Executive dysfunction in young adults born preterm : Neuropsychological test results and structural brain correlates

• Preterm children appear to develop a different neurobehavioral organization from children born at term, and executive function (EF) has repeatedly been cited as an area of specific weakness. Likewise, neuroimaging studies have shown that the majority of very preterm infants display structural abnormalities, including white matter injury and volumetric differences (Nagy et al., 2003, 2009). Based on the analysis of the effects of lesion in adults, Stuss & Alexander (2007) have proposed a theoretical model, relating discrete categories of EF to regions within the frontal lobes. These EF categories and their coarse frontal localizations are: Executive cognition – dorsolateral prefrontal cortex (DLPFC), Behavioral / emotional self regulation – Ventral prefrontal cortex (VPFC) and Energization- superior medial frontal gyrus. The aim of this study was to identify preterm young adults’ strengths and weakness in terms of EF categories, and investigate their brain structural correlates. Preterm children appear to develop a different neurobehavioral organization from children born at term, and executive function (EF) has repeatedly been cited as an area of specific weakness. Likewise, neuroimaging studies have shown that the majority of very preterm infants display structural abnormalities, including white matter injury and volumetric differences (Nagy et al., 2003, 2009). Based on the analysis of the effects of lesion in adults, Stuss & Alexander (2007) have proposed a theoretical model, relating discrete categories of EF to regions within the frontal lobes. These EF categories and their coarse frontal localizations are: Executive cognition – dorsolateral prefrontal cortex (DLPFC), Behavioral / emotional self regulation – Ventral prefrontal cortex (VPFC) and Energization- superior medial frontal gyrus. The aim of this study was to identify preterm young adults’ strengths and weakness in terms of EF categories, and investigate their brain structural correlates. As a part of the longitudinal Stockholm Neonatal Project, 62 preterm and 38 term children were administered the Delis-Kaplan Executive Function System (D-KEFS) and behavioral self-reports (YSR and SDQ) as indices of EF at age 18. To investigate structural brain correlates, T1 and T2 weighted and diffusion weighted magnetic resonance images have been collected using a 1.5 T scanner. Results showed that preterm children had deficits primarily in Executive cognition and Energization, and less so in Behavioral self-regulation, with the extremely preterm children, born GA 23-28, having the most marked deficits also when controlling for overall cognitive level. Structural brain correlates are presently analyzed and preliminary findings are presented. Conclusion: A theory-based and interdisciplinary approach promotes our understanding of executive dysfunction in preterm children.

Subject headings

SAMHÄLLSVETENSKAP  -- Psykologi (hsv//swe)

SOCIAL SCIENCES  -- Psychology (hsv//eng)

Keyword

prematurity

neuroimaging

executive functions

Psychology

Psykologi

Psychology

psykologi

Publication and Content Type

ref (subject category)

kon (subject category)