Abstract
AIM—To determine whether neurological deficits are associated with structural anomalies of the brain in very low birthweight (VLBW) infants with subsequent learning disorders but without cerebral palsy, or whether other factors, such as poor early growth, are responsible. METHODS—Eighty seven VLBW infants and eight term controls who had been examined at school between the ages of 12 and 13 years, had cranial magnetic resonance imaging (MRI) scans at 15-17 years of age. RESULTS—Thirty seven (42.5%) of the VLBW children had abnormalities reported on their scans (two porencephaly, 28 periventricular leucomalacia, 24 ventricular dilatation, and 15 thinning of the corpus callosum). No significant differences in intelligence quotient, motor clumsiness, or frequency of attention deficit / hyperactivity disorder were observed between those children with MRI lesions and those with normal scans. Quantitative measurements showed the VLBW infants had smaller brains, and a relatively smaller corpus callosum compared with controls. No association between brain measurements and school performance was observed among the VLBW infants. CONCLUSIONS—The difficulties experienced by VLBW children at school are unlikely to be the result of perinatal brain injury, but they might to be attributable to the effects of poor postnatal growth.
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- Angold A., Prendergast M., Cox A., Harrington R., Simonoff E., Rutter M. The Child and Adolescent Psychiatric Assessment (CAPA). Psychol Med. 1995 Jul;25(4):739–753. doi: 10.1017/s003329170003498x. [DOI] [PubMed] [Google Scholar]
- Baker L. L., Stevenson D. K., Enzmann D. R. End-stage periventricular leukomalacia: MR evaluation. Radiology. 1988 Sep;168(3):809–815. doi: 10.1148/radiology.168.3.3406411. [DOI] [PubMed] [Google Scholar]
- Battin M. R., Maalouf E. F., Counsell S. J., Herlihy A. H., Rutherford M. A., Azzopardi D., Edwards A. D. Magnetic resonance imaging of the brain in very preterm infants: visualization of the germinal matrix, early myelination, and cortical folding. Pediatrics. 1998 Jun;101(6):957–962. doi: 10.1542/peds.101.6.957. [DOI] [PubMed] [Google Scholar]
- Botting N., Powls A., Cooke R. W., Marlow N. Attention deficit hyperactivity disorders and other psychiatric outcomes in very low birthweight children at 12 years. J Child Psychol Psychiatry. 1997 Nov;38(8):931–941. doi: 10.1111/j.1469-7610.1997.tb01612.x. [DOI] [PubMed] [Google Scholar]
- Castellanos F. X., Giedd J. N., Eckburg P., Marsh W. L., Vaituzis A. C., Kaysen D., Hamburger S. D., Rapoport J. L. Quantitative morphology of the caudate nucleus in attention deficit hyperactivity disorder. Am J Psychiatry. 1994 Dec;151(12):1791–1796. doi: 10.1176/ajp.151.12.1791. [DOI] [PubMed] [Google Scholar]
- Childs A. M., Ramenghi L. A., Evans D. J., Ridgeway J., Saysell M., Martinez D., Arthur R., Tanner S., Levene M. I. MR features of developing periventricular white matter in preterm infants: evidence of glial cell migration. AJNR Am J Neuroradiol. 1998 May;19(5):971–976. [PMC free article] [PubMed] [Google Scholar]
- Cooke R. W. Early and late cranial ultrasonographic appearances and outcome in very low birthweight infants. Arch Dis Child. 1987 Sep;62(9):931–937. doi: 10.1136/adc.62.9.931. [DOI] [PMC free article] [PubMed] [Google Scholar]
- DRILLIEN C. M. The incidence of mental and physical handicaps in school-age children of very low birth weight. Pediatrics. 1961 Mar;27:452–464. [PubMed] [Google Scholar]
- Dammann O., Leviton A. Infection remote from the brain, neonatal white matter damage, and cerebral palsy in the preterm infant. Semin Pediatr Neurol. 1998 Sep;5(3):190–201. doi: 10.1016/s1071-9091(98)80034-x. [DOI] [PubMed] [Google Scholar]
