Exploring the Early Organization and Maturation of Linguistic Pathways in the Human Infant Brain

Diffusion-tensor-imaging 1-year-old and 2-year-old infant brain atlases with comprehensive gray and white matter labels

Human infancy is marked by fastest postnatal brain structural changes. It also coincides with the onset of many neurodevelopmental disorders. Atlas-based automated structure labeling has been widely used for analyzing various neuroimaging data. However, the relatively large and nonlinear neuroanatomical differences between infant and adult brains can lead to significant offsets of the labeled structures in infant brains when adult brain atlas is used. Age-specific 1- and 2-year-old brain atlases covering all major gray and white matter (GM and WM) structures with diffusion tensor imaging (DTI) and structural MRI are critical for precision medicine for infant population yet have not been established. In this study, high-quality DTI and structural MRI data were obtained from 50 healthy children to build up three-dimensional age-specific 1- and 2-year-old brain templates and atlases. Age-specific templates include a single-subject template as well as two population-averaged templates from linear and nonlinear transformation, respectively. Each age-specific atlas consists of 124 comprehensively labeled major GM and WM structures, including 52 cerebral cortical, 10 deep GM, 40 WM, and 22 brainstem and cerebellar structures. When combined with appropriate registration methods, the established atlases can be used for highly accurate automatic labeling of any given infant brain MRI. We demonstrated that one can automatically and effectively delineate deep WM microstructural development from 3 to 38 months by using these age-specific atlases. These established 1- and 2-year-old infant brain DTI atlases can advance our understanding of typical brain development and serve as clinical anatomical references for brain disorders during infancy.

Cortical specialization associated with native speech category acquisition in early infancy

This study investigates neural processes in infant speech processing, with a focus on left frontal brain regions and hemispheric lateralization in Mandarin-speaking infants' acquisition of native tonal categories. We tested 2- to 6-month-old Mandarin learners to explore age-related improvements in tone discrimination, the role of inferior frontal regions in abstract speech category representation, and left hemisphere lateralization during tone processing. Using a block design, we presented four Mandarin tones via [ta] and measured oxygenated hemoglobin concentration with functional near-infrared spectroscopy. Results showed age-related improvements in tone discrimination, greater involvement of frontal regions in older infants indicating abstract tonal representation development and increased bilateral activation mirroring native adult Mandarin speakers. These findings contribute to our broader understanding of the relationship between native speech acquisition and infant brain development during the critical period of early language learning.

The development of human cortical scene processing

Decades of research have uncovered the neural basis of place (or "scene") processing in adulthood, revealing a set of three regions that respond selectively to visual scene information, each hypothesized to support distinct functions within scene processing (e.g., recognizing a particular kind of place versus navigating through it). Despite this considerable progress, surprisingly little is known about how these cortical regions develop. Here we review the limited evidence to date, highlighting the first few studies exploring the origins of cortical scene processing in infancy, and the several studies addressing when the scene regions reach full maturity, unfortunately with inconsistent findings. This inconsistency likely stems from common pitfalls in pediatric functional magnetic resonance imaging, and accordingly, we discuss how these pitfalls may be avoided. Furthermore, we point out that almost all studies to date have focused only on general scene selectivity and argue that greater insight could be gleaned by instead exploring the more distinct functions of each region, as well as their connectivity. Finally, with this last point in mind, we offer a novel hypothesis that scene regions supporting navigation (including the occipital place area and retrosplenial complex) mature later than those supporting scene categorization (including the parahippocampal place area).

Structural networking of the developing brain: from maturation to neurosurgical implications

Modern neuroscience agrees that neurological processing emerges from the multimodal interaction among multiple cortical and subcortical neuronal hubs, connected at short and long distance by white matter, to form a largely integrated and dynamic network, called the brain "connectome." The final architecture of these circuits results from a complex, continuous, and highly protracted development process of several axonal pathways that constitute the anatomical substrate of neuronal interactions. Awareness of the network organization of the central nervous system is crucial not only to understand the basis of children's neurological development, but also it may be of special interest to improve the quality of neurosurgical treatments of many pediatric diseases. Although there are a flourishing number of neuroimaging studies of the connectome, a comprehensive vision linking this research to neurosurgical practice is still lacking in the current pediatric literature. The goal of this review is to contribute to bridging this gap. In the first part, we summarize the main current knowledge concerning brain network maturation and its involvement in different aspects of normal neurocognitive development as well as in the pathophysiology of specific diseases. The final section is devoted to identifying possible implications of this knowledge in the neurosurgical field, especially in epilepsy and tumor surgery, and to discuss promising perspectives for future investigations.

[Stress during prenatal and early postnatal period when everything begins]

Early severe stresses are known to affect the biological and psychological development in childhood. Good and adaptable stress during prenatal and early postnatal period can switch to traumatic during these highly susceptible developmental stages. These different stresses modulate genetic/epigenetic processes and the setting up of connectome during these highly plastic and adaptable time periods. The polyvagal processes control the base of the security/well-being perception of the newborn by the onset of synchronized interactions between the mother/parent/nurse and the baby. These positive adjustments in mirror lead to attachment and social links and to implicit learning processes leading to a balanced emotional and cognitive development.

Lateralization of major white matter tracts during infancy is time-varying and tract-specific

Lateralization patterns are a major structural feature of brain white matter and have been investigated as a neural architecture that indicates and supports the specialization of cognitive processing and observed behaviors, e.g. language skills. Many neurodevelopmental disorders have been associated with atypical lateralization, reinforcing the need for careful measurement and study of this structural characteristic. Unfortunately, there is little consensus on the direction and magnitude of lateralization in major white matter tracts during the first months and years of life-the period of most rapid postnatal brain growth and cognitive maturation. In addition, no studies have examined white matter lateralization in a longitudinal pediatric sample-preventing confirmation of if and how white matter lateralization changes over time. Using a densely sampled longitudinal data set from neurotypical infants aged 0-6 months, we aim to (i) chart trajectories of white matter lateralization in 9 major tracts and (ii) link variable findings from cross-sectional studies of white matter lateralization in early infancy. We show that patterns of lateralization are time-varying and tract-specific and that differences in lateralization results during this period may reflect the dynamic nature of lateralization through development, which can be missed in cross-sectional studies.

Early maturation of sound duration processing in the infant's brain

The ability to process sound duration is crucial already at a very early age for laying the foundation for the main functions of auditory perception, such as object perception and music and language acquisition. With the availability of age-appropriate structural anatomical templates, we can reconstruct EEG source activity with much-improved reliability. The current study capitalized on this possibility by reconstructing the sources of event-related potential (ERP) waveforms sensitive to sound duration in 4- and 9-month-old infants. Infants were presented with short (200 ms) and long (300 ms) sounds equiprobable delivered in random order. Two temporally separate ERP waveforms were found to be modulated by sound duration. Generators of these waveforms were mainly located in the primary and secondary auditory areas and other language-related regions. The results show marked developmental changes between 4 and 9 months, partly reflected by scalp-recorded ERPs, but appearing in the underlying generators in a far more nuanced way. The results also confirm the feasibility of the application of anatomical templates in developmental populations.

