Neonatal multi-modal cortical profiles predict 18-month developmental outcomes

Gestational age at birth and cognitive outcomes in term-born children: Evidence from Chinese and British cohorts

INTRODUCTION

Older gestational age (GA) has been associated with more favourable cognitive outcomes in preterm children. Recent evidence suggests this may also apply to term-born children. This study aims to examine the association between GA and early neurodevelopmental outcomes in children born at term in China and the UK.

METHODS

Participants were term-born children from two cohorts, the Sichuan Multi-stratified Infants and Early Life (SMILE) study in China and the Developing Human Connectome Project (dHCP) in the UK. Early cognitive outcomes were assessed at 6 months in the SMILE study, and at 18 months in the dHCP. Linear regression models were conducted to examine the association between GA at birth and early cognitive outcomes in each cohort separately.

RESULTS

A sample of 1245 participants from the SMILE study and 406 participants for the dHCP were included in the analysis. In the SMILE study, longer GA was associated with better mental developmental (B = 2.47 [1.60, 3.34], P < .001) and psychomotor outcomes (B = 2.91 [2.01, 3.82], P < .001), after controlling for sex, parental education, family yearly income, maternal age, maternal depressive symptoms, and birth weight; in the dHCP, longer GA was associated with better cognitive (B = 1.35 [0.33, 2.37], P = .010) and motor outcomes (B = 1.49 [0.59, 2.39], P = .001), after controlling for sex, relative social deprivation, maternal depressive symptoms and birth weight.

CONCLUSIONS

Older GA in term-born toddlers is associated with more favourable developmental outcomes across different cultural contexts.

Early Development and Co-Evolution of Microstructural and Functional Brain Connectomes: A Multi-Modal MRI Study in Preterm and Full-Term Infants

Functional networks characterized by coherent neural activity across distributed brain regions have been observed to emerge early in neurodevelopment. Synchronized maturation across regions that relate to functional connectivity (FC) could be partially reflected in the developmental changes in underlying microstructure. Nevertheless, covariation of regional microstructural properties, termed "microstructural connectivity" (MC), and its relationship to the emergence of functional specialization during the early neurodevelopmental period remain poorly understood. We investigated the evolution of MC and FC postnatally across a set of cortical and subcortical regions, focusing on 45 preterm infants scanned longitudinally, and compared to 45 matched full-term neonates as part of the developing Human Connectome Project (dHCP) using direct comparisons of grey-matter connectivity strengths as well as network-based analyses. Our findings revealed a global strengthening of both MC and FC with age, with connection-specific variability influenced by the connection maturational stage. Prematurity at term-equivalent age was associated with significant connectivity disruptions, particularly in FC. During the preterm period, direct comparisons of MC and FC strength showed a positive linear relationship, which seemed to weaken with development. On the other hand, overlaps between MC- and FC-derived networks (estimated with Mutual Information) increased with age, suggesting a potential convergence towards a shared underlying network structure that may support the co-evolution of microstructural and functional systems. Our study offers novel insights into the dynamic interplay between microstructural and functional brain development and highlights the potential of MC as a complementary descriptor for characterizing brain network development and alterations due to perinatal insults such as premature birth.

White-matter controllability at birth predicts social engagement and language outcomes in toddlerhood

Social engagement and language are connected through early development. Alterations in their development can have a prolonged impact on children's lives. However, the role of white matter at birth in this ongoing connection is less well-known. Here, we investigate how white matter at birth jointly supports social engagement and language outcomes in 642 infants. We use edge-centric network control theory to quantify edge controllability, or the ability of white-matter connections to drive transitions between diverse brain states, at 1 month. Next, we used connectome-based predictive modeling (CPM) to predict the Quantitative Checklist for Autism in Toddlers (Q-CHAT) for social engagement risks and the Bayley Scales of Infant and Toddler Development (BSID-III) for language skills at 18 months from edge controllability. We created the social engagement network (SEN) to predict Q-CHAT scores and the language network (LAN) to predict BSID-III scores. The SEN and LAN were complex, spanning the whole brain. They also significantly overlapped in anatomy and generalized across measures. Controllability in the SEN at 1 month partially mediated associations between Q-CHAT and BSID-III language scores at 18 months. Further, controllability in the SEN significantly differed between term and preterm infants and predicted Q-CHAT scores in an external sample of preterm infants. Together, our results suggest that the intertwined nature of social engagement and language development is rooted in an infant's white-matter controllability.

Significance Statement

During infancy and toddlerhood, social engagement and language emerge together. Delays are often observed in both simultaneously. These interactions persist into later childhood, potentially affecting life quality. We reveal that the interplay between social engagement and language milestones in toddlerhood is rooted in the infant's structural connectivity, which may assist in early risk identification of developmental delays. Insights into the early brain foundations for emerging social engagement and language skills may open opportunities for individualized interventions to improve developmental outcomes.

