A major focus of research is on the long-term sequelae of very preterm birth (<33 weeks’ gestation), using a multidisciplinary perspective bridging neuroscience, neuropsychology and psychiatry. We were previously the first to conduct neuroimaging studies demonstrating significant associations between anatomical brain alterations and neurocognitive and behavioural outcomes in adolescents who were born very preterm. We are leading the follow-up of several longitudinal studies, including the Developing Human Connectome Project, the Brain, Immunity and Psychopathology following very Preterm birth (BIPP) Study and the University College Hospital London Cohort Study. We are using multimodal imaging in combination with cognitive, behavioural, social and environmental data to identify those children who are most vulnerable to psychopathology.
Current areas of investigation:
Identifying early biomarkers of outcome
Currently, it is not possible to predict solely on clinical grounds which infants will develop cognitive and behavioural difficulties later in life. We believe that alterations in early neurodevelopment, or the process by which the brain grows and adapts to change, could at least partly explain such difficulties.
Using early multimodal imaging of the brain we aim to identify novel imaging features associated with adverse outcomes. Elucidating early biomarkers predictive of later outcomes will inform the development and implementation of neurobehaviourally-informed preventative interventions targeting those infants who may be at risk of developing cognitive and behavioural sequelae.
Parsing heterogeneity in paediatric samples
Heterogeneity in childhood behavioural, cognitive and mental health outcomes associated with clinical, social and environmental risk/resilience factors makes it challenging to establish markers of poor/optimal outcomes. By stratifying heterogenous paediatric samples into sub-classes of individuals characterised by similarities, we aim to identify new groups of individuals (i.e., new brain-behaviour phenotypes) who share similar profiles. This approach represents a potential application of precision psychiatry, to enable meaningful inferences to be made at the individual level.
Defining longitudinal brain-behavioural trajectories
Mapping dynamic changes in brain development and delineating maturational patterns supporting emerging socio-emotional and neurocognitive functions along a typical-to-atypical continuum can help us better understand the neurobiological underpinnings of risk and resilience. Therefore, as well as studying brain development during the perinatal period, we investigate how postnatal experience continues to shape the architecture of a child’s brain as well as his/her behaviour in childhood and adolescence, especially during sensitive periods, with consequences persisting throughout the lifespan.
Parental factors and infant development
To elucidate the links between parental factors and infant neurodevelopment, we study the association between parental stress, sensitivity, mental health and parenting style and both infant brain development and child cognitive and behavioural outcomes. This research helps us understand how environmental experiences interact with other facets of child development and become embedded in the developing brain, maintaining mental health, or driving the transition from mental health to mental illness. This work can also inform how to better support parents and their infants in ways which facilitate adaptive development.
Professor Chiara Nosarti, King's College London