Auditory event-related potentials are related to cognition at preschool age after very preterm birth Hemisphere Differences in Speech-Sound Event-Related Potentials in Intensive Care Neonates Effects of Early Intervention on Cognitive Function of Low Birth Weight Preterm Infants, Brain structure and neurocognitive and behavioural function in adolescents who were born very preterm Patterned feeding experience for preterm infants: study protocol for a randomized controlled trial Cognitive development in low risk preterm infants at 3–4 years of life Diagnostic and Predictive Value of Auditory Evoked Responses in Preterm Infants: II. Auditory Evoked Responses
Background : Auditory event-related potentials ( AERP ) are neurophysiological correlates of sound perception and cognitive processes . Our aim was to study in very preterm born children at preschool age if AERP correlate with cognitive outcome . Methods : Seventy children ( mean ± SD gestational age 27.4 ± 1.9 wk , birth weight 996 ± 288 g ) were investigated at age 4.3–5.3 y with psychological testing ( WPPSI-R , four subtests of NEPSY ) . Electroencephalogram was recorded while they listened to a repeated st and ard tone , r and omly replaced by one of three deviants .  Latencies and amplitudes for AERP components and mean amplitudes in successive 50-ms AERP time windows were measured . Results : Better cognitive test results and higher gestational age correlated with shorter P1 latencies and more positive mean amplitudes 150–500 ms after stimulus change onset . Neonatal brain damage was associated with a negative displacement of AERP curves . Neonatal morbidity had an impact on earlier time windows while gestational age and brain damage on both early and later time windows . Conclusion : AERP measures were associated with cognitive outcome . Neonatal morbidity mainly affects early cortical auditory encoding , while immaturity and brain damage additionally influence higher cortical functions of auditory perception and distraction . Perinatal auditory environment might play a role in development of auditory processing Neurodevelopmental delays in intensive care neonates are common but difficult to predict . In children , hemisphere differences in cortical processing of speech are predictive of cognitive performance . We hypothesized that hemisphere differences in auditory event-related potentials in intensive care neonates are predictive of neurodevelopment in infancy , even in those born preterm .  Event-related potentials to speech sounds were prospect ively recorded in 57 infants ( gestational age 24 - 40 weeks ) prior to discharge . The Developmental Assessment of Young Children was performed at 6 and 12 months . Hemisphere differences in mean amplitudes increased with postnatal age ( P < .01 ) but not with gestational age . Greater hemisphere differences were associated with improved communication and cognitive scores at 6 and 12 months , but decreased in significance at 12 months after adjusting for socioeconomic and clinical factors . Auditory cortical responses can be used in intensive care neonates to help identify infants at higher risk for delays in infancy The Infant Health and Development Program is a r and omized clinical trial to test the efficacy of educational and family support services and pediatric follow-up , offered during the first 3 years of life , in reducing the incidence of developmental delay in low birth weight preterm infants at eight clinical sites ( N = 985 ) . It was hypothesized that larger intervention effects would be found for the domains in which low birth weight preterm infants are known to have problems , specifically visual-motor and spatial skills and receptive language skills . These analyses explore the effects of the Infant Health and Development Program on different domains of cognitive functioning . Cognitive domains are identified by means of factor analysis of the intelligence tests used at 12 , 24 , and 36 months ( Bayley Scales of Infant Development ( including the Mental and Motor scales ) at 12 and 24 months ; the Stanford-Binet , Peabody Picture Vocabulary Test , and Beery Test of Visual Motor Intergration at 36 months ) . Our results reveal that , although intervention benefits accrue across cognitive domains at 24 and 36 months , gains are most pronounced for receptive language and visual-motor and spatial skills BACKGROUND Infants born very preterm ( <33 weeks ) are at increased risk of neurocognitive deficits . Their neurodevelopmental outcome up to age 8 years can be predicted by neonatal ultrasonography , but little is known of their later function . We investigated the effect of very preterm birth on brain structure and neurocognitive and behavioural functioning in adolescence . METHODS A cohort of 105 infants born before 33 weeks of gestation in 1979 - 80 had ultrasonographic scans at University College Hospital , London , and were prospect ively examined at 1 , 4 , and 8 years . At age 14 - 15 years , 72 of those who remained in UK ( cases ) and 21 age-matched full-term controls underwent brain magnetic resonance imaging ( MRI ) , as well as neurological , cognitive , and behavioural assessment . MRI images were assessed by two neuroradiologists unaware of ultrasonographic findings or case or control status . FINDINGS Of the 72 cases , 40 had unequivocally abnormal MRI and 15 had equivocal scans . Of the 21 controls , one had abnormal and five equivocal MRI . Abnormalities of ventricles , corpus callosum , and white matter were especially common in cases . More brain lesions were identified by MRI than by neonatal ultrasonography . The cases had significantly more reading , adjustment , and neurological impairments than controls , but their behaviour was significantly related to MRI abnormality . INTERPRETATION Individuals born very preterm show an excess of neurocognitive and behavioural problems in adolescence , and more than half have abnormal MRI brain scans Background Neurobehavioral disabilities occur in 5–15 % of preterm infants with an estimated 50–70 % of very low birth weight preterm infants experiencing later dysfunction , including cognitive , behavioral , and social delays that often persist into adulthood . Factors implicated in poor neurobehavioral and developmental outcomes are hospitalization in the neonatal intensive care unit ( NICU ) and inconsistent caregiving