Attention and Regional Gray Matter Development in Very Preterm Children at Age 12 Years

Objectives: This study examines the selective, sustained, and executive attention abilities of very preterm (VPT) born children in relation to concurrent structural magnetic resonance imaging (MRI) measures of regional gray matter development at age 12 years. Methods: A regional cohort of 110 VPT (<= 32 weeks gestation) and 113 full term (FT) born children were assessed at corrected age 12 years on the Test of Everyday Attention-Children. They also had a structural MRI scan that was subsequently analyzed using voxel-based morphometry to quantify regional between-group differences in cerebral gray matter development, which were then related to attention measures using multivariate methods. Results: VPT children obtained similar selective (p = .85), but poorer sustained (p = .02) and executive attention (p = .01) scores than FT children. VPT children were also characterized by reduced gray matter in the bilateral parietal, temporal, prefrontal and posterior cingulate cortices, bilateral thalami, and left hippocampus; and increased gray matter in the occipital and anterior cingulate cortices (family-wise error-corrected p < .05). Poorer sustained auditory attention was associated with increased gray matter in the anterior cingulate cortex (p = .04). Poor executive shifting attention was associated with reduced gray matter in the right superior temporal cortex (p = .04) and bilateral thalami (p = .05). Poorer executive divided attention was associated with reduced gray matter in the occipital (p = .001), posterior cingulate (p = .02), and left temporal (p = .01) cortices; and increased gray matter in the anterior cingulate cortex (p = .001). Conclusions: Disturbances in regional gray matter development appear to contribute, at least in part, to the poorer attentional performance of VPT children at school age.