Parsing brain-behavior heterogeneity in very preterm born children using integrated similarity networks.

Autor: Hadaya L; Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK.; Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK., Dimitrakopoulou K; Translational Bioinformatics Platform, NIHR Biomedical Research Centre, Guy's and St. Thomas' NHS Foundation Trust and King's College London, London, UK., Vanes LD; Centre for Neuroimaging Sciences, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK., Kanel D; Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK.; Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK., Fenn-Moltu S; Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK.; Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK., Gale-Grant O; Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK.; Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK.; MRC Centre for Neurodevelopmental Disorders, King's College London, London, UK., Counsell SJ; Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK., Edwards AD; Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK., Saqi M; Translational Bioinformatics Platform, NIHR Biomedical Research Centre, Guy's and St. Thomas' NHS Foundation Trust and King's College London, London, UK., Batalle D; Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK.; Department of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK., Nosarti C; Centre for the Developing Brain, Department of Perinatal Imaging and Health, Faculty of Life Sciences & Medicine, King's College London, London, UK. chiara.nosarti@kcl.ac.uk.; Department of Child and Adolescent Psychiatry, Institute of Psychiatry Psychology and Neuroscience, King's College London, London, UK. chiara.nosarti@kcl.ac.uk.
Jazyk: angličtina
Zdroj: Translational psychiatry [Transl Psychiatry] 2023 Apr 03; Vol. 13 (1), pp. 108. Date of Electronic Publication: 2023 Apr 03.
DOI: 10.1038/s41398-023-02401-w
Abstrakt: Very preterm birth (VPT; ≤32 weeks' gestation) is associated with altered brain development and cognitive and behavioral difficulties across the lifespan. However, heterogeneity in outcomes among individuals born VPT makes it challenging to identify those most vulnerable to neurodevelopmental sequelae. Here, we aimed to stratify VPT children into distinct behavioral subgroups and explore between-subgroup differences in neonatal brain structure and function. 198 VPT children (98 females) previously enrolled in the Evaluation of Preterm Imaging Study (EudraCT 2009-011602-42) underwent Magnetic Resonance Imaging at term-equivalent age and neuropsychological assessments at 4-7 years. Using an integrative clustering approach, we combined neonatal socio-demographic, clinical factors and childhood socio-emotional and executive function outcomes, to identify distinct subgroups of children based on their similarity profiles in a multidimensional space. We characterized resultant subgroups using domain-specific outcomes (temperament, psychopathology, IQ and cognitively stimulating home environment) and explored between-subgroup differences in neonatal brain volumes (voxel-wise Tensor-Based-Morphometry), functional connectivity (voxel-wise degree centrality) and structural connectivity (Tract-Based-Spatial-Statistics). Results showed two- and three-cluster data-driven solutions. The two-cluster solution comprised a 'resilient' subgroup (lower psychopathology and higher IQ, executive function and socio-emotional scores) and an 'at-risk' subgroup (poorer behavioral and cognitive outcomes). No neuroimaging differences between the resilient and at-risk subgroups were found. The three-cluster solution showed an additional third 'intermediate' subgroup, displaying behavioral and cognitive outcomes intermediate between the resilient and at-risk subgroups. The resilient subgroup had the most cognitively stimulating home environment and the at-risk subgroup showed the highest neonatal clinical risk, while the intermediate subgroup showed the lowest clinical, but the highest socio-demographic risk. Compared to the intermediate subgroup, the resilient subgroup displayed larger neonatal insular and orbitofrontal volumes and stronger orbitofrontal functional connectivity, while the at-risk group showed widespread white matter microstructural alterations. These findings suggest that risk stratification following VPT birth is feasible and could be used translationally to guide personalized interventions aimed at promoting children's resilience.
(© 2023. The Author(s).)
Databáze: MEDLINE
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