Growth of prefrontal and limbic brain regions and anxiety disorders in children born very preterm,Psychological Medicine

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Growth of prefrontal and limbic brain regions and anxiety disorders in children born very preterm
Psychological Medicine ( IF 5.9 ) Pub Date : 2021-06-09 , DOI: 10.1017/s0033291721002105
Courtney P Gilchrist _{1,

2,

3} , Deanne K Thompson _{2,

3,

4,

5} , Bonnie Alexander _{2,

3,

6} , Claire E Kelly _{2,

3} , Karli Treyvaud _{2,

7,

8} , Lillian G Matthews _{9,

10,

11} , Leona Pascoe _{2,

10} , Diana Zannino ₁₂ , Rosemary Yates _{2,

10} , Chris Adamson ₃ , Mary Tolcos ₁ , Jeanie L Y Cheong _{2,

8,

13} , Terrie E Inder _{2,

9} , Lex W Doyle _{2,

4,

8,

13} , Angela Cumberland ₁ , Peter J Anderson _{2,

10}

Affiliation

School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia.
Victorian Infant Brain Studies, Murdoch Children's Research Institute, Melbourne, Australia.
Developmental Imaging, Murdoch Children's Research Institute, Melbourne, Australia.
Department of Paediatrics, University of Melbourne, Melbourne, Australia.
Florey Institute of Neuroscience and Mental Health, Melbourne, Australia.
Department of Neurosurgery, Royal Children's Hospital, Melbourne, Australia.
La Trobe University, Melbourne, Australia.
Royal Women's Hospital, Melbourne, Victoria, Australia.
Monash Biomedical Imaging, Monash University, Melbourne, Australia.
Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia.
Brigham and Women's Hospital, Harvard Medical School, Boston, USA.
Clinical Epidemiology and Biostatistics Unit, Murdoch Children's Research Institute, Melbourne, Australia.
Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia.

Background

Children born very preterm (VP) display altered growth in corticolimbic structures compared with full-term peers. Given the association between the cortiocolimbic system and anxiety, this study aimed to compare developmental trajectories of corticolimbic regions in VP children with and without anxiety diagnosis at 13 years.

Methods

MRI data from 124 VP children were used to calculate whole brain and corticolimbic region volumes at term-equivalent age (TEA), 7 and 13 years. The presence of an anxiety disorder was assessed at 13 years using a structured clinical interview.

Results

VP children who met criteria for an anxiety disorder at 13 years (n = 16) displayed altered trajectories for intracranial volume (ICV, p < 0.0001), total brain volume (TBV, p = 0.029), the right amygdala (p = 0.0009) and left hippocampus (p = 0.029) compared with VP children without anxiety (n = 108), with trends in the right hippocampus (p = 0.062) and left medial orbitofrontal cortex (p = 0.079). Altered trajectories predominantly reflected slower growth in early childhood (0–7 years) for ICV (β = −0.461, p = 0.020), TBV (β = −0.503, p = 0.021), left (β = −0.518, p = 0.020) and right hippocampi (β = −0.469, p = 0.020) and left medial orbitofrontal cortex (β = −0.761, p = 0.020) and did not persist after adjusting for TBV and social risk.

Conclusions

Region- and time-specific alterations in the development of the corticolimbic system in children born VP may help to explain an increase in anxiety disorders observed in this population.

中文翻译：

极早产儿的前额叶和边缘脑区域的生长与焦虑症

背景

与足月同龄人相比，极早产儿 (VP) 的皮质边缘结构生长发生了变化。鉴于皮质边缘系统与焦虑之间的关联，本研究旨在比较 13 岁时有和没有焦虑诊断的 VP 儿童皮质边缘区域的发育轨迹。

方法

使用 124 名 VP 儿童的 MRI 数据计算足月等效年龄 (TEA)、7 岁和 13 岁时的全脑和皮质边缘区域体积。在 13 岁时，通过结构化临床访谈评估了是否存在焦虑症。

结果

13 岁时符合焦虑症标准的 VP 儿童 ( n = 16) 表现出颅内容量 (ICV, p < 0.0001)、总脑容量 (TBV, p = 0.029)、右侧杏仁核 ( p = 0.0009)轨迹的改变与没有焦虑的 VP 儿童( n = 108) 相比，右海马体 ( p = 0.062) 和左内侧眶额皮质 ( p = 0.079) 具有趋势。改变的轨迹主要反映了儿童早期（0-7岁）ICV（β = -0.461，p = 0.020）、TBV（β = -0.503，p = 0.021）、左（β = -0.518，p = 0.020 ）的生长减慢）和右侧海马体（β = -0.469，p = 0.020）和左侧内侧眶额皮质（β = -0.761，p = 0.020），并且在调整 TBV 和社会风险后并未持续存在。