Early experience alters brain function and structure

Objective. To investigate the effects of early experience on brain function and structure. Methods. A randomized clinical trial tested the neu- rodevelopmental effectiveness of the Newborn Individ- ualized Developmental Care and Assessment Program (NIDCAP). Thirty preterm infants, 28 to 33 weeks' ges- tational age (GA) at birth and free of known develop- mental risk factors, participated in the trial. NIDCAP was initiated within 72 hours of intensive care unit admission and continued to the age of 2 weeks, corrected for pre- maturity. Control (14) and experimental (16) infants were assessed at 2 weeks' and 9 months' corrected age on health status, growth, and neurobehavior, and at 2 weeks' corrected age additionally on electroencephalogram spec- tral coherence, magnetic resonance diffusion tensor im- aging, and measurements of transverse relaxation time. Results. The groups were medically and demograph- ically comparable before as well as after the treatment. However, the experimental group showed significantly better neurobehavioral functioning, increased coherence between frontal and a broad spectrum of mainly occipital brain regions, and higher relative anisotropy in left in- ternal capsule, with a trend for right internal capsule and frontal white matter. Transverse relaxation time showed no difference. Behavioral function was improved also at 9 months' corrected age. The relationship among the 3 neurodevelopmental domains was significant. The re- sults indicated consistently better function and more ma- ture fiber structure for experimental infants compared with their controls. Conclusions. This is the first in vivo evidence of en- hanced brain function and structure due to the NIDCAP. The study demonstrates that quality of experience before term may influence brain development significantly. Pe- diatrics 2004;113:846 - 857; preterm infants, NIDCAP, neu- robehavior, spectral coherence, diffusion tensor imaging, transverse relaxation time, Bayley Scales of Infant Devel- opment, APIB.