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Karimi A, Setänen S, Larsson E, Holmström G, Fredriksson Kaul Y, Kochukhova O, Johansson M, Montgomery C, Hellström-Westas L, Wikström J. Brain MRI findings and their association with visual impairment in young adolescents born very preterm. Neuroradiology 2024; 66:145-154. [PMID: 37870588 PMCID: PMC10761469 DOI: 10.1007/s00234-023-03235-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2023] [Accepted: 10/04/2023] [Indexed: 10/24/2023]
Abstract
PURPOSE Very preterm birth increases risk for neonatal white matter injury, but there is limited data on to what extent this persists into adolescence and how this relates to ophthalmological outcomes. The aim of this study was to assess brain MRI findings in 12-year-old children born very preterm compared to controls and their association with concurrent ophthalmological outcomes. METHODS We included 47 children born very preterm and 22 full-term controls (gestational age <32 and >37 weeks, respectively). Brain MRI findings were studied in association with concurrent ophthalmological outcomes at 12-year follow-up. RESULTS Evans index (0.27 vs 0.25, p<0.001) and a proposed "posterior ventricle index" (0.47 vs 0.45, p=0.018) were increased in children born very preterm. Higher gestational age associated with larger corpus callosum area (β=10.7, 95%CI 0.59-20.8). Focal white matter lesions were observed in 15 (32%) of very preterm children and in 1 (5%) of full-term controls. Increased posterior ventricle index increased risk for visual acuity ≤1.0 (OR=1.07×1011, 95%CI=7.78-1.48×1021) and contrast sensitivity <0.5 (OR=2.6×1027, 95%CI=1.9×108-3.5×1046). Decreased peritrigonal white matter thickness associated with impaired visual acuity (β=0.04, 95%CI 0.002-0.07). CONCLUSION More white matter lesions and evidence of lower white matter volume were found in children born very preterm compared with full-term controls at 12-year follow-up. The association between larger posterior ventricle index and reduced visual acuity and contrast sensitivity suggests disturbances of the posterior visual pathway due to diffuse white matter lesions.
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Affiliation(s)
- Annette Karimi
- Department of Surgical Sciences, Neuroradiology, Uppsala University, Uppsala, Sweden.
- Radiology Department, Uppsala University Hospital, Uppsala, Sweden.
| | - Sirkku Setänen
- Department of Pediatric Neurology, University of Turku, Turku, Finland
- Department of Pediatrics, Turku University Hospital, Turku, Finland
| | - Eva Larsson
- Department of Surgical Sciences, Ophthalmology, Uppsala University, Uppsala, Sweden
| | - Gerd Holmström
- Department of Surgical Sciences, Ophthalmology, Uppsala University, Uppsala, Sweden
| | | | - Olga Kochukhova
- Departments of Women's and Children's Health, Uppsala University, Uppsala, Sweden
- Departments of Psychology, Uppsala University, Uppsala, Sweden
| | - Martin Johansson
- Departments of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Cecilia Montgomery
- Departments of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | | | - Johan Wikström
- Department of Surgical Sciences, Neuroradiology, Uppsala University, Uppsala, Sweden
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Kaul YF, Naseh N, Strand Brodd K, Böhm B, Holmström G, Hellström‐Westas L. Average 2.5-year neurodevelopmental test results in children born very preterm did not rule out cognitive deficits at 6.5 years of age. Acta Paediatr 2021; 110:846-854. [PMID: 32945030 PMCID: PMC7983961 DOI: 10.1111/apa.15586] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 09/12/2020] [Accepted: 09/16/2020] [Indexed: 12/24/2022]
Abstract
Aim The aim of the study was to investigate cognitive outcomes at 6.5 years in children born very preterm, in relation to neonatal characteristics and 2.5‐year neurodevelopment. Methods A prospective cohort, with gestational age 22.3‐31.9 weeks, born 2004‐2007, were examined at 2.5 years with the Bayley Scales of Infant and Toddler Development (Bayley‐III) (n = 100) and at 6.5 years with the Wechsler Intelligence Scales (n = 91). Results Neonatal factors independently related to 6.5‐year outcome were gestational age, retinopathy of prematurity and treated persistent ductus arteriosus. The Bayley‐III cognitive scores explained only 44% of the Full‐Scale Intelligence Quotient result at 6.5 years, and 22% of the children had Wechsler index results below −1 SD, indicating cognitive impairment, after average test results at 2.5 years. The relative risk to score below −1 SD on the Full‐Scale IQ was 2.83 (95% CI 1.45‐5.53) in children with gestational age below 28 weeks and 2.22 (95% CI 1.18‐4.17) at gestational age 28‐31 weeks. Conclusion Very preterm infants born in the 2000s had increased risks for impaired cognition at 6.5 years, but individual predictions based on neonatal risks and 2.5‐year test results were not enough to identify all high‐risk children.