Sensorimotor foundations of speech perception in infancy

The perceptual system for speech is highly organized from early infancy. This organization bootstraps young human learners' ability to acquire their native speech and language from speech input. Here, we review behavioral and neuroimaging evidence that perceptual systems beyond the auditory modality are also specialized for speech in infancy, and that motor and sensorimotor systems can influence speech perception even in infants too young to produce speech-like vocalizations. These investigations complement existing literature on infant vocal development and on the interplay between speech perception and production systems in adults. We conclude that a multimodal speech and language network is present before speech-like vocalizations emerge.

Language exposure during infancy is negatively associated with white matter microstructure in the arcuate fasciculus

Decades of research have established that the home language environment, especially quality of caregiver speech, supports language acquisition during infancy. However, the neural mechanisms behind this phenomenon remain under studied. In the current study, we examined associations between the home language environment and structural coherence of white matter tracts in 52 typically developing infants from English speaking homes in a western society. Infants participated in at least one MRI brain scan when they were 3, 6, 12, and/or 24 months old. Home language recordings were collected when infants were 9 and/or 15 months old. General linear regression models indicated that infants who heard the most adult words and participated in the most conversational turns at 9 months of age also had the lowest fractional anisotropy in the left posterior parieto-temporal arcuate fasciculus at 24 months. Similarly, infants who vocalized the most at 9 months also had the lowest fractional anisotropy in the same tract at 6 months of age. This is one of the first studies to report significant associations between caregiver speech collected in the home and white matter structural coherence in the infant brain. The results are in line with prior work showing that protracted white matter development during infancy confers a cognitive advantage.

Impact of feeding habits on the development of language-specific processing of phonemes in brain: An event-related potentials study

Introduction

Infancy is a stage characterized by multiple brain and cognitive changes. In a short time, infants must consolidate a new brain network and develop two important properties for speech comprehension: phonemic normalization and categorical perception. Recent studies have described diet as an essential factor in normal language development, reporting that breastfed infants show an earlier brain maturity and thus a faster cognitive development. Few studies have described a long-term effect of diet on phonological perception.

Methods

To explore that effect, we compared the event-related potentials (ERPs) collected during an oddball paradigm (frequent /pa/80%, deviant/ba/20%) of infants fed with breast milk (BF), cow-milk-based formula (MF), and soy-based formula (SF), which were assessed at 3, 6, 9, 12, and 24 months of age [Mean across all age groups: 127 BF infants, Mean (M) 39.6 gestation weeks; 121 MF infants, M = 39.16 gestation weeks; 116 SF infants, M = 39.16 gestation weeks].

Results

Behavioral differences between dietary groups in acoustic comprehension were observed at 24-months of age. The BF group displayed greater scores than the MF and SF groups. In phonological discrimination task, the ERPs analyses showed that SF group had an electrophysiological pattern associated with difficulties in phonological-stimulus awareness [mismatch negativity (MMN)-2 latency in frontal left regions of interest (ROI) and longer MMN-2 latency in temporal right ROI] and less brain maturity than BF and MF groups. The SF group displayed more right-lateralized brain recruitment in phonological processing at 12-months old.

Discussion

We conclude that using soy-based formula in a prolonged and frequent manner might trigger a language development different from that observed in the BF or MF groups. The soy-based formula's composition might affect frontal left-brain area development, which is a nodal brain region in phonological-stimuli awareness.

A comparative study of the superior longitudinal fasciculus subdivisions between neonates and young adults

The superior longitudinal fasciculus (SLF) is a complex associative tract comprising three distinct subdivisions in the frontoparietal cortex, each of which has its own anatomical connectivity and functional roles. However, many studies on white matter development, hampered by limitations of data quality and tractography methods, treated the SLF as a single entity. The exact anatomical trajectory and developmental status of each sub-bundle of the human SLF in neonates remain poorly understood. Here, we compared the morphological and microstructural characteristics of each branch of the SLF at two ages using diffusion MRI data from 40 healthy neonates and 40 adults. A multi-shell multi-tissue constrained spherical deconvolution (MSMT-CSD) algorithm was used to ensure the successful separation of the three SLF branches (SLF I, SLF II and SLF III). Then, between-group differences in the diffusion tensor imaging (DTI) and neurite orientation dispersion and density imaging (NODDI) metrics were investigated in all the SLF branches. Meanwhile, Mahalanobis distances based on all the diffusion metrics were computed to quantify the maturation of neonatal SLF branches, considering the adult brain as the reference. The SLF branches, excluding SLF II, had similar fibre morphology and connectivity between the neonatal and adult groups. The Mahalanobis distance values further supported the notion of heterogeneous maturation among SLF branches. The greatest Mahalanobis distance was observed in SLF II, possibly indicating that it was the least mature. Our findings provide a new anatomical basis for the early diagnosis and treatment of diseases caused by abnormal neonatal SLF development.

Multimodal brain features at 3 years of age and their relationship with pre-reading measures 1 year later

Pre-reading language skills develop rapidly in early childhood and are related to brain structure and functional architecture in young children prior to formal education. However, the early neurobiological development that supports these skills is not well understood. Here we acquired anatomical, diffusion tensor imaging (DTI) and resting state functional MRI (rs-fMRI) from 35 children at 3.5 years of age. Children were assessed for pre-reading abilities using the NEPSY-II subtests 1 year later (4.5 years). We applied a data-driven linked independent component analysis (ICA) to explore the shared co-variation of gray and white matter measures. Two sources of structural variation at 3.5 years of age demonstrated relationships with Speeded Naming scores at 4.5 years of age. The first imaging component involved volumetric variability in reading-related cortical regions alongside microstructural features of the superior longitudinal fasciculus (SLF). The second component was dominated by cortical volumetric variations within the cerebellum and visual association area. In a subset of children with rs-fMRI data, we evaluated the inter-network functional connectivity of the left-lateralized fronto-parietal language network (FPL) and its relationship with pre-reading measures. Higher functional connectivity between the FPL and the default mode and visual networks at 3.5 years significantly predicted better Phonological Processing scores at 4.5 years. Together, these results suggest that the integration of functional networks, as well as the co-development of white and gray matter brain structures in early childhood, support the emergence of pre-reading measures in preschool children.

