Atypical neural responses to dynamically changing facial expressions correlate with behavioral risk in toddlers born preterm: Evidence from an ERP study.

Premature birth increases lifelong risk for emotional dysregulation and mental health problems. Identifying alterations in neural pathways that subserve social cognitive development may help identify variability of prospective risk on behavioral levels. In a sample of 45 toddlers (15-30 months corrected age) born prematurely (23-36 gestational weeks; extremely preterm: n = 21, very preterm: n = 13, late preterm: n = 11), we leveraged EEG as a developmentally sensitive neuroimaging tool, and examined associations between premature birth status and event related potentials (ERPs; N290, P400 and NC) elicited while toddlers passively viewed dynamically changing facial emotion expressions. Using linear-mixed effects models, earlier gestational age was associated with larger P400 and frontal NC amplitudes and with differences in the latencies and hemispheric organization of ERP responses to facial emotion (FDR-corrected p < 0.05). Specifically, toddlers born at earlier gestational ages showed reduced right to left hemispheric differentiation in N290 latency, reflecting diminished rightward specialization, along with emotion dependent differences in P400 and NC latencies, consistent with a less mature profile of social brain development. Source localization techniques pointed to frontal and temporal regions as neural generators of ERP components, which supports prior work showing heightened vulnerability of these circuitries to effect of prematurity. Brain-behavioral correlations support preliminary associations between ERPs and early childhood psychopathology risk, highlighting the potential to leverage neural markers to inform prevention and intervention.