Extreme prematurity and perinatal risk factors related to extremely preterm birth are associated with complex patterns of regional brain volume alterations at 10 years of age: a voxel-based morphometry study

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dc.contributor.authorKvanta, Hedvig
dc.contributor.authorBolk, Jenny
dc.contributor.authorBroström, Lina
dc.contributor.authorFernández de Gamarra Oca, Lexuri
dc.contributor.authorPadilla, Nelly
dc.contributor.authorÅdén, Ulrika
dc.date.accessioned2025-05-22T15:33:25Z
dc.date.available2025-05-22T15:33:25Z
dc.date.issued2023-05-19
dc.date.updated2025-05-22T15:33:25Z
dc.description.abstractObjective: Structural brain volumetric differences have been investigated previously in very preterm children. However, children born extremely preterm, at the border of viability, have been studied to a lesser degree. Our group previously analyzed children born extremely preterm at term using voxel-based morphometry. In this study, we aimed to examine regional gray and white matter differences for children born extremely preterm derived from the same cohort during childhood. We also aimed to explore the effect of perinatal risk factors on brain volumes in the same group. Methods: At 10 years of age, 51 children born extremely preterm (before 27 weeks and 0 days) and 38 term-born controls with high-quality 3.0 Tesla magnetic resonance images were included. Statistical analyses using voxel-based morphometry were conducted on images that were normalized using age-specific templates, modulated, and smoothed. Analyses were also performed in stratified groups of children born extremely preterm in the absence or presence of perinatal risk factors that have previously been shown to be associated with volumetric differences at term. Results: We found volumetric decreases in gray and white matter in the temporal lobes, gray matter decreases in the precuneus gyri, and white matter decreases in the anterior cingulum for children born extremely preterm (all p < 0.001, and pfwe < 0.05). Gray and white matter increases were predominantly observed in the right posterior cingulum and occipital lobe (all p < 0.001, and pfwe < 0.05). Of the examined perinatal risk factors, intraventricular hemorrhage grades I-II compared with no intraventricular hemorrhage and patent ductus arteriosus ligation compared with no treated patent ductus arteriosus or patent ductus arteriosus treated with ibuprofen led to volumetric differences at 10 years of age (all p < 0.001, and pfwe < 0.05). Conclusions: Children born extremely preterm exhibit volumetric alterations in a pattern overlapping that previously found at term, where many regions with differences are the main hubs of higher order networks. Some, but not all, risk factors known to be associated with structural alterations at term were associated with alterations at 10 years of age.en
dc.description.sponsorshipThis study was supported by grants from the Swedish Medical Research Council (grant number, 2017-03043) (UÅ), the regional agreement on medical training and clinical research (grant number, ALF SLL 20170243) between Stockholm County Council and the Karolinska Institutet (UÅ), the Swedish Order of Freemasons in Stockholm (NP), the Swedish Medical Society (UÅ), the Swedish Brain Foundation (grant number, FO2019-0045) (UÅ), the Philipson Foundation (UÅ), the Crown Princess Lovisa’s Foundation (NP), the Sällskapet Barnavård, and the Erik and Edith Fernström Stiftelse (NP); Region Stockholm (clinical postdoctoral appointment) (JB); Region Stockholm (combined clinical residency and Ph.D. training program) (HK). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscripten
dc.identifier.citationKvanta, H., Bolk, J., Broström, L., Fernández de Gamarra-Oca, L., Padilla, N., & Ådén, U. (2023). Extreme prematurity and perinatal risk factors related to extremely preterm birth are associated with complex patterns of regional brain volume alterations at 10 years of age: a voxel-based morphometry study. Frontiers in Neurology, 14. https://doi.org/10.3389/FNEUR.2023.1148781
dc.identifier.doi10.3389/FNEUR.2023.1148781
dc.identifier.eissn1664-2295
dc.identifier.urihttp://hdl.handle.net/20.500.14454/2819
dc.language.isoeng
dc.publisherFrontiers Media S.A.
dc.rights© 2023 Kvanta, Bolk, Broström, Fernández de Gamarra-Oca, Padilla and Ådén
dc.subject.otherExtremely preterm
dc.subject.otherGray matter volume
dc.subject.otherIntraventricular hemorrhage
dc.subject.otherMagnetic resonance imaging
dc.subject.otherPatent ductus arteriosus
dc.subject.otherVoxel-based morphometry
dc.subject.otherWhite matter volume
dc.titleExtreme prematurity and perinatal risk factors related to extremely preterm birth are associated with complex patterns of regional brain volume alterations at 10 years of age: a voxel-based morphometry studyen
dc.typejournal article
dcterms.accessRightsopen access
oaire.citation.titleFrontiers in Neurology
oaire.citation.volume14
oaire.licenseConditionhttps://creativecommons.org/licenses/by/4.0/
oaire.versionVoR
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