Shared and distinct morphometric similarity network abnormalities in generalized anxiety disorder, posttraumatic stress disorder and social anxiety disorder

BACKGROUND

The high comorbidity and symptom overlap of generalized anxiety disorder (GAD), posttraumatic stress disorder (PTSD), and social anxiety disorder (SAD), has led to the study of their shared and disorder-specific neural substrates. However, the morphometric similarity network (MSN) differences among these disorders remain unknown.

METHODS

MSN derived from T1-weighted images in patients of GAD, PTSD, and SAD, and health controls (HC) using a Siemens 3T magnetic resonance imaging system. Covariance analysis and post hoc tests were used to investigate group differences. In addition, the relationship between MSN and clinical characteristics was analyzed.

RESULTS

Increased morphometric similarity (MS) between left bankssts (BA22, superior temporal cortex, STC) and right precentral gyrus, and decreased MS between left precentral gyrus and right cuneus_part1/part2, and between right rostral middle frontal cortex (rMFC) and right STC were common in GAD and PTSD relative to HC and SAD. Compared to the other three groups, SAD exhibited disorder-specific alterations of increased MS between right rMFC and right STC, and between left cuneus and right inferior parietal cortex. Additionally, increased regional MSN in left precentral gyrus was found in PTSD compared to HC and SAD. A mild positive correlation of the MS value between left bankssts and right precentral gyrus and the Hamilton Anxiety Rating Scale scores (uncorrected p = 0.041) was found in PTSD.

CONCLUSIONS

Our study provides the first evidence for common and distinct brain MSN abnormalities underlying the pathophysiology of GAD, PTSD, and SAD, which may aid in differential diagnosis and determining potential disorder-specific intervention targets.

Structural MRI of brain similarity networks

Recent advances in structural MRI analytics now allow the network organization of individual brains to be comprehensively mapped through the use of the biologically principled metric of anatomical similarity. In this Review, we offer an overview of the measurement and meaning of structural MRI similarity, especially in relation to two key assumptions that often underlie its interpretation: (i) that MRI similarity can be representative of architectonic similarity between cortical areas and (ii) that similar areas are more likely to be axonally connected, as predicted by the homophily principle. We first introduce the historical roots and technical foundations of MRI similarity analysis and compare it with the distinct MRI techniques of structural covariance and tractography analysis. We contextualize this empirical work with two generative models of homophilic networks: an economic model of cost-constrained connectional homophily and a heterochronic model of ontogenetically phased cortical maturation. We then review (i) studies of the genetic and transcriptional architecture of MRI similarity in population-averaged and disorder-specific contexts and (ii) developmental studies of normative cohorts and clinical studies of neurodevelopmental and neurodegenerative disorders. Finally, we prioritize knowledge gaps that must be addressed to consolidate structural MRI similarity as an accessible, valid marker of the architecture and connectivity of an individual brain network.

Profiling cortical morphometric similarity in perinatal brains: Insights from development, sex difference, and inter-individual variation

The topological organization of the macroscopic cortical networks important for the development of complex brain functions. However, how the cortical morphometric organization develops during the third trimester and whether it demonstrates sexual and individual differences at this particular stage remain unclear. Here, we constructed the morphometric similarity network (MSN) based on morphological and microstructural features derived from multimodal MRI of two independent cohorts (cross-sectional and longitudinal) scanned at 30-44 postmenstrual weeks (PMW). Sex difference and inter-individual variations of the MSN were also examined on these cohorts. The cross-sectional analysis revealed that both network integration and segregation changed in a nonlinear biphasic trajectory, which was supported by the results obtained from longitudinal analysis. The community structure showed remarkable consistency between bilateral hemispheres and maintained stability across PMWs. Connectivity within the primary cortex strengthened faster than that within high-order communities. Compared to females, male neonates showed a significant reduction in the participation coefficient within prefrontal and parietal cortices, while their overall network organization and community architecture remained comparable. Furthermore, by using the morphometric similarity as features, we achieved over 65 % accuracy in identifying an individual at term-equivalent age from images acquired after birth, and vice versa. These findings provide comprehensive insights into the development of morphometric similarity throughout the perinatal cortex, enhancing our understanding of the establishment of neuroanatomical organization during early life.

