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Thalamocortical functional connectivity in infants with prenatal opioid exposure correlates with severity of neonatal opioid withdrawal syndrome

  • Paediatric Neuroradiology
  • Published:
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Abstract

Purpose

Prenatal opioid exposure (POE) is a growing public health concern due to its associated adverse outcomes including neonatal opioid withdrawal syndrome (NOWS). The aim of this study was to assess alterations in thalamic functional connectivity in neonates with POE using resting-state functional magnetic resonance imaging (rs-fMRI) and identify whether these altered connectivity measures were associated with NOWS severity.

Methods

In this prospective, IRB-approved study, we performed rs-fMRI in 19 infants with POE and 20 healthy control infants without POE. Following standard pre-processing, we performed seed-based functional connectivity analysis with the right and left thalamus as the regions of interest. We performed post hoc analysis in the prenatal opioid exposure group to identify associations of altered thalamocortical connectivity with severity of NOWS. P value of < .05 was considered statistically significant.

Results

There were several regions of significantly altered thalamic to cortical functional connectivity in infants with POE compared to the healthy infants. Distinct regions of thalamocortical functional connectivity correlated with maximum modified Finnegan score. Association between thalamocortical connectivity and severity of NOWS was nominally modified by maternal psychological conditions and polysubstance use.

Conclusion

Our findings reveal prenatal opioid exposure-related alterations in thalamic functional connectivity in the infant brain that are correlated with severity of NOWS. Future studies may benefit from evaluation of thalamocortical resting state functional connectivity in infants with POE to help  stratify risk of long term neurodevelopmental outcomes.

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Abbreviations

R:

Right

L:

Left

POE:

Prenatal opioid exposure

NOWS:

Neonatal opioid withdrawal syndrome

NAS:

Neonatal abstinence syndrome

ROI:

Region of interest

MRI:

Magnetic resonance imaging

rs-fMRI:

Resting-state functional magnetic resonance imaging

FD:

Framewise displacement

DVARS:

Temporal derivative of time courses, root-mean-squared variance over voxels

ADHD:

Attention deficit hyperactivity disorder

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Funding

RR was supported by the American Roentgen Ray Scholarship Award 2018 and Radiological Society of North America Seed Grant 2018. ZG was supported by the Indiana University CTSI. SS, RR, and DH were supported by the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health under Award, R01HD096800 (PI: Sadhasivam). The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health.

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Authors and Affiliations

  1. Department of Radiology and Imaging Sciences, Indiana University School of Medicine, 705 Riley Hospital Drive, Indianapolis, IN, 46202, USA

    Rupa Radhakrishnan & Ramana V. Vishnubhotla

  2. Indiana University School of Medicine, Indianapolis, IN, USA

    Zoe Guckien

  3. Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA