Abstract
Children and adolescents born very preterm born (i.e., < 32 weeks of gestational age) have an increased risk for adverse cognitive, behavioral, and academic outcomes. Among the abilities most frequently impaired are executive functions, a set of higher order cognitive skills, which allow for adaptive and goal-directed behavior. Despite improved neonatal care and survival rates over recent decades, there is little evidence that such long-term outcomes have substantially improved. Therefore, identifying the neuronal mechanisms underpinning theses deficits and understanding their consequences is crucial to develop tailored interventions and provide adequate support. This thesis contributes to a better understanding by applying different modalities to investigate neurodevelopment within the frame of an ongoing prospective follow-up study, i.e., the EpoKids study. We found altered brain metabolism in the frontal white matter to be related to global executive function deficits in children born very preterm. Widespread differences in global structural connectivity were observed in children born very preterm compared to term-born peers alongside comparable overall inhibition abilities. These findings suggest long-term effects of preterm birth on white matter development reflected in aberrant microstructure and metabolism, which may partly explain executive function deficits, and further underscore the complexity of altered neurodevelopment following very preterm birth. Additionally, we revealed that executive function deficits may contribute to the increase in behavioral problems in very preterm children at school-age. In summary, this thesis provides new insights into the complex associations between neurobiological alterations and long-term consequences following very preterm birth.
Schnider, Barbara