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Growth of prefrontal and limbic brain regions and anxiety disorders in children born very preterm

Published online by Cambridge University Press:  09 June 2021

Courtney P. Gilchrist
School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia Victorian Infant Brain Studies, Murdoch Children’s Research Institute, Melbourne, Australia Developmental Imaging, Murdoch Children’s Research Institute, Melbourne, Australia
Deanne K. Thompson
Victorian Infant Brain Studies, Murdoch Children’s Research Institute, Melbourne, Australia Developmental Imaging, Murdoch Children’s Research Institute, Melbourne, Australia Department of Paediatrics, University of Melbourne, Melbourne, Australia Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
Bonnie Alexander
Victorian Infant Brain Studies, Murdoch Children’s Research Institute, Melbourne, Australia Developmental Imaging, Murdoch Children’s Research Institute, Melbourne, Australia Department of Neurosurgery, Royal Children’s Hospital, Melbourne, Australia
Claire E. Kelly
Victorian Infant Brain Studies, Murdoch Children’s Research Institute, Melbourne, Australia Developmental Imaging, Murdoch Children’s Research Institute, Melbourne, Australia
Karli Treyvaud
Victorian Infant Brain Studies, Murdoch Children’s Research Institute, Melbourne, Australia La Trobe University, Melbourne, Australia Royal Women's Hospital, Melbourne, Victoria, Australia
Lillian G. Matthews
Monash Biomedical Imaging, Monash University, Melbourne, Australia Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia Brigham and Women’s Hospital, Harvard Medical School, Boston, USA
Leona Pascoe
Victorian Infant Brain Studies, Murdoch Children’s Research Institute, Melbourne, Australia Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
Diana Zannino
Clinical Epidemiology and Biostatistics Unit, Murdoch Children’s Research Institute, Melbourne, Australia
Rosemary Yates
Victorian Infant Brain Studies, Murdoch Children’s Research Institute, Melbourne, Australia Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
Chris Adamson
Developmental Imaging, Murdoch Children’s Research Institute, Melbourne, Australia
Mary Tolcos
School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
Jeanie L. Y. Cheong
Victorian Infant Brain Studies, Murdoch Children’s Research Institute, Melbourne, Australia Royal Women's Hospital, Melbourne, Victoria, Australia Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
Terrie E. Inder
Victorian Infant Brain Studies, Murdoch Children’s Research Institute, Melbourne, Australia Monash Biomedical Imaging, Monash University, Melbourne, Australia
Lex W. Doyle
Victorian Infant Brain Studies, Murdoch Children’s Research Institute, Melbourne, Australia Department of Paediatrics, University of Melbourne, Melbourne, Australia Royal Women's Hospital, Melbourne, Victoria, Australia Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Australia
Angela Cumberland
School of Health and Biomedical Sciences, RMIT University, Bundoora, Australia
Peter J. Anderson*
Victorian Infant Brain Studies, Murdoch Children’s Research Institute, Melbourne, Australia Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Australia
Author for correspondence: Peter J. Anderson, E-mail:



Children born very preterm (VP) display altered growth in corticolimbic structures compared with full-term peers. Given the association between the cortiocolimbic system and anxiety, this study aimed to compare developmental trajectories of corticolimbic regions in VP children with and without anxiety diagnosis at 13 years.


MRI data from 124 VP children were used to calculate whole brain and corticolimbic region volumes at term-equivalent age (TEA), 7 and 13 years. The presence of an anxiety disorder was assessed at 13 years using a structured clinical interview.


VP children who met criteria for an anxiety disorder at 13 years (n = 16) displayed altered trajectories for intracranial volume (ICV, p < 0.0001), total brain volume (TBV, p = 0.029), the right amygdala (p = 0.0009) and left hippocampus (p = 0.029) compared with VP children without anxiety (n = 108), with trends in the right hippocampus (p = 0.062) and left medial orbitofrontal cortex (p = 0.079). Altered trajectories predominantly reflected slower growth in early childhood (0–7 years) for ICV (β = −0.461, p = 0.020), TBV (β = −0.503, p = 0.021), left (β = −0.518, p = 0.020) and right hippocampi (β = −0.469, p = 0.020) and left medial orbitofrontal cortex (β = −0.761, p = 0.020) and did not persist after adjusting for TBV and social risk.


Region- and time-specific alterations in the development of the corticolimbic system in children born VP may help to explain an increase in anxiety disorders observed in this population.

Original Article
Copyright © The Author(s), 2021. Published by Cambridge University Press

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Joint senior authors.


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