Brain structures and their association with executive and attentional abilities in very preterm 8-year-old children

Very preterm (VPT) children are prone to a variety of neurodevelopmental impairments, particularly regarding their attention and executive functions (i.e., inhibition, shifting, and working memory). Here, we aimed to investigate whether morphometric and connectivity characteristics from key brain regions associated with attention and executive functions may underlie their difficulties. Thirty-three VPT children (M_{gestational age} = 27.22 weeks, SD = 1.36) aged 8-10 years (M_age = 8.85, SD = 0.49, 17 girls) underwent a brain magnetic resonance imaging (MRI) session alongside neurodevelopmental testing. We performed a factor analysis to group the different behavioural variables measuring executive and attentional capacities. The analysis yielded a tripartite structure wherein the first factor was predominantly characterized by inhibitory abilities, the second by attentiveness, and the third by flexibility. To encompass brain regions involved in attention and executive processes, based on functional MRI meta-analyses, we selected the anterior cingulate (ACC) and the dorsolateral prefrontal cortices (DLPFC). From T1-weighted and diffusion MRI images we estimated their cortical thickness, fractional anisotropy, volume, cortical surface area, and betweenness centrality. Significant negative associations were observed for cortical thickness after multiple comparison corrections and adjustments for age and sex. Thinner cortex was related to higher inhibitory, flexibility, and attentional functioning. While these associations were independent of the hemispheres, the association with the inhibitory abilities was stronger in the DLPFC than in the ACC. No associations were found for the other brain measures. These findings provide new insights into brain structures underpinning executive and attentional abilities in VPT children at school age.