Early protein intake predicts functional connectivity and neurocognition in preterm born children

Emma G Duerden,Steven P Miller,Greg Gamble,Jane Alsweiler,Trecia Wouldes,Tanya Poppe,Mkh Leung ,Benjamin Thompson,Anna C Tottman ,Yannan Jiang,Jane E Harding

doi:10.1038/s41598-021-83125-z

Abstract

Nutritional intake can promote early neonatal brain development in very preterm born neonates (< 32 weeks’ gestation). In a group of 7-year-old very preterm born children followed since birth, we examined whether early nutrient intake in the first weeks of life would be associated with long-term brain function and neurocognitive skills at school age. Children underwent resting-state functional MRI (fMRI), intelligence testing (Wechsler Intelligence Scale for Children, 5th Ed) and visual-motor processing (Beery-Buktenica, 5th Ed) at 7 years. Relationships were assessed between neonatal macronutrient intakes, functional connectivity strength between thalamic and default mode networks (DMN), and neuro-cognitive function using multivariable regression. Greater functional connectivity strength between thalamic networks and DMN was associated with greater intake of protein in the first week (β = 0.17; 95% CI 0.11, 0.23, p < 0.001) but lower intakes of fat (β = − 0.06; 95% CI − 0.09, − 0.02, p = 0.001) and carbohydrates (β = − 0.03; 95% CI − 0.04, − 0.01, p = 0.003). Connectivity strength was also associated with protein intake during the first month (β = 0.22; 95% CI 0.06, 0.37, p = 0.006). Importantly, greater thalamic-DMN connectivity strength was associated with higher processing speed indices (β = 26.9; 95% CI 4.21, 49.49, p = 0.02) and visual processing scores (β = 9.03; 95% CI 2.27, 15.79, p = 0.009). Optimizing early protein intake may contribute to promoting long-term brain health in preterm-born children.

Highlights

Nutritional intake can promote early neonatal brain development in very preterm born neonates (< 32 weeks’ gestation)
No significant differences in sex (p = 0.30), adjusted age (t = − 0.9, p = 0.35), gestational age (GA) at birth (t = 0.22, p = 0.08), or birth weight (t = 0.91, p = 0.37) were evident between the children with useable MRI data compared to the children in the full cohort
Greater functional connectivity strength between the thalamic networks and aDMN was predicted by greater intake of protein in the first week (β = 0.17; 95% CI 0.11, 0.23, p < 0.001, Fig. 2) but lower intakes of fat (β = − 0.06; 95% CI − 0.09, − 0.02, p = 0.001) and carbohydrates (β = − 0.03; 95% CI − 0.04, − 0.01, p = 0.003)

Summary

Introduction

Nutritional intake can promote early neonatal brain development in very preterm born neonates (< 32 weeks’ gestation). Alterations in structural and intrinsic functional connectivity affecting networks associated with higher-order cognitive functions including default mode networks (DMN) have been reported in school-age children, adolescents and adults born p reterm[14,17,18]. The anterior DMN includes portions of the medial and lateral prefrontal cortices as well as the anterior cingulate cortex, and anterior temporal lobe It is involved in higher order cognitive functions[21] and early disruptions in this network may underlie cognitive deficits in children born p reterm[23,24]. There have been no studies of the relationship between very early macronutrient intakes in very preterm infants and brain connectivity and neurodevelopmental outcomes at school age, when different aspects of brain function can be more reliably assessed

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Discussion

Conclusion