The Effect of Intrauterine Growth Restriction on Long-Term Outcome in Very or Extremely Low Birth Weight Infants

The project consisted of two long-term follow-up studies of preterm children addressing the question whether intrauterine growth restriction affects the outcome. Assessment at 5 years of age of 203 children with a birth weight less than 1000 g born in Finland in 1996-1997 showed that 9% of the children had cognitive impairment, 14% cerebral palsy, and 4% needed a hearing aid. The intelligence quotient was lower (p<0.05) than the reference value. Thus, 20% exhibited major, 19% minor disabilities, and 61% had no functional abnormalities. Being small for gestational age (SGA) was associated with sub-optimal growth later. In children born before 27 gestational weeks, the SGA had more neuropsychological disabilities than those appropriate for gestational age (AGA). In another cohort with birth weight less than 1500 g assessed at 5 years of age, echocardiography showed a thickened interventricular septum and a decreased left ventricular end-diastolic diameter in both SGA and AGA born children. They also had a higher systolic blood pressure than the reference. Laser-Doppler flowmetry showed different endothelium-dependent and -independent vasodilation responses in the AGA children compared to those of the controls. SGA was not associated with cardio-vascular abnormalities. Auditory event-related potentials (AERPs) were recorded using an oddball paradigm with frequency deviants (standard tone 500 Hz and deviant 750-Hz with 10% probability). At term, the P350 was smaller in SGA and AGA infants than in controls. At 12 months, the automatic change detection peak (mismatch negativity, MMN) was observed in the controls. However, the pre-term infants had a difference positivity that correlated with their neurodevelopment scores. At 5 years of age, the P1-deflection, which reflects primary auditory processing, was smaller, and the MMN larger in the preterm than in the control children. Even with a challenging paradigm or a distraction paradigm, P1 was smaller in the preterm than in the control children. The SGA and AGA children showed similar AERP responses. Prematurity is a major risk factor for abnormal brain development. Preterm children showed signs of cardiovascular abnormality suggesting that prematurity per se may carry a risk for later morbidity. The small positive amplitudes in AERPs suggest persisting altered auditory processing in the preterm in-fants.

Music in the recovering brain

Listening to music involves a widely distributed bilateral network of brain regions that controls many auditory perceptual, cognitive, emotional, and motor functions. Exposure to music can also temporarily improve mood, reduce stress, and enhance cognitive performance as well as promote neural plasticity. However, very little is currently known about the relationship between music perception and auditory and cognitive processes or about the potential therapeutic effects of listening to music after neural damage. This thesis explores the interplay of auditory, cognitive, and emotional factors related to music processing after a middle cerebral artery (MCA) stroke. In the acute recovery phase, 60 MCA stroke patients were randomly assigned to a music listening group, an audio book listening group, or a control group. All patients underwent neuropsychological assessments, magnetoencephalography (MEG) measurements, and magnetic resonance imaging (MRI) scans repeatedly during a six-month post-stroke period. The results revealed that amusia, a deficit of music perception, is a common and persistent deficit after a stroke, especially if the stroke affects the frontal and temporal brain areas in the right hemisphere. Amusia is clearly associated with deficits in both auditory encoding, as indicated by the magnetic mismatch negativity (MMNm) response, and domain-general cognitive processes, such as attention, working memory, and executive functions. Furthermore, both music and audio book listening increased the MMNm, whereas only music listening improved the recovery of verbal memory and focused attention as well as prevented a depressed and confused mood during the first post-stroke months. These findings indicate a close link between musical, auditory, and cognitive processes in the brain. Importantly, they also encourage the use of listening to music as a rehabilitative leisure activity after a stroke and suggest that the auditory environment can induce long-term plastic changes in the recovering brain.

Neurocognitive processing of inflected and derived words

The representation of morphologically complex words in the mental lexicon and their neurocognitive processing has been a vigorously debated topic in psycholinguistics and the cognitive neuroscience of language. This thesis investigates the effect of stimulus modality on morphological processing, the spatiotemporal dynamics of the neural processing of inflected (e.g., work+ed ) and derived (e.g., work+er ) words and their interaction, using the Finnish language. Overall, the results suggest that the constituent morphemes of isolated written and spoken inflected words are accessed separately, whereas spoken derived words activate both their full form and the constituent morphemes. The processing of both spoken and written inflected words elicited larger N400 responses than monomorphemic words (Study I), whereas the responses to spoken derived words did not differ from those to monomorphemic words (Study IV). Spoken inflected words elicited a larger left-lateralized negativity and greater source strengths in the left temporal cortices than derived words (Study IV). Thus, the results suggest different cortical processing for derived and inflected words. Moreover, the neural mechanisms underlying inflection and derivation seem to be not only different, but also independent as indexed by the linear summation of the responses to derived and inflected stimuli in a combined (derivation+inflection) condition (Study III). Furthermore, the processing of meaningless, spoken derived pseudowords was more difficult than for existing derived words, indexed by a larger N400-type effect for the pseudowords. However, no differences were observed between meaningful derived pseudowords and existing derived words (Study II). The results of Study II suggest that semantic compatibility between morphemes seems to have a crucial role in a successful morphological analysis. As a methodological note, time-locking the auditory event-related potentials/fields (ERP/ERF) to the suffix onset revealed the processes related to morphological analysis more precisely (Studies II and IV), which also enables comparison of the neural processes in different modalities (Study I).