Structural Brain Asymmetries for Language: A Comparative Approach across Primates

Humans are the only species that can speak. Nonhuman primates, however, share some ‘domain-general’ cognitive properties that are essential to language processes. Whether these shared cognitive properties between humans and nonhuman primates are the results of a continuous evolution [homologies] or of a convergent evolution [analogies] remain difficult to demonstrate. However, comparing their respective underlying structure—the brain—to determinate their similarity or their divergence across species is critical to help increase the probability of either of the two hypotheses, respectively. Key areas associated with language processes are the Planum Temporale, Broca’s Area, the Arcuate Fasciculus, Cingulate Sulcus, The Insula, Superior Temporal Sulcus, the Inferior Parietal lobe, and the Central Sulcus. These structures share a fundamental feature: They are functionally and structurally specialised to one hemisphere. Interestingly, several nonhuman primate species, such as chimpanzees and baboons, show human-like structural brain asymmetries for areas homologous to key language regions. The question then arises: for what function did these asymmetries arise in non-linguistic primates, if not for language per se? In an attempt to provide some answers, we review the literature on the lateralisation of the gestural communication system, which may represent the missing behavioural link to brain asymmetries for language area’s homologues in our common ancestor.

Quantitative mapping of the brain's structural connectivity using diffusion MRI tractography: A review

Diffusion magnetic resonance imaging (dMRI) tractography is an advanced imaging technique that enables in vivo reconstruction of the brain's white matter connections at macro scale. It provides an important tool for quantitative mapping of the brain's structural connectivity using measures of connectivity or tissue microstructure. Over the last two decades, the study of brain connectivity using dMRI tractography has played a prominent role in the neuroimaging research landscape. In this paper, we provide a high-level overview of how tractography is used to enable quantitative analysis of the brain's structural connectivity in health and disease. We focus on two types of quantitative analyses of tractography, including: 1) tract-specific analysis that refers to research that is typically hypothesis-driven and studies particular anatomical fiber tracts, and 2) connectome-based analysis that refers to research that is more data-driven and generally studies the structural connectivity of the entire brain. We first provide a review of methodology involved in three main processing steps that are common across most approaches for quantitative analysis of tractography, including methods for tractography correction, segmentation and quantification. For each step, we aim to describe methodological choices, their popularity, and potential pros and cons. We then review studies that have used quantitative tractography approaches to study the brain's white matter, focusing on applications in neurodevelopment, aging, neurological disorders, mental disorders, and neurosurgery. We conclude that, while there have been considerable advancements in methodological technologies and breadth of applications, there nevertheless remains no consensus about the "best" methodology in quantitative analysis of tractography, and researchers should remain cautious when interpreting results in research and clinical applications.

Fiber tracing and microstructural characterization among audiovisual integration brain regions in neonates compared with young adults

Audiovisual integration has been related with cognitive-processing and behavioral advantages, as well as with various socio-cognitive disorders. While some studies have identified brain regions instantiating this ability shortly after birth, little is known about the structural pathways connecting them. The goal of the present study was to reconstruct fiber tracts linking AVI regions in the newborn in-vivo brain and assess their adult-likeness by comparing them with analogous fiber tracts of young adults. We performed probabilistic tractography and compared connective probabilities between a sample of term-born neonates (N = 311; the Developing Human Connectome Project (dHCP, http://www.developingconnectome.org) and young adults (N = 311 The Human Connectome Project; https://www.humanconnectome.org/) by means of a classification algorithm. Furthermore, we computed Dice coefficients to assess between-group spatial similarity of the reconstructed fibers and used diffusion metrics to characterize neonates' AVI brain network in terms of microstructural properties, interhemispheric differences and the association with perinatal covariates and biological sex. Overall, our results indicate that the AVI fiber bundles were successfully reconstructed in a vast majority of neonates, similarly to adults. Connective probability distributional similarities and spatial overlaps of AVI fibers between the two groups differed across the reconstructed fibers. There was a rank-order correspondence of the fibers' connective strengths across the groups. Additionally, the study revealed patterns of diffusion metrics in line with early white matter developmental trajectories and a developmental advantage for females. Altogether, these findings deliver evidence of meaningful structural connections among AVI regions in the newborn in-vivo brain.

White matter myelination during early infancy is linked to spatial gradients and myelin content at birth

Development of myelin, a fatty sheath that insulates nerve fibers, is critical for brain function. Myelination during infancy has been studied with histology, but postmortem data cannot evaluate the longitudinal trajectory of white matter development. Here, we obtained longitudinal diffusion MRI and quantitative MRI measures of longitudinal relaxation rate (R1) of white matter in 0, 3 and 6 months-old human infants, and developed an automated method to identify white matter bundles and quantify their properties in each infant's brain. We find that R1 increases from newborns to 6-months-olds in all bundles. R1 development is nonuniform: there is faster development in white matter that is less mature in newborns, and development rate increases along inferior-to-superior as well as anterior-to-posterior spatial gradients. As R1 is linearly related to myelin fraction in white matter bundles, these findings open new avenues to elucidate typical and atypical white matter myelination in early infancy.

The Arcuate Fasciculus and language origins: Disentangling existing conceptions that influence evolutionary accounts

The Arcuate Fasciculus (AF) is of considerable interdisciplinary interest, because of its major implication in language processing. Theories about language brain evolution are based on anatomical differences in the AF across primates. However, changing methodologies and nomenclatures have resulted in conflicting findings regarding interspecies AF differences: Historical knowledge about the AF originated from human blunt dissections and later from monkey tract-tracing studies. Contemporary tractography studies reinvestigate the fasciculus' morphology, but remain heavily bound to unclear anatomical priors and methodological limitations. First, we aim to disentangle the influences of these three epistemological steps on existing AF conceptions, and to propose a contemporary model to guide future work. Second, considering the influence of various AF conceptions, we discuss four key evolutionary changes that propagated current views about language evolution: 1) frontal terminations, 2) temporal terminations, 3) greater Dorsal- versus Ventral Pathway expansion, 4) lateralisation. We conclude that new data point towards a more shared AF anatomy across primates than previously described. Language evolution theories should incorporate this continuous AF evolution across primates.

Microstructural Measures of the Inferior Longitudinal Fasciculus Predict Later Cognitive and Language Development in Infants Born With Extremely Low Birth Weight

OBJECTIVE

Extremely preterm children are at high risk for adverse neurodevelopmental outcomes. Identifying predictors of discrete developmental outcomes early in life would allow for targeted neuroprotective therapies when neuroplasticity is at its peak. Our goal was to examine whether diffusion magnetic resonance imaging (MRI) metrics of the inferior longitudinal and uncinate fasciculi early in life could predict later cognitive and language outcomes.

STUDY DESIGN

In this pilot study, 43 extremely low-birth-weight preterm infants were scanned using diffusion MRI at term-equivalent age. White matter tracts were assessed via diffusion tensor imaging metrics of fractional anisotropy and mean diffusivity. The Language and Cognitive subscale scores of the Bayley Scales of Infant & Toddler Development-III at 18-22 months corrected age were our outcomes of interest. Multiple linear regression models were created to assess diffusion metrics of the inferior longitudinal and uncinate fasciculi as predictors of Bayley scores. We controlled for brain injury score on structural MRI, maternal education, birth weight, and age at MRI scan.

RESULTS

Of the 43 infants, 36 infants had high-quality diffusion tensor imaging and returned for developmental testing. The fractional anisotropy of the inferior longitudinal fasciculus was associated with Bayley-III scores in univariate analyses and was an independent predictor of Bayley-III cognitive and language development over and above known predictors in multivariable analyses.

CONCLUSIONS

Incorporating new biomarkers such as the fractional anisotropy of the inferior longitudinal fasciculus with structural MRI findings could enhance accuracy of neurodevelopment predictive models. Additional research is needed to validate our findings in a larger cohort.

Differential White Matter Maturation from Birth to 8 Years of Age

Comprehensive delineation of white matter (WM) microstructural maturation from birth to childhood is critical for understanding spatiotemporally differential circuit formation. Without a relatively large sample of datasets and coverage of critical developmental periods of both infancy and early childhood, differential maturational charts across WM tracts cannot be delineated. With diffusion tensor imaging (DTI) of 118 typically developing (TD) children aged 0–8 years and 31 children with autistic spectrum disorder (ASD) aged 2–7 years, the microstructure of every major WM tract and tract group was measured with DTI metrics to delineate differential WM maturation. The exponential model of microstructural maturation of all WM was identified. The WM developmental curves were separated into fast, intermediate, and slow phases in 0–8 years with distinctive time period of each phase across the tracts. Shorter periods of the fast and intermediate phases in certain tracts, such as the commissural tracts, indicated faster earlier development. With TD WM maturational curves as the reference, higher residual variance of WM microstructure was found in children with ASD. The presented comprehensive and differential charts of TD WM microstructural maturation of all major tracts and tract groups in 0–8 years provide reference standards for biomarker detection of neuropsychiatric disorders.

White matter in infancy is prospectively associated with language outcomes in kindergarten

Language acquisition is of central importance to child development. Although this developmental trajectory is shaped by experience postnatally, the neural basis for language emerges prenatally. Thus, a fundamental question remains: do structural foundations for language in infancy predict long-term language abilities? Longitudinal investigation of 40 children from infancy to kindergarten reveals that white matter in infancy is prospectively associated with subsequent language abilities, specifically between: (i) left arcuate fasciculus and phonological awareness and vocabulary knowledge, (ii) left corticospinal tract and phonological awareness, and bilateral corticospinal tract with phonological memory; controlling for age, cognitive, and environmental factors. Findings link white matter in infancy with school-age language abilities, suggesting that white matter organization in infancy sets a foundation for long-term language development.

Resting state functional networks in 1-to-3-year-old typically developing children

Brain functional networks undergo substantial development and refinement during the first years of life. Yet, the maturational pathways of functional network development remain poorly understood. Using resting-state fMRI data acquired during natural sleep from 24 typically developing toddlers, ages 1.5-3.5 years, we aimed to examine the large-scale resting-state functional networks and their relationship with age and developmental skills. Specifically, two network organization indices reflecting network connectivity and spatial variability were derived. Our results revealed that reduced spatial variability or increased network homogeneity in one of the default mode network components was associated with age, with older children displaying less spatially variable posterior DMN subcomponent, consistent with the notion of increased spatial and functional specialization. Further, greater network homogeneity in higher-order functional networks, including the posterior default mode, salience, and language networks, was associated with more advanced developmental skills measured with a standardized assessment of early learning, regardless of age. These results not only improve our understanding of brain functional network development during toddler years, but also inform the relationship between brain network organization and emerging cognitive and behavioral skills.

Gradual development of non-adjacent dependency learning during early childhood

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Transition between developmental stages of non-adjacent dependency (NAD) learning.

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Children between 1 and 3 years of age showed learning of NADs in a foreign language.

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Brain responses revealed associative NAD learning, triggered by passive listening.

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Gradual decrease of the strength of associative non-adjacent dependency learning.

In order to become proficient native speakers, children have to learn the morpho-syntactic relations between distant elements in a sentence, so-called non-adjacent dependencies (NADs). Previous research suggests that NAD learning in children comprises different developmental stages, where until 2 years of age children are able to learn NADs associatively under passive listening conditions, while starting around the age of 3–4 years children fail to learn NADs during passive listening. To test whether the transition between these developmental stages occurs gradually, we tested children’s NAD learning in a foreign language using event-related potentials (ERPs). We found ERP evidence of NAD learning across the ages of 1, 2 and 3 years. The amplitude of the ERP effect indexing NAD learning, however, decreased with age. These findings might indicate a gradual transition in children’s ability to learn NADs associatively. Cognitively, this transition might be driven by children’s increasing knowledge of their native language, hindering NAD learning in novel contexts. Neuroanatomically, maturation of the prefrontal cortex might play a crucial role, promoting top-down learning, affecting bottom-up, associative learning. In sum, our study suggests that NAD learning under passive listening conditions undergoes a gradual transition between different developmental stages during early childhood.

Neural indicators of articulator-specific sensorimotor influences on infant speech perception

While there is increasing acceptance that even young infants detect correspondences between heard and seen speech, the common view is that oral-motor movements related to speech production cannot influence speech perception until infants begin to babble or speak. We investigated the extent of multimodal speech influences on auditory speech perception in prebabbling infants who have limited speech-like oral-motor repertoires. We used event-related potentials (ERPs) to examine how sensorimotor influences to the infant's own articulatory movements impact auditory speech perception in 3-mo-old infants. In experiment 1, there were ERP discriminative responses to phonetic category changes across two phonetic contrasts (bilabial-dental /ba/-/ɗa/; dental-retroflex /ɗa/-/ɖa/) in a mismatch paradigm, indicating that infants auditorily discriminated both contrasts. In experiment 2, inhibiting infants' own tongue-tip movements had a disruptive influence on the early ERP discriminative response to the /ɗa/-/ɖa/ contrast only. The same articulatory inhibition had contrasting effects on the perception of the /ba/-/ɗa/ contrast, which requires different articulators (the lips vs. the tongue) during production, and the /ɗa/-/ɖa/ contrast, whereby both phones require tongue-tip movement as a place of articulation. This articulatory distinction between the two contrasts plausibly accounts for the distinct influence of tongue-tip suppression on the neural responses to phonetic category change perception in definitively prebabbling, 3-mo-old, infants. The results showing a specificity in the relation between oral-motor inhibition and phonetic speech discrimination suggest a surprisingly early mapping between auditory and motor speech representation already in prebabbling infants.

