Poster No:
2453
Submission Type:
Abstract Submission
Authors:
W. Dale Stevens1, Scott Adler1, Laetitia Mwilambwe-Tshilobo2, Diana Gorbet1, Lily Solomon-Harris1, Audrey Wong-Kee-You1, Roni Setton3, Gary Turner1, R. Nathan Spreng4
Institutions:
1York University, Toronto, Ontario, 2Princeton University, Princeton, NJ, 3Harvard University, Cambridge, MA, 4Montreal Neurological Institute, McGill University, Montreal, Quebec
First Author:
Co-Author(s):
R. Nathan Spreng
Montreal Neurological Institute, McGill University
Montreal, Quebec
Introduction:
Caesarean section (C-section) is a relatively safe and potentially life-saving surgical procedure in the face of labor complications. However, there is evidence of abnormal brain and behavioral development associated with C-section birth in non-human mammals. Moreover, epidemiological/meta-analytic studies in humans have indicated increased rates of autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) associated with C-section birth. But to our knowledge, no study to date has directly investigated the potential long-term neurocognitive effects of C-section in human adults. We previously reported visual attention deficits in 3-month-old human infants born via C-section vs. vaginal birth (V-birth), measured with eye-tracking in a cued visuospatial attention task. Here, we used multiple behavioral measures of visual attention, eye-tracking, and whole-brain connectomic analyses of resting-state functional MRI (rs-fMRI) data in multiple independent samples of human adults to investigate potential long-term effects of C-section birth on visual attention and brain network connectivity.
Methods:
We used eye-tracking with the same cued visuospatial attention task previously used in infants in adults (n = 24: 12 C-section; 12 V-delivery). In an independent sample of adults (n = 94: 24 C-section; 70 V-delivery), visual attention and other cognitive domains were assessed using using a visual flanker task, as well as other tasks in the the NIH Toolbox, and the Symbol Digit Modalities Test (SDMT). Multi-echo rs-fMRI data (20 min) were acquired for 81 adults (20 C-section, 64 V-delivery). We used multi-echo independent components analysis (ME-ICA) and group prior individual parcellation (GPIP) to individually localize 400 cortical nodes across 7 large-scale canonical brain networks in each participant. The right and left superior colliculi (SC), subcortical regions responsible for eye movements, were also individually localized. We used the multivariate technique partial least squares (PLS) to compare patterns of intrinsic functional connectivity (RSFC) across all 402 brain regions.
Results:
Replicating our findings in infants, C-section adults showed significantly longer saccade latencies in the cued visuospatial attention task, as measured with eye-tracking (F(1,88) = 11.56, p = .001, η2ρ = .12). An independent sample of C-section adults showed a visual attention deficit relative to V-birth adults on the visual flanker task (Wilk's F(1,84) = 4.21; p < .05; partial η2ρ = .048). We determined the specificity of this visual attention deficit by controlling for global processing speed, memory, and executive function, which did not differ between groups (t's < 1.2; p's >.20). In a hypothesis-driven ROI approach, we examined RSFC of early visual regions including primary visual cortex (V1) and SC with the rest of the brain; there was a significant difference between C-section and V-delivery adults (permuted p = 0.04, covariance explained = 100%; bootstrap resampling: t(74) = 7.9, p < 0.001, Cohen's d = 2.06). C-section adults showed hyperconnectivity of early visual regions within the visual network and, critically, with the default network, relative to V-birth adults. A control analysis ruled out more general/global group differences in RSFC, confirming the specificity of group differences in cortical connectivity to early visual regions.
Conclusions:
To our knowledge, we report the first behavioral and neuroimaging evidence of potentially life-long neurocognitive abnormalities associated with C-section birth. These findings suggest a potential neural mechanism underlying increased rates of neurodevelopmental disorders (i.e., ASD and ADHD) associated with C-section. These findings warrant further investigation to determine the underlying causes and should be weighed among the critical risks and benefits considered by physicians and prospective parents in making informed decisions about optional, non-medically indicated C-section births.
Modeling and Analysis Methods:
fMRI Connectivity and Network Modeling 2
Multivariate Approaches
Segmentation and Parcellation
Task-Independent and Resting-State Analysis
Perception, Attention and Motor Behavior:
Attention: Visual 1
Keywords:
FUNCTIONAL MRI
MRI
Vision
Other - caesarean section
1|2Indicates the priority used for review
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