Functional plasticity before the cradle: a review of neural functional imaging in the human fetus

Imaging the "At-Risk" Brain: Future Directions

OBJECTIVES

Clinical neuroscience is increasingly turning to imaging the human brain for answers to a range of questions and challenges. To date, the majority of studies have focused on the neural basis of current psychiatric symptoms, which can facilitate the identification of neurobiological markers for diagnosis. However, the increasing availability and feasibility of using imaging modalities, such as diffusion imaging and resting-state fMRI, enable longitudinal mapping of brain development. This shift in the field is opening the possibility of identifying predictive markers of risk or prognosis, and also represents a critical missing element for efforts to promote personalized or individualized medicine in psychiatry (i.e., stratified psychiatry).

METHODS

The present work provides a selective review of potentially high-yield populations for longitudinal examination with MRI, based upon our understanding of risk from epidemiologic studies and initial MRI findings.

RESULTS

Our discussion is organized into three topic areas: (1) practical considerations for establishing temporal precedence in psychiatric research; (2) readiness of the field for conducting longitudinal MRI, particularly for neurodevelopmental questions; and (3) illustrations of high-yield populations and time windows for examination that can be used to rapidly generate meaningful and useful data. Particular emphasis is placed on the implementation of time-appropriate, developmentally informed longitudinal designs, capable of facilitating the identification of biomarkers predictive of risk and prognosis.

CONCLUSIONS

Strategic longitudinal examination of the brain at-risk has the potential to bring the concepts of early intervention and prevention to psychiatry.

Patterns of Spontaneous Local Network Activity in Developing Cerebral Cortex: Relationship to Adult Cognitive Function

Detecting neurodevelopμental disorders of cognition at the earliest possible stages could assist in understanding them mechanistically and ultimately in treating them. Finding early physiological predictors that could be visualized with functional neuroimaging would represent an important advance in this regard. We hypothesized that one potential source of physiological predictors is the spontaneous local network activity prominent during specific periods in development. To test this we used calcium imaging in brain slices and analyzed variations in the frequency and intensity of this early activity in one area, the entorhinal cortex (EC), in order to correlate early activity with level of cognitive function later in life. We focused on EC because of its known role in different types of cognitive processes and because it is an area where spontaneous activity is prominent during early postnatal development in rodent models of cortical development. Using rat strains (Long-Evans, Wistar, Sprague-Dawley and Brattleboro) known to differ in cognitive performance in adulthood we asked whether neonatal animals exhibit corresponding strain-related differences in EC spontaneous activity. Our results show significant differences in this activity between strains: compared to a high cognitive-performing strain, we consistently found an increase in frequency and decrease in intensity in neonates from three lower performing strains. Activity was most different in one strain considered a model of schizophrenia-like psychopathology. While we cannot necessarily infer a causal relationship between early activity and adult cognition our findings suggest that the pattern of spontaneous activity in development could be an early predictor of a developmental trajectory advancing toward sub-optimal cognitive performance in adulthood. Our results further suggest that the strength of dopaminergic signaling, by setting the balance between excitation and inhibition, is a potential underlying mechanism that could explain the observed differences in early spontaneous activity patterns.

Age-related increases in long-range connectivity in fetal functional neural connectivity networks in utero

Formation of operational neural networks is one of the most significant accomplishments of human fetal brain growth. Recent advances in functional magnetic resonance imaging (fMRI) have made it possible to obtain information about brain function during fetal development. Specifically, resting-state fMRI and novel signal covariation approaches have opened up a new avenue for non-invasive assessment of neural functional connectivity (FC) before birth. Early studies in this area have unearthed new insights about principles of prenatal brain function. However, very little is known about the emergence and maturation of neural networks during fetal life. Here, we obtained cross-sectional rs-fMRI data from 39 fetuses between 24 and 38 weeks postconceptual age to examine patterns of connectivity across ten neural FC networks. We identified primitive forms of motor, visual, default mode, thalamic, and temporal networks in the human fetal brain. We discovered the first evidence of increased long-range, cerebral-cerebellar, cortical-subcortical, and intra-hemispheric FC with advancing fetal age. Continued aggregation of data about fundamental neural connectivity systems in utero is essential to establishing principles of connectomics at the beginning of human life. Normative data provides a vital context against which to compare instances of abnormal neurobiological development.

