Specific Cognitive Abilities in 2-Year-Old Children with Subependymal and Mild Intraventricular Hemorrhage

doi:10.1006/brcg.1996.0054

Brain and Cognition

Volume 32, Issue 1, October 1996, Pages 1-13

https://doi.org/10.1006/brcg.1996.0054 Get rights and content

Abstract

Subependymal and mild intraventricular hemorrhages (S/IVH) are likely to affect the subcortical and frontal cortex regions of the brain in premature infants. Damage to the subcortical and frontal areas has been associated with poorer performance in certain abilities, including visual attention, memory for location, and ability to change response set. This study investigated whether S/IVH, occurring at birth, affect these abilities in young children. Two-year-old premature children with S/IVH, premature children with normal neonatal head ultrasound scans, and full term children with normal births were evaluated on a series of tasks. These tasks were a habituation/novelty preference task (visual attention), Piaget's invisible displacement task (memory for location), an object discrimination reversal task (ability to change response set), and the Bayley Scales of Infant Development (traditional infant test). Premature children with hemorrhage performed significantly less well on the task of ability to remember the last location of a hidden object and on the task of ability to reverse response set. Both groups of premature children performed significantly less well than full term children on systematic search for an object once the order of hiding was reversed. There were no significant differences among the three groups on the habituation/novelty preference task or on Bayley scores. Results suggest that both S/IVH and prematurity affect development of specific cognitive abilities.