MRI of the Neonatal Brain: A Review of Methodological Challenges and Neuroscientific Advances

In recent years, exploration of the developing brain has become a major focus for researchers and clinicians in an attempt to understand what allows children to acquire amazing and unique abilities, as well as the impact of early disruptions (eg, prematurity, neonatal insults) that can lead to a wide range of neurodevelopmental disorders. Noninvasive neuroimaging methods such as MRI are essential to establish links between the brain and behavioral changes in newborns and infants. In this review article, we aim to highlight recent and representative studies using the various techniques available: anatomical MRI, quantitative MRI (relaxometry, diffusion MRI), multiparametric approaches, and functional MRI. Today, protocols use 1.5 or 3T MRI scanners, and specialized methodologies have been put in place for data acquisition and processing to address the methodological challenges specific to this population, such as sensitivity to motion. MR sequences must be adapted to the brains of newborns and infants to obtain relevant good soft-tissue contrast, given the small size of the cerebral structures and the incomplete maturation of tissues. The use of age-specific image postprocessing tools is also essential, as signal and contrast differ from the adult brain. Appropriate methodologies then make it possible to explore multiple neurodevelopmental mechanisms in a precise way, and assess changes with age or differences between groups of subjects, particularly through large-scale projects. Although MRI measurements only indirectly reflect the complex series of dynamic processes observed throughout development at the molecular and cellular levels, this technique can provide information on brain morphology, structural connectivity, microstructural properties of gray and white matter, and on the functional architecture. Finally, MRI measures related to clinical, behavioral, and electrophysiological markers have a key role to play from a diagnostic and prognostic perspective in the implementation of early interventions to avoid long-term disabilities in children. EVIDENCE LEVEL: 2 TECHNICAL EFFICACY STAGE: 1.

Signatures of brain plasticity supporting language recovery after perinatal arterial ischemic stroke

Brain imaging methods such as functional Magnetic Resonance Imaging (fMRI) and Diffusion Tensor Imaging (DTI) have already been used to decipher the functional and structural brain changes occurring during normal language development. However, little is known about the differentiation of the language network after an early lesion. While in adults, stroke over the left hemisphere generally induces post-stroke aphasia, it is not always the case when a stroke occurs in the perinatal period, thus revealing a remarkable plastic power of the language network during early development. In particular, the role of perilesional tissues, as opposed to undamaged brain areas in the functional recovery of language functions after an early insult, remains unclear. In this review article, we provide an overview of the extant literature using functional and structural neuroimaging data revealing the signatures of brain plasticity underlying near-normal language development.

Abnormal Habituation of the Auditory Event-Related Potential P2 Component in Patients With Schizophrenia

Auditory event-related potentials (ERP) may serve as diagnostic tools for schizophrenia and inform on the susceptibility for this condition. Particularly, the examination of N1 and P2 components of the auditory ERP may shed light on the impairments of information processing streams in schizophrenia. However, the habituation properties (i.e., decreasing amplitude with the repeated presentation of an auditory stimulus) of these components remain poorly studied compared to other auditory ERPs. Therefore, the current study used a roving paradigm to assess the modulation and habituation of N1 and P2 to simple (pure tones) and complex sounds (human voices and bird songs) in 26 first-episode patients with schizophrenia and 27 healthy participants. To explore the habituation properties of these ERPs, we measured the decrease in amplitude over a train of seven repetitions of the same stimulus (either bird songs or human voices). We observed that, for human voices, N1 and P2 amplitudes decreased linearly from stimulus 1-7, in both groups. Regarding bird songs, only the P2 component showed a decreased amplitude with stimulus presentation, exclusively in the control group. This suggests that patients did not show a fading of neural responses to repeated bird songs, reflecting abnormal habituation to this stimulus. This could reflect the inability to inhibit irrelevant or redundant information at later stages of auditory processing. In turn schizophrenia patients appear to have a preserved auditory processing of human voices.

A systematic review of MRI studies of language development from birth to 2 years of age

Neurocognitive functions supporting language development start to develop well before first words are spoken during the first years of life. This process coincides with the initial growth spurt of the brain. While the core components of the language network are well characterized in adults and children, the initial neural correlates of language skills are still relatively unknown. We reviewed 10 studies identified via a systematic search that combined magnetic resonance imaging and language-related measures in healthy infants from birth to 2 years of age. We aimed to describe the current knowledge as well as point out viable future directions for similar studies. Expectedly, the implicated cerebral areas included many established components of the language networks, including frontal and temporal regions. A volumetric leftward asymmetry of the brain was suggested as a determinant of language skills, yet with marked interindividual variation. Overall, temporal and frontal brain volumes associated positively with language skills. Positive associations were described between the maturation of language related white matter tracts and language skills. The language networks showed adult-like structural similarities already in neonates, with weaker asymmetry compared to adults. In summary, we found some evidence that the language circuit described in older age groups is also associated to language skills during the first 2 years of life. However, across the reviewed studies there were no systematic neural correlates of language skills, which is partly explained by a modest number of studies, scattered representation of ages in measurements and the variance in the used methods.

Meaning before grammar: A review of ERP experiments on the neurodevelopmental origins of semantic processing

According to traditional linguistic theories, the construction of complex meanings relies firmly on syntactic structure-building operations. Recently, however, new models have been proposed in which semantics is viewed as being partly autonomous from syntax. In this paper, we discuss some of the developmental implications of syntax-based and autonomous models of semantics. We review event-related brain potential (ERP) studies on semantic processing in infants and toddlers, focusing on experiments reporting modulations of N400 amplitudes using visual or auditory stimuli and different temporal structures of trials. Our review suggests that infants can relate or integrate semantic information from temporally overlapping stimuli across modalities by 6 months of age. The ability to relate or integrate semantic information over time, within and across modalities, emerges by 9 months. The capacity to relate or integrate information from spoken words in sequences and sentences appears by 18 months. We also review behavioral and ERP studies showing that grammatical and syntactic processing skills develop only later, between 18 and 32 months. These results provide preliminary evidence for the availability of some semantic processes prior to the full developmental emergence of syntax: non-syntactic meaning-building operations are available to infants, albeit in restricted ways, months before the abstract machinery of grammar is in place. We discuss this hypothesis in light of research on early language acquisition and human brain development.

