Neonatal somatosensory responses and neurocognition in extremely low gestational age children

Research output: ThesisDoctoral ThesisCollection of Articles

Abstract

Despite advancements in neonatal intensive care and increased survival of infants born extremely preterm, many of them still develop with motor, sensory, cognitive, and behavioral impairments. Predicting adverse neurodevelopmental outcome as early as possible is a challenge in neonatology. Structural neuroimaging methods partly fail to detect milder brain abnormalities that may interfere with later developmental outcome, and neurological assessment is more unreliable in the neonatal period than in childhood. Thus, additional methods are needed for earlier and more accurate recognition of extremely preterm infants with adverse neurodevelopmental outcome. The first purpose of this study was to assess the value of measuring higher cortical function by neurophysiological methods in predicting outcome of infants born extremely preterm. Second, we aimed to examine possible difficulties in behavioral somatosensory processing and in mother-child interaction and their associations with developmental outcome. The lack of somatosensory evoked magnetic fields from the secondary somatosensory cortex in magnetoencephalography at term equivalent age, reflecting abnormal higher cortical functioning during somatosensory processing, was associated with worse neuromotor outcome of extremely preterm infants at two years of corrected age, not foreseen with structural neuroimaging methods. Further, we showed that responses from the secondary somatosensory cortex can also be detected by measuring somatosensory evoked potentials during electroencephalography. The quality of mother-infant interaction in mother- extremely preterm child dyads did not differ from that in mother-term child dyads. However, among children born extremely preterm worse child adjustment and lower quality of maternal and dyadic behavior were associated with lower neurocognitive outcomes. Half of the children born extremely preterm presented atypical behavioral sensory processing at two years of corrected age. Sensation seeking was common in extremely preterm children with neonatal neuroanatomical lesions. In conclusion, the functional neurophysiological methods magnetoencephalography and measurement of somatosensory evoked potentials during electroencephalography hold promise as valuable additional tools in predicting outcome of children born extremely preterm. The quality of mother-infant interaction may play a significant role in optimizing cognitive outcome after extremely preterm birth. Atypical behavioral sensory processing in children born extremely preterm is common, but the pathogenesis and developmental significance of this phenomenon call for more research in the future.
Original languageEnglish
Place of PublicationHelsinki
Publisher
Print ISBNs978-951-51-0466-3
Electronic ISBNs978-951-51-0467-0
Publication statusPublished - 2014
MoE publication typeG5 Doctoral dissertation (article)

Fields of Science

  • 3123 Gynaecology and paediatrics

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