- Escobar G. J., Littenberg B., Petitti D. B. Outcome among surviving very low birthweight infants: a meta-analysis. Arch Dis Child. 1991 Feb;66(2):204–211. doi: 10.1136/adc.66.2.204. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Giedd J. N., Castellanos F. X., Casey B. J., Kozuch P., King A. C., Hamburger S. D., Rapoport J. L. Quantitative morphology of the corpus callosum in attention deficit hyperactivity disorder. Am J Psychiatry. 1994 May;151(5):665–669. doi: 10.1176/ajp.151.5.665. [DOI] [PubMed] [Google Scholar]
- Guzzetta F., Shackelford G. D., Volpe S., Perlman J. M., Volpe J. J. Periventricular intraparenchymal echodensities in the premature newborn: critical determinant of neurologic outcome. Pediatrics. 1986 Dec;78(6):995–1006. [PubMed] [Google Scholar]
- Hynd G. W., Hern K. L., Novey E. S., Eliopulos D., Marshall R., Gonzalez J. J., Voeller K. K. Attention deficit-hyperactivity disorder and asymmetry of the caudate nucleus. J Child Neurol. 1993 Oct;8(4):339–347. doi: 10.1177/088307389300800409. [DOI] [PubMed] [Google Scholar]
- Hynd G. W., Semrud-Clikeman M., Lorys A. R., Novey E. S., Eliopulos D. Brain morphology in developmental dyslexia and attention deficit disorder/hyperactivity. Arch Neurol. 1990 Aug;47(8):919–926. doi: 10.1001/archneur.1990.00530080107018. [DOI] [PubMed] [Google Scholar]
- Hynd G. W., Semrud-Clikeman M., Lorys A. R., Novey E. S., Eliopulos D., Lyytinen H. Corpus callosum morphology in attention deficit-hyperactivity disorder: morphometric analysis of MRI. J Learn Disabil. 1991 Mar;24(3):141–146. doi: 10.1177/002221949102400302. [DOI] [PubMed] [Google Scholar]
- Levene M., Dowling S., Graham M., Fogelman K., Galton M., Phillips M. Impaired motor function (clumsiness) in 5 year old children: correlation with neonatal ultrasound scans. Arch Dis Child. 1992 Jun;67(6):687–690. doi: 10.1136/adc.67.6.687. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marlow N., Roberts B. L., Cooke R. W. Motor skills in extremely low birthweight children at the age of 6 years. Arch Dis Child. 1989 Jun;64(6):839–847. doi: 10.1136/adc.64.6.839. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Marlow N., Roberts L., Cooke R. Outcome at 8 years for children with birth weights of 1250 g or less. Arch Dis Child. 1993 Mar;68(3 Spec No):286–290. doi: 10.1136/adc.68.3_spec_no.286. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mercuri E., Faundez J. C., Roberts I., Flora S., Bouza H., Cowan F., Pennock J., Bydder G., Dubowitz L. Neurological 'soft' signs may identify children with sickle cell disease who are at risk for stroke. Eur J Pediatr. 1995 Feb;154(2):150–156. [PubMed] [Google Scholar]
- Nickel R. E., Bennett F. C., Lamson F. N. School performance of children with birth weights of 1,000 g or less. Am J Dis Child. 1982 Feb;136(2):105–110. doi: 10.1001/archpedi.1982.03970380017004. [DOI] [PubMed] [Google Scholar]
- Njiokiktjien C., de Sonneville L., Vaal J. Callosal size in children with learning disabilities. Behav Brain Res. 1994 Oct 20;64(1-2):213–218. doi: 10.1016/0166-4328(94)90133-3. [DOI] [PubMed] [Google Scholar]
- Olsén P., Päkkö E., Vainionpä L., Pyhtinen J., Järvelin M. R. Magnetic resonance imaging of periventricular leukomalacia and its clinical correlation in children. Ann Neurol. 1997 Jun;41(6):754–761. doi: 10.1002/ana.410410611. [DOI] [PubMed] [Google Scholar]
- Powls A., Botting N., Cooke R. W., Pilling D., Marlow N. Growth impairment in very low birthweight children at 12 years: correlation with perinatal and outcome variables. Arch Dis Child Fetal Neonatal Ed. 1996 Nov;75(3):F152–F157. doi: 10.1136/fn.75.3.f152. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ringelberg J., van de Bor M. Outcome of transient periventricular echodensities in preterm infants. Neuropediatrics. 1993 Oct;24(5):269–273. doi: 10.1055/s-2008-1071555. [DOI] [PubMed] [Google Scholar]
- de Vries L. S., Eken P., Groenendaal F., van Haastert I. C., Meiners L. C. Correlation between the degree of periventricular leukomalacia diagnosed using cranial ultrasound and MRI later in infancy in children with cerebral palsy. Neuropediatrics. 1993 Oct;24(5):263–268. doi: 10.1055/s-2008-1071554. [DOI] [PubMed] [Google Scholar]
