Alternative neurodevelopmental pathways in the structural connectome of adults born preterm

Motivation: Prematurity is associated with heterogeneous cognitive outcomes. How connectomes developed for cognitive functioning remains unclear for preterm adults. Goal(s): To investigate the developmental trajectories in adults born preterm of different cognitive outcome. Approach: This study uses unsupervised learning algorithms to define a subgroup of preterm-born adults with generally reduced cognitive function and compared their network properties with control and cognitively higher-performing preterm-born participants. Results: Significant differences were observed in network measures, including increased global efficiency and clustering coefficient in the higher-performing group, and increased betweenness centrality in the lower-performing group. This stratification cannot be explained by birth weight, gestation age or nutritional history. Impact: This study suggests compensatory mechanisms leading to a divergent state of structural connectome i.e. 2 or more optimal states of network topologies achieving the same cognitive ability in adults born preterm.