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Affiliation(s)
- Ylva F. Kaul
- Department of Women’s and Children’s Health Uppsala University Uppsala Sweden
| | - Nima Naseh
- Department of Women’s and Children’s Health Uppsala University Uppsala Sweden
| | - Katarina Strand Brodd
- Department of Women’s and Children’s Health Uppsala University Uppsala Sweden
- Centre for Clinical Research Sörmland Uppsala University Uppsala Sweden
| | - Birgitta Böhm
- Department of Women’s and Children’s Health Karolinska Institute Stockholm Sweden
| | - Gerd Holmström
- Department of Neuroscience, Ophthalmology Uppsala University Uppsala Sweden
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Kim SY, Liu M, Hong SJ, Toga AW, Barkovich AJ, Xu D, Kim H. Disruption and Compensation of Sulcation-based Covariance Networks in Neonatal Brain Growth after Perinatal Injury. Cereb Cortex 2020; 30:6238-6253. [PMID: 32656563 DOI: 10.1093/cercor/bhaa181] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 05/05/2020] [Accepted: 06/02/2020] [Indexed: 12/11/2022] Open
Abstract
Perinatal brain injuries in preterm neonates are associated with alterations in structural neurodevelopment, leading to impaired cognition, motor coordination, and behavior. However, it remains unknown how such injuries affect postnatal cortical folding and structural covariance networks, which indicate functional parcellation and reciprocal brain connectivity. Studying 229 magnetic resonance scans from 158 preterm neonates (n = 158, mean age = 28.2), we found that severe injuries including intraventricular hemorrhage, periventricular leukomalacia, and ventriculomegaly lead to significantly reduced cortical folding and increased covariance (hyper-covariance) in only the early (<31 weeks) but not middle (31-35 weeks) or late stage (>35 weeks) of the third trimester. The aberrant hyper-covariance may drive acceleration of cortical folding as a compensatory mechanism to "catch-up" with normal development. By 40 weeks, preterm neonates with/without severe brain injuries exhibited no difference in cortical folding and covariance compared with healthy term neonates. However, graph theory-based analysis showed that even after recovery, severely injured brains exhibit a more segregated, less integrated, and overall inefficient network system with reduced integration strength in the dorsal attention, frontoparietal, limbic, and visual network systems. Ultimately, severe perinatal injuries cause network-level deviations that persist until the late stage of the third trimester and may contribute to neurofunctional impairment.
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Affiliation(s)
- Sharon Y Kim
- Laboratory of Neuro Imaging at USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, 2025 Zonal Ave, Los Angeles, CA 90033, USA
| | - Mengting Liu
- Laboratory of Neuro Imaging at USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, 2025 Zonal Ave, Los Angeles, CA 90033, USA
| | - Seok-Jun Hong
- Center for the Developing Brain, Child Mind Institute, New York, NY 10022, USA
| | - Arthur W Toga
- Laboratory of Neuro Imaging at USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, 2025 Zonal Ave, Los Angeles, CA 90033, USA
| | - A James Barkovich
- Department of Radiology, School of Medicine, University of California San Francisco, 1 Irving St., San Francisco, CA 94143, USA
| | - Duan Xu
- Department of Radiology, School of Medicine, University of California San Francisco, 1 Irving St., San Francisco, CA 94143, USA
| | - Hosung Kim
- Laboratory of Neuro Imaging at USC Stevens Neuroimaging and Informatics Institute, Keck School of Medicine of USC, University of Southern California, 2025 Zonal Ave, Los Angeles, CA 90033, USA
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Pisella L, Martel M, Roy AC, Vuillerot C, Gonzalez-Monge S. Validation of a simple screening test for elementary visuo-spatial perception deficit. Ann Phys Rehabil Med 2020; 63:302-308. [DOI: 10.1016/j.rehab.2019.03.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2019] [Revised: 03/26/2019] [Accepted: 03/26/2019] [Indexed: 01/17/2023]
