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Using Functional Connectivity Magnetic Resonance Imaging to Measure Brain Connectivity in Preterm Infants
Rita Pickler1, Stephanie Sealschott, Margo Moore
1Rita Pickler, PhD, RN, FAAN, is the FloAnn Sours Easton Professor of Child and Adolescent Health and Director, PhD and MS in Nursing Science Programs, College of Nursing, The Ohio State University, Columbus. Stephanie Sealschott, BS, RN, is T32 Predoctoral Fellow, College of Nursing, The Ohio State University, Columbus, and Research Nurse I, Cincinnati Children's Hospital Medical Center, Ohio. Margo Moore, MS, RN, is Research Nurse III, Cincinnati Children's Hospital Medical Center, Ohio. Stephanie Merhar, MD, MS, is Attending Neonatologist, Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, and Assistant Professor, Department of Pediatrics, University of Cincinnati, Ohio. Jean Tkach, PhD, is Associate Professor, Department of Radiology, University of Cincinnati and Cincinnati Children's Hospital Medical Center, Ohio. Andrew P. Salzwedel, PhD, is Project Scientist, Department of Biomedical Sciences, Cedars-Sinai Biomedical Imaging Research Institute-Gao Laboratory, Los Angeles, California. Weili Lin, PhD, is Professor of Radiology Neurology and Biomedical Engineering; Director of MR Research Center, Department of Radiology; Director, Small Animal Imaging Core Facility; Associate Director of Biomedical Research Imaging Center; and Vice Chair, Basic Research, Radiology, University of North Carolina, Chapel Hill. Wai Gao, PhD, is Associate Professor, Biomedical Sciences, and Director, Neuroimaging Research, Cedars-Sinai Medical Center, Los Angeles, California.
Background:
The use of functional connectivity magnetic resonance imaging (fcMRI) in research involving preterm infants is relatively new, and its feasibility in this population is not fully established. However, fcMRI images reveal functional neural connections that may be useful in establishing the mechanisms of neuroprotective interventions in preterm infants.
Objective:
The aim of this study was to determine the feasibility of using fcMRI to measure differences in functional neural connections in nursing intervention studies.
Methods:
A pilot study was conducted as part of a longitudinal, randomized controlled trial (RCT) testing the effect of a feeding intervention on neurodevelopmental and clinical outcomes of preterm infants randomly assigned to one of two groups: a patterned feeding experience (PFE) group and a usual feeding care (UFC) group. The fcMRIs were done at term-equivalent age. Visual, motor, and default mode networks were analyzed.
Results:
Seven infants were studied (four were in the PFE group, and three were in the UFC group). Participants were selected sequentially from the parent RCT. Clear images were obtained from all participants. Differences were noted among PFE and UFC infants: Infants receiving PFE were hyperconnective in the default mode (caudate, anterior cingulate cortex, and precuneus) and motor networks (middle temporal and middle occipital areas) and hypoconnective in others areas of the default mode (hippocampal and lingual regions) and motor networks (precentral and superior frontal cortices) relative to UFC infants. No differences were noted in visual networks.
Discussion:
The feasibility of using fcMRI at term-equivalent age in preterm infants who participated in an RCT on the effect of a nursing intervention was shown. Differences in connectivity among infants by group were detected. Further research is needed to show the benefit of fcMRI in studies of preterm infants given the costs of the procedure as well as the uncertain relationship of this early outcome measure to long-term neurodevelopment.
