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Attention and Regional Gray Matter Development in Very Preterm Children at Age 12 Years

Published online by Cambridge University Press:  01 June 2017

Rachel E. Lean
Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
Tracy R. Melzer
Department of Medicine, University of Otago, Christchurch, New Zealand New Zealand Brain Research Institute, Christchurch, New Zealand
Samudragupta Bora
Mothers, Babies and Women’s Health Program, Mater Research Institute, The University of Queensland, Brisbane, QLD, Australia
Richard Watts
Department of Radiology, University of Vermont, Burlington, Vermont
Lianne J. Woodward*
Department of Pediatric Newborn Medicine, Brigham and Women’s Hospital and Harvard Medical School, Boston, Massachusetts Department of Psychology, University of Canterbury, Christchurch, New Zealand
Correspondence and reprint requests to: Lianne Woodward, Department of Pediatric Newborn Medicine, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA 02115. E-mail:


Objectives: This study examines the selective, sustained, and executive attention abilities of very preterm (VPT) born children in relation to concurrent structural magnetic resonance imaging (MRI) measures of regional gray matter development at age 12 years. Methods: A regional cohort of 110 VPT (≤32 weeks gestation) and 113 full term (FT) born children were assessed at corrected age 12 years on the Test of Everyday Attention-Children. They also had a structural MRI scan that was subsequently analyzed using voxel-based morphometry to quantify regional between-group differences in cerebral gray matter development, which were then related to attention measures using multivariate methods. Results: VPT children obtained similar selective (p=.85), but poorer sustained (p=.02) and executive attention (p=.01) scores than FT children. VPT children were also characterized by reduced gray matter in the bilateral parietal, temporal, prefrontal and posterior cingulate cortices, bilateral thalami, and left hippocampus; and increased gray matter in the occipital and anterior cingulate cortices (family-wise error–corrected p<.05). Poorer sustained auditory attention was associated with increased gray matter in the anterior cingulate cortex (p=.04). Poor executive shifting attention was associated with reduced gray matter in the right superior temporal cortex (p=.04) and bilateral thalami (p=.05). Poorer executive divided attention was associated with reduced gray matter in the occipital (p=.001), posterior cingulate (p=.02), and left temporal (p=.01) cortices; and increased gray matter in the anterior cingulate cortex (p=.001). Conclusions: Disturbances in regional gray matter development appear to contribute, at least in part, to the poorer attentional performance of VPT children at school age. (JINS, 2017, 23, 539–550)

Research Articles
Copyright © The International Neuropsychological Society 2017 

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