Altered functional brain organisation in preterm Children: Motor task and resting-state fMRI findings at six years

Very preterm birth significantly increases the risk of lifelong cognitive and motor deficits by disrupting early brain development. We characterised functional brain organisation at six years of age in children born very preterm (VPT) compared to term-born controls (TC). Functional MRI comprised i) visually cued ∼1 Hz right- and left-hand tapping analysed with a general linear model and permutation testing, and ii) eyes-closed resting-state acquisitions assessed with ROI-to-ROI connectivity for cortical/cerebellar and subcortical networks. Seventy-one children born <31 weeks gestation were scanned; high-quality task data were available from 58 (43 VPT, 15 TC) for right-hand and 48 (36 VPT, 12 TC) for left-hand tapping, and resting-state data from 40 (28 VPT, 12 TC). Both groups activated expected motor regions, but VPT children showed greater activation and stronger left-temporal lateralisation during right-hand tapping (p < 0.032). Resting-state analyses revealed weaker connectivity in VPT children within striatal circuits and between salience, dorsal-attention, and visual networks, alongside reduced anticorrelation between default-mode and frontoparietal networks. Our findings indicate that children born very preterm exhibit a persistent reorganisation of both task-evoked motor activation and large-scale cortical and subcortical resting-state network connectivity at six years of age. These differences in functional brain organisation provide insights into long-lasting neurobiological changes associated with very preterm birth during a critical period of child development.