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Impact of low-grade intraventricular hemorrhage on neurodevelopmental outcome in very preterm infants at two years of age
2023, Early Human Development
High-grade intraventricular hemorrhage (IVH) in very preterm infants is a known risk factor for adverse neurodevelopmental outcome. Prognosis is less clear for low-grade (grades I/II) IVH however, with conflicting study results in recent years.
To evaluate the impact of low-grade IVH on neurodevelopmental outcome at 2 years corrected age in preterm infants born below 32 weeks gestation at the University hospital of Zurich between 2009 and 2014.
Among 843 live-born preterm infants born during the observation period, 509 were included in our study. Exclusion criteria were death, high-grade IVH, cystic periventricular leukomalacia and congenital malformations. Infants were grouped into those with or without low-grade IVH according to cranial ultrasound. Neurodevelopmental impairment (NDI) was defined as cognitive or motor developmental score > 2 standard deviations below the mean and/or CP grades 2–5 and/or moderate/severe vision loss and/or hearing problem corrected with hearing aids. Multivariate linear regression was used to assess effect of low-grade IVH on endpoints while adjusting for other risk factors.
87 preterm infants had low-grade IVH (42 grade I, 45 grade II) on cranial ultrasound. These were compared to 422 preterm infants without IVH. Follow-up rate was 82.4 %. Preterm infants with low-grade IVH had higher rates of NDI (21.8 vs 13.3 %, p = 0.047). Infants with IVH grade II had significantly higher rates for CP (8.9 % vs 3.6 %, p = 0.003), visual impairment (20.5 % vs 8.3 %, p = 0.009) and NDI (33.3 % vs 13.3 %, p < 0.001).
In our study, low-grade IVH – and especially IVH grade II - is associated with adverse neurodevelopmental outcome at 2 years of corrected age.
Preterm brain injury: Germinal matrix–intraventricular hemorrhage and post-hemorrhagic ventricular dilatation
2019, Handbook of Clinical Neurology
Citation Excerpt :
Isolated grade I–II IVH was also independently associated with a higher risk of neurosensory impairment (adjusted OR 1.73; 95% CI 1.22–2.46) (Bolisetty et al., 2014). In contrast, other studies suggest that infants with low-grade GMH-IVH perform equally well in cognitive and motor developmental outcome as preterm infants with no GMH-IVH, although lower scores were found in their visual-motor integration (Vohr et al., 1992; Ross et al., 1996; Reubsaet et al., 2017). Also, in a large cohort in infants born at < 27 weeks’ gestation, no difference in outcome at 18–22 months was found between infants without a hemorrhage and those with a grade I–II GMH-IVH (Payne et al., 2013).
Germinal matrix hemorrhage and intraventricular hemorrhages (GMH-IVH) remain a common and clinically significant problem in preterm infants, particularly extremely preterm infants. A large GMH-IVH is often complicated by posthemorrhagic ventricular dilation (PHVD) or parenchymal hemorrhagic infarction and is associated with an increased risk of adverse neurologic sequelae.
The widespread use of cranial ultrasonography since the early 1980s has shown a gradual decrease in the incidence of GMH-IVH and has helped with the identification of antenatal and perinatal risk factors and timing of the lesion. The increased use of magnetic resonance imaging (MRI) has contributed to more detailed visualization of the site and extent of the GMH-IVH. In addition, MRI has contributed to the awareness of associated white matter changes as well as associated cerebellar hemorrhages. Although GMH-IVH and PHVD still cannot be prevented, cerebrospinal fluid drainage initiated in the early stage of PHVD development seems to be associated with a better neurodevelopmental outcome. Further studies are underway to improve treatment strategies for PHVD and to potentially prevent and repair GMH-IVH and PHVD and associated brain injury.
This chapter discusses the pathogenesis, incidence, risk factors, and management, including preventive measures, of GHM-IVH and PHVD.
Motor learning and working memory in children born preterm: A systematic review
2012, Neuroscience and Biobehavioral Reviews
Citation Excerpt :
The three groups then performed similarly on the AB task. On the invisible displacement task, preterm children with S/IVH performed worse than preterm controls and term controls in finding the objects and both preterm groups performed worse than controls on systematic searching for an object (Ross et al., 1996). Rose et al. (2009b) found no differences between LBW infants and controls at 12 months of age on delayed recognition.
Children born preterm have a higher risk for developing motor, cognitive, and behavioral problems. Motor problems can occur in combination with working memory problems, and working memory is important for explicit learning of motor skills. The relation between motor learning and working memory has never been reviewed. The goal of this review was to provide an overview of motor learning, visual working memory and the role of working memory on motor learning in preterm children. A systematic review conducted in four databases identified 38 relevant articles, which were evaluated for methodological quality. Only 4 of 38 articles discussed motor learning in preterm children. Thirty-four studies reported on visual working memory; preterm birth affected performance on visual working memory tests. Information regarding motor learning and the role of working memory on the different components of motor learning was not available. Future research should address this issue. Insight in the relation between motor learning and visual working memory may contribute to the development of evidence based intervention programs for children born preterm.
Cerebral visual impairment: Which perceptive visual dysfunctions can be expected in children with brain damage? A systematic review
2010, Research in Developmental Disabilities
Citation Excerpt :
This study measured object recognition and visual spatial perception using the visual perceptual battery L94 (Stiers et al., 2001). Ross et al. (1996) investigated children with subependymal or intraventricular cerebral hemorrhage (S/IVH) and their visual memory, using the Invisible Displacement task (ID). This task features two items; the invisible displacement (ID) trial and the systematic search (SS) trial.
The current definition of Cerebral Visual Impairment (CVI) includes all visual dysfunctions caused by damage to, or malfunctioning of, the retrochiasmatic visual pathways in the absence of damage to the anterior visual pathways or any major ocular disease. CVI is diagnosed by exclusion and the existence of many different causes and symptoms make it an overall non-categorized group. To date, no discrimination is made within CVI based on types of perceptive visual dysfunctions. The aim of this review was to outline which perceptive visual dysfunctions are to be expected based on a number of etiologies of brain damage and brain development disorders with their onset in the pre-, peri- or postnatal period. For each period two etiologies were chosen as the main characteristic brain damage. For each etiology a main search was performed. The selection of the articles was based on the following criteria: age, etiology, imaging, central pathology and perceptive visual function test. The perceptive visual functions included for this review were object recognition, face recognition, visual memory, orientation, visual spatial perception, motion perception and simultaneous perception. Our search resulted in 11 key articles. A diversity of research history is performed for the selected etiologies and their relation to perceptive visual dysfunctions. Periventricular Leukomalacia (PVL) was most studied, whereas the main tested perceptive visual function was visual spatial perception. As a conclusion, the present status of research in the field of CVI does not allow to correlate between etiology, location and perceptive visual dysfunctions in children with brain damage or a brain development disorder. A limiting factor could be the small number of objective tests performed in children experiencing problems in visual processing. Based on recent insights in central visual information processing, we recommend an alternative approach for the definition of CVI that is based on functional visual processing, rather than anatomical landmarks. This could be of benefit in daily practice to diagnose CVI.
Volumetric analysis of regional cerebral development in preterm children
2004, Pediatric Neurology
Preterm birth is frequently associated with both neuropathologic and cognitive sequelae. This study examined cortical lobe, subcortical, and lateral ventricle development in association with perinatal variables and cognitive outcome. High-resolution volumetric magnetic resonance imaging scans were acquired and quantified using advanced image processing techniques. Seventy-three preterm and 33 term control children ages 7.3-11.4 years were included in the study. Results indicated disproportionately enlarged parietal and frontal gray matter, occipital horn, and ventricular body, as well as reduced temporal and subcortical gray volumes in preterm children compared with control subjects. Birth weight was negatively correlated with parietal and frontal gray, as well as occipital horn volumes. Intraventricular hemorrhage was associated with reduced subcortical gray matter. Ventricular cerebrospinal fluid was negatively correlated with subcortical gray matter volumes but not with white matter volumes. Maternal education was the strongest predictor of cognitive function in the preterm group. Preterm birth appears to be associated with disorganized cortical development, possibly involving disrupted synaptic pruning and neural migration. Lower birth weight and the presence of intraventricular hemorrhage may increase the risk for neuroanatomic abnormality.
Preschool Executive Control on the Shape School Task: Measurement Considerations and Utility
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Regular ArticleSpecific Cognitive Abilities in 2-Year-Old Children with Subependymal and Mild Intraventricular Hemorrhage

Abstract

Regular Article
Specific Cognitive Abilities in 2-Year-Old Children with Subependymal and Mild Intraventricular Hemorrhage