Study brings hope for wellbeing of premature babies
require complicated information transfer tween both hemispheres of the brain.
The cerebellum, located at the base of the brain and playing a crucial role in motor co-ordination, muscle tone and different types of cognitive functioning, including planning ability, also seems susceptible to the effects of early birth.
The hippocampus is further implicated in the learning difficulties, particularly memory impairments, that children born prematurely may demonstrate upon reaching school age.
Yet the reasons why prematurity causes these changes in the brain remains something of a mystery.
What is known is that during the third trimester, the brain is maturing at a rapid rate and the developmental events that are occurring
be- during this period are likely to explain why some parts are more vulnerable than others to alteration by pre-term birth.
Fever, infections, breathing difficulties and hypoxic episodes (during which the babies’ brains receive insufficient oxygen) are also suspected to play a part.
Even the medical interventions designed to save their lives and the environment of the neonatal intensive care unit — typically involving bright lights, loud noises and painful medical procedures — might expose fragile bodies and brains to damaging stimuli.
Their sensory systems are immature and just aren’t ready for all of that input,’’ Anderson says.
What impact it all has on the brain is not known but it is likely to be negative.’’
But there’s no simple or single thing that’s causing these abnormalities in pre-term babies’ brains . . . It’s clear that there are a number of factors that are involved, and many of these are inter-related.’’
While MRI has been in use for many years, it is still not used routinely with very premature infants, despite the high rates of brain abnormalities and neurodevelopmental problems. This is partly because it is difficult to scan very sick infants.
Before Angus went for a repeat scan at two years old, we recorded all the screeches and grinds and other awful sounds from the machine and played that to him at bed-time, so he was more comfortable,’’ says Krieger. But she says it was worth all the trouble: There was huge development in his brain right up to the skull... he’s perhaps still behind his peers, but I could see the difference.’’
Now aged 5, and looking forward to kindergar- ten, Angus’ life is not without its challenges. His muscle tone remains low — which means, for instance, that producing the sounds required for speech is difficult for him, and as a result he continues to have speech therapy and physiotherapy. But as children like Angus start to be scheduled for the scans due when they turn seven, and the associated neuropsychological assessments, Anderson is hopeful of gaining insight into some of the factors that facilitate brain development in this vulnerable group of children.
The group that we’re following up is the largest group of children anywhere in the world to undergo neonatal scans and follow-up,’’ says Anderson. While most infants with severe brain injury develop marked disabilities, others have reasonable outcomes, (and so) identifying the processes associated with such recovery is of major importance.’’