Neural basis of language trajectories in extremely preterm children

极早产儿语言轨迹的神经基础

• 批准号: 10841153
• 负责人: STEPHANIE L MERHAR
• 金额: $ 27.71万
• 依托单位: CINCINNATI CHILDRENS HOSP MED CTR
• 依托单位国家: 美国
• 财政年份: 2023
• 资助国家: 美国
• 起止时间: 2023-06-01 至 2030-03-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10841153
• 关键词: 3 year old; Age; Auditory; Birth; Brain; Caregivers; Child; Clinical Research; Cognition; Collaborations; Data; Data Collection; Data Set; Development; Exhibits; Family; Follow-Up Studies; Future; Generations; Heterogeneity; Image; Infant; Infant Development; Knowledge; Language; Language Delays; Language Development; Language Therapy; Learning; Life; Link; Magnetic Resonance Imaging; Magnetoencephalography; Measures; Motor; Multicenter Neonatal Research Network; National Institute of Child Health and Human Development; Neonatal Intensive Care Units; Nursery Schools; Observational Study; Outcome; Pattern; Pediatric Hospitals; Performance; Philadelphia; Pregnancy; Premature Infant; Public Health; Quality of life; Recording of previous events; Reporting; Research; Research Personnel; Rest; Risk; Risk Factors; School-Age Population; Site; Socioeconomic Status; Socioenvironmental Therapy; Speech; Testing; Time; Vocabulary Test; Work; auditory processing; brain based; clinical center; cognitive development; cohort; connectome; critical period; experience; extreme prematurity; improved; language processing; multimodal neuroimaging; neural; neuroimaging; neuromechanism; neuroprotection; peer; premature; prenatal; recruit; research clinical testing; response; skills; socioenvironmental factor; synergism; tool

PROJECT SUMMARY/ABSTRACT Prematurity is a public health crisis impacting 10% of children. Children born extremely preterm (EPT) have a significant risk for language difficulties which can adversely impact quality of life. Current tools do not account for trajectories, focus on risk factors which are often not modifiable, and fail to prioritize outcomes that matter to families. There is a critical need for advanced neuroimaging studies of extremely preterm children at preschool age, a dynamic period of language development, to investigate the trajectories of language development and to evaluate the neural basis of difficulties in language in preterm children as compared to term comparisons. The proposed study will address this need by leveraging an existing cohort of 35 children born at <27 weeks gestation who are part of the Neonatal Research Network (NRN) Follow-up study and have received language assessments at 2 years corrected age in Cincinnati to be seen again at 3-3.5 years corrected. We will recruit 35 term comparison children to undergo the same language assessments and magnetoencephalography (MEG) and structural MRI at the same time point. Additionally, we will coordinate data collection with the Children’s Hospital of Philadelphia, an NRN site and frequent collaborator, to increase the power and validity of our research findings. Our previous studies of language and neuroimaging in preterm children have shown a specific pattern of increased brain activity in preterm children with normal language development as compared to term children. We therefore hypothesize that the trajectory of language skills in preterm children will relate to functional connectivity measured by MEG as children perform language tasks, representing a positive adaptation in the setting of prematurity-induced dysmaturation. The objective of the proposed study is to assess the trajectory of and neural mechanisms underlying language delay in EPT (including auditory encoding, processing of naturalistic speech during stories listening, and covert verb generation). The first aim is to assess the trajectory of language skills from 2 to 3 years of age in extremely preterm children (at least 35 from Cincinnati, at least 85 across sites). The second aim is to assess language skills at 3 years of age, including expressive language or talking, in EPT and age-matched TC (at least 35 from Cincinnati, at least 85 across sites). The third aim is to assess the brain activity and connectivity supporting language in EPT and describing any differences between EPT and TC during language tasks (stories listening, verb generation auditory encoding) using MEG. We will relate this to language trajectories for the group of EPT children. More comprehensive assessments of language skills and neuroimaging during this dynamic critical period will help elucidate the mechanisms underlying normal and delayed language development and will be highly hypothesis-generating for future longitudinal work promoting neuroprotective strategies for preterm children.

项目概要/摘要 早产是一种影响 10% 儿童的公共卫生危机。极早产儿 (EPT) 语言困难的重大风险，可能对生活质量产生不利影响。当前工具不考虑 对于轨迹，重点关注通常不可改变的风险因素，并且无法优先考虑重要的结果 家庭。迫切需要对学前班的极早产儿进行高级神经影像学研究 年龄是语言发展的动态时期，旨在研究语言发展的轨迹和 与足月比较相比，评估早产儿语言困难的神经基础。 拟议的研究将通过利用现有的 35 名 27 周以下出生儿童队列来满足这一需求 参加新生儿研究网络 (NRN) 随访研究并接受过语言治疗的妊娠期女性 辛辛那提 2 岁校正年龄的评估将在 3-3.5 岁校正时再次看到。我们将招募 35名学期比较儿童接受相同的语言评估和脑磁图检查 (MEG) 和结构 MRI 在同一时间点进行。此外，我们将与 费城儿童医院是 NRN 网站和经常合作者，旨在提高 我们的研究结果。我们之前对早产儿语言和神经影像学的研究表明 与语言发育正常的早产儿相比，大脑活动增加的特定模式 足月儿童。因此，我们假设早产儿语言技能的轨迹与 当儿童执行语言任务时，MEG 测量的功能连接性代表了积极的 早产引起的成熟不良的适应。拟议研究的目的是 评估 EPT 中语言延迟的轨迹和神经机制（包括听觉） 编码、听故事期间自然语音的处理以及隐性动词生成）。第一个目标 旨在评估极早产儿（至少 35 来自辛辛那提，跨站点至少 85 个）。第二个目标是评估 3 岁时的语言技能， 包括表达性语言或谈话，在 EPT 和年龄匹配的 TC 中（至少 35 名来自辛辛那提，至少 85 名来自辛辛那提） 跨站点）。第三个目标是评估 EPT 和语言中支持语言的大脑活动和连接性 描述 EPT 和 TC 在语言任务（听故事、动词生成）过程中的任何差异 听觉编码）使用 MEG。我们会将其与 EPT 儿童群体的语言轨迹联系起来。更多的 在这个动态的关键时期对语言技能和神经影像进行全面评估将有助于 阐明正常和延迟语言发展的机制，并将受到高度重视 为未来的纵向工作提出假设，促进早产儿的神经保护策略。