ABSTRACT

Preterm delivery may interrupt the intrauterine brain development and implies a risk factor for the developing brain. In the long term, most frequently particular forms of attention deficits are described which refer to the basic aspects of attention i.e., arousal or tonic alertness. As this reflects top-down processes, the current study focuses on bottom-up processed phasic alertness in preschool aged preterm children. Additionally, we made a division of response times into decision and movement time to quantify more exactly the contribution of cognitive and motor performance to reaction times. We investigated basic aspects of attention functioning and contrasted phasic and tonic alertness in 31 low-risk healthy preterm (28–36 weeks of gestation) and 22 term children of five to 6 years of age by using a self-designed computerized test. Preterm children exhibited delayed decision and reaction time in the tonic non-cued alertness condition but not in the phasic cued alertness condition compared to term children. Current results suggest that preterm birth, even when clinically relevant symptoms are absent, may have long-term consequences on basic aspects of attention functioning. Results further suggest that preterm children may profit from auditory cues to overcome these deviations, which yield evidence for a clear distinction between impaired top-down and intact bottom-up controlled processes. These findings might provide a promising groundwork for the development of therapeutical interventions and prevention strategies, whose use and impact to support preterm children should be addressed in further investigations.

摘要

早产可能会中断宫内大脑发育，并暗示发育中的大脑的危险因素。从长远来看，最常见的特定形式的注意力缺陷被描述为注意力的基本方面，即觉醒或强直性警觉。由于这反映了自上而下的过程，当前的研究侧重于学龄前早产儿自下而上的阶段性警觉性。此外，我们将响应时间划分为决策时间和运动时间，以更准确地量化认知和运动表现对反应时间的贡献。我们通过使用自行设计的计算机化测试调查了 31 名低风险健康早产儿（妊娠 28-36 周）和 22 名 5 至 6 岁足月儿的注意力功能的基本方面以及对比阶段性和强直性警觉性。与足月儿童相比，早产儿在强直非提示警觉状态下表现出延迟的决定和反应时间，但在阶段性提示警觉状态下则没有。目前的结果表明，即使没有临床相关症状，早产也可能对注意力功能的基本方面产生长期影响。结果进一步表明，早产儿可能会从听觉线索中获益，以克服这些偏差，这为自上而下受损和自下而上完整受控过程之间存在明显区别提供了证据。这些发现可能为治疗干预和预防策略的发展提供有希望的基础，其在支持早产儿方面的使用和影响应在进一步调查中得到解决。