Nurturing the preterm infant brain: leveraging neuroplasticity to improve neurobehavioral outcomes

An intrinsic feature of the developing brain is high susceptibility to environmental influence—known as plasticity. Research indicates cascading disruption to neurological development following preterm (PT) birth; yet, the interactive effects of PT birth and plasticity remain unclear. It is possible...

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Bibliographic Details
Published in:Pediatric research 2019-01, Vol.85 (2), p.166-175
Main Authors: DeMaster, Dana, Bick, Johanna, Johnson, Ursula, Montroy, Janelle J., Landry, Susan, Duncan, Andrea F.
Format: Article
Language:English
Subjects:
Animals
Brain - growth & development
Brain - physiopathology
Brain research
Central Nervous System Diseases - physiopathology
Child, Preschool
Humans
Infant
Infant, Newborn
Infant, Premature
Medicine
Medicine & Public Health
Neuronal Plasticity
Neuroplasticity
Pediatric Surgery
Pediatrics
Premature babies
Review Article
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Summary:An intrinsic feature of the developing brain is high susceptibility to environmental influence—known as plasticity. Research indicates cascading disruption to neurological development following preterm (PT) birth; yet, the interactive effects of PT birth and plasticity remain unclear. It is possible that, with regard to neuropsychological outcomes in the PT population, plasticity is a double-edged sword. On one side, high plasticity of rapidly developing neural tissue makes the PT brain more vulnerable to injury resulting from events, including inflammation, hypoxia, and ischemia. On the other side, plasticity may be a mechanism through which positive experience can normalize neurological development for PT children. Much of the available literature on PT neurological development is clinically weighted and focused on diagnostic utility for predicting long-term outcomes. Although diagnostic utility is valuable, research establishing neuroprotective factors is equally beneficial. This review will: (1) detail specific mechanisms through which plasticity is adaptive or maladaptive depending on the experience; (2) integrate research from neuroimaging, intervention, and clinical science fields in a summary of findings suggesting inherent plasticity of the PT brain as a mechanism to improve child outcomes; and (3) summarize how responsive caregiving experiences situate parents as agents of change in normalizing PT infant brain development.
ISSN:0031-3998
1530-0447
DOI:10.1038/s41390-018-0203-9