Development of structure and function in the infant brain: implications for cognition, language and social behaviour

Parent attention-orienting behavior is associated with neural entropy in infancy

Parents use joint attention to direct infants to environmental stimuli. We hypothesized that infants whose parents provide more bids for joint attention will display a more complex neural response when viewing social scenes. Sixty-one 8-month-old infants underwent electroencephalography (EEG) while viewing videos of joint- and parallel-play and participated in a free play interaction. EEG data was analyzed using multiscale entropy, which quantifies neural variability. Free play interactions assessed parent alternating gaze, a behavioral mechanism for directing attention to environmental cues. We found a significant positive association between parent alternating gaze and neural entropy in frontal and central regions. These results suggest a relationship between parent behavior and infant neural mechanisms that regulate social attention, underlying the importance of parental cues in forming neural networks.

Baby Observational Selective Control AppRaisal (BabyOSCAR): Convergent and discriminant validity and reliability in infants with and without spastic cerebral palsy

AIM

To describe the development of an observational measure of spontaneous independent joint motion in infants with spastic cerebral palsy (CP), the Baby Observational Selective Control AppRaisal (BabyOSCAR), and to test its convergent validity and reliability.

METHOD

A retrospective sample of 75 infants (45 with spastic CP and 30 without CP) at 3 months of age were scored with the BabyOSCAR and compared with diagnosis of spastic CP, limbs affected, and Gross Motor Function Classification level at 2 years of age or later for convergent validity using t-tests, Kruskal-Wallis tests, and Spearman's rank correlation coefficients. BabyOSCAR interrater and test-retest reliability was also evaluated using intraclass correlation coefficients.

RESULTS

Infants with spastic CP had significantly lower BabyOSCAR scores than children without CP (p < 0.001) and scores were significantly correlated with Gross Motor Function Classification System levels (p < 0.001). Children with unilateral CP had significantly higher asymmetry scores than children with bilateral CP or no CP (p < 0.01). Interrater and test-retest reliabilities were good to excellent.

INTERPRETATION

Reductions in independent joint control measured in infancy are a hallmark of eventual diagnosis of spastic CP, and influence gross motor function later in childhood (with or without a diagnosis of CP).

Parent attention-orienting behavior is associated with neural entropy in infancy

Parents play a significant role in directing infant's attention to environmental stimuli via joint attention. We hypothesized that infants whose parents provide more bids for joint attention will display a more complex neural response when viewing social scenes. Sixty-one 8-month-old infants underwent electroencephalography (EEG) while viewing videos of joint- and parallel-play and participated in a parent-infant free play interaction. EEG data was analyzed using multiscale entropy, which quantifies moment-to-moment neural variability. Free play interactions were coded for parent alternating gaze, a behavioral mechanism for directing attention to environmental cues. We found a significant positive association between parent alternating gaze and neural entropy in frontal and central brain regions. These results suggest a relationship between parent behavior and infant neural mechanisms that regulate social attention, underlying the importance of parent cues in the formation of neural networks in infancy.

Microstate Analysis of Continuous Infant EEG: Tutorial and Reliability

Microstate analysis of resting-state EEG is a unique data-driven method for identifying patterns of scalp potential topographies, or microstates, that reflect stable but transient periods of synchronized neural activity evolving dynamically over time. During infancy - a critical period of rapid brain development and plasticity - microstate analysis offers a unique opportunity for characterizing the spatial and temporal dynamics of brain activity. However, whether measurements derived from this approach (e.g., temporal properties, transition probabilities, neural sources) show strong psychometric properties (i.e., reliability) during infancy is unknown and key information for advancing our understanding of how microstates are shaped by early life experiences and whether they relate to individual differences in infant abilities. A lack of methodological resources for performing microstate analysis of infant EEG has further hindered adoption of this cutting-edge approach by infant researchers. As a result, in the current study, we systematically addressed these knowledge gaps and report that most microstate-based measurements of brain organization and functioning except for transition probabilities were stable with four minutes of video-watching resting-state data and highly internally consistent with just one minute. In addition to these results, we provide a step-by-step tutorial, accompanying website, and open-access data for performing microstate analysis using a free, user-friendly software called Cartool. Taken together, the current study supports the reliability and feasibility of using EEG microstate analysis to study infant brain development and increases the accessibility of this approach for the field of developmental neuroscience.

Automated Prediction of Infant Cognitive Development Risk by Video: A Pilot Study

OBJECTIVE

Cognition is an essential human function, and its development in infancy is crucial. Traditionally, pediatricians used clinical observation or medical imaging to assess infants' current cognitive development (CD) status. The object of pediatricians' greater concern is however their future outcomes, because high-risk infants can be identified early in life for intervention. However, this opportunity has not yet been realized. Fortunately, some recent studies have shown that the general movement (GM) performance of infants around 3-4 months after birth might reflect their future CD status, which gives us an opportunity to achieve this goal by cameras and artificial intelligence.

METHODS

First, infants' GM videos were recorded by cameras, from which a series of features reflecting their bilateral movement symmetry (BMS) were extracted. Then, after at least eight months of natural growth, the infants' CD status was evaluated by the Bayley Infant Development Scale, and they were divided into high-risk and low-risk groups. Finally, the BMS features extracted from the early recorded GM videos were fed into the classifiers, using late infant CD risk assessment as the prediction target.

RESULTS

The area under the curve, recall and precision values reached 0.830, 0.832, and 0.823 for two-group classification, respectively.

CONCLUSION

This pilot study demonstrates that it is possible to automatically predict the CD of infants around the age of one year based on their GMs recorded early in life.

SIGNIFICANCE

This study not only helps clinicians better understand infant CD mechanisms, but also provides an economical, portable and non-invasive way to screen infants at high-risk early to facilitate their recovery.

Ontogeny of collective behaviour

During their lifetime, superorganisms, like unitary organisms, undergo transformations that change the machinery of their collective behaviour. Here, we suggest that these transformations are largely understudied and propose that more systematic research into the ontogeny of collective behaviours is needed if we hope to better understand the link between proximate behavioural mechanisms and the development of collective adaptive functions. In particular, certain social insects engage in self-assemblage, forming dynamic and physically connected architectures with striking similarities to developing multicellular organisms, making them good model systems for ontogenetic studies of collective behaviour. However, exhaustive time series and three-dimensional data are required to thoroughly characterize the different life stages of the collective structures and the transitions between these stages. The well-established fields of embryology and developmental biology offer practical tools and theoretical frameworks that could speed up the acquisition of new knowledge about the formation, development, maturity and dissolution of social insect self-assemblages and, by extension, other superorganismal behaviours. We hope that this review will encourage an expansion of the ontogenetic perspective in the field of collective behaviour and, in particular, in self-assemblage research, which has far-reaching applications in robotics, computer science and regenerative medicine. This article is part of a discussion meeting issue 'Collective behaviour through time'.

