Brain Advance Access originally published online on September 15, 2004
Brain 2004 127(12):2595-2607; doi:10.1093/brain/awh300
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Brain Vol. 127 No. 12 © Guarantors of Brain 2004; all rights reserved
Brain morphometry and IQ measurements in preterm children
1 MRC Childhood Nutrition Research Centre and 2 Radiology and Physics Unit, Institute of Child Health, University College London, London WC1N 1EH, 3 Department of Radiology, Great Ormond Street Hospital for Children NHS Trust, London, UK and 4 University of Melbourne Department of Paediatrics and Murdoch Childrens Research Institute, Royal Children's Hospital, Victoria, Australia
Correspondence to: Dr E. B. Isaacs, MRC Childhood Nutrition Research Centre, Institute of Child Health, University College London, 30 Guilford Street, London WC1N 1EH, UK E-mail: E.Isaacs{at}ich.ucl.ac.uk
Although IQ is thought to remain relatively stable in the normal population, a decline in IQ has been noted in children born preterm. It is not clear, however, to what extent the inclusion of children with clear neurological damage has influenced these findings. We examined IQ scores obtained in childhood and then again in adolescence from a group of children born at 30 weeks gestation or less who had been classified as neurologically normal at 7.5–8 years. They showed a significant decline in mean IQ scores over time. MRI scans obtained from a subset of children at adolescence were read as normal in 
50% of cases and, in the others, there were no consistent relationships between radiological abnormalities and IQ results. Such children can, however, have relatively subtle brain abnormalities that are not seen on conventional MRI, and we hypothesized that these would be related to declines in IQ. Voxel-based morphometry (VBM) analyses of the MRI scans revealed that absolute IQ scores were related to areas in both the parietal and temporal lobes. The analyses also showed that frontal and temporal lobe regions were associated with the decline in VIQ, while occipital and temporal lobe regions (including the hippocampi) were associated with the decline in PIQ. Hippocampal volume measurements were consistent with the VBM findings. We concluded that preterm children are at risk of declining IQ over time even if they have not suffered obvious neurological damage and that the decline is associated with specific neural regions. Whether this is true of children born at >30 weeks gestation and what other factors predispose to this decline have yet to be determined.
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