White Matter Development from Birth to 6 Years of Age: A Longitudinal Study

Human white matter development in the first years of life is rapid, setting the foundation for later development. Microstructural properties of white matter are linked to many behavioral and psychiatric outcomes; however, little is known about when in development individual differences in white matter microstructure are established. The aim of the current study is to characterize longitudinal development of white matter microstructure from birth through 6 years to determine when in development individual differences are established. Two hundred and twenty-four children underwent diffusion-weighted imaging after birth and at 1, 2, 4, and 6 years. Diffusion tensor imaging data were computed for 20 white matter tracts (9 left-right corresponding tracts and 2 commissural tracts), with tract-based measures of fractional anisotropy and axial and radial diffusivity. Microstructural maturation between birth and 1 year are much greater than subsequent changes. Further, by 1 year, individual differences in tract average values are consistently predictive of the respective 6-year values, explaining, on average, 40% of the variance in 6-year microstructure. Results provide further evidence of the importance of the first year of life with regard to white matter development, with potential implications for informing early intervention efforts that target specific sensitive periods.

Brain Characteristics Noted Prior to and Following Cranial Orthotic Treatment

Objective:

This case report aims to assess a potential association between cranial asymmetry, brain deformation, and associated developmental delay.

Study Design:

Two infants born at ≥37 weeks pursuing cranial orthotic treatment for severe Deformational Plagiocephaly (DP) (cranial vault asymmetry index >8.75%) underwent developmental assessment using Mullen Scales of Early Learning (MSEL) and non-sedated brain structural and diffusion magnetic resonance imaging (MRI) prior to and following cranial orthotic treatment.

Results:

In both infants with DP, tractography results revealed alterations in the white matter pathways of the brain. Both infants also had low to low/normal visual receptivity and fine motor skills. After cranial orthotic treatment, cranial asymmetry improved but did not completely resolve, tractography demonstrated a change toward normalized white matter pathways, and visual receptivity and fine motor skills improved.

Conclusions:

These preliminary findings suggest a potential link between DP, altered brain structures, and developmental assessment. Further investigation with a larger sample is warranted.

Anatomo-functional correlates of auditory development in infancy

Infant brain development incorporates several intermingled mechanisms leading to intense and asynchronous maturation across cerebral networks and functional modalities. Combining electroencephalography (EEG) and diffusion magnetic resonance imaging (MRI), previous studies in the visual modality showed that the functional maturation of the event-related potentials (ERP) during the first postnatal semester relates to structural changes in the corresponding white matter pathways. Here investigated similar issues in the auditory modality. We measured ERPs to syllables in 1- to 6-month-old infants and related them to the maturational properties of underlying neural substrates measured with diffusion tensor imaging (DTI). We first observed a decrease in the latency of the auditory P2, and in the diffusivities in the auditory tracts and perisylvian regions with age. Secondly, we highlighted some of the early functional and structural substrates of lateralization. Contralateral responses to monoaural syllables were stronger and faster than ipsilateral responses, particularly in the left hemisphere. Besides, the acoustic radiations, arcuate fasciculus, middle temporal and angular gyri showed DTI asymmetries with a more complex and advanced microstructure in the left hemisphere, whereas the reverse was observed for the inferior frontal and superior temporal gyri. Finally, after accounting for the age-related variance, we correlated the inter-individual variability in P2 responses and in the microstructural properties of callosal fibers and inferior frontal regions. This study combining dedicated EEG and MRI approaches in infants highlights the complex relation between the functional responses to auditory stimuli and the maturational properties of the corresponding neural network.

Impact of prematurity on neurodevelopment

The consequences of prematurity on brain functional development are numerous and diverse, and impact all brain functions at different levels. Prematurity occurs between 22 and 36 weeks of gestation. This period is marked by extreme dynamics in the physiologic maturation, structural, and functional processes. These different processes appear sequentially or simultaneously. They are dependent on genetic and/or environmental factors. Disturbance of these processes or of the fine-tuning between them, when caring for premature children, is likely to induce disturbances in the structural and functional development of the immature neural networks. These will appear as impairments in learning skills progress and are likely to have a lasting impact on the development of children born prematurely. The level of severity depends on the initial alteration, whether structural or functional. In this chapter, after having briefly reviewed the neurodevelopmental, structural, and functional processes, we describe, in a nonexhaustive manner, the impact of prematurity on the different brain, motor, sensory, and cognitive functions.

Sensorimotor influences on speech perception in pre-babbling infants: Replication and extension of Bruderer et al. (2015)

The relationship between speech perception and production is central to understanding language processing, yet remains under debate, particularly in early development. Recent research suggests that in infants aged 6 months, when the native phonological system is still being established, sensorimotor information from the articulators influences speech perception: The placement of a teething toy restricting tongue-tip movements interfered with infants' discrimination of a non-native contrast, /Da/-/da/, that involves tongue-tip movement. This effect was selective: A different teething toy that prevented lip closure but not tongue-tip movement did not disrupt discrimination. We conducted two sets of studies to replicate and extend these findings. Experiments 1 and 2 replicated the study by Bruderer et al. (Proceedings of the National Academy of Sciences of the United States of America, 112 (44), 13531-13536, 2015), but with synthesized auditory stimuli. Infants discriminated the non-native contrast (dental /da/ - retroflex /Da/) (Experiment 1), but showed no evidence of discrimination when the tongue-tip movement was prevented with a teething toy (Experiment 2). Experiments 3 and 4 extended this work to a native phonetic contrast (bilabial /ba/ - dental /da/). Infants discriminated the distinction with no teething toy present (Experiment 3), but when they were given a teething toy that interfered only with lip closure, a movement involved in the production of /ba/, discrimination was disrupted (Experiment 4). Importantly, this was the same teething toy that did not interfere with discrimination of /da/-/Da/ in Bruderer et al. (2015). These findings reveal specificity in the relation between sensorimotor and perceptual processes in pre-babbling infants, and show generalizability to a second phonetic contrast.

TRActs constrained by UnderLying INfant anatomy (TRACULInA): An automated probabilistic tractography tool with anatomical priors for use in the newborn brain

The ongoing myelination of white-matter fiber bundles plays a significant role in brain development. However, reliable and consistent identification of these bundles from infant brain MRIs is often challenging due to inherently low diffusion anisotropy, as well as motion and other artifacts. In this paper we introduce a new tool for automated probabilistic tractography specifically designed for newborn infants. Our tool incorporates prior information about the anatomical neighborhood of white-matter pathways from a training data set. In our experiments, we evaluate this tool on data from both full-term and prematurely born infants and demonstrate that it can reconstruct known white-matter tracts in both groups robustly, even in the presence of differences between the training set and study subjects. Additionally, we evaluate it on a publicly available large data set of healthy term infants (UNC Early Brain Development Program). This paves the way for performing a host of sophisticated analyses in newborns that we have previously implemented for the adult brain, such as pointwise analysis along tracts and longitudinal analysis, in both health and disease.

