Neural basis of language trajectories in extremely preterm children

项目总结/摘要 早产是一种公共卫生危机，影响着10%的儿童。极早产儿（EPT）有一个 语言困难的重大风险，可能对生活质量产生不利影响。目前的工具不考虑 对于轨迹，关注通常无法改变的风险因素，并且未能优先考虑重要的结果 家庭对学龄前极早产儿进行先进的神经影像学研究是非常必要的 年龄，语言发展的动态时期，研究语言发展的轨迹， 评估早产儿语言困难的神经基础与足月儿比较。 拟议的研究将通过利用现有的35名出生于<27周的儿童来解决这一需求 新生儿研究网络（NRN）后续研究的一部分，并已收到语言 在辛辛那提矫正后2岁时进行评估，在矫正后3-3.5岁时再次观察。我们将招募 35名足月对照儿童接受相同的语言评估和脑磁图检查 (MEG)和结构磁共振成像此外，我们还将与 费城儿童医院，一个NRN网站和经常的合作者，以增加的权力和有效性， 我们的研究成果。我们以前对早产儿语言和神经影像学的研究表明， 与正常语言发育的早产儿相比， 来称呼孩子因此，我们假设，早产儿语言技能的轨迹将与 在儿童执行语言任务时，通过MEG测量的功能连接，代表了积极的 在早产引起的发育障碍的情况下的适应。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，在听故事期间处理自然主义言语，以及隐性动词生成）。第一个目标 评估极早产儿（至少35岁）2至3岁语言技能的轨迹 来自辛辛那提，各研究中心至少85例）。第二个目标是在3岁时评估语言技能， 包括表达性语言或谈话，在EPT和年龄匹配的TC（至少35岁，来自辛辛那提，至少85岁， 跨站点）。第三个目的是评估EPT中支持语言的大脑活动和连接， 描述在语言任务（故事听，动词生成）中EPT和TC之间的任何差异 听觉编码）。我们将把这一点与EPT儿童群体的语言轨迹联系起来。更 在这个动态的关键时期，对语言技能和神经成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，并将高度 为未来促进早产儿神经保护策略的纵向工作提出假设。

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.