Developmental Progression of Inhibitory Control and Flexible Problem-solving Among Infants with Histories of Preterm Birth.

IF 2.3 4区 医学 Q2 DEVELOPMENTAL BIOLOGY
Srishti Jayakumar, Ezequiel Ramos, Kathryn A Carson, Krysten Garcia, Katherine M Raja, Natasha N Ludwig, Ananya Sarkar, Lauren L Jantzie, Shenandoah Robinson, Marilee C Allen, V Joann Burton, Gwendolyn Gerner
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引用次数: 0

Abstract

Introduction: Inhibitory control during visually guided reaching allows for the development of flexible problem-solving in healthy infants born at term. Inhibitory control is often impaired among older children born preterm, but the developmental trajectory of inhibitory control in infants born preterm is not well understood. The objective of this study was to evaluate the developmental trajectory of inhibitory control on the Object Retrieval Task in infants born preterm.

Methods: This was a cross-sectional study including a convenience sample of infants born preterm (less than 37 weeks), who were evaluated at corrected ages 5-6, 7-8, 9-10, 11-12, 13-15, and 16-18 months. Children born preterm with additional diagnoses of congenital anomalies, known genetic disorders, focal stroke, neoplasm, or maternal HIV exposure, or children in the care of the state were excluded. Children in each of the age groups were asked to retrieve a toy from a Plexiglas box with an opening on one side. The orientation of the opening was rotated over three trials, and the visually guided reach patterns were scored based on methods used by Diamond. Visually guided reach patterns ranged from perseverative hitting of the box to immediately reaching through the box opening. Analysis consisted of Fischer's exact tests to compare categorical measures, Jonckheere-Terpstra tests to compared ordinal measures, F-test from general linear models to compare continuous measures and ordinal logistic regression to assess the association between brain injury and reach patterns.

Results: The majority of infants born preterm in corrected age groups of 5-6, 7-8, and 9-10 months perseveratively hit the box regardless of the orientation of the opening. This pattern of predominant immature visually guided reaching persisted at 12 months corrected age in this cohort of infants born preterm, with 75% participants demonstrating an immature reach with the box opening at the front and to the left, and 88% demonstrating this with the box opening to the right.

Conclusions: In this cohort of preterm infants, developmental progression of inhibitory control and progression of visually guided reaching did not follow the same developmental trajectory observed in full term typically developing infants previously documented by Diamond (1994). While 100% of typically developing infants born term in Diamond's cohort demonstrated inhibitory control and mature visually guided reach patterns by age 12 months, 75% of participants in our cohort of infants born preterm continued to demonstrate a predominance of immature visually guided reach patterns. This study demonstrates identification of early impairments in inhibitory control using a resource-conscious, low-cost and brief neurobehavioral assessment tool. This provides a window for early interventions to limit problems in executive dysfunction at school age and beyond.

早产儿抑制控制和灵活问题解决的发展进展。
在视觉引导下达到抑制控制允许发展灵活的解决问题的健康婴儿足月出生。抑制控制通常在年龄较大的早产儿中受损,但早产儿抑制控制的发育轨迹尚不清楚。本研究旨在探讨早产儿客体检索任务中抑制控制的发展轨迹。方法:这是一项横断面研究,包括早产儿(少于37周)的方便样本,在5-6、7-8、9-10、11-12、13-15和16-18个月时进行评估。本研究排除了伴有先天性异常、已知遗传疾病、局灶性中风、肿瘤或母体感染艾滋病毒的早产儿童,以及接受国家护理的儿童。每个年龄组的孩子都被要求从一个有一侧开口的有机玻璃盒子里取出一个玩具。在三次试验中旋转开口的方向,并根据Diamond使用的方法对视觉引导的到达模式进行评分。视觉引导的触碰模式从持续的触碰盒子到立即触碰盒子的开口。分析包括Fischer精确检验来比较分类测量,Jonckheere-Terpstra检验来比较有序测量,一般线性模型的f检验来比较连续测量和有序逻辑回归来评估脑损伤和到达模式之间的关系。结果:5-6月、7-8月和9-10月矫正组的大多数早产儿,无论盒子开口的方向如何,都能坚持不懈地击中盒子。在这个早产儿队列中,这种主要的不成熟的视觉引导伸手模式持续到12个月矫正年龄,75%的参与者表现出不成熟的伸手,盒子打开在前面和左边,88%的人表现出盒子打开在右边。结论:在这组早产儿中,抑制控制的发展进程和视觉引导的进展并不遵循Diamond(1994)先前记录的足月典型发育婴儿的发展轨迹。在Diamond的队列中,100%的正常发育婴儿在12个月大时表现出抑制控制和成熟的视觉引导到达模式,而在我们的早产儿队列中,75%的参与者继续表现出不成熟的视觉引导到达模式的优势。本研究展示了利用资源意识、低成本和简短的神经行为评估工具识别抑制控制的早期损伤。这为早期干预提供了一个窗口,以限制学龄期及以后的执行功能障碍问题。
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来源期刊
Developmental Neuroscience
Developmental Neuroscience 医学-发育生物学
CiteScore
4.00
自引率
3.40%
发文量
49
审稿时长
>12 weeks
期刊介绍: ''Developmental Neuroscience'' is a multidisciplinary journal publishing papers covering all stages of invertebrate, vertebrate and human brain development. Emphasis is placed on publishing fundamental as well as translational studies that contribute to our understanding of mechanisms of normal development as well as genetic and environmental causes of abnormal brain development. The journal thus provides valuable information for both physicians and biologists. To meet the rapidly expanding information needs of its readers, the journal combines original papers that report on progress and advances in developmental neuroscience with concise mini-reviews that provide a timely overview of key topics, new insights and ongoing controversies. The editorial standards of ''Developmental Neuroscience'' are high. We are committed to publishing only high quality, complete papers that make significant contributions to the field.
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