Relationships between early postnatal cranial ultrasonography linear measures and neurobehaviour at term-equivalent age in infants born <30 weeks' gestational age

Modality-level obstacles and initiatives to improve representation in fetal, infant, and toddler neuroimaging research samples

Fetal, infant, and toddler (FIT) neuroimaging researchers study early brain development to gain insights into neurodevelopmental processes and identify early markers of neurobiological vulnerabilities to target for intervention. However, the field has historically excluded people from global majority countries and from marginalized communities in FIT neuroimaging research. Inclusive and representative samples are essential for generalizing findings across neuroimaging modalities, such as magnetic resonance imaging, magnetoencephalography, electroencephalography, functional near-infrared spectroscopy, and cranial ultrasonography. These FIT neuroimaging techniques pose unique and overlapping challenges to equitable representation in research through sampling bias, technical constraints, limited accessibility, and insufficient resources. The present article adds to the conversation around the need to improve inclusivity by highlighting modality-specific historical and current obstacles and ongoing initiatives. We conclude by discussing tangible solutions that transcend individual modalities, ultimately providing recommendations to promote equitable FIT neuroscience.

Relationships between early postnatal cranial ultrasonography linear measures and neurodevelopment at 2 years in infants born at <30 weeks' gestational age without major brain injury

OBJECTIVE

To explore relationships of early postnatal cranial ultrasonography (cUS) linear measures of brain size and brain growth with neurodevelopment at 2 years in infants born <30 weeks' gestational age (GA) and free of major brain injury.

DESIGN

Prospective observational cohort study.

SETTING

Tertiary neonatal intensive care unit.

PATIENTS

139 infants born <30 weeks' GA, free of major brain injury on neonatal cUS and without congenital or chromosomal anomalies known to affect neurodevelopment.

INTERVENTION

Linear measures of brain tissue and fluid spaces made from cUS at 1-week, 1-month and 2-months' postnatal age.

MAIN OUTCOME MEASURES

Cognitive, language and motor scores on the Bayley Scales of Infant and Toddler Development, third edition at 2 years' corrected age.

RESULTS

313 scans were evaluated from the 131 children who were assessed at 2 years. Larger measures of the corpus callosum at 1 week, 1 month and 2 months, cerebellum and vermis at 2 months and faster positive growth of the cerebellum and vermis between 1 month and 2 months, were related to higher cognitive and language scores at 2 years. No relation between tissue measures and motor scores was found. Larger measures, and faster rate of increase, of fluid spaces within the first weeks after birth were related to better cognitive, language and motor outcomes at 2 years.

CONCLUSIONS

Early postnatal cUS linear measures of brain tissue were related to cognitive and language development at 2 years in infants born <30 weeks' GA without major brain injury. Relationships between cUS linear measures of fluid spaces in the early postnatal period and later neurodevelopment warrant further exploration.