Resting-State Networks in School-Aged Very Preterm Children: Links With Cognition and Theory of Mind

This study investigates the relationship between gestational age (GA) and resting-state functional connectivity (rsFC) in a cohort of very preterm children at school age, and how these neural patterns relate to cognitive and theory of mind (ToM) performance. Resting-state functional magnetic resonance imaging (fMRI) data were collected from 52 children (GA < 32 weeks, birth weight <1500 g) and independent component analysis was applied to extract the resting-state networks. Results showed that GA was positively associated with rsFC of the precuneus and the paracentral region within the left posterior cerebellar network (lpCER), while negatively associated with rsFC of the insula and putamen within the anterior default mode network (DMN), and with rsFC of the postcentral gyrus within the right frontoparietal network (rFPN). Cognitive and neuropsychological assessments revealed that increased connectivity involving the lpCER correlated with better verbal comprehension, visuospatial ability, fluid reasoning, working memory, and ToM performance. Conversely, increased aDMN connectivity was associated with lower working memory and decreased rFPN connectivity was found associated with lower intelligence quotient. These results underscore the influence of GA on intrinsic brain networks supporting cognitive and socio-cognitive functions, and highlight potential neural markers that could inform targeted intervention strategies for preterm children.