Adopting a child perspective for exposome research on mental health and cognitive development - Conceptualisation and opportunities

Mental disorders among children and adolescents pose a significant global challenge. The exposome framework covering the totality of internal, social and physical exposures over a lifetime provides opportunities to better understand the causes of and processes related to mental health, and cognitive functioning. The paper presents a conceptual framework on exposome, mental health, and cognitive development in children and adolescents, with potential mediating pathways, providing a possibility for interventions along the life course. The paper underscores the significance of adopting a child perspective to the exposome, acknowledging children's specific vulnerability, including differential exposures, susceptibility of effects and capacity to respond; their susceptibility during development and growth, highlighting neurodevelopmental processes from conception to young adulthood that are highly sensitive to external exposures. Further, critical periods when exposures may have significant effects on a child's development and future health are addressed. The paper stresses that children's behaviour, physiology, activity pattern and place for activities make them differently vulnerable to environmental pollutants, and calls for child-specific assessment methods, currently lacking within today's health frameworks. The importance of understanding the interplay between structure and agency is emphasized, where agency is guided by social structures and practices and vice-versa. An intersectional approach that acknowledges the interplay of social and physical exposures as well as a global and rural perspective on exposome is further pointed out. To advance the exposome field, interdisciplinary efforts that involve multiple scientific disciplines are crucial. By adopting a child perspective and incorporating an exposome approach, we can gain a comprehensive understanding of how exposures impact children's mental health and cognitive development leading to better outcomes.

Individual-level brain morphological similarity networks: Current methodologies and applications

AIMS

The human brain is an extremely complex system in which neurons, clusters of neurons, or regions are connected to form a complex network. With the development of neuroimaging techniques, magnetic resonance imaging (MRI)-based brain networks play a key role in our understanding of the intricate architecture of human brain. Among them, the structural MRI-based brain morphological network approach has attracted increasing attention due to the advantages in data acquisition, image quality, and in revealing the structural organizing principles intrinsic to the brain. This review is to summarize the methodology and related applications of individual-level morphological networks.

BACKGROUND

There have been a growing number of studies related to brain morphological similarity networks. Conventional morphological networks are intersubject covariance networks constructed using a certain morphological indicator of a group of subjects; individual-level morphological networks, on the other hand, measure the morphological similarity between brain regions for individual brains and can reflect the morphological information of single subjects. In recent years, individual morphological networks have demonstrated significant worth in exploring the topological changes of the human brain under both normal and disease conditions. Such studies provided novel perspectives for understanding human brain development and exploring the pathological mechanisms of neuropsychiatric disorders.

CONCLUSION

This paper mainly focuses on the studies of brain morphological networks at the individual level, introduces several ways for network construction, reviews representative work in this field, and finally points out current problems and future directions.

Neurocognitive Dysfunction After Treatment for Pediatric Brain Tumors: Subtype-Specific Findings and Proposal for Brain Network-Informed Evaluations

The increasing number of long-term survivors of pediatric brain tumors requires us to incorporate the most recent knowledge derived from cognitive neuroscience into their oncological treatment. As the lesion itself, as well as each treatment, can cause specific neural damage, the long-term neurocognitive outcomes are highly complex and challenging to assess. The number of neurocognitive studies in this population grows exponentially worldwide, motivating modern neuroscience to provide guidance in follow-up before, during and after treatment. In this review, we provide an overview of structural and functional brain connectomes and their role in the neuropsychological outcomes of specific brain tumor types. Based on this information, we propose a theoretical neuroscientific framework to apply appropriate neuropsychological and imaging follow-up for future clinical care and rehabilitation trials.

Developmental Pattern of Individual Morphometric Similarity Network in the Human Fetal Brain

The development of the cerebral cortex during the fetal period is a complex yet well-coordinated process. MRI-based morphological brain network provides a powerful tool for describing this process at a network level. Due to the challenges of in-utero MRI acquisition and image processing, the fetal morphological brain network has not been established. In this study, utilizing high-resolution in-utero MRI data, we constructed an individual morphometric similarity network for each fetus based on multiple cortical features. The spatiotemporal development of morphological connections was described at the level of edge, node, and lobe, respectively. Based on graph theoretical method, the topology structure of fetal morphological network was characterized. Edge analysis demonstrated an increase of morphological dissimilarity between hemispheres with gestational age, especially for the parietal cortex. The limbic and parieto-occipital regions exhibited the most drastic changes of morphological connections at both the edge and node levels. Between- and within-lobe analysis illustrated that the limbic lobe became more similar to other lobes, while the parietal and occipital lobes became more dissimilar to other lobes. Graph theoretical analysis indicated that the small-world structure of the fetal morphological network appeared as early as 22 weeks and that the network topology exhibited an enhanced integration and reduced segregation during prenatal development. The findings obtained from the preterm-born neonates agreed well with those of the fetuses. In summary, this study fills a gap in prenatal morphological brain network research and provides a piece of important evidence for understanding the normal development of fetal brain connectome during the second-third trimester.

