Trajectories of Cortico-Cerebellar Connectivity, Social Competence, and Internalizing Symptoms in Adolescents Born Very Preterm

项目摘要：早产儿(妊娠32周)患社交疾病的风险增加 与他们出生时的同龄人相比，能力受损，包括社交沟通障碍和更差 高质量的同伴关系会导致同伴受害和社会排斥。此外，内化性障碍是2- VPT儿童的发病率高出3倍，症状在儿童早期明显，一直持续到成年。关键是， 社交能力障碍是如何演变并持续到青春期的，以及已知风险因素的程度 与VPT出生相关的，包括心理社会逆境和执行功能障碍，塑造了他们的轨迹 增加内化性疾病的风险仍是未知的。此外，小脑是一个关键的结构。 VPT出生的不利影响和小脑发育异常现在被认为是一个主要的危险因素 社交沟通障碍。小脑发育的改变及其与脑组织的功能相互作用 额顶和默认模式网络参与社会情绪功能，可能是连接的关键机制 VPT出生、社会损伤和内化性障碍。我们假设皮质区的个体特有模式- 小脑连接和相关的白质束(即小脑脚)的发育是 社会能力缺陷的演变，进而内化在14-15岁持续或恶化的障碍， 同伴互动变得更加复杂和中心的关键时期。这一过程开始于 婴儿期和青春期，心理社会风险起着关键的调节作用。磁共振成像的研究进展 方法论现在能够用无与伦比的空间描述结构和功能的大脑网络 和时间分辨率。我们将创新的核磁共振技术与详细的社会互动和精神病学相结合 对VPT和足月出生青少年(N=302；137 VPT和165个足月儿)进行独特的纵向队列评估 出生)，现在14-15岁有很高的心理社会逆境发生率。这个队列从出生起就一直在跟踪， 接受预期高质量新生儿和学龄儿童结构和功能连接的MRI扫描 以及社会能力、社会情绪功能、心理社会和家庭关系的纵向评估 2岁、5岁和9-10岁的风险(&gt；在所有波浪期保持80%)。对这一宝贵群体的持续评价 提供了一个前所未有的机会来确定：1)社会能力和内化的轨迹 症状，以更好地识别青少年的最大精神病理风险和2)如何轨迹 皮质-小脑的结构和功能连接是这些缺陷的基础。最先进的磁共振成像采集 分析将表征VPT出生对大脑皮质-小脑连接的有害影响 青春期。我们将描述皮质-小脑连接、社交能力和 将障碍内化以阐明可修改的心理社会暴露并提高个人水平 提供预防性干预时机的神经成像、行为和心理社会预测模型 在大脑和社会情绪发育的敏感期，以减轻内在性障碍的风险。

PROJECT SUMMARY: Children born very preterm (VPT, <32 weeks’ gestation) are at increased risk for social competency impairments compared to their term-born peers, including social communication deficits and poorer quality peer relationships leading to peer victimization and social rejection. Further, internalizing disorders are 2- 3 times higher in VPT children, with symptoms evident in early childhood and lasting into adulthood. Critically, how social competence impairments evolve and persist into adolescence, and the extent that known risk factors associated with VPT birth, including psychosocial adversity and executive dysfunction, shape their trajectory to increase risk for internalizing disorders remains unknown. Additionally, the cerebellum is a key structure adversely impacted by VPT birth, and aberrant cerebellar development is now recognized as a major risk factor for social communication deficits. Altered cerebellar development, along with its functional interactions with the Frontoparietal and Default Mode Networks involved in socio-emotional function, may be a key mechanism linking VPT birth, social impairment, and internalizing disorders. We posit that individual-specific patterns of cortico- cerebellar connectivity and related white matter tract (i.e., cerebellar peduncle) development underlie the evolution of social competence deficits, and in turn, internalizing disorders that persist or worsen at age 14-15, a critical period when peer interactions become more sophisticated and central. This process begins during infancy and extends to adolescence, with psychosocial risk playing a pivotal modifying role. Advances in MRI methodology now enable characterization of structural and functional brain networks with unparalleled spatial and temporal resolution. We couple innovative MRI techniques with detailed social-interaction and psychiatric assessments in a unique, longitudinal cohort of VPT and term-born adolescents (N=302; 137 VPT and 165 term- born) with high rates of psychosocial adversity now aged 14-15 years. The cohort has been followed since birth, undergoing prospective high-quality neonatal and school-age structural and functional connectivity MRI scans and longitudinal assessments of social competence, socio-emotional functioning, and psychosocial and familial risk at ages 2, 5, and 9-10 years (>80% retention at all waves). Continued evaluation of this valuable cohort provides an unprecedented opportunity to determine: 1) trajectories of social competence and internalizing symptoms for better identification of adolescents at greatest risk for psychopathology and 2) how trajectories of cortico-cerebellar structural and functional connectivity underlie these deficits. State-of-the-art MRI acquisition and analyses will characterize the deleterious effects of VPT birth on cortico-cerebellar connectivity into adolescence. We will delineate links between cortico-cerebellar connectivity, social competence, and internalizing disorders to elucidate modifiable psychosocial exposures and improve individual-level neuroimaging, behavior, and psychosocial predictive models that inform the timing of preventative interventions during sensitive periods of brain and socio-emotional development to mitigate risk for internalizing disorders.