Functional MRI (fMRI) findings in a group of 5 pre-term infants were correlated with a unilateral passive forearm extension/flexion to relate the functional data to structural and behavioral data, in studies at the University of Bonn, Germany; and University Medical Center, Groningen, Netherlands. Measurement of blood oxygen level-dependent (BOLD) responses in the sensorimotor cortex showed bilateral activation during unilateral passive sensorimotor stimulation. The prevailing hemodynamic response was a negative blood oxygenation level-dependent signal. Positive blood oxygenation level-dependent response or failure to activate the sensorimotor cortex was found in patients with abnormal brain structural and behavioral problems. [1]

COMMENT. The authors propose that their fMRI findings are compatible with a bilaterally distributed sensorimotor system in the preterm infant. The reductions of oxy/deoxy-Hb ratio in activated brain tissue may reflect ineffective neural processing during this maturational stage of rapid synapse formation. Positive blood oxygenation level-dependent responses or failure to activate the sensorimotor cortex in a preterm infant may predict abnormal cerebral development and need for careful follow-up. fMRI should provide a more effective measure of long-term developmental problems than the neonatal neurological exam.