ICAM-Reg: Interpretable Classification and Regression With Feature Attribution for Mapping Neurological Phenotypes in Individual Scans

An important goal of medical imaging is to be able to precisely detect patterns of disease specific to individual scans; however, this is challenged in brain imaging by the degree of heterogeneity of shape and appearance. Traditional methods, based on image registration, historically fail to detect variable features of disease, as they utilise population-based analyses, suited primarily to studying group-average effects. In this paper we therefore take advantage of recent developments in generative deep learning to develop a method for simultaneous classification, or regression, and feature attribution (FA). Specifically, we explore the use of a VAE-GAN (variational autoencoder - general adversarial network) for translation called ICAM, to explicitly disentangle class relevant features, from background confounds, for improved interpretability and regression of neurological phenotypes. We validate our method on the tasks of Mini-Mental State Examination (MMSE) cognitive test score prediction for the Alzheimer's Disease Neuroimaging Initiative (ADNI) cohort, as well as brain age prediction, for both neurodevelopment and neurodegeneration, using the developing Human Connectome Project (dHCP) and UK Biobank datasets. We show that the generated FA maps can be used to explain outlier predictions and demonstrate that the inclusion of a regression module improves the disentanglement of the latent space. Our code is freely available on GitHub https://github.com/CherBass/ICAM.

Adolescent neurodevelopment and psychopathology: The interplay between adversity exposure and genetic risk for accelerated brain ageing

In adulthood, stress exposure and genetic risk heighten psychological vulnerability by accelerating neurobiological senescence. To investigate whether molecular and brain network maturation processes play a similar role in adolescence, we analysed genetic, as well as longitudinal task neuroimaging (inhibitory control, incentive processing) and early life adversity (i.e., material deprivation, violence) data from the Adolescent Brain and Cognitive Development study (N = 980, age range: 9-13 years). Genetic risk was estimated separately for Major Depressive Disorder (MDD) and Alzheimer's Disease (AD), two pathologies linked to stress exposure and allegedly sharing a causal connection (MDD-to-AD). Adversity and genetic risk for MDD/AD jointly predicted functional network segregation patterns suggestive of accelerated (GABA-linked) visual/attentional, but delayed (dopamine [D2]/glutamate [GLU5R]-linked) somatomotor/association system development. A positive relationship between brain maturation and psychopathology emerged only among the less vulnerable adolescents, thereby implying that normatively maladaptive neurodevelopmental alterations could foster adjustment among the more exposed and genetically more stress susceptible youths. Transcriptomic analyses suggested that sensitivity to stress may underpin the joint neurodevelopmental effect of adversity and genetic risk for MDD/AD, in line with the proposed role of negative emotionality as a precursor to AD, likely to account for the alleged causal impact of MDD on dementia onset.

Maternal depressive symptoms, neonatal white matter, and toddler social-emotional development

Maternal prenatal depression is associated with increased likelihood of neurodevelopmental and psychiatric conditions in offspring. The relationship between maternal depression and offspring outcome may be mediated by in-utero changes in brain development. Recent advances in magnetic resonance imaging (MRI) have enabled in vivo investigations of neonatal brains, minimising the effect of postnatal influences. The aim of this study was to examine associations between maternal prenatal depressive symptoms, infant white matter, and toddler behaviour. 413 mother-infant dyads enrolled in the developing Human Connectome Project. Mothers completed the Edinburgh Postnatal Depression Scale (median = 5, range = 0-28, n = 52 scores ≥ 11). Infants (n = 223 male) (median gestational age at birth = 40 weeks, range 32.14-42.29) underwent MRI (median postmenstrual age at scan = 41.29 weeks, range 36.57-44.71). Fixel-based fibre metrics (mean fibre density, fibre cross-section, and fibre density modulated by cross-section) were calculated from diffusion imaging data in the left and right uncinate fasciculi and cingulum bundle. For n = 311, internalising and externalising behaviour, and social-emotional abilities were reported at a median corrected age of 18 months (range 17-24). Statistical analysis used multiple linear regression and mediation analysis with bootstrapping. Maternal depressive symptoms were positively associated with infant fibre density in the left (B = 0.0005, p = 0.003, q = 0.027) and right (B = 0.0006, p = 0.003, q = 0.027) uncinate fasciculus, with left uncinate fasciculus fibre density, in turn, positively associated with social-emotional abilities in toddlerhood (B = 105.70, p = 0.0007, q = 0.004). In a mediation analysis, higher maternal depressive symptoms predicted toddler social-emotional difficulties (B = 0.342, t(307) = 3.003, p = 0.003), but this relationship was not mediated by fibre density in the left uncinate fasciculus (Sobel test p = 0.143, bootstrapped indirect effect = 0.035, SE = 0.02, 95% CI: [-0.01, 0.08]). There was no evidence of an association between maternal depressive and cingulum fibre properties. These findings suggest that maternal perinatal depressive symptoms are associated with neonatal uncinate fasciculi microstructure, but not fibre bundle size, and toddler behaviour.