Developmental Exposure to Bisphenol a Degrades Auditory Cortical Processing in Rats

Developmental exposure to bisphenol A (BPA), an endocrine-disrupting contaminant, impairs cognitive function in both animals and humans. However, whether BPA affects the development of primary sensory systems, which are the first to mature in the cortex, remains largely unclear. Using the rat as a model, we aimed to record the physiological and structural changes in the primary auditory cortex (A1) following lactational BPA exposure and their possible effects on behavioral outcomes. We found that BPA-exposed rats showed significant behavioral impairments when performing a sound temporal rate discrimination test. A significant alteration in spectral and temporal processing was also recorded in their A1, manifested as degraded frequency selectivity and diminished stimulus rate-following by neurons. These post-exposure effects were accompanied by changes in the density and maturity of dendritic spines in A1. Our findings demonstrated developmental impacts of BPA on auditory cortical processing and auditory-related discrimination, particularly in the temporal domain. Thus, the health implications for humans associated with early exposure to endocrine disruptors such as BPA merit more careful examination.

Newborn differential DNA methylation and subcortical brain volumes as early signs of severe neurodevelopmental delay in a South African Birth Cohort Study

OBJECTIVES

Early detection of neurodevelopmental delay is crucial for intervention and treatment strategies. We analysed associations between newborn DNA methylation (DNAm), neonatal magnetic resonance imaging (MRI) neuroimaging data, and neurodevelopment.

METHODS

Neurodevelopment was assessed in 161 children from the South African Drakenstein Child Health Study at 2 years of age using the Bayley Scales of Infant and Toddler Development III. We performed an epigenome-wide association study of neurodevelopmental delay using DNAm from cord blood. Subsequently, we analysed if associations between DNAm and neurodevelopmental delay were mediated by altered neonatal brain volumes (subset of 51 children).

RESULTS

Differential DNAm at SPTBN4 (cg26971411, Δbeta = -0.024, p-value = 3.28 × 10-08), and two intergenic regions (chromosome 11: cg00490349, Δbeta = -0.036, p-value = 3.02 × 10-08; chromosome 17: cg15660740, Δbeta = -0.078, p-value = 6.49 × 10-08) were significantly associated with severe neurodevelopmental delay. While these associations were not mediated by neonatal brain volume, neonatal caudate volumes were independently associated with neurodevelopmental delay, particularly in language (Δcaudate volume = 165.30 mm3, p = 0.0443) and motor (Δcaudate volume = 365.36 mm3, p-value = 0.0082) domains.

CONCLUSIONS

Differential DNAm from cord blood and increased neonatal caudate volumes were independently associated with severe neurodevelopmental delay at 2 years of age. These findings suggest that neurobiological signals for severe developmental delay may be detectable in very early life.

Influences of infants' and mothers' contingent vocal responsiveness on young infants' vocal social bids in the Still Face Task

Infants' social bids in the still face phase of the Still Face Task demonstrate their emerging sense of self agency as these behaviors happen in the absence of the partner's social overtures. The study examined the role of infants' contingent responsiveness to their mothers in social interactions on their social bidding to the mother when she becomes unresponsive. Social bids are non-distress vocalizations or smiles while looking at the unresponsive partner. Infants and their mothers longitudinally engaged in the Still Face Task when infants were one, two, and three months. At two months, infant non-distress vocalizations and smiles and contingent vocal and smiling responsiveness increased in the initial interactive phase and vocal and smile social bids increased in the still face phase. Infant contingent vocal responsiveness predicted infant vocal social bids but infant contingent smiling responsiveness did not predict infant smile social bids. Infant contingent vocal responsiveness was a stronger predictor than infant non-distress vocalizations per se of infant vocal social bids at two and three months. However, maternal contingent vocal responsiveness was the primary predictor of infant vocal social bids at these ages. Maternal contingent responsiveness to infant behavior allows infants to sense their agency in affecting their mothers' behavior. Yet infants are active participants, becoming contingently responsive to their mothers, which facilitates their awareness that they are effective agents in instigating social interaction, as demonstrated by social bids.

Research Summit V: Optimizing Transitions From Infancy to Early Adulthood in Children With Neuromotor Conditions

PURPOSE

The purpose of this executive summary is to review the process and outcomes of the Academy of Pediatric Physical Therapy Research Summit V, "Optimizing transitions from infancy to young adulthood in children with neuromotor disabilities: biological and environmental factors to support functional independence."

SUMMARY OF KEY POINTS

An interdisciplinary group of researchers, representatives from funding agencies, and individuals with neuromotor disabilities and their parents participated in an intensive 2.5-day summit to determine research priorities to optimize life transitions for children with neuromotor disabilities. Recommended priorities for research included (1) promoting self-determination and self-efficacy of individuals with neuromotor disabilities and their families, (2) best care at the right time: evidence-based best practice care, led and navigated by families seamlessly across the lifespan, (3) strengthening connections between developmental domains to enhance function and participation, and (4) optimal dosing and timing to support adaptive bone, muscle, and brain plasticity across the lifespan.

Developmental organization of neural dynamics supporting auditory perception

Purpose:

A prominent view of language acquisition involves learning to ignore irrelevant auditory signals through functional reorganization, enabling more efficient processing of relevant information. Yet, few studies have characterized the neural spatiotemporal dynamics supporting rapid detection and subsequent disregard of irrelevant auditory information, in the developing brain. To address this unknown, the present study modeled the developmental acquisition of cost-efficient neural dynamics for auditory processing, using intracranial electrocorticographic responses measured in individuals receiving standard-of-care treatment for drug-resistant, focal epilepsy. We also provided evidence demonstrating the maturation of an anterior-to-posterior functional division within the superior-temporal gyrus (STG), which is known to exist in the adult STG.

Methods:

We studied 32 patients undergoing extraoperative electrocorticography (age range: eight months to 28 years) and analyzed 2,039 intracranial electrode sites outside the seizure onset zone, interictal spike-generating areas, and MRI lesions. Patients were given forward (normal) speech sounds, backward-played speech sounds, and signal-correlated noises during a task-free condition. We then quantified sound processing-related neural costs at given time windows using high-gamma amplitude at 70–110 Hz and animated the group-level high-gamma dynamics on a spatially normalized three-dimensional brain surface. Finally, we determined if age independently contributed to high-gamma dynamics across brain regions and time windows.