A Penny for Your Thoughts: Children's Inner Speech and Its Neuro-Development

Inner speech emerges in early childhood, in parallel with the maturation of the dorsal language stream. To date, the developmental relations between these two processes have not been examined. We review evidence that the dorsal language stream has a role in supporting the psychological phenomenon of inner speech, before considering pediatric studies of the dorsal stream's anatomical development and evidence for its emerging functional roles. We examine possible causal accounts of the relations between these two developmental processes and consider their implications for phylogenetic theories about the evolution of inner speech and the accounts of the ontogenetic relations between language and cognition.

Language and cognitive outcomes after childhood stroke: Theoretical implications for hemispheric specialization

The purpose of this study was to investigate language and cognitive outcomes following severe childhood stroke, and the role of age at stroke according to lesion lateralization. We retrospectively included children consecutively admitted to a physical medicine and rehabilitation department between 1992 and 2015 following childhood stroke (age at stroke 1 month to15 years). Data collection included demographic and clinical information, results of cognitive assessments on the Wechsler Intelligence scales, detailed language assessments by speech and language therapists, and long-term academic outcome. Overall, 184 children (52% boys; mean age at assessment = 8.5 years, range .7-15.4 years) were hospitalized following ischemic (n = 79) or hemorrhagic (n = 105) stroke. After a median time since stroke of 4 months (n = 135), mean Full-Scale, Verbal, and Performance Intellectual Quotient (FSIQ, VIQ and PIQ) were 85 (SD = 19), 93 (SD = 22), and 85 (SD = 20), respectively. In language tests (n = 130) assessing lexical and syntactic expression and comprehension, 26%-53% of the children exhibited impairments (scores <2SD). After a median follow-up of 40 months, only 27% of the children were following a normal curriculum without adaptations or delay, and 27% were attending special education programs. School situation was strongly associated with language and FSIQ scores. Language and verbal IQ scores were significantly lower (p < .01) among patients with lesions in the left hemisphere as opposed to the right. After a left hemisphere lesion, language skills were not associated with age at stroke, but for right hemisphere lesions, language was more impaired among children who were younger at stroke onset. PIQ tended to correlate positively with age at stroke in left hemisphere lesions (poorer PIQ in early lesions) and negatively for right hemisphere lesions (poorer PIQ in late lesions). These findings, discussed in the light of the brain vulnerability and plasticity hypotheses, are in favor of a developmental view of hemispheric specialization.

Developmental conduction aphasia after neonatal stroke

Objective

Impairment of speech repetition following injury to the dorsal language stream is a feature of conduction aphasia, a well‐described “disconnection syndrome” in adults. The impact of similar lesions sustained in infancy has not been established.

Methods

We compared language outcomes in term‐born individuals with confirmed neonatal stroke (n = 30, age = 7–18 years, left‐sided lesions in 21 cases) to matched controls (n = 40). Injury to the dorsal and/or ventral language streams was assessed using T₁‐ and T₂‐weighted magnetic resonance imaging (MRI) and diffusion tractography. Language lateralization was determined using functional MRI.

Results

At the group level, left dorsal language stream injury was associated with selective speech repetition impairment for nonwords (p = 0.021) and sentences (p < 0.0001). The majority of children with significant repetition impairment had retained left hemisphere language representation, but right hemisphere dominance was correlated with minimal or absent repetition deficits. Post hoc analysis of the repetition‐impaired group revealed additional language‐associated deficits, but these were more subtle and variable.

Interpretation

We conclude that (1) despite the considerable plasticity of the infant brain, early dorsal language stream injury can result in specific and long‐lasting problems with speech repetition that are similar to the syndrome of conduction aphasia seen in adults; and (2) language reorganization to the contralateral hemisphere has a protective effect. Ann Neurol 2018;83:664–675 Ann Neurol 2018;83:664–675

Bilingual effects on lexical selection: A neurodevelopmental perspective

When a listener hears a word, multiple lexical items may come to mind; for instance, /kæn/ may activate concepts with similar phonological onsets such as candy and candle. Acquisition of two lexicons may increase such linguistic competition. Using functional Near-Infrared Spectroscopy neuroimaging, we investigate whether bilingualism impacts word processing in the child's brain. Bilingual and monolingual children (N = 52; ages 7-10) completed a lexical selection task in English, where participants adjudicated phonological competitors (e.g., car/cat vs. car/pen). Children were less accurate and responded more slowly during competing than non-competing items. In doing so, children engaged top-down fronto-parietal regions associated with cognitive control. In comparison to bilinguals, monolinguals showed greater activity in left frontal regions, a difference possibly due to bilinguals' adaptation for dual-lexicons. These differences provide insight to theories aiming to explain the role of experience on children's emerging neural networks for lexical selection and language processing.

A catalog of single nucleotide changes distinguishing modern humans from archaic hominins

Throughout the past decade, studying ancient genomes has provided unique insights into human prehistory, and differences between modern humans and other branches like Neanderthals can enrich our understanding of the molecular basis of unique modern human traits. Modern human variation and the interactions between different hominin lineages are now well studied, making it reasonable to go beyond fixed genetic changes and explore changes that are observed at high frequency in present-day humans. Here, we identify 571 genes with non-synonymous changes at high frequency. We suggest that molecular mechanisms in cell division and networks affecting cellular features of neurons were prominently modified by these changes. Complex phenotypes in brain growth trajectory and cognitive traits are likely influenced by these networks and other non-coding changes presented here. We propose that at least some of these changes contributed to uniquely human traits, and should be prioritized for experimental validation.

Altered lateralization of dorsal language tracts in 6-week-old infants at risk for autism

Altered structural connectivity has been identified as a possible biomarker of autism spectrum disorder (ASD) risk in the developing brain. Core features of ASD include impaired social communication and early language delay. Thus, examining white matter tracts associated with language may lend further insight into early signs of ASD risk and the mechanisms that underlie language impairments associated with the disorder. Evidence of altered structural connectivity has previously been detected in 6-month-old infants at high familial risk for developing ASD. However, as language processing begins in utero, differences in structural connectivity between language regions may be present in the early infant brain shortly after birth. Here we investigated key white matter pathways of the dorsal language network in 6-week-old infants at high (HR) and low (LR) risk for ASD to identify atypicalities in structural connectivity that may predict altered developmental trajectories prior to overt language delays and the onset of ASD symptomatology. Compared to HR infants, LR infants showed higher fractional anisotropy (FA) in the left superior longitudinal fasciculus (SLF); in contrast, in the right SLF, HR infants showed higher FA than LR infants. Additionally, HR infants showed more rightward lateralization of the SLF. Across both groups, measures of FA and lateralization of these pathways at 6 weeks of age were related to later language development at 18 months of age as well as ASD symptomatology at 36 months of age. These findings indicate that early differences in the structure of language pathways may provide an early predictor of future language development and ASD risk.

