Greater Increase in Hippocampal Activity During the Early Postnatal Period After Preterm Birth Is Associated With Better Cognitive and Motor Outcomes at 18 Months

Anika Guha ¹, Sharon K Hunter ¹, Kristina T Legget ^1,2

⁰Department of Psychiatry, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.

Developmental Neurobiology +

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October 31, 2025

View abstract on PubMed

Summary

Early increases in hippocampal activity in preterm infants predict better cognitive and motor skills. Dynamic brain changes, not static measures, are key indicators for neurodevelopmental outcomes in infants born prematurely.

Area Of Science

Neuroscience
Developmental Neuroscience
Pediatric Neurology

Background

A balance between neuronal excitation and inhibition (E/I) is critical for brain development.
Deviations in E/I balance are implicated in neurodevelopmental disorders.
Early postnatal hippocampal activity is hypothesized to stabilize neural circuitry, but this remains unexamined in humans.

Purpose Of The Study

To investigate the impact of early hippocampal activity and gestational age on neurodevelopmental outcomes in preterm infants.
To determine if dynamic changes in hippocampal function are more sensitive indicators than baseline measures in this population.

Main Methods

Longitudinal resting-state functional magnetic resonance imaging (fMRI) data from 58 preterm infants.
Assessment of hippocampal activity using amplitude of low-frequency fluctuations (ALFF) at two early postnatal timepoints.
Correlation of early hippocampal activity and gestational age with cognitive and motor function at 18 months.

Main Results

Increased hippocampal activity in early infancy predicted enhanced cognitive and motor function at 18 months.
Higher gestational age at birth correlated with a greater increase in hippocampal activity over the early postnatal period.
No significant association was found between baseline hippocampal activity and later outcomes, highlighting the importance of dynamic changes.

Conclusions

Changes in early hippocampal function and gestational age are crucial risk factors for neurodevelopmental concerns in preterm infants.
Dynamic alterations in brain activity, rather than static measures, are sensitive indicators of neurodevelopmental trajectories following preterm birth.
These findings emphasize the need to monitor early brain development dynamics in preterm populations.

Keywords:

cognition excitatory/inhibitory balance hippocampal activity neurodevelopment preterm infants resting‐state functional magnetic resonance imaging (fMRI)