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Hreinsdottir J, Fredriksson Kaul Y, Hellström-Westas L, Rosander K, von Hofsten C, Holmström G. Impaired cognitive ability at 2.5 years predicts later visual and ophthalmological problems in children born very preterm. Acta Paediatr 2018; 107:822-830. [PMID: 29288532 DOI: 10.1111/apa.14209] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2017] [Revised: 12/20/2017] [Accepted: 12/22/2017] [Indexed: 02/06/2023]
Abstract
AIM To identify possible predictive factors for visual problems at 6.5 years in children born very preterm. METHODS During 2004-2007, all very preterm infants (gestational age [GA] <32 weeks) in Uppsala County, Sweden were screened for retinopathy of prematurity (ROP) neonatally; at four months, visual tracking was tested; at 2.5 years, visuospatial and cognitive tests were carried out. At 6.5 years, 84 preterm children and a reference group of 64 full-term children underwent ophthalmological testing. RESULTS Mean visual acuity (VA) did not differ between the groups, but subnormal VA (≤0.8) was more common in the preterm group (31% vs 14%; p < 0.05). More often than full-term children, preterm children had impaired contrast sensitivity (<0.5) (36% vs 19%; p < 0.05) and strabismus (8% vs 0%; p < 0.05). Low GA, ROP, intraventricular haemorrhage 3-4/periventricular leukomalacia and cognitive disability at 2.5 years predicted ophthalmological and visual problems at 6.5 years. Visual tracking ability at four months was not predictive of ophthalmological outcome. CONCLUSION Children born preterm had more ophthalmological problems at 6.5 years of age, including subtle dysfunctions. ROP, early brain injury and impaired cognitive function around 2.5 years predicted later ophthalmological dysfunctions.
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Affiliation(s)
- Jonina Hreinsdottir
- Department of Neuroscience; Ophthalmology; Uppsala University; Uppsala Sweden
| | | | | | | | | | - Gerd Holmström
- Department of Neuroscience; Ophthalmology; Uppsala University; Uppsala Sweden
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Al-Haddad C, Fattah MA, Smeets L, Tamim H, Dirani L, Safadieh L, Sinno D, Charafeddine L. Ophthalmologic Outcomes of Children Born Premature Without ROP: Correlations With Gestational Age and Psychomotor Development. J Pediatr Ophthalmol Strabismus 2017; 54:32-38. [PMID: 27668872 DOI: 10.3928/01913913-20160831-02] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2015] [Accepted: 07/11/2016] [Indexed: 11/20/2022]
Abstract
PURPOSE To study ophthalmological outcomes of premature children with no retinopathy of prematurity (ROP) and correlate with neurodevelopmental outcomes. METHODS A total of 69 former preterm infants were evaluated at 2 to 7 years of age. Detailed ophthalmologic examinations were performed. Neurodevelopment was assessed using the Peabody Developmental Motor Scale and Wechsler Preschool and Primary Scale of Intelligence. Another 69 healthy children served as controls. RESULTS The 69 preterm children (38 of 69 boys) and 69 controls (38 of 69 boys) had a mean age of 4.9 ± 1.5 and 4.9 ± 1.4 years, respectively. Compared to controls, preterm infants had vision impairment of 19% versus 1.4% (P = .001), hyperopia of 87% versus 98.5% (P = .21), myopia of 11% versus 1.4% (P = .017), and astigmatism of 39% versus 30.4% (P = .37). Children with any motor disability tended to have worse vision. CONCLUSIONS In the absence of ROP, hyperopia was more common in infants 32 weeks or older who weighed more than 1,500 g at birth; other vision problems were similar in subgroups. This may represent impending myopia in those younger than 32 weeks weighing less than 1,500 g. [J Pediatr Ophthalmol Strabismus. 2017;54(1):32-38.].