Results:

Group-level analysis of noise-related neural costs in the STG revealed developmental enhancement of early high-gamma augmentation and diminution of delayed augmentation. Analysis of speech-related high-gamma activity demonstrated an anterior-to-posterior functional parcellation in the STG. The left anterior STG showed sustained augmentation throughout stimulus presentation, whereas the left posterior STG showed transient augmentation after stimulus onset. We found a double dissociation between the locations and developmental changes in speech sound-related high-gamma dynamics. Early left anterior STG high-gamma augmentation (i.e., within 200 ms post-stimulus onset) showed developmental enhancement, whereas delayed left posterior STG high-gamma augmentation declined with development.

Conclusions:

Our observations support the model that, with age, the human STG refines neural dynamics to rapidly detect and subsequently disregard uninformative acoustic noises. Our study also supports the notion that the anterior-to-posterior functional division within the left STG is gradually strengthened for efficient speech sound perception after birth.

Why the parent's gaze is so powerful in organizing the infant's gaze: The relationship between parental referential cues and infant object looking

Parental scaffolding such as looking at and showing objects has long been considered to be helpful for early attention and language development. However, relatively little is known about how parental social multimodal cues work alone or together in guiding an infant's attention toward the referent items. The present study aims to document the dynamics of social referential input during an interactive play session and specify the different types of social cues in directing infant attention. Forty-three parent-infant dyads (infants aged from 5.0 to 18.0 months) in the U.S. completed a short play session recorded by head-mounted camera with eye-trackers. The present findings suggest that joint attention between parent and infant toward the same referent item often co-occurred with other referential input. Infants were more likely to maintain sustained attention to an object under the circumstance that the parent looked at the same item and named it explicitly. This was not the case when parent object looking accompanied other utterances, like "Look!" or the child's name. The present study highlights the importance of multimodal referential input, which sets up enriched opportunities for children to become sensitive to social input and develop sustained attention for further learning.

Normal development of the brain: a survey of joint structural-functional brain studies

Joint structural-functional (S-F) developmental studies present a novel approach to address the complex neuroscience questions on how the human brain works and how it matures. Joint S-F biomarkers have the inherent potential to model effectively the brain's maturation, fill the information gap in temporal brain atlases, and demonstrate how the brain's performance matures during the lifespan. This review presents the current state of knowledge on heterochronous and heterogeneous development of S-F links during the maturation period. The S-F relationship has been investigated in early-matured unimodal and prolonged-matured transmodal regions of the brain using a variety of structural and functional biomarkers and data acquisition modalities. Joint S-F unimodal studies have employed auditory and visual stimuli, while the main focus of joint S-F transmodal studies has been resting-state and cognitive experiments. However, nonsignificant associations between some structural and functional biomarkers and their maturation show that designing and developing effective S-F biomarkers is still a challenge in the field. Maturational characteristics of brain asymmetries have been poorly investigated by the joint S-F studies, and the results were partially inconsistent with previous nonjoint ones. The inherent complexity of the brain performance can be modeled using multifactorial and nonlinear techniques as promising methods to simulate the impact of age on S-F relations considering their analysis challenges.

EEG effective connectivity during the first year of life mirrors brain synaptogenesis, myelination, and early right hemisphere predominance

INTRODUCTION

The maturation of electroencephalogram (EEG) effective connectivity in healthy infants during the first year of life is described.

METHODS

Participants: A cross-sectional sample of 125 healthy at-term infants, from 0 to 12 months of age, underwent EEG in a state of quiet sleep.

PROCEDURES

The EEG primary currents at the source were described with the sLoreta method. An unmixing algorithm was applied to reduce the leakage, and the isolated effective coherence, a direct and directed measurement of information flow, was calculated.

RESULTS AND DISCUSSION

Initially, the highest indices of connectivity are at the subcortical nuclei, continuing to the parietal lobe, predominantly the right hemisphere, then expanding to temporal, occipital, and finally the frontal areas, which is consistent with the myelination process. Age-related connectivity changes were mostly long-range and bilateral. Connections increased with age, mainly in the right hemisphere, while they mainly decreased in the left hemisphere. Increased connectivity from 20 to 30 Hz, mostly at the right hemisphere. These findings were consistent with right hemisphere predominance during the first three years of life. Theta and alpha connections showed the greatest changes with age. Strong connectivity was found between the parietal, temporal, and occipital regions to the frontal lobes, responsible for executive functions and consistent with behavioral development during the first year. The thalamus exchanges information bidirectionally with all cortical regions and frequency bands.

CONCLUSIONS

The maturation of EEG connectivity during the first year in healthy infants is very consistent with synaptogenesis, reductions in synaptogenesis, myelination, and functional and behavioral development.

Degraded cortical temporal processing in the valproic acid-induced rat model of autism

Hearing disorders, such as abnormal speech perception, are frequently reported in individuals with autism. However, the mechanisms underlying these auditory-associated signature deficits in autism remain largely unknown. In this study, we documented significant behavioral impairments in the sound temporal rate discrimination task for rats prenatally exposed to valproic acid (VPA), a well-validated animal model for studying the pathology of autism. In parallel, there was a large-scale degradation in temporal information-processing in their primary auditory cortices (A1) at both levels of spiking outputs and synaptic inputs. Substantially increased spine density of excitatory neurons and decreased numbers of parvalbumin- and somatostatin-labeled inhibitory inter-neurons were also recorded in the A1 after VPA exposure. Given the fact that cortical temporal processing of sound is associated with speech perception in humans, these results in the animal model of VPA exposure provide insight into a possible neurological mechanism underlying auditory and language-related deficits in individuals with autism.

Disentangling the Effects of Exposure to Maternal Substance Misuse and Physical Abuse and Neglect on Child Behavioral Problems

There is inconsistent evidence on the association between prenatal substance exposure and child behavioral problems. Children affected by maternal substance misuse are vulnerable to physical abuse and neglect. Few studies have examined factors contributing to internalizing and externalizing problems in these children. This study, with a focus on children with prenatal substance exposure, investigated whether family characteristics (the duration of maternal substance misuse postpartum or the existence of a sibling) moderated the association between adverse exposure (physical abuse or neglect) and behavior (internalizing or externalizing problems). We recruited 54 Hong Kong Chinese mothers with registered records of substance misuse during pregnancy and their children (2-9 years). Mothers completed questionnaires on drug use patterns during pregnancy and postpartum, abusive and neglectful parenting behaviors in the preceding year, and children's current behavioral problems. Moderated regression analyses tested whether abusive and neglectful parenting behavior interacted with family characteristics to affect child behavioral problems. The existence of a sibling moderated the relationship between neglect experience and internalizing problems, with a positive relationship observed only among single children (adjusted B [95% confidence interval] = 3.70 [0.98, 6.41], p = .012). The duration of maternal substance misuse postpartum moderated the relationship between physical abuse experience and externalizing problems, with a positive relationship observed only among children of mothers abusing substances beyond the child's infancy period (adjusted B [95% confidence interval] = 6.86 [2.34, 11.38], p = .008). The results show that the impact of physical abuse and neglect experiences depend on the type of behavior assessed and family and child characteristics. Positive sibling relationship and early detoxification in the mother can foster healthy behavioral development for children exposed prenatally to maternal substance misuse.