Neuroscience and education: Cerebral lateralization of networks and oscillations in dyslexia

Liaison between neuroscience and education has resulted in significant advances in our understanding of the neurobiological learning requirements of individuals with reading disability, the neuroplasticity of the developing brain, and the participation of the right hemisphere in reading. Research in neural network theory and cortical oscillations suggests that the hemispheres collaborate in high-level language processes. The right hemisphere specializes in coding low frequencies of the speech envelope and interhemispheric cognitive control, while the left is specialized for local high frequency, verbal computations. Studies in neural networks, and cortical oscillations which controlled for reading-level, converge in identifying an impaired right hemisphere circuitry of frontoparietal attention networks as a primary cause of dyslexia. Occurring in early development, such a dysfunction would have a cascading negative effect on phonemic processing in the left hemisphere dorsal reading network. Such integrative hemispheric cooperation suggests a more comprehensive approach to early reading instruction and interventions in dyslexia.

Does early motor development contribute to speech perception?

At the end of the target article, Keven & Akins (K&A) put forward a challenge to the developmental psychology community to consider the development of complex psychological processes - in particular, intermodal infant perception - across different levels of analysis. We take up that challenge and consider the possibility that early emerging stereotypies might help explain the foundations of the link between speech perception and speech production.

Connectivity between the visual word form area and the parietal lobe improves after the first year of reading instruction: a longitudinal MRI study in children

Shortly after reading instruction, a region in the ventral occipital temporal cortex (vOTC) of the left hemisphere, the Visual Word Form Area (VWFA), becomes specialized for written words. Its reproducible location across scripts suggests important anatomical constraints, such as specific patterns of connectivity, notably to spoken language areas. Here, we explored the structural connectivity of the emerging VWFA in terms of its specificity relative to other ventral visual regions and its stability throughout the process of reading instruction in ten children studied longitudinally over 2 years. Category-specific regions for words, houses, faces, and tools were identified in the left vOTC of each subject with functional MRI. With diffusion MRI and tractography, we reconstructed the connections of these regions at two time points (mean age ± standard deviation: 6.2 ± 0.3, 7.2 ± 0.4 years). We first showed that the regions for each visual category harbor their own specific connectivity, all of which precede reading instruction and remain stable throughout development. The most specific connections of the VWFA were to the dorsal posterior parietal cortex. We then showed that microstructural changes in these connections correlated with improvements in reading scores over the first year of instruction but not 1 year later in a subsample of eight children (age: 8.4 ± 0.3 years). These results suggest that the VWFA location depends on its connectivity to distant regions, in particular, the left inferior parietal region which may play a crucial role in visual field maps and eye movement dynamics in addition to attentional control in letter-by-letter reading and disambiguation of mirror-letters during the first stages of learning to read.

Clinical application of advanced MR methods in children: points to consider

The application of both functional MRI and diffusion MR tractography prior to a neurosurgical operation is well established in adults, but less so in children, for several reasons. For this review, we have identified several aspects (task design, subject preparation, actual scanning session, data processing, interpretation of results, and decision-making) where pediatric peculiarities should be taken into account. Further, we not only systematically identify common issues, but also provide solutions, based on our experience as well as a review of the pertinent literature. The aim is to provide the clinician as well as the imaging scientist with information that helps to plan, conduct, and interpret such a clinically-indicated exam in a way that maximizes benefit for, and minimizes the burden on the individual child.

Advanced diffusion imaging for assessing normal white matter development in neonates and characterizing aberrant development in congenital heart disease

Background

Elucidating developmental trajectories of white matter (WM) microstructure is critically important for understanding normal development and regional vulnerabilities in several brain disorders. Diffusion Weighted Imaging (DWI) is currently the method of choice for in-vivo white matter assessment. A majority of neonatal studies use the standard Diffusion Tensor Imaging (DTI) model although more advanced models such as the Neurite Orientation Dispersion and Density Imaging (NODDI) model and the Gaussian Mixture Model (GMM) have been used in adult population. In this study, we compare the ability of these three diffusion models to detect regional white matter maturation in typically developing control (TDC) neonates and regional abnormalities in neonates with congenital heart disease (CHD).

Methods

Multiple b-value diffusion Magnetic Resonance Imaging (dMRI) data were acquired from TDC neonates (N = 16) at 38 to 47 gestational weeks (GW) and CHD neonates (N = 19) aged 37 weeks to 41 weeks. Measures calculated from the diffusion signal included not only Mean Diffusivity (MD) and Fractional Anisotropy (FA) derived from the standard DTI model, but also three advanced diffusion measures, namely, the fiber Orientation Dispersion Index (ODI), the isotropic volume fraction (Viso), and the intracellular volume fraction (Vic) derived from the NODDI model. Further, we used two novel measures from a non-parametric GMM, namely the Return-to-Origin Probability (RTOP) and Return-to-Axis Probability (RTAP), which are sensitive to axonal/cellular volume and density respectively. Using atlas-based registration, 22 white matter regions (6 projection, 4 association, and 1 callosal pathways bilaterally in each hemisphere) were selected and the mean value of all 7 measures were calculated in each region. These values were used as dependent variables, with GW as the independent variable in a linear regression model. Finally, we compared CHD and TDC groups on these measures in each ROI after removing age-related trends from both the groups.

Results

Linear analysis in the TDC population revealed significant correlations with GW (age) in 12 projection pathways for MD, Vic, RTAP, and 11 pathways for RTOP. Several association pathways were also significantly correlated with GW for MD, Vic, RTAP, and RTOP. The right callosal pathway was significantly correlated with GW for Vic. Consistent with the pathophysiology of altered development in CHD, diffusion measures demonstrated differences in the association pathways involved in language systems, namely the Uncinate Fasciculus (UF), the Inferior Fronto-occipital Fasciculus (IFOF), and the Superior Longitudinal Fasciculus (SLF). Overall, the group comparison between CHD and TDC revealed lower FA, Vic, RTAP, and RTOP for CHD bilaterally in the a) UF, b) Corpus Callosum (CC), and c) Superior Fronto-Occipital Fasciculus (SFOF). Moreover, FA was lower for CHD in the a) left SLF, b) bilateral Anterior Corona Radiata (ACR) and left Retrolenticular part of the Internal Capsule (RIC). Vic was also lower for CHD in the left Posterior Limb of the Internal Capsule (PLIC). ODI was higher for CHD in the left CC. RTAP was lower for CHD in the left IFOF, while RTOP was lower in CHD in the: a) left ACR, b) left IFOF and c) right Anterior Limb of the Internal Capsule (ALIC).

Conclusion

In this study, all three methods revealed the expected changes in the WM regions during the early postnatal weeks; however, GMM outperformed DTI and NODDI as it showed significantly larger effect sizes while detecting differences between the TDC and CHD neonates. Future studies based on a larger sample are needed to confirm these results and to explore clinical correlates.