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Title: Neonatal brain connectivity and association with outcome in infants born preterm
Author: Toulmin, Hilary
ISNI:       0000 0005 0287 5385
Awarding Body: King's College London
Current Institution: King's College London (University of London)
Date of Award: 2020
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In adults, thalamus and corpus striatum contain topographic cortical representations. It is not known whether newborn infants demonstrate adult-like thalamic or striatal topography, and it is not known how development or disruption of this architecture affects the acquisition of neurocognitive capabilities. This thesis explores the hypothesis that both thalamus and corpus striatum have topographic and integrative cortical representations at the time of normal birth; that these are modulated by early-life adversity; and that the strength of perinatal thalamocortical and corticostriatal functional connectivity would predict later functionality. Using resting state functional magnetic resonance imaging (rfMRI) at the time of normal birth to define cortical regions of interest, and estimating functional connectivity using seed-based correlations, connectivity between bilateral cortical regions and thalamus and striatum in a cohort of 47 preterm infants born between 24- and 32-weeks gestational age, and 19 term-born infants was modelled and precise topographic representations found. This topography is similar to that found in adults with regards to thalamocortical connections, but dissimilar to the pattern found in adult studies with regards to striatocortical connections. Linear regression with gestational age at birth shows that preterm infants have altered connectivity between both thalamus and striatum and a network consisting of fronto-parietalinsular cortex. Thalamocortical connectivity with anterior cingulate and dorsolateral prefrontal cortex and striatocortical connectivity with sensory-motor association area is also correlated with degree of preterm birth. To investigate connectivity at birth and neurodevelopmental outcome around 20 months, a cohort of 102 preterm infants, born between 24- and 32-weeks gestational age, was imaged at birth and subsequently followed up at 20 months old with neurodevelopmental testing using Bayley Scales of Infant and Toddler Development. Only subcortical connections with motor and pre-motor cortex are associated with developmental scores. Striatal-pre-motor connectivity is associated with cognitive and language abilities, and thalamo-pre-motor with motor function. Primary sensory-motor cortex connectivity to striatum is correlated with motor scores and to thalamus with cognitive scores. Thalamus and corpus striatum thus show precise cortical topographic connections at the time of normal birth which are required for normal development and vulnerable to adverse perinatal events.
Supervisor: Edwards, Anthony David Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available