Extremely preterm (EPT) birth, defined as birth at a gestational age (GA) <28 weeks, can have a lasting impact on cognition throughout the life span. Previous investigations reveal differences in brain structure and connectivity between infants born preterm and full-term (FT), but how does preterm birth impact the adolescent connectome?
Methods:
In this study, we investigate how EPT birth can alter broadscale network organization later in life by comparing resting-state functional magnetic resonance imaging connectome-based parcellations of the entire cortex in adolescents born EPT (N = 22) to age-matched adolescents born FT (GA ≥37 weeks, N = 28). We compare these parcellations to adult parcellations from previous studies and explore the relationship between an individual's network organization and behavior.
Results:
Primary (occipital and sensorimotor) and frontoparietal networks were observed in both groups. However, there existed notable differences in the limbic and insular networks. Surprisingly, the connectivity profile of the limbic network of EPT adolescents was more adultlike than the same network in FT adolescents. Finally, we found a relationship between adolescents' overall cognition score and their limbic network maturity.
Discussion:
Overall, preterm birth may contribute to the atypical development of broadscale network organization in adolescence and may partially explain the observed cognitive deficits.
Impact statement
Extremely preterm (EPT) birth is associated with persistent cognitive and behavioral impairments throughout the life span. Previous research in infants has revealed altered resting-state networks due to EPT, but are these differences also observed in adolescence? In this study, we compare brain-wide parcellations based on patterns in functional connectivity in EPT and full-term adolescents. We found differences in the insula and limbic network, where EPT adolescents show a more adultlike limbic network, and the maturity of personalized limbic networks may predict cognition. These results highlight the effect of preterm birth on brain network organization well beyond infancy.
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