Abstract
Preterm birth is a major cause of lifelong motor disability that has significant impacts on multiple domains of quality of life, yet individual-level outcome prediction and understanding of specifically when and where the brain is impacted remains limited. This thesis examines neonatal functional (FC) and structural (SC) connectivity as potential predictors of motor outcomes through age ten years in very preterm children with and without brain injury. Findings are presented with age two outcomes in Chapter 2, age five outcomes in Chapter 3, and age ten outcomes in Chapter 4. All three include FC. Only chapter 4 excludes the children with brain injury due to the different ages of subsets of the cohort, and only Chapter 4 includes SC. Overall, there are two patterns of brain measures and later impairment, differing by brain injury status. Among children with brain injury, cerebral palsy is common and identifiable by age two. FC between left and right motor cortex is correlated with motor scores at two and five years, but age ten was not tested. Among children without brain injury, most motor impairment is not apparent at age two but is by age five and persists at age ten, appearing in alignment with a developmental coordination disorder pattern. Cerebellum-motor cortex FC is predictive of balance scores at ages five and ten years, while basal ganglia-motor cortex FC is related to age five fine motor scores. Fractional anisotropy of the left internal capsule is also related to fine and gross motor scores in this population. These two patterns of brain findings and later motor development may reflect the impacts of brain injury and abnormal early sensorimotor experiences respectively and may not be mutually exclusive. Neonatal FC and SC have potential for earlier identification of motor disability in very preterm children, which may enable earlier intervention, accommodation, family support, and integration into the disability community. Longer follow-up in this population is key to providing the necessary support to live happy, healthy lives.
Committee Chair
Christopher Smyser
Committee Members
Cynthia Rogers; Adam Eggebrecht; Jeffrey Neil; John Zempel; Tamara Hershey; Thomas Rodebaugh
Degree
Doctor of Philosophy (PhD)
Author's Department
Biology & Biomedical Sciences (Neurosciences)
Document Type
Dissertation
Date of Award
5-8-2025
Language
English (en)
DOI
https://doi.org/10.7936/21gn-zx20
Author's ORCID
https://orcid.org/0000-0002-7456-1762
Recommended Citation
Cyr, Peppar Elizabeth Pei-pei, "Functional and Structural Connectivity as Predictors of Long-term Motor Development in Very Preterm Children with and without Brain Injury" (2025). Arts & Sciences Theses and Dissertations. 3514.
The definitive version is available at https://doi.org/10.7936/21gn-zx20