Brain damage and early visuospatial problems: a structure-function coupling in very preterm born children

Abstract

Background: Preterm born children are at high risk of brain damage, which can adversely affect visuospatial attention and processing development. To clinically validate an adaptation of a standardized magnetic resonance imaging (MRI) scoring system for brain damage [Kidokoro et al.], we assessed its association with visuospatial performance at 1-year and 2-years corrected age (CA) in very preterm born children. Method: 112 children born < 32 weeks postmenstrual age (PMA) underwent an MRI scan at 29–35 weeks PMA. We scored brain damage and growth of cerebral white matter, cortical gray matter, deep gray matter, and cerebellum. Intra- and interrater reproducibility was assessed. At 1y CA, 82 children participated in an eye tracking-based visuospatial attention and motion processing task. At 2y CA, 59 children participated. Visuospatial performance was measured by calculating eye movement reaction times (RT) to visual stimuli. Results: Reproducibility of the adapted MRI scoring system was excellent, with intra- and interrater agreement of 92–100%. 21% of children born preterm had moderate-severe brain damage, whereas 43% had mild and 36% had no brain damage. Preterm children with moderate-severe brain damage had significantly slower RTs to motion stimuli than children with less severe or no brain damage. At 1y CA, slower attentional RTs correlated with more severe cortical gray matter damage (rs=.32; p=.008) and slower motion RTs with more severe cerebral white matter damage (rs=.33; p=.005). At 2y CA, no correlations were found. Conclusion: The present results show that very preterm children with moderate-severe perinatal brain damage are at risk of visuospatial attention and motion processing problems early in development. Besides further clinical validation for the MRI scoring system, the findings warrant a combined approach of quantitative structural and functional methods to infer the effects of brain damage and growth on visuospatial performance, and to timely detect and support preterm children at-risk.

Acknowledgement: Funding for this study was provided by NOVUM (sticht-ingnovum.org)