Disruption to functional networks in neonates with perinatal brain injury predicts motor skills at 8 months

Abstract

ObjectiveFunctional connectivity magnetic resonance imaging (fcMRI) of neonates with perinatal brain injury could improve prediction of motor impairment before symptoms manifest, and establish how early brain organization relates to subsequent development. This cohort study is the first to describe and quantitatively assess functional brain networks and their relation to later motor skills in neonates with a diverse range of perinatal brain injuries.MethodsInfants (n = 65, included in final analyses: n = 53) were recruited from the neonatal intensive care unit (NICU) and were stratified based on their age at birth (premature vs. term), and on whether neuropathology was diagnosed from structural MRI. Functional brain networks and a measure of disruption to functional connectivity were obtained from 14 min of fcMRI acquired during natural sleep at term-equivalent age.ResultsDisruption to connectivity of the somatomotor and frontoparietal executive networks predicted motor impairment at 4 and 8 months. This disruption in functional connectivity was not found to be driven by differences between clinical groups, or by any of the specific measures we captured to describe the clinical course.ConclusionfcMRI was predictive over and above other clinical measures available at discharge from the NICU, including structural MRI. Motor learning was affected by disruption to somatomotor networks, but also frontoparietal executive networks, which supports the functional importance of these networks in early development. Disruption to these two networks might be best addressed by distinct intervention strategies.

A machine learning investigation of volumetric and functional MRI abnormalities in adults born preterm

“…These results are similar to previous preterm studies that have found disrupted functional connectivity of sensorimotor networks in premature neonates (Linke et al, 2018) and in perceptual and motor networks more broadly in adults born preterm, including the sensorimotor, visual, and auditory networks . These results are similar to previous preterm studies that have found disrupted functional connectivity of sensorimotor networks in premature neonates (Linke et al, 2018) and in perceptual and motor networks more broadly in adults born preterm, including the sensorimotor, visual, and auditory networks .…”

“…In addition to increased ALFF in thalamus, more widespread increases were found in the pre-and post-central gyri. These results are similar to previous preterm studies that have found disrupted functional connectivity of sensorimotor networks in premature neonates (Linke et al, 2018) and in perceptual and motor networks more broadly in adults born preterm, including the sensorimotor, visual, and auditory networks . Similar primary damage and secondary disease effects may explain these results.…”

Functional Connectome of the Fetal Brain

“…In contrast, the frontoparietal network is still fragmented around birth and during the first year of life (Fransson et al, 2009;Gao et al, 2015;He and Parikh, 2016). Disruptions of the developing somatomotor and frontoparietal functional networks around term equivalent age has been recently linked to motor impairments in the first 4 -8 months of life (Linke et al, 2018). Combining these findings we observe that local development of the functional architecture of the brain before birth is dynamic and develops in a sequential primary to higher cognitive fashion (Gao et al, 2009;Doria et al, 2010;Smyser et al, 2010;Schöpf et al, 2012;Thomason et al, 2013van den Heuvel et al, 2015).…”

Neonatal Functional and Structural Connectivity Are Associated with Cerebral Palsy at Two Years of Age

“…[8][9][10][11][12] Only one published study has correlated neonatal functional connectivity with later outcomes in infants with brain injury, finding that functional connectivity MRI predicted motor impairment at 4 and 8 months of age. 13 Our long-term goal is to determine whether DTI and fMRI can be used as an adjunct to conventional structural clinical MRI in the first few weeks after birth to add additional information for clinicians and families about potential damage to motor pathways. Our goal for this study was to evaluate the prognostic value of DTI and functional connectivity derived from task-based fMRI in infants with perinatal brain injury at <48 weeks' corrected age for motor outcomes at 2 years of age.…”