Structural and functional brain network alterations in prenatal alcohol exposed neonates

Prenatal alcohol exposure leads to alterations in cognition, behavior and underlying brain architecture. However, prior studies have not integrated structural and functional imaging data in children with prenatal alcohol exposure. The aim of this study was to characterize disruptions in both structural and functional brain network organization after prenatal alcohol exposure in very early life. A group of 11 neonates with prenatal alcohol exposure and 14 unexposed controls were investigated using diffusion weighted structural and resting state functional magnetic resonance imaging. Covariance networks were created using graph theoretical analyses for each data set, controlling for age and sex. Group differences in global hub arrangement and regional connectivity were determined using nonparametric permutation tests. Neonates with prenatal alcohol exposure and controls exhibited similar global structural network organization. However, global functional networks of neonates with prenatal alcohol exposure comprised of temporal and limbic hubs, while hubs were more distributed in controls representing an early default mode network. On a regional level, controls showed prominent structural and functional connectivity in parietal and occipital regions. Neonates with prenatal alcohol exposure showed regionally, predominant structural and functional connectivity in several subcortical regions and occipital regions. The findings suggest early functional disruption on a global and regional level after prenatal alcohol exposure and indicate suboptimal organization of functional networks. These differences likely underlie sensory dysregulation and behavioral difficulties in prenatal alcohol exposure.

[Formula: see text] Neural correlates of socioeconomic status in early childhood: a systematic review of the literature

It is now established that socioeconomic variables are associated with cognitive, academic achievement, and psychiatric outcomes. Recent years have shown the advance in our understanding of how socioeconomic status (SES) relates to brain development in the first years of life (ages 0-5 years). However, it remains unknown which neural structures and functions are most sensitive to the environmental experiences associated with SES. Pubmed, PsycInfo, and Google Scholar databases from January 1, 2000, to December 31, 2019, were systematically searched using terms "Neural" OR "Neuroimaging" OR "Brain" OR "Brain development," AND "Socioeconomic" OR "SES" OR "Income" OR "Disadvantage" OR "Education," AND "Early childhood" OR "Early development". Nineteen studies were included in the full review after applying all exclusion criteria. Studies revealed associations between socioeconomic and neural measures and indicated that, in the first years of life, certain neural functions and structures (e.g., those implicated in language and executive function) may be more sensitive to socioeconomic context than others. Findings broadly support the hypothesis that SES associations with neural structure and function operate on a gradient. Socioeconomic status is reflected in neural architecture and function of very young children, as early as shortly after birth, with its effects possibly growing throughout early childhood as a result of postnatal experiences. Although socioeconomic associations with neural measures were relatively consistent across studies, results from this review are not conclusive enough to supply a neural phenotype of low SES. Further work is necessary to understand causal mechanisms underlying SES-brain associations.

Gut-Brain Axis in the Early Postnatal Years of Life: A Developmental Perspective

Emerging evidence suggests that alterations in the development of the gastrointestinal (GI) tract during the early postnatal period can influence brain development and vice-versa. It is increasingly recognized that communication between the GI tract and brain is mainly driven by neural, endocrine, immune, and metabolic mediators, collectively called the gut-brain axis (GBA). Changes in the GBA mediators occur in response to the developmental changes in the body during this period. This review provides an overview of major developmental events in the GI tract and brain in the early postnatal period and their parallel developmental trajectories under physiological conditions. Current knowledge of GBA mediators in context to brain function and behavioral outcomes and their synthesis and metabolism (site, timing, etc.) is discussed. This review also presents hypotheses on the role of the GBA mediators in response to the parallel development of the GI tract and brain in infants.

Neural and psychophysiological correlates of social communication development: Evidence from sensory processing, motor, cognitive, language and emotional behavioral milestones across infancy

This article presents a literature review focusing on the neural and psychophysiological correlates associated with social communication development in infancy. Studies presenting evidence on infants' brain activity and developments in infant sensory processing, motor, cognitive, language, and emotional abilities are described in regard to the neuropsychophysiological processes underlying the emergence of these specific behavioral milestones and their associations with social communication development. Studies that consider specific age-related characteristics across the infancy period are presented. Evidence suggests that specific neural and physiological signatures accompany age-related social communication development during the first 18 months of life.

Neuroimaging young children and associations with neurocognitive development in a South African birth cohort study

Magnetic resonance imaging (MRI) is an indispensable tool for investigating brain development in young children and the neurobiological mechanisms underlying developmental risk and resilience. Sub-Saharan Africa has the highest proportion of children at risk of developmental delay worldwide, yet in this region there is very limited neuroimaging research focusing on the neurobiology of such impairment. Furthermore, paediatric MRI imaging is challenging in any setting due to motion sensitivity. Although sedation and anesthesia are routinely used in clinical practice to minimise movement in young children, this may not be ethical in the context of research. Our study aimed to investigate the feasibility of paediatric multimodal MRI at age 2–3 years without sedation, and to explore the relationship between cortical structure and neurocognitive development at this understudied age in a sub-Saharan African setting. A total of 239 children from the Drakenstein Child Health Study, a large observational South African birth cohort, were recruited for neuroimaging at 2–3 years of age. Scans were conducted during natural sleep utilising locally developed techniques. T1-MEMPRAGE and T2-weighted structural imaging, resting state functional MRI, diffusion tensor imaging and magnetic resonance spectroscopy sequences were included. Child neurodevelopment was assessed using the Bayley-III Scales of Infant and Toddler Development. Following 23 pilot scans, 216 children underwent scanning and T1-weighted images were obtained from 167/216 (77%) of children (median age 34.8 months). Furthermore, we found cortical surface area and thickness within frontal regions were associated with cognitive development, and in temporal and frontal regions with language development (beta coefficient ≥0.20). Overall, we demonstrate the feasibility of carrying out a neuroimaging study of young children during natural sleep in sub-Saharan Africa. Our findings indicate that dynamic morphological changes in heteromodal association regions are associated with cognitive and language development at this young age. These proof-of-concept analyses suggest similar links between the brain and cognition as prior literature from high income countries, enhancing understanding of the interplay between cortical structure and function during brain maturation.

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MRI data are challenging to acquire in the early years of life.

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Paediatric MRI without sedation is feasible in sub-Saharan Africa, with 77% success.

