Neural Basis of Emergent Math Difficulties in Healthy Preterm Children

描述（由申请人提供）：非常早产的儿童是神经发育障碍的高危人群。学业成绩和教育成果明显低于预期，特别是在数学领域。即使新生儿病程相对良性，在婴儿/幼儿随访中被认为正常的儿童，仍有显著数学困难的风险。此外，这些“健康的早产”儿童有显著的注意力、视觉、知觉、运动和执行功能缺陷的风险，但很少有人知道这些缺陷在早产儿学龄前儿童中的出现可能与后来的数学困难有关。目前还没有研究选择性神经心理缺陷和早期学习困难的神经基础的数据，但这是动态神经认知发展的关键时期，干预可能最有可能减轻后来的缺陷。本研究旨在评估健康早产儿神经心理和数学缺陷的出现情况，揭示早产对儿童早期大脑发育的影响，并探讨健康早产儿数学和神经心理发育与发育性脑异常的关系。参与者将是60名健康的早产儿（出生25-32孕周），平均智力和40名年龄、性别、社会经济地位和语言智商相匹配的足月儿童。幼儿将于入园前6个月内入园。我们将在每年的三个时间点将多模式神经成像（使用结构MRI的全脑形态测量和使用弥散加权成像的白质完整性指数）与神经心理学和学术测量相结合。我们预测，特定的早期感知和认知缺陷将与新出现的数学缺陷有关。我们将研究后期的数学缺陷是否与早期的非符号和符号处理缺陷有关。我们的纵向研究设计旨在阐明受影响最严重的皮层表面积和底层纤维束与一组相关神经认知和数学功能的表现水平之间的联系，并获得更多关于这些影响如何影响神经系统中正在进行的生物发育的信息，这些影响在发育早期不太直接影响。我们还将检查其他中介因素，如早产程度以及医疗和人口变量。这个项目的结果将大大提高我们对为什么某些技能更容易受到早产的影响，这些技能如何与早期出现的数学缺陷相关，以及潜在的神经病理学如何解释健康早产儿神经发育结果的广泛变化。这些结果将为确定最适合进行有效干预的缺陷提供关键基础。

DESCRIPTION (provided by applicant): Very preterm children are at high risk for neurodevelopmental impairments. Academic achievement and educational outcomes are significantly lower than expected, particularly in the area of mathematics. Even children with relatively benign neonatal courses who are deemed normal at infant/toddler follow-up remain at risk for significant math difficulties. In addition, these "healthy preterm" children are at risk fr significant attention, visual, perceptual, motor, and executive function deficits, but little is knwn about how the emergence of these deficits in preterm preschoolers may be related to later math difficulties. There are currently no data examining the neural basis of selective neuropsychological deficits and early academic difficulties, yet this is a critical period of dynamc neurocognitive development when intervention may have the best potential for mitigating later deficits. This longitudinal study aims to evaluate the emergence of neuropsychological and math deficits in healthy preterm children, map the impact of preterm birth on brain development during early childhood, and examine the relationship between math and neuropsychological development and developmental brain abnormalities in healthy preterm children. Participants will be 60 healthy preterm children (born 25-32 gestational weeks) with average intelligence and 40 full term children matched for age, sex, SES, and verbal IQ. Children will enter the study within 6 months prior to kindergarten entry. We will integrate multimodal neuroimaging (whole brain morphometric measures using structural MRI and indices of white matter integrity using diffusion weighted imaging) with neuropsychological and academic measures across three annual time points. We predict that specific early perceptual and cognitive deficits will be relate to emerging math deficits. We will examine whether later math deficits are related to early non-symbolic and symbolic processing deficits. Our longitudinal study design aims to elucidate the links between the most affected cortical surface areas and underlying fiber tracts and level of performance on a set of implicated neurocognitive and math functions, and to acquire more information about how these effects impact ongoing biological development in neural systems less directly affected early in development. We will also examine other mediating factors, such as degree of prematurity and medical and demographic variables. The results from this project will greatly enhance our understanding of why certain skills appear more vulnerable to preterm birth, how these skills are related to the early emergence of math deficits, and how the underlying neuropathology accounts for extensive variations in neurodevelopmental outcome in healthy preterm children. These results will provide the critical foundation for identifying the deficits most amenable to effective interventions.