Third-Trimester Development of Central Autonomic Network Connectivity Is Altered in an Extrauterine Environment

Area of Science:

• Neuroscience
• Developmental Pediatrics
• Autonomic Nervous System Research

Background:

• The central autonomic network (CAN) regulates the autonomic nervous system and may influence psychosocial and behavioral outcomes in preterm infants.
• Preterm birth is associated with an increased risk of developmental challenges.

Purpose of the Study:

• To compare resting-state functional connectivity of the CAN between healthy term-born controls and preterm infants.
• To investigate the relationship between CAN connectivity, postmenstrual age (PMA), and behavioral outcomes in preterm infants.

Main Methods:

• Resting-state functional MRI was used to assess CAN connectivity in 94 term-born and 94 preterm infants at term-equivalent age.
• Correlations were performed between CAN connectivity and PMA in preterm infants.
• Infant-Toddler Social and Emotional Assessment scores at 18 months were correlated with CAN connectivity in the preterm cohort.

Main Results:

• Term infants exhibited significantly higher CAN connectivity in the amygdala, hippocampus, insula, brainstem, and thalamus compared to preterm infants.
• In preterm infants, CAN connectivity positively correlated with PMA in the thalamus, insula, precuneus, hippocampus, and amygdala.
• Higher insula CAN connectivity in preterm infants was associated with fewer externalizing behaviors at 18 months.

Conclusions:

• The CAN develops dynamically in preterm neonates during the third trimester and differs from term-born neonates, affecting developmental trajectories.
• This study provides the first description of CAN connectivity using resting-state fMRI in a large cohort of neonates and links it to behavioral outcomes.