Deficits in Top-Down Sensory Prediction in Infants At Risk due to Premature Birth

A prominent theoretical view is that the brain is inherently predictive [1, 2] and that prediction helps drive the engine of development [3, 4]. While infants exhibit neural signatures of top-down, sensory prediction [5, 6], it must be established that deficits in early prediction alter developmental trajectories to start to infer causality between prediction and development. We investigated prediction in infants born prematurely, a leading cause of neuro-cognitive impairment worldwide [7]. Prematurity, independent of medical complications, leads to developmental disturbances [8, 9, 10, 11, 12] and a broad range of developmental delays [13, 14, 15, 16, 17]. Is an alteration in early prediction abilities the common cause? Using functional near-infrared spectroscopy (fNIRS), we measured top-down, sensory prediction in preterm infants (born <33 weeks) before infants exhibited clinically-identifiable developmental delays (6 months corrected age). While preterm infants had typical neural responses to presented visual stimuli, they exhibited altered neural responses to predicted visual stimuli. Importantly, a separate behavioral control confirmed that preterm infants detect pattern violations at the same rate as full-terms, establishing selectivity of this response to top-down predictions (e.g., not in learning an AV association). These findings suggest that top-down, sensory prediction plays a crucial role in development and deficits in this ability may be the reason why preterm infants experience altered developmental trajectories and are at-risk for poor developmental outcomes. Moreover, this work presents an opportunity for establishing a neuro-biomarker for early identification of infants at-risk and could guide to early intervention regimens