to -5.26; I2?=?91%) assessments. Across the assessments of lower-order skills, children born preterm scored significantly lower than their term-born peers in calculation (MD, -10.57; 95% CI, -15.62 to -5.52; I2?=?92%), decoding (MD, -10.18; 95% CI, -16.83 to -3.53; I2?=?71%), mathematical knowledge (MD, -9.88; 95% CI, -11.68 to -8.08; I2?=?62%), word identification (MD, -7.44; 95% CI, -9.08 to -5.80; I2?=?69%), and mathematical fluency (MD, -6.89; 95% CI, -13.54 to -0.23; I2?=?72%). The associations remained unchanged after sensitivity analyses for reducing heterogeneity. Conclusions and Relevance:These findings provide evidence that preterm birth is associated with academic underperformance in aggregate measures of reading and mathematics, as well as a variety of related subskills.

Project description:BackgroundExecutive function deficits in children born very preterm (VPT) have been linked to anatomical abnormalities in white matter and subcortical brain structures. This study aimed to investigate how altered brain metabolism contributes to these deficits in VPT children at school-age.MethodsFifty-four VPT participants aged 8-13 years and 62 term-born peers were assessed with an executive function test battery. Brain metabolites were obtained in the frontal white matter and the basal ganglia/thalami, using proton magnetic resonance spectroscopy (MRS). N-acetylaspartate (NAA)/creatine (Cr), choline (Cho)/Cr, glutamate + glutamine (Glx)/Cr, and myo-Inositol (mI)/Cr were compared between groups and associations with executive functions were explored using linear regression.ResultsIn the frontal white matter, VPT showed lower Glx/Cr (mean difference: -5.91%, 95% CI [-10.50, -1.32]), higher Cho/Cr (7.39%, 95%-CI [2.68, 12.10]), and higher mI/Cr (5.41%, 95%-CI [0.18, 10.64]) while there were no differences in the basal ganglia/thalami. Lower executive functions were associated with lower frontal Glx/Cr ratios in both groups (β = 0.16, p = 0.05) and higher mI/Cr ratios in the VPT group only (interaction: β = -0.17, p = 0.02).ConclusionLong-term brain metabolite alterations in the frontal white matter may be related to executive function deficits in VPT children at school-age.ImpactVery preterm birth is associated with long-term brain metabolite alterations in the frontal white matter. Such alterations may contribute to deficits in executive function abilities. Injury processes in the brain can persist for years after the initial insult. Our findings provide new insights beyond structural and functional imaging, which help to elucidate the processes involved in abnormal brain development following preterm birth. Ultimately, this may lead to earlier identification of children at risk for developing deficits and more effective interventions.

Project description:ObjectiveThe control of gait requires executive and attentional functions. As preterm children show executive and attentional deficits compared to full-term children, performing concurrent tasks that impose additional cognitive load may lead to poorer walking performance in preterm compared to full-term children. Knowledge regarding gait in preterm children after early childhood is scarce. We examined straight walking and if it is more affected in very preterm than in full-term children in dual-task paradigms.Study designTwenty preterm children with very low birth-weight (≤ 1500 g), 24 preterm children with birth-weight > 1500 g, and 44 full-term children, born between 2001 and 2006, were investigated. Gait was assessed using an electronic walkway system (GAITRite) while walking without a concurrent task (single-task) and while performing one concurrent (dual-task) or two concurrent (triple-task) tasks. Spatio-temporal gait parameters (gait velocity, cadence, stride length, single support time, double support time), normalized gait parameters (normalized velocity, normalized cadence, normalized stride length) and gait variability parameters (stride velocity variability, stride length variability) were analyzed.ResultsIn dual- and triple-task conditions children showed decreased gait velocity, cadence, stride length, as well as increased single support time, double support time and gait variability compared to single-task walking. Further, results showed systematic decreases in stride velocity variability from preterm children with very low birth weight (≤ 1500 g) to preterm children with birth weight > 1500 g to full-term children. There were no significant interactions between walking conditions and prematurity status.ConclusionsDual and triple tasking affects gait of preterm and full-term children, confirming previous results that walking requires executive and attentional functions. Birth-weight dependent systematic changes in stride velocity variability indicate poorer walking performance in preterm children who were less mature at birth.

Project description:In this study, we investigated the effects of context-related semantic anomalies on the fixation-related brain potentials of 12-13-year-old Finnish children in grade 6 during sentence reading. The detection of such anomalies is typically reflected in the N400 event-related potential. We also examined whether the representation invoked by the sentence context extends to the orthographic representation level by replacing the final words of the sentence with an anomalous word neighbour of a plausible word. The eye-movement results show that the anomalous word neighbours of plausible words cause similar first-fixation and gaze duration reactions, as do other anomalous words. Similarly, we observed frontal negativity in the fixation-related potential of the unrelated anomalous words and in the anomalous word neighbours. This frontal negativity was larger in both anomalous conditions than in the response elicited by the plausible condition. We thus show that the brain successfully uses context to separate anomalous words from plausible words on a single letter level during free reading. From the P600 response of the scalp waveform, we observed that the P600 was delayed in the anomalous word neighbour condition. We performed group-level decomposition on the data with ICA (independent component analysis) and analysed the time course and source structure of the decomposed data. This analysis of decomposed brain signals not only confirmed the delay of the P600 response but also revealed that the frontal negativity concealed s more typical and separate N400 response, which was similarly delayed in the anomalous word neighbour condition, as was the P600 response. Source analysis of these independent components implicated the right frontal eye field as the cortical source for the frontal negativity and the middle temporal and parietal regions as cortical sources for the components resembling the N400 and P600 responses. We interpret the delays present in N400 and P600 responses to anomalous word neighbours to reflect competition with the representation of the plausible word just one letter different.

Dataset Information

Language outcome related to brain structures in school-aged preterm children: A systematic review.

Publications

Language outcome related to brain structures in school-aged preterm children: A systematic review.

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