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The Drakenstein Child Health study has novel MRI data of South African children.

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Morphological features of the cortex associate with neurocognitive development.

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Structure-cognition relationships in heteromodal association regions at 2–3 years.

Nutritional and immunological factors in breast milk: A role in the intergenerational transmission from maternal psychopathology to child development

Perinatal psychopathologies affect more than 25% of women during and after their gestational period. These psychiatric disorders can potentially determine important biological variations in their organisms, affecting many different physiological and metabolic pathways. Of relevance, any of these changes occurring in the mother can alter the normal composition of breast milk, particularly the concentration of nutritional and inflammatory components, which play a role in child brain functioning and development. Indeed, there is evidence showing that changes in milk composition can contribute to cognitive impairments and alterations in mental abilities in children. This review aims to shed light on the unique intergenerational role played by breast milk composition, from maternal psychopathologies to child development.

Surface-constrained volumetric registration for the early developing brain

The T1-weighted and T2-weighted MRI contrasts of the infant brain evolve drastically during the first year of life. This poses significant challenges to inter- and intra-subject registration, which is key to subsequent statistical analyses. Existing registration methods that do not consider temporal contrast changes are ineffective for infant brain MRI data. To address this problem, we present in this paper a method for deformable registration of infant brain MRI. The key advantage of our method is threefold: (i) To deal with appearance changes, registration is performed based on segmented tissue maps instead of image intensity. Segmentation is performed by using an infant-centric algorithm previously developed by our group. (ii) Registration is carried out with respect to both cortical surfaces and volumetric tissue maps, thus allowing precise alignment of both cortical and subcortical structures. (iii) A dynamic elasticity model is utilized to allow large non-linear deformation. Experimental results in comparison with well-established registration methods indicate that our method yields superior accuracy in both cortical and subcortical alignment.

Auditory Training Reverses Lead (Pb)-Toxicity-Induced Changes in Sound-Azimuth Selectivity of Cortical Neurons

Lead (Pb) causes significant adverse effects on the developing brain, resulting in cognitive and learning disabilities in children. The process by which lead produces these negative changes is largely unknown. The fact that children with these syndromes also show deficits in central auditory processing, however, indicates a speculative but disturbing relationship between lead-exposure, impaired auditory processing, and behavioral dysfunction. Here we studied in rats the changes in cortical spatial tuning impacted by early lead-exposure and their potential restoration to normal by auditory training. We found animals that were exposed to lead early in life displayed significant behavioral impairments compared with naïve controls while conducting the sound-azimuth discrimination task. Lead-exposure also degraded the sound-azimuth selectivity of neurons in the primary auditory cortex. Subsequent sound-azimuth discrimination training, however, restored to nearly normal the lead-degraded cortical azimuth selectivity. This reversal of cortical spatial fidelity was paralleled by changes in cortical expression of certain excitatory and inhibitory neurotransmitter receptor subunits. These results in a rodent model demonstrate the persisting neurotoxic effects of early lead-exposure on behavioral and cortical neuronal processing of spatial information of sound. They also indicate that attention-demanding auditory training may remediate lead-induced cortical neurological deficits even after these deficits have occurred.

Infant Brain Development Prediction With Latent Partial Multi-View Representation Learning

The early postnatal period witnesses rapid and dynamic brain development. However, the relationship between brain anatomical structure and cognitive ability is still unknown. Currently, there is no explicit model to characterize this relationship in the literature. In this paper, we explore this relationship by investigating the mapping between morphological features of the cerebral cortex and cognitive scores. To this end, we introduce a multi-view multi-task learning approach to intuitively explore complementary information from different time-points and handle the missing data issue in longitudinal studies simultaneously. Accordingly, we establish a novel model, latent partial multi-view representation learning. Our approach regards data from different time-points as different views and constructs a latent representation to capture the complementary information from incomplete time-points. The latent representation explores the complementarity across different time-points and improves the accuracy of prediction. The minimization problem is solved by the alternating direction method of multipliers. Experimental results on both synthetic and real data validate the effectiveness of our proposed algorithm.

Association between hemodynamic activity and motor performance in six-month-old full-term and preterm infants: a functional near-infrared spectroscopy study

This study aimed to assess task-induced activation in motor cortex and its association with motor performance in full-term and preterm born infants at six months old. A cross-sectional study of 73 six-month-old infants was conducted (35 full-term and 38 preterm infants). Motor performance was assessed using the Bayley Scales of Infant Development third edition-Bayley-III. Brain hemodynamic activity during motor task was measured by functional near-infrared spectroscopy (fNIRS). Motor performance was similar in full-term and preterm infants. However, differences in hemodynamic response were identified. Full terms showed a more homogeneous unilateral and contralateral activated area, whereas in preterm-born the activation response was predominantly bilateral. The full-term group also exhibited a shorter latency for the hemodynamic response than the preterm group. Hemodynamic activity in the left sensorimotor region was positively associated with motor performance measured by Bayley-III. The results highlight the adequacy of fNIRS to assess differences in task-induced activation in sensorimotor cortex between groups. The association between motor performance and the hemodynamic activity require further investigation and suggest that fNIRS can become a suitable auxiliary tool to investigate aspects of neural basis on early development of motor abilities.

A numerical analysis of a semi-dry coupling configuration in photoacoustic computed tomography for infant brain imaging

In the application of photoacoustic human infant brain imaging, debubbled ultrasound gel or water is commonly used as a couplant for ultrasonic transducers due to their acoustic properties. The main challenge in using such a couplant is its discomfort for the patient. In this study, we explore the feasibility of a semi-dry coupling configuration to be used in photoacoustic computed tomography (PACT) systems. The coupling system includes an inflatable container consisting of a thin layer of Aqualene with ultrasound gel or water inside of it. Finite element method (FEM) is used for static and dynamic structural analysis of the proposed configuration to be used in PACT for infant brain imaging. The outcome of the analysis is an optimum thickness of Aqualene in order to meet the weight tolerance requirement with the least attenuation and best impedance match to recommend for an experimental setting.

A Population-based Study Evaluating the Association between Surgery in Early Life and Child Development at Primary School Entry

Background

It is unclear whether exposure to surgery in early life has long-term adverse effects on child development. The authors aimed to investigate whether surgery in early childhood is associated with adverse effects on child development measured at primary school entry.

Methods

The authors conducted a population-based cohort study in Ontario, Canada, by linking provincial health administrative databases to children’s developmental outcomes measured by the Early Development Instrument (EDI). From a cohort of 188,557 children, 28,366 children who underwent surgery before EDI completion (age 5 to 6 yr) were matched to 55,910 unexposed children. The primary outcome was early developmental vulnerability, defined as any domain of the EDI in the lowest tenth percentile of the population. Subgroup analyses were performed based on age at first surgery (less than 2 and greater than or equal to 2 yr) and frequency of surgery.

