title: Early experience alters brain function and structure.
abstract: OBJECTIVE
  To investigate the effects of early experience on brain function and structure.
  
  
  METHODS
  A randomized clinical trial tested the neurodevelopmental effectiveness of the Newborn Individualized Developmental Care and Assessment Program (NIDCAP). Thirty preterm infants, 28 to 33 weeks' gestational age (GA) at birth and free of known developmental 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 prematurity. 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 spectral coherence, magnetic resonance diffusion tensor imaging, and measurements of transverse relaxation time.
  
  
  RESULTS
  The groups were medically and demographically 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 internal 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 results indicated consistently better function and more mature fiber structure for experimental infants compared with their controls.
  
  
  CONCLUSIONS
  This is the first in vivo evidence of enhanced brain function and structure due to the NIDCAP. The study demonstrates that quality of experience before term may influence brain development significantly.
authors.affiliation: Department of Psychiatry, Harvard Medical School and Children's Hospital Boston, Pediatric Research Laboratories, Boston, Massachusetts 02115, USA. heidelise.als@childrens.harvard.edu
authors.forename: Heidelise
authors.initials: H
authors.lastname: Als
authors.forename: Frank H
authors.initials: FH
authors.lastname: Duffy
authors.forename: Gloria B
authors.initials: GB
authors.lastname: McAnulty
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Rivkin
authors.forename: Sridhar
authors.initials: S
authors.lastname: Vajapeyam
authors.forename: Robert V
authors.initials: RV
authors.lastname: Mulkern
authors.forename: Simon K
authors.initials: SK
authors.lastname: Warfield
authors.forename: Petra S
authors.initials: PS
authors.lastname: Huppi
authors.forename: Samantha C
authors.initials: SC
authors.lastname: Butler
authors.forename: Nikk
authors.initials: N
authors.lastname: Conneman
authors.forename: Christine
authors.initials: C
authors.lastname: Fischer
authors.forename: Eric C
authors.initials: EC
authors.lastname: Eichenwald
mesh_terms: D001921:Brain / Q000033:anatomy & histology / Q000254:growth & development* / Q000502:physiology; D002657:Child Development; D018479:Early Intervention, Educational; D004569:Electroencephalography; D005260:Female; D006801:Humans; D018730:Infant Behavior; D007224:Infant Care / Q000379:methods; D007231:Infant, Newborn; D007234:Infant, Premature / Q000254:growth & development / Q000502:physiology; D015931:Intensive Care, Neonatal; D007858:Learning; D008279:Magnetic Resonance Imaging; D008297:Male; D009483:Neuropsychological Tests; D016037:Single-Blind Method