patterns . Although much underlying brain damage occurs in utero or shortly after birth , neuroprotective strategies can stop lesions from progressing , particularly when these strategies are used during the most sensitive periods of neural plasticity occurring months before term age . The purpose of this r and omized trial is to test the effect of a patterned feeding experience on preterm infants ’ neurobehavioral organization and development , cognitive function , and clinical outcomes . Methods This trial uses an experimental , longitudinal , 2-group design with 120 preterm infants . Infants are enrolled within the first week of life and r and omized to an experimental group receiving a patterned feeding experience from the first gavage feeding through discharge or to a control group receiving usual feeding care experience . The intervention involves a continuity of tactile experiences associated with feeding to train and build neuronal networks supportive of normal infant feeding experience . Primary outcomes are neurobehavioral organization as measured by Neurobehavioral Assessment of the Preterm Infant at 3 time points : the transition to oral feedings , NICU discharge , and 2 months corrected age . Secondary aims are cognitive function measured using the Bayley Scales of Infant and Toddler Development , Third Edition at 6 months corrected age , neurobehavioral development ( sucking organization , feeding performance , and heart rate variability ) , and clinical outcomes ( length of NICU stay and time to full oral feeding ) . The potential effects of demographic and biobehavioral factors ( perinatal events and conditions of maternal or fetal/newborn origin and immunologic and genetic biomarkers ) on the outcome variables will also be considered . Discussion Theoretically , the intervention provided at a critical time in neurologic system development and associated with a recurring event ( feeding ) should enhance neural connections that may be important for later development , particularly language and other cognitive and neurobehavioral organization skills . Trial registration NCT01577615 11 April 2012 Background : Major neurological h and icaps and neuropsychological disturbances are more common in ex-preterm children than their counterparts born at term . Objective : To establish in a prospect i ve study whether a characteristic neuropsychological profile exists in ex-preterm children who do not exhibit neurodevelopmental deficits on routine clinical examination . Methods : Thirty intellectually normal children born preterm ( 30–34 weeks gestation ) without major neurological disabilities and a control group of term children matched for age , sex , and parental educational and occupational status were assessed at 3–4 years of age to obtain a complete neuropsychological profile . Intellectual ability , language comprehension and expression , perceptual and visual motor function , working memory , and attention and behavioural problems were investigated . Results : Even in the absence of major neurological signs , children born preterm achieved lower mean scores than controls on the Stanford-Binet intelligence scale ( 110.8 v 121 , p<0.001 ) , visual perception test ( 33.8 v 42.7 , p<0.001 ) , visual motor integration test ( 42.6 v 47.4 , p = 0.049 ) , memory for location test ( 8.4 v 9.5 , p = 0.007 ) , sustained attention test ( 41.6 v 51.5 , p = 0.009 ) , and the picture vocabulary test ( 33.3 v 44.7 , p = 0.021 ) . Conclusions : Neuropsychological abnormalities can be detected early in childhood in apparently normal ex-preterm children and are consistent with a growing body of evidence that prematurity may be associated with long term neuropsychological morbidity in childhood and adolescence In this study , the diagnostic and predictive value of brainstem , middle latency , and cortical auditory evoked responses ( BMC -AERs ) obtained in the neonatal period in 81 preterm infants was assessed in relation to neurodevelopmental outcome .  The preterm infants were neonatally classified according to risk category and gestational age . The  BMC -AERs  were analyzed with respect to detectability , latencies , and amplitudes as well as derived latency and amplitude measures . At 5 y of age the neurodevelopmental outcome was assessed from neurologic and neuropsychologic evaluations . The results showed that BMC -AER differences mainly correlated with risk category ( low risk/high risk ) and to some extent with degree of prematurity . In view of these findings the degree of prematurity and the effect of risk category have to be taken into account , when BMC -AERs are applied in the preterm period to predict neurodevelopmental outcome . In this study the BMC -AERs for infants with abnormal neurodevelopmental outcome were scarcely distinguishable from the BMC -AERs for infants with normal neurodevelopmental outcome . Thus far , this and previous reports have indicated that BMC -AERs in preterm infants are useful in maturational studies and with infants showing symptoms related to lesions or dysfunction of the peripheral and /or central auditory system . For predicting neurodevelopmental outcome in preterm infants , BMC -AERs are of limited clinical value
According to our findings , auditory event‐related potentials can help to predict neurodevelopmental outcome in preterms .
Both prospect i ve and cross‐sectional studies reported a relationship between AERPs and cognitive outcome .
Our results show that larger amplitudes and shorter latencies of late AERPs are related to better cognitive outcomes .
HIGHLIGHTSPreterm birth is associated with an elevated risk for neurodevelopmental deficits .
Auditory event‐related potentials can be used to assess early cognitive functioning .
This paper represents the first systematic review investigating the predictive power of AERPs on  cognition in preterms .
ABSTRACT Prematurity is a known risk factor for later cognitive deficits .
At present there are neither behavioral nor neurological tests available to detect those preterm infants who would benefit most from early interventions .
Neurophysiologic methods , and more specifically , auditory event‐related potentials ( AERPs ) are convenient tools to investigate early cognitive functioning .
However , the capability of AERPs as a prognostic factor for mental development in preterm infants remains unclear .