Neuroimaging of structural and functional connectivity in preterm infants with intraventricular hemorrhage

Abstract

Preterm infants with intraventricular hemorrhage (IVH) are known to have some of the worst neurodevelopmental outcomes in all of neonatal medicine, with a growing body of evidence relating these outcomes to underlying disruptions in brain structure and function. This review begins by summarizing state-of-the-art neuroimaging techniques delineating structural and functional connectivity (diffusion and resting state functional MRI) and their application in infants with IVH, including unique technical challenges and emerging methods. We then review studies of altered structural and functional connectivity, highlighting the role of IVH severity and location. We subsequently detail investigations linking structural and functional findings in infancy to later outcomes in early childhood. We conclude with future directions including methodologic considerations for prospective and potentially interventional studies designed to mitigate disruptions to underlying structural and functional connections and improve neurodevelopmental outcomes in this high-risk population.

Keywords: diffusion tensor imaging (DTI); functional connectivity; intraventricular hemorrhage (IVH); magnetic resonance imaging (MRI); neurodevelopment; post-hemorrhagic hydrocephalus; resting state functional MRI (rs-fMRI); very preterm infant.