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Brain Advance Access published online on September 8, 2005
Brain, doi:10.1093/brain/awh618
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© The Author (2005). Published by Oxford University Press on behalf of the Guarantors of Brain. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received February 1, 2005
Revised June 3, 2005
Accepted July 19, 2005

Article

Object working memory deficits predicted by early brain injury and development in the preterm infant

Lianne J. Woodward 1*, Jamie O. Edgin 1, Deanne Thompson 2, and Terrie E. Inder 3

1 University of Canterbury and Van der Veer Institute for Parkinson's and Brain Research, New Zealand
2 Howard Florey Institute, University of Melbourne, Australia
3 Murdoch Childrens' Research Institute, Howard Florey Institute, University of Melbourne, Australia

* To whom correspondence should be addressed.
Lianne J. Woodward, E-mail: lianne.woodward{at}canterbury.ac.nz


  Abstract

Children born preterm and of very low birth weight are at increased risk of learning difficulties and educational under-achievement. However, little is known about the specific neuropsychological problems facing these children or their neurological basis. Using prospective longitudinal data from a regional cohort of 92 preterm and 103 full-term children, this study examined relations between term MRI measures of cerebral injury and structural brain development and children's subsequent performance on an object working memory task at the age of 2 years. Results revealed clear between-group differences, with preterm children having greater difficulty encoding new information in working memory than term control children. Within the preterm group, task performance at the age of 2 years was related to both qualitative MRI measures of white matter (WM) injury and quantitative measures of total and regional brain volumes assessed at term equivalent. Bilateral reductions in total tissue volumes (%region) of the following cerebral regions were specifically related to subsequent working memory performance: dorsolateral prefrontal cortex, sensorimotor, parietooccipital and premotor. Associations between total cerebral tissue volumes at term (adjusted and unadjusted for intracranial volume) persisted even after the effects of WM injury were taken into account. This suggests that early disturbance in cerebral development may have an independent adverse impact on later working memory function in the preterm infant. These findings add to our understanding of the neuropathological pathways associated with later executive dysfunction in the very preterm infant.

Keywords: MRI; preterm; working memory; white matter injury; brain development.
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