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Kaul YF, Rosander K, von Hofsten C, Brodd KS, Holmström G, Kaul A, Böhm B, Hellström-Westas L. Visual tracking in very preterm infants at 4 mo predicts neurodevelopment at 3 y of age. Pediatr Res 2016; 80:35-42. [PMID: 27027722 DOI: 10.1038/pr.2016.37] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2015] [Accepted: 12/05/2015] [Indexed: 11/09/2022]
Abstract
BACKGROUND Typically developing infants track moving objects with eye and head movements in a smooth and predictive way at 4 mo of age, but this ability is delayed in very preterm infants. We hypothesized that visual tracking ability in very preterm infants predicts later neurodevelopment. METHOD In 67 very preterm infants (gestational age<32 wk), eye and head movements were assessed at 4 mo corrected age while the infant tracked a moving object. Gaze gain, smooth pursuit, head movements, and timing of gaze relative the object were analyzed off line. Results of the five subscales included in the Bayley Scales of Infant Development (BSID-III) at 3 y of age were evaluated in relation to the visual tracking data and to perinatal risk factors. RESULTS Significant correlations were obtained between gaze gain and cognition, receptive and expressive language, and fine motor function, respectively, also after controlling for gestational age, severe brain damage, retinopathy of prematurity, and bronchopulmonary dysplasia. CONCLUSION This is the first study demonstrating that the basic ability to visually track a moving object at 4 mo robustly predicts neurodevelopment at 3 y of age in children born very preterm.
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Affiliation(s)
| | | | | | - Katarina Strand Brodd
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.,Centre for Clinical Research Sörmland, Uppsala University, Uppsala, Sweden
| | - Gerd Holmström
- Department of Neuroscience/Ophthalmology, Uppsala University, Uppsala, Sweden
| | - Alexander Kaul
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Birgitta Böhm
- Department of Women's and Children's Health, Karolinska Institute, Stockholm, Sweden
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Roohipoor R, Karkhaneh R, Riazi Esfahani M, Alipour F, Haghighat M, Ebrahimiadib N, Zarei M, Mehrdad R. Comparison of Refractive Error Changes in Retinopathy of Prematurity Patients Treated with Diode and Red Lasers. Ophthalmologica 2016; 235:173-8. [DOI: 10.1159/000443844] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2015] [Accepted: 01/06/2016] [Indexed: 11/19/2022]
Abstract
Aim: To compare refractive error changes in retinopathy of prematurity (ROP) patients treated with diode and red lasers. Methods: A randomized double-masked clinical trial was performed, and infants with threshold or prethreshold type 1 ROP were assigned to red or diode laser groups. Gestational age, birth weight, pretreatment cycloplegic refraction, time of treatment, disease stage, zone and disease severity were recorded. Patients received either red or diode laser treatment and were regularly followed up for retina assessment and refraction. The information at month 12 of corrected age was considered for comparison. Results: One hundred and fifty eyes of 75 infants were enrolled in the study. Seventy-four eyes received diode and 76 red laser therapy. The mean gestational age and birth weight of the infants were 28.6 ± 3.2 weeks and 1,441 ± 491 g, respectively. The mean baseline refractive error was +2.3 ± 1.7 dpt. Posttreatment refraction showed a significant myopic shift (mean 2.6 ± 2.0 dpt) with significant difference between the two groups (p < 0.001). There was a greater myopic shift among children with zone I and diode laser treatment (mean 6.00 dpt) and a lesser shift among children with zone II and red laser treatment (mean 1.12 dpt). The linear regression model, using the generalized estimating equation method, showed that the type of laser used has a significant effect on myopic shift even after adjustment for other variables. Conclusion: Myopic shift in laser-treated ROP patients is related to the type of laser used and the involved zone. Red laser seems to cause less myopic shift than diode laser, and those with zone I involvement have a greater myopic shift than those with ROP in zone II.
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González Viejo I, Pueyo V, Ferrer C, García-Ormaechea I, Prieto E. Visual syndrome of prematurity. ACTA ACUST UNITED AC 2014; 89:429-30. [PMID: 25439543 DOI: 10.1016/j.oftal.2014.10.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2014] [Accepted: 10/01/2014] [Indexed: 10/24/2022]
Affiliation(s)
- I González Viejo
- Servicio de Oftalmología, Hospital Materno-Infantil, HUMS, Zaragoza. España.
| | - V Pueyo
- Servicio de Oftalmología, Hospital Materno-Infantil, HUMS, Zaragoza. España
| | - C Ferrer
- Servicio de Oftalmología, Hospital Materno-Infantil, HUMS, Zaragoza. España
| | | | - E Prieto
- Servicio de Oftalmología, Hospital Materno-Infantil, HUMS, Zaragoza. España
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