Results

Early developmental vulnerability was increased in the exposed group (7,259/28,366; 25.6%) compared with the unexposed group (13,957/55,910; 25.0%), adjusted odds ratio, 1.05; 95% CI, 1.01 to 1.08. Children aged greater than or equal to 2 yr at the time of first surgery had increased odds of early developmental vulnerability compared with unexposed children (odds ratio, 1.05; 95% CI, 1.01 to 1.10), but children aged less than 2 yr at the time of first exposure were not at increased risk (odds ratio, 1.04; 95% CI, 0.98 to 1.10). There was no increase in odds of early developmental vulnerability with increasing frequency of exposure.

Conclusions

Children who undergo surgery before primary school age are at increased risk of early developmental vulnerability, but the magnitude of the difference between exposed and unexposed children is small.

Temporal tuning in the bat auditory cortex is sharper when studied with natural echolocation sequences

Precise temporal coding is necessary for proper acoustic analysis. However, at cortical level, forward suppression appears to limit the ability of neurons to extract temporal information from natural sound sequences. Here we studied how temporal processing can be maintained in the bats' cortex in the presence of suppression evoked by natural echolocation streams that are relevant to the bats' behavior. We show that cortical neurons tuned to target-distance actually profit from forward suppression induced by natural echolocation sequences. These neurons can more precisely extract target distance information when they are stimulated with natural echolocation sequences than during stimulation with isolated call-echo pairs. We conclude that forward suppression does for time domain tuning what lateral inhibition does for selectivity forms such as auditory frequency tuning and visual orientation tuning. When talking about cortical processing, suppression should be seen as a mechanistic tool rather than a limiting element.

An alternative to domain-general or domain-specific frameworks for theorizing about human evolution and ontogenesis

This paper maintains that neither a domain-general nor a domain-specific framework is appropriate for furthering our understanding of human evolution and ontogenesis. Rather, as we learn increasingly more about the dynamics of gene-environment interaction and gene expression, theorists should consider a third alternative: a domain-relevant approach, which argues that the infant brain comes equipped with biases that are relevant to, but not initially specific to, processing different kinds of input. The hypothesis developed here is that domain-specific core knowledge/specialized functions do not constitute the start state; rather, functional specialization emerges progressively through neuronal competition over developmental time. Thus, the existence of category-specific deficits in brain-damaged adults cannot be used to bolster claims that category-specific or domain-specific modules underpin early development, because neural specificity in the adult brain is likely to have been the emergent property over time of a developing, self-structuring system in interaction with the environment.

Perceptual Training Restores Impaired Cortical Temporal Processing Due to Lead Exposure

Low-level lead exposure is a risk factor for cognitive and learning disabilities in children and has been specifically associated with deficits in auditory temporal processing that impair aural language and reading abilities. Here, we show that rats exposed to low levels of lead in early life display a significant behavioral impairment in an auditory temporal rate discrimination task. Lead exposure also results in a degradation of the neuronal repetition-rate following capacity and response synchronization in primary auditory cortex. A modified go/no-go repetition-rate discrimination task applied in adult animals for ∼50 days nearly restores to normal these lead-induced deficits in cortical temporal fidelity. Cortical expressions of parvalbumin, brain-derived neurotrophic factor, and NMDA receptor subunits NR2a and NR2b, which are down-regulated in lead-exposed animals, are also partially reversed with training. These studies in an animal model identify the primary auditory cortex as a novel target for low-level lead exposure and demonstrate that perceptual training can ameliorate lead-induced deficits in cortical discrimination between sound sequences.

Environmental acoustic enrichment promotes recovery from developmentally degraded auditory cortical processing

It has previously been shown that environmental enrichment can enhance structural plasticity in the brain and thereby improve cognitive and behavioral function. In this study, we reared developmentally noise-exposed rats in an acoustic-enriched environment for ∼4 weeks to investigate whether or not enrichment could restore developmentally degraded behavioral and neuronal processing of sound frequency. We found that noise-exposed rats had significantly elevated sound frequency discrimination thresholds compared with age-matched naive rats. Environmental acoustic enrichment nearly restored to normal the behavioral deficit resulting from early disrupted acoustic inputs. Signs of both degraded frequency selectivity of neurons as measured by the bandwidth of frequency tuning curves and decreased long-term potentiation of field potentials recorded in the primary auditory cortex of these noise-exposed rats also were reversed partially. The observed behavioral and physiological effects induced by enrichment were accompanied by recovery of cortical expressions of certain NMDA and GABAA receptor subunits and brain-derived neurotrophic factor. These studies in a rodent model show that environmental acoustic enrichment promotes recovery from early noise-induced auditory cortical dysfunction and indicate a therapeutic potential of this noninvasive approach for normalizing neurological function from pathologies that cause hearing and associated language impairments in older children and adults.

Cell size anomalies in the auditory thalamus of rats with hypoxic-ischemic injury on postnatal day 3 or 7

Children born prematurely (<37 weeks gestational age) or at very low birth weight (VLBW; <1500g) are at increased risk for hypoxic ischemic (HI) brain injuries. Term infants can also suffer HI from birth complications. In both groups, blood/oxygen delivery to the brain is compromised, often resulting in brain damage and later cognitive delays (e.g., language deficits). Literature suggests that language delays in a variety of developmentally impaired populations (including specific language impairment (SLI), dyslexia, and early HI-injury) may be associated with underlying deficits in rapid auditory processing (RAP; the ability to process and discriminate brief acoustic cues). Data supporting a relationship between RAP deficits and poor language outcomes is consistent with the "magnocellular theory," which purports that damage to or loss of large (magnocellular) cells in thalamic nuclei could underlie disruptions in temporal processing of sensory input, possibly including auditory (medial geniculate nucleus; MGN) information This theory could be applied to neonatal HI populations that show subsequent RAP deficits. In animal models of neonatal HI, persistent RAP deficits are seen in postnatal (P)7 HI injured rats (who exhibit neuropathology comparable to term birth injury), but not in P1-3 HI injured rodents (who exhibit neuropathology comparable to human pre-term injury). The current study sought to investigate the mean cell size, cell number, and cumulative probability of cell size in the MGN of P3 HI and P7 HI injured male rats that had previously demonstrated behavioral RAP deficits. Pilot data from our lab (Alexander, 2011) previously revealed cell size abnormalities (a shift toward smaller cells) in P7 but not P1 HI injured animals when compared to shams. Our current finding support this result, with evidence of a significant shift to smaller cells in the experimental MGN of P7 HI but not P3 HI subjects. P7 HI animals also showed significantly fewer cells in the affected (right) MGN as compared P3 HI and shams animals. Moreover, cell number in the right hemisphere was found to correlate with gap detection (fewer cells=worse performance) in P7 HI injured subjects. These findings could be applied to clinical populations, providing an anatomic marker that may index potential long-term language disabilities in HI injured infants and possibly other at-risk populations.

