The Very Preterm Brain in Young Adulthood: The Neural Correlates of Verbal Paired Associate Learning

Objective To determine whether preterm birth influences functional neuronal development in adulthood. Study design We evaluated adults born very preterm (VPT; <33 weeks of gestation) using a verbal paired-associate learning task within a functional magnetic resonance imaging paradigm. Hippocampi and parahippocampal gyri gray matter volumes were also quantified. Results Despite similar task performance compared with control participants, VPT adults showed increased brain activation in the left parahippocampal and precentral gyri during Encoding, and in the precentral gyrus during Recall. Very preterm participants also had decreased gray matter volume in the left and right hippocampi yet increased gray matter in the left parahippocampal gyrus. In VPT participants alone, activation in the left parahippocampal gyrus during Encoding (VPT > control participants) was positively associated with gray matter volume in the left parahippocampal gyrus, with VPT participants with the youngest gestational age (eg, born 28 weeks or less) having both increased gray matter and functional activation in this region. These results may reflect the process of neural reorganization after early brain injury. Conclusion Preterm birth leads to functional neuronal differences in adulthood, which are meditated by both structural variations in task-specific regions, and gestational age. (J Pediatr 2010;156:889-95).