In the first study of its kind, Natasha Leporé, PhD, and colleagues have pinpointed structural anomalies in the developing brain that may increase the risk of cognitive disabilities, such as frontal executive dysfunction (FED) and attention deficit hyperactivity disorder (ADHD), in premature newborns. This study was published by the Public Library of Science, on July 3, in PLOS ONE.
“The next step will be to see whether we can find a way to predict which premature children will develop ADHD based on the differences that we see in their putamens compared to babies born full term”
"Dr. Leporé's innovative research is an important step toward developing non-subjective criteria for the diagnosis of ADHD, one of the most common neurobehavioral disorders of childhood. Her work also provides a potential therapeutic target for more specific pharmacological intervention to help children reach their fullest potential," said Brent Polk, MD, director of The Saban Research Institute of Children's Hospital Los Angeles.
Often regarded as the most advanced area of the brain, the frontal lobe gives humans the ability to plan, problem-solve, memorize, remain attentive and suppress socially unacceptable behaviors. In order to carry out these executive functions, extensive connections throughout the cerebral cortex must properly develop in utero. Miscommunications between the frontal lobe and other areas of the brain can be broadly categorized as FED and include cognitive and behavioral disorders such as ADHD.
ADHD is a condition characterized by extreme inattention, hyperactivity or impulsiveness, and is often diagnosed when children reach school-age. While previous studies have shown strong correlations between premature birth and behavioral problems later in life, no potential mechanism has been discovered until now.
By using magnetic resonance imaging (MRI) scans and surface-generation technologies, researchers were able to reconstruct three-dimensional images of internal structures in the brains of preterm and healthy full-term infants. When comparing these two groups, significant structural differences were found in a centrally located area, the putamen, which is part of an intricate circuit connecting to the frontal lobe. The same variances seen in the premature newborns are known to be abnormal in older children diagnosed with ADHD. Discovering this atypical development in infants born preterm provides a structural explanation for the increased rates of FED, ADHD and other behavioral disorders seen in this population.
"The next step will be to see whether we can find a way to predict which premature children will develop ADHD based on the differences that we see in their putamens compared to babies born full term," said the study's senior author, Natasha Leporé, from The Saban Research Institute of Children's Hospital Los Angeles.
While survival rates of preterm infants have greatly improved due to advancements in neonatal care, these children are still at a high risk of exhibiting cognitive and behavioral problems once they are a few years old. The ability to identify structural signs of FED and ADHD shortly after birth will allow for early interventions, greatly increasing the child's social and learning behaviors as they age.
Children's Hospital Los Angeles