Adaptive mechanisms of developing brain: cerebral lateralization in the prematurely-born

Preterm birth results in alterations in neural connectivity, but the impact of prematurity on the functional organization of the developing brain has yet to be explored. To test the hypothesis that preterm birth alters cortical organization during the late second and third trimesters of gestation, we interrogated cerebral lateralization at rest in 26 very preterm subjects (birth weight 500-1500g) with no evidence of brain injury and 25 healthy term control subjects at term equivalent age. Employing an unbiased voxel-based measure of functional connectivity, these data demonstrated that cerebral lateralization is impaired in the prematurely-born. At term equivalent age, preterm neonates showed significantly less lateralization in regions subserving both receptive and expressive language, left Brodmann (BA) areas insula-BA22-BA21 and L BA45-BA47 (p<0.05 corrected for multiple comparisons for both). Exploratory region of interest analyses demonstrated significantly less inter-hemispheric connectivity from L BA22 to R BA22 in preterm infants compared to term controls (p<0.005) and from R BA22 to its homolog (p<0.005). L BA22, Wernicke's area, was more strongly connected to R BA39, foreshadowing neural networks for language in preterm subjects at school age, adolescence and young adulthood. For these very preterm neonates born at less than 30weeks' PMA, the degree of prematurity had no influence on lateralization in these differential regions.

A mechanistic approach to cross-domain perceptual narrowing in the first year of life

Language and face processing develop in similar ways during the first year of life. Early in the first year of life, infants demonstrate broad abilities for discriminating among faces and speech. These discrimination abilities then become tuned to frequently experienced groups of people or languages. This process of perceptual development occurs between approximately 6 and 12 months of age and is largely shaped by experience. However, the mechanisms underlying perceptual development during this time, and whether they are shared across domains, remain largely unknown. Here, we highlight research findings across domains and propose a top-down/bottom-up processing approach as a guide for future research. It is hypothesized that perceptual narrowing and tuning in development is the result of a shift from primarily bottom-up processing to a combination of bottom-up and top-down influences. In addition, we propose word learning as an important top-down factor that shapes tuning in both the speech and face domains, leading to similar observed developmental trajectories across modalities. Importantly, we suggest that perceptual narrowing/tuning is the result of multiple interacting factors and not explained by the development of a single mechanism.

Quantitative magnetic resonance imaging of the fetal brain in utero: Methods and applications

Application of modern magnetic resonance imaging (MRI) techniques to the live fetus in utero is a relatively recent endeavor. The relative advantages and disadvantages of clinical MRI relative to the widely used and accepted ultrasonographic approach are the subject of a continuing debate; however the focus of this review is on the even younger field of quantitative MRI as applied to non-invasive studies of fetal brain development. The techniques covered under this header include structural MRI when followed by quantitative (e.g., volumetric) analysis, as well as quantitative analyses of diffusion weighted imaging, diffusion tensor imaging, magnetic resonance spectroscopy and functional MRI. The majority of the published work reviewed here reflects information gathered from normal fetuses scanned during the 3^rd trimester, with relatively smaller number of studies of pathological samples including common congenital pathologies such as ventriculomegaly and viral infection.

Separating acoustic deviance from novelty during the first year of life: a review of event-related potential evidence

Orienting to salient events in the environment is a first step in the development of attention in young infants. Electrophysiological studies have indicated that in newborns and young infants, sounds with widely distributed spectral energy, such as noise and various environmental sounds, as well as sounds widely deviating from their context elicit an event-related potential (ERP) similar to the adult P3a response. We discuss how the maturation of event-related potentials parallels the process of the development of passive auditory attention during the first year of life. Behavioral studies have indicated that the neonatal orientation to high-energy stimuli gradually changes to attending to genuine novelty and other significant events by approximately 9 months of age. In accordance with these changes, in newborns, the ERP response to large acoustic deviance is dramatically larger than that to small and moderate deviations. This ERP difference, however, rapidly decreases within first months of life and the differentiation of the ERP response to genuine novelty from that to spectrally rich but repeatedly presented sounds commences during the same period. The relative decrease of the response amplitudes elicited by high-energy stimuli may reflect development of an inhibitory brain network suppressing the processing of uninformative stimuli. Based on data obtained from healthy full-term and pre-term infants as well as from infants at risk for various developmental problems, we suggest that the electrophysiological indices of the processing of acoustic and contextual deviance may be indicative of the functioning of auditory attention, a crucial prerequisite of learning and language development.