Peri-pubertal gonadotropin-releasing hormone agonist treatment affects sex biased gene expression of amygdala in sheep

The nature of hormonal involvement in pubertal brain development has attracted wide interest. Structural changes within the brain that occur during pubertal development appear mainly in regions closely linked with emotion, motivation and cognitive functions. Using a sheep model, we have previously shown that peri-pubertal pharmacological blockade of gonadotropin releasing hormone (GnRH) receptors, results in exaggerated sex-differences in cognitive executive function and emotional control, as well as sex and hemisphere specific patterns of expression of hippocampal genes associated with synaptic plasticity and endocrine signaling. In this study, we explored effects of this treatment regime on the gene expression profile of the ovine amygdala. The study was conducted with 30 same-sex twin lambs (14 female and 16 male), half of which were treated with the GnRH agonist (GnRHa) goserelin acetate every 4th week, beginning before puberty, until approximately 50 weeks of age. Gene expression profiles of the left and right amygdala were measured using 8×15 K Agilent ovine microarrays. Differential expression of selected genes was confirmed by qRT-PCR (Quantitative real time PCR). Networking analyses and Gene Ontology (GO) Term analyses were performed with Ingenuity Pathway Analysis (IPA), version 7.5 and DAVID (Database for Annotation, Visualization and integrated Discovery) version 6.7 software packages, respectively. GnRHa treatment was associated with significant sex- and hemisphere-specific differential patterns of gene expression. GnRHa treatment was associated with differential expression of 432 (|logFC|>0.3, adj. p value <0.05) and 46 (p value <0.0.5) genes in the left and right amygdala, respectively, of female animals, relative to the reference sample which consisted of all a pooled sample from control and treated animals of both sexes. No genes were found to be differentially expressed as a result of GnRHa treatment in the male animals. The results indicated that GnRH may, directly and/or indirectly, be involved in the regulation of sex- and hemisphere-specific differential expression of genes in the amygdala. This finding should be considered when long-term peri-pubertal GnRHa treatment is used in children.

Paranoid thinking, suspicion, and risk for aggression: a neurodevelopmental perspective

This article represents an effort to extend our understanding of paranoia or suspicion and its development by integrating findings across clinical, developmental, and neuroscience literatures. We first define "paranoia" or paranoid thought and examine its prevalence across typically and atypically developing individuals and theoretical perspectives regarding its development and maintenance. We then briefly summarize current ideas regarding the neural correlates of adaptive, appropriately trusting interpersonal perception, social cognition, and behavior across development. Our focus shifts subsequently to examining in normative and atypical developmental contexts the neural correlates of several component cognitive processes thought to contribute to paranoid thinking: (a) attention bias for threat, (b) jumping to conclusions biases, and (c) hostile intent attribution biases. Where possible, we also present data regarding independent links between these cognitive processes and aggressive behavior. By examining data regarding the behavioral and neural correlates of varied cognitive processes that are likely components of a paranoid thinking style, we hope to advance both theoretical and empirical research in this domain.

Effects of diet on early stage cortical perception and discrimination of syllables differing in voice-onset time: a longitudinal ERP study in 3 and 6 month old infants

The influence of diet on cortical processing of syllables was examined at 3 and 6 months in 239 infants who were breastfed or fed milk or soy-based formula. Event-related potentials to syllables differing in voice-onset-time were recorded from placements overlying brain areas specialized for language processing. P1 component amplitude and latency measures indicated that at both ages infants in all groups could extract and discriminate categorical information from syllables. Between-syllable amplitude differences-present across groups-were generally greater for SF infants. Responses peaked earlier over left hemisphere speech-perception than speech-production areas. Encoding was faster in BF than formula-fed infants. The results show that in preverbal infants: (1) discrimination of phonetic information occurs in early stages of cortical processing; (2) areas overlying brain regions of speech perception are activated earlier than those involved in speech production; and (3) these processes are differentially modulated by infant diet and environmental factors.

Cortical responses to speech sounds in 3- and 6-month-old infants fed breast milk, milk formula, or soy formula

Controversy exists about the safety of soy formula, with the main concern relating to potential estrogenic effects of soy protein. Since estrogens influence early brain development, we compared behavioral development and cortical responses (event-related potentials; ERPs) to speech sounds in infants fed either breast milk or formula (milk- or soy-based). Across-groups ERP measures were generally similar and behavioral measures were within normal ranges, suggesting no important influences of soy formula on behavioral development and brain function during the study period. Analyses relating ERP and behavioral measures revealed diet- and gender-specific emphases that may reflect differences in developmental trajectories of brain-behavior relationships.

Investigando os distúrbios de aquisição de linguagem a partir das queixas

OBJETIVO: Investigar as queixas comumente relatadas por pais de crianças com Distúrbio de Linguagem. Além disso, buscou-se analisar as condições de recepção e expressão verbais destas crianças. MÉTODOS: A amostra foi constituída por 55 crianças, na faixa etária entre 2 e 12 anos, de ambos os gêneros. As queixas relatadas pela família no inicio da intervenção terapêutica foram analisadas e subdivididas, considerando-se prejuízo de produção verbal, compreensão verbal e misto (compreensão e produção). Posteriormente, foram analisados os desempenhos das crianças em provas de compreensão verbal e produção nos níveis fonológico, semântico, gramatical e pragmático. RESULTADOS: Ao analisarmos o desempenho de crianças cujos familiares apresentavam queixa quanto à produção verbal (82,6%), observamos que 55,2% delas também apresentavam desvios na compreensão verbal. O comprometimento da produção verbal ocorreu em nível fonológico (97,3%), semântico (76,3%), gramatical (78,9%) e pragmático (5,2%). CONCLUSÃO: Embora a queixa sobre prejuízos na produção verbal seja mais mencionada pelos familiares, os prejuízos na compreensão verbal também são evidenciados em crianças com Distúrbio de Linguagem. Esses achados confirmam a importância da realização de uma avaliação cuidadosa a partir da investigação da queixa relatada pelas famílias.

Effects of joint attention on long-term memory in 9-month-old infants: an event-related potentials study

Joint attention develops during the first year of life but little is known about its effects on long-term memory. We investigated whether joint attention modulates long-term memory in 9-month-old infants. Infants were familiarized with visually presented objects in either of two conditions that differed in the degree of joint attention (high versus low). EEG indicators in response to old and novel objects were probed directly after the familiarization phase (immediate recognition), and following a 1-week delay (delayed recognition). In immediate recognition, the amplitude of positive slow-wave activity was modulated by joint attention. In the delayed recognition, the amplitude of the Pb component differentiated between high and low joint attention. In addition, the positive slow-wave amplitude during immediate and delayed recognition correlated with the frequency of infants' looks to the experimenter during familiarization. Under both high- and low-joint-attention conditions, the processing of unfamiliar objects was associated with an enhanced Nc component. Our results show that the degree of joint attention modulates EEG during immediate and delayed recognition. We conclude that joint attention affects long-term memory processing in 9-month-old infants by enhancing the relevance of attended items.

A longitudinal study of differences in electroencephalographic activity among breastfed, milk formula-fed, and soy formula-fed infants during the first year of life

BACKGROUND

The extent to which adequate nutrition from infant diets differentially influence developmental outcomes in healthy infants has not been determined.

AIM

To compare the effects of the major infant diets on the development of brain electrical activity during infancy.

STUDY DESIGN

Scalp EEG signals (124 sites) recorded from the same infants during quiet wakefulness at 3, 6, 9, and 12months.

SUBJECTS

Healthy, full-term infants (40/group; gender matched) either breastfed (BF) or fed milk formula (MF) or soy formula (SF) through the first 6months.

OUTCOME MEASURES

Power spectral values for frequencies in the 0.1-30Hz range.

RESULTS

Significant diet-related differences were present across frequency bands and included effects that were time- [peaks in 0.1-3Hz at 6 (MF,SF) and 9months (BF); 3-6Hz at 6months (MF, SF>BF); increases in 6-9Hz from 3 to 6months (MF>BF) and from 6 to 9months (MF>SF)] and gender-related (9-12Hz and 12-30Hz: at 9months BF>MF, SF boys, and MF>SF girls).

CONCLUSIONS

The development of brain electrical activity during infancy differs between those who are breastfed compared with those fed either milk or soy formula, but is generally similar for formula-fed groups. These variations in EEG activity reflect diet-related influences on the development of brain structure and function that could put infants on different neurodevelopmental trajectories along which cognitive and brain function development will proceed.

Enduring effects of early structured noise exposure on temporal modulation in the primary auditory cortex

Studies have shown that acoustic experiences significantly contribute to the functional shaping of the structural organization and signal processing capacities of the mammalian auditory system during postnatal development. Here, we show how an early epoch of exposure to structured noise influences temporal processing in the rat primary auditory cortex documented immediately after exposure and again in adulthood. Pups were continuously exposed to broadband-pulsed noise across the critical period for auditory system development. Immediately after cessation of exposure at postnatal day approximately 35 (P35) or approximately 55 days later (i.e., P90) in other rats, the temporal modulation-transfer functions of cortical neurons were documented. We found that pulsed noise exposure at a low modulation rate significantly decreased cortical responses to repetitive stimuli presented across a range of higher modulation rates. The highest temporal rate at which temporal modulation-transfer function was at half of its maximum was reduced when compared with naïve rats. Low-rate pulsed noise exposure also decreased cortical response synchronization at higher stimulus rates, as shown by vector strength and Rayleigh statistic measures. These postexposure changes endured into adulthood. These findings bear significant implications for the role of early sound experiences as contributors to the ontogeny of human auditory and language-related abilities and impairments.

Linkage, association, and gene-expression analyses identify CNTNAP2 as an autism-susceptibility gene

Autism is a genetically complex neurodevelopmental syndrome in which language deficits are a core feature. We describe results from two complimentary approaches used to identify risk variants on chromosome 7 that likely contribute to the etiology of autism. A two-stage association study tested 2758 SNPs across a 10 Mb 7q35 language-related autism QTL in AGRE (Autism Genetic Resource Exchange) trios and found significant association with Contactin Associated Protein-Like 2 (CNTNAP2), a strong a priori candidate. Male-only containing families were identified as primarily responsible for this association signal, consistent with the strong male affection bias in ASD and other language-based disorders. Gene-expression analyses in developing human brain further identified CNTNAP2 as enriched in circuits important for language development. Together, these results provide convergent evidence for involvement of CNTNAP2, a Neurexin family member, in autism, and demonstrate a connection between genetic risk for autism and specific brain structures.

Assessment of functional development in normal infant brain using arterial spin labeled perfusion MRI

Arterial spin labeled (ASL) perfusion MRI provides a noninvasive approach for longitudinal imaging of regional brain function in infants. In the present study, continuous ASL (CASL) perfusion MRI was carried out in normally developing 7- and 13-month-old infants while asleep without sedation. The 13-month infant group showed an increase (P<0.05) of relative CBF in frontal regions as compared to the 7-month group using a region of interest based analysis. Using a machine-learning algorithm to automatically classify the relative CBF maps of the two infant groups, a significant (P<0.05, permutation testing) regional CBF increase was found in the hippocampi, anterior cingulate, amygdalae, occipital lobes, and auditory cortex in the 13-month-old infants. These results are consistent with current understanding of infant brain development and demonstrate the feasibility of using perfusion MRI to noninvasively monitor developing brain function.

Recombinant thyrotropin in the diagnosis of congenital hypothyroidism

CONTEXT

A modern approach to congenital hypothyroidism requires a definitive diagnosis of the underlying mechanisms; this can be achieved within the first weeks of life. When uncertainty persists, treatment is commenced, and the definitive diagnosis of congenital hypothyroidism is deferred to the age of 3 yr.

OBJECTIVES

The interruption of thyroid replacement treatment is perceived as risky by parents and physicians. The aim of this pilot study was to test the possibility of a definitive diagnosis during thyroid replacement treatment, using stimulation of thyroid tissue by recombinant human (rh)TSH.

SUBJECTS

Eight patients, three boys and five girls, age 5-15 yr (mean, 9.5+/-3.7 yr), with congenital hypothyroidism that had been diagnosed by the neonatal screening program, and having their diagnosis verified between the ages of 3-4 yr, were reevaluated while on thyroid replacement therapy.

INTERVENTIONS

Patients received im 0.6 mg/m2 rhTSH on two consecutive days.

RESULTS

rhTSH pharmacokinetics, maximal concentration, t1/2, and area under the curve in children were different as compared with adults. In the patients with intact TSH receptors, free T4 levels decreased after the first and the second injection of rhTSH (P=0.0137 and P=0.0149, respectively). All eight children showed identical scintigraphy after rhTSH administration as compared with thyroid replacement withdrawal.

CONCLUSIONS

The use of rhTSH is effective for definitive diagnosis of congenital hypothyroidism during thyroid replacement treatment, and no safety issues were encountered.