Neural basis of language trajectories in extremely preterm children

项目摘要/摘要 早产是一种影响10%儿童的公共卫生危机。极早产儿(EPT)有一种 存在语言障碍的重大风险，这可能会对生活质量产生不利影响。当前工具不支持 对于轨迹，重点放在通常不可修改的风险因素上，而不是对与以下结果相关的结果进行优先排序 家人。迫切需要对学龄前极早产儿进行高级神经影像研究。 年龄，一个语言发展的动态时期，来研究语言发展的轨迹和 目的：评价早产儿语言障碍的神经基础，并与足月儿进行比较。 这项拟议的研究将通过利用现有的35名出生于27周的儿童来满足这一需求 受孕者是新生儿研究网络(NRN)后续研究的一部分，并已获得语言 在辛辛那提，2岁时的评估纠正了年龄，3-3.5岁时再次出现。我们将招募 35名学期对照儿童接受相同的语言评估和脑磁图检查 (脑磁图)和结构磁共振成像在同一时间点。此外，我们将协调数据收集与 费城儿童医院，NRN网站和频繁合作者，以增加权力和有效性 我们的研究成果。我们之前对早产儿的语言和神经成像的研究表明 语言发育正常早产儿脑活动增强的特异型式比较 来指代孩子。因此，我们假设早产儿语言技能的发展轨迹与 在儿童执行语言任务时由脑磁图测量的功能连接性，代表着积极的 早产儿所致发育不成熟环境的适应。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 在听故事时自然语言的编码、处理和隐蔽动词的生成)。第一个目标 评估极早产儿(至少35岁)从2岁到3岁的语言技能发展轨迹 来自辛辛那提，在各个地点至少有85人)。第二个目标是评估3岁儿童的语言技能， 包括富有表现力的语言或谈话，在EPT和年龄匹配的TC中(至少35人来自辛辛那提，至少85人 跨站点)。第三个目标是评估EPT和EPT中支持语言的大脑活动和连接性 描述在语言任务(故事听力、动词生成)中EPT和TC之间的任何差异 听觉编码)使用脑磁图。我们将把这与EPT儿童群体的语言轨迹联系起来。更多 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所帮助 阐明正常和延迟语言发展的潜在机制，并将高度 为促进早产儿神经保护策略的未来纵向工作的假说生成。

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.