Early cortical maturation predicts neurodevelopment in very preterm infants

Area of Science:

• Neuroscience
• Developmental Pediatrics
• Radiology

Background:

• Very preterm (VPT) infants face risks for neurodevelopmental challenges.
• Early identification of neurodevelopmental risks is crucial for timely intervention.
• Structural MRI at term-equivalent age (TEA) offers insights into brain maturation.

Purpose of the Study:

• To assess if cortical maturation features (surface area, gyrification, sulcal depth, curvature) on MRI at TEA predict cognitive and language development at 2 years corrected age in VPT infants.
• To identify novel biomarkers for neurodevelopmental outcomes in VPT infants.

Main Methods:

• Prospective, population-based cohort study of 110 VPT infants (gestational age ≤ 31 weeks).
• Structural brain MRI acquired at 40–44 weeks postmenstrual age, processed using the developing Human Connectome Project pipeline.
• Cognitive and language development assessed at 2 years corrected age using Bayley Scales of Infant and Toddler Development, Third Edition (Bayley-III).

Main Results:

• Cortical surface area positively correlated with cognitive and language scores across most brain regions.
• Inner cortical curvature negatively correlated with Bayley scores in frontal, parietal, and temporal lobes.
• Regional surface area and curvature independently explained over one-third of the variance in 2-year cognitive and language scores, adjusting for confounders.

Conclusions:

• Increased cortical curvature at TEA is a novel prognostic biomarker for adverse neurodevelopment in VPT infants.
• Combining cortical surface area and curvature enhances prediction of cognitive and language development.
• External validation in larger cohorts is recommended.