RESUMO
OBJECTIVE: To investigate the relationship between preterm birth, adolescent, and adult psychosocial outcomes, and alterations in gray matter volume. STUDY DESIGN: Individuals (n = 73) born at <33 weeks of gestation (very preterm) and 49 controls completed the Child Behavior Checklist (CBCL) at age 15 years to identify 'social immaturity' (SI) cases. Voxel-based morphometry was used to investigate gray matter volumes according to CBCL-SI 'caseness.' The Clinical Interview Schedule-Revised (CIS-R) was administered at age 19 years. RESULTS: Very preterm adolescents were almost 4 times more likely to reach CBCL-SI 'caseness' compared with controls. Ex-preterm SI 'cases' had increased gray matter volume in the fusiform gyrus bilaterally (Talairach coordinates: x = 60, y = -27, z = -30; Z = 3.78; x = -61, y = -35, z = -27; Z = 3.56, after correction for multiple comparisons) compared with ex-preterm SI 'noncases.' Left fusiform volume displayed a stronger correlation with ipsilateral orbitofrontal cortex in SI 'cases' (x = -15, y = 22, z = -26; Z = 3.64). CIS-R total scores were slightly higher in ex-preterm individuals compared with controls. In the whole sample, SI 'cases' in midadolescence also had higher CIS-R scores in adulthood compared with 'noncases' (SI 'cases': mean = 5.7, 95% CI = 4.0-7.4; SI 'noncases': mean = 2.7, 95% CI = 1.1-4.3; F = 6.4, df = 74; P = .013). CONCLUSIONS: Ex-preterm adolescents had increased socialization problems in adolescence, which were associated with volumetric alterations in an emotion-processing brain network. Atypical social development is linked to an increased vulnerability to psychiatric disorder.
Assuntos
Comportamento do Adolescente/psicologia , Encéfalo/fisiologia , Emoções/fisiologia , Psicologia do Adolescente , Comportamento Social , Adolescente , Feminino , Seguimentos , Humanos , Recém-Nascido , Recém-Nascido Prematuro , Estudos Longitudinais , Masculino , Adulto JovemRESUMO
OBJECTIVE: To determine whether preterm birth influences functional neuronal development in adulthood. STUDY DESIGN: We evaluated adults born very preterm (VPT; < 33 weeks of gestation) using a verbal paired-associate learning task within a functional magnetic resonance imaging paradigm. Hippocampi and parahippocampal gyri gray matter volumes were also quantified. RESULTS: Despite similar task performance compared with control participants, VPT adults showed increased brain activation in the left parahippocampal and precentral gyri during Encoding, and in the precentral gyrus during Recall. Very preterm participants also had decreased gray matter volume in the left and right hippocampi yet increased gray matter in the left parahippocampal gyrus. In VPT participants alone, activation in the left parahippocampal gyrus during Encoding (VPT>control participants) was positively associated with gray matter volume in the left parahippocampal gyrus, with VPT participants with the youngest gestational age (eg, born 28 weeks or less) having both increased gray matter and functional activation in this region. These results may reflect the process of neural reorganization after early brain injury. CONCLUSION: Preterm birth leads to functional neuronal differences in adulthood, which are meditated by both structural variations in task-specific regions, and gestational age.
Assuntos
Mapeamento Encefálico , Aprendizagem por Associação de Pares/fisiologia , Giro Para-Hipocampal/fisiologia , Nascimento Prematuro/fisiopatologia , Aprendizagem Verbal/fisiologia , Adulto , Feminino , Idade Gestacional , Humanos , Imageamento por Ressonância Magnética , Masculino , Adulto JovemRESUMO
BACKGROUND: It remains unclear if the excess of neurological soft signs, or of certain types of neurological soft signs, is common to all psychoses, and whether this excess is simply an epiphenomenon of the lower general cognitive ability present in psychosis. AIMS: To investigate whether an excess of neurological soft signs is independent of diagnosis (schizophrenia v. affective psychosis) and cognitive ability (IQ). METHOD: Evaluation of types of neurological soft signs in a prospective cohort of all individuals presenting with psychoses over 2 years (n=310), and in a control group from the general population (n=239). RESULTS: Primary (P<0.001), motor coordination (P<0.001), and motor sequencing (P<0.001) sign scores were significantly higher in people with any psychosis than in the control group. However, only primary and motor coordination scores remained higher when individuals with psychosis and controls were matched for premorbid and current IQ. CONCLUSIONS: Higher rates of primary and motor coordination signs are not associated with lower cognitive ability, and are specific to the presence of psychosis.