Functional connectivity markers of prematurity at birth predict neurodevelopmental outcomes at 6, 12, 24, and 36 months

In the field of developmental neuropsychology, interesting patterns of association between functional brain development at birth and neurodevelopmental outcomes during early childhood have been recently highlighted. In this work, we investigated a population of preterm neonates (n = 32) and (1) derived perinatal functional connectivity (p-FC) markers of prematurity, through direct comparison with a group of at-term borns and (2) tested the role of these markers as predictors of cognitive (COG), language (LANG), and socioemotional (SE) outcomes measured at 6, 12, 24, and 36 months. We did this by means of regression models in which functional markers were tested as predictors, after accounting for variability captured by metrics derived from current clinical practice and which were previously reported to be associated with a higher risk for adverse neurodevelopmental outcomes (i.e., pregnancy, perinatal weight and physiological conditions, and structural brain development variability). Our results revealed that (1) p-FC between the bilateral cerebellar hemispheres predicted SE outcomes at 6 months; (2) p-FC between the bilateral visual cortices predicted COG outcomes at 12 months; (3) p-FC between cortices related to language and emotional control predicted SE outcomes at 12 months; (4 and 5) p-FC between somatosensory motor and higher-order control cortices predicted LANG outcomes at 24 months and COG outcomes at 36 months; and (6 and 7) p-FC between language-related cortices predicted SE and COG outcomes at 36 months. Linear mixed model analyses with pattern mixture modeling, performed to comprehensively explore the longitudinal impact of significant perinatal functional predictors, demonstrated the importance of specific perinatal functional predictors of global neurodevelopment over time. We discuss our results by suggesting that perinatal functional imaging of the brain at rest could represent a very valuable and unique addition to current preterm clinical care routines, to improve pediatric clinical practices of the near future.