Each year, preterm birth affects roughly 12% of babies born in the United States. Children born preterm have higher rates of psychiatric disorders, including ADHD and autism, and related attentional and social deficits. To address the factors contributing to outcomes in very preterm infants, the Institute of Medicine recommended a multidisciplinary approach with research focused on identifying neonatal predictors of development including social, emotional and behavioral outcomes. The purpose of this Mentored Patient-Oriented Career Development Award (K23) is to enable the candidate to develop a funded research program aimed at understanding the relationship between neonatal structural and functional brain connectivity and psychiatric outcomes in preterm infants. The candidate's long-term goal is to become an independent clinical investigator studying the neuroimaging manifestations of psychiatric outcomes in high-risk infants. To achieve this goal, training and mentorship are proposed in three key areas: 1) applying advanced brain MRI analysis techniques, specifically diffusion tensor imaging and resting state functional connectivity, 2) enhancement of skills in the design, interpretation and analysis of longitudinal studies of developmental psychopathology and 3) modeling cumulative psychosocial risk exposure and key covariates of brain-behavior relationships. The research plan for this award will be implemented with the support of the training plan and an interdisciplinary team of expert mentors and advisors. The project in this K23 proposal will address the unexplained etiology of increased rates of psychiatric disorders in preterm children by 1) comprehensively evaluating psychiatric symptoms during the preschool period with a particular focus on ADHD and autism symptoms, 2) relating alterations in neonatal microstructural and functional connectivity to ADHD and ASD symptoms during early childhood as well as 3) exploring whether key psychosocial risk factors also impact poor social-emotional and psychiatric outcomes. The proposed study adds a comprehensive psychiatric and social-emotional assessment during the preschool period in a captured sample of premature children longitudinally followed since birth for whom neonatal structural and resting state functional connectivity MRI data are available. This project provides an unprecedented opportunity to address this key scientific question and a unique training opportunity at an institution at the forefront of neuroscience research. The candidate is committed to further developing expertise in the area of neonatal neuroimaging and preschool psychopathology in preterm populations. Data from these research activities will support the development of an R01 application tracking developmental psychopathology trajectories and subsequent brain development of this study population into school-age. This project could inform early identification and targeted intervention strategies during a period of significant brain plasticity improving psychiatric outcomes for preterm children.
This study is designed to improve our understanding of whether the altered brain development of prematurely-born infants is responsible for their greater risk of Attention Deficit Hyperactivity Disorder and Autism Spectrum Disorders. The longitudinal design, using both advanced MR imaging acquired during infancy and psychiatric evaluations, will allow us to study the impact of preterm birth on preschoolers social and emotional development. This study will assist us in understanding how to improve the outcomes of these vulnerable children.
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| Sylvester, Chad M; Smyser, Christopher D; Smyser, Tara et al. (2018) Cortical Functional Connectivity Evident After Birth and Behavioral Inhibition at Age 2. Am J Psychiatry 175:180-187 |
| Lean, Rachel E; Paul, Rachel A; Smyser, Tara A et al. (2018) Social Adversity and Cognitive, Language, and Motor Development of Very Preterm Children from 2 to 5 Years of Age. J Pediatr 203:177-184.e1 |
| Herzmann, Charlotte S; Snyder, Abraham Z; Kenley, Jeanette K et al. (2018) Cerebellar Functional Connectivity in Term- and Very Preterm-Born Infants. Cereb Cortex : |
| Lean, Rachel E; Paul, Rachel A; Smyser, Christopher D et al. (2018) Maternal intelligence quotient (IQ) predicts IQ and language in very preterm children at age 5 years. J Child Psychol Psychiatry 59:150-159 |
| Matthews, Lillian G; Walsh, Brian H; Knutsen, Clare et al. (2018) Brain growth in the NICU: critical periods of tissue-specific expansion. Pediatr Res 83:976-981 |
| Lean, Rachel E; Rogers, Cynthia E; Paul, Rachel A et al. (2018) NICU Hospitalization: Long-Term Implications on Parenting and Child Behaviors. Curr Treat Options Pediatr 4:49-69 |
| Monson, Brian B; Eaton-Rosen, Zach; Kapur, Kush et al. (2018) Differential Rates of Perinatal Maturation of Human Primary and Nonprimary Auditory Cortex. eNeuro 5: |
| Garcia, Kara E; Robinson, Emma C; Alexopoulos, Dimitrios et al. (2018) Dynamic patterns of cortical expansion during folding of the preterm human brain. Proc Natl Acad Sci U S A 115:3156-3161 |
| Rogers, Cynthia E (2017) Here/In This Issue and There/Abstract Thinking: Does This Answer Your Question? J Am Acad Child Adolesc Psychiatry 56:801-802 |
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