Sustained attention processes in very preterm adolescents and their relationship to socio-emotional competence

Very preterm (VPT) adolescents are at high risk of impaired sustained attention processes, as well as behavioral and socio-emotional problems. Previous studies have highlighted altered attentional patterns of brain activation in this population, but results are inconsistent. The current study aims to explore brain activity related to sustained attention in VPT and full-term adolescents aged 11-18, as well as its associations with attentional capacities and socio-emotional competences. Event-related functional MRI (fMRI) was used to assess sustained attention performance and associated brain activations by comparing VPT (n = 34) and their age-matched full-term (FT, n = 28) peers from a previously validated continuous performance task with gradual onset (gradCPT) paradigm, using two different modality versions (i.e., face and scene). In both groups, linear regression analyses were performed to examine associations between attentional and socio-emotional difficulties and brain activations related to sustained attention. Results show preserved sustained attention processes in VPT adolescents, indicated by comparable behavioral attentional performance and cerebral patterns of activations in both groups across the two modalities of the gradCPT. In addition, VPT adolescents showed over-recruitments in posterior occipital areas compared to FT adolescents. Moreover, higher socio-emotional difficulties (i.e., higher anxiety and social difficulties) in VPT were linked to altered activations specifically in the right middle frontal gyrus, occipito-temporal gyri and bilateral cerebellum, but exclusively observed during the face modality of the gradCPT. Overall, these results suggest that despite preserved sustained attention competences, VPT adolescents present a less mature sustained attention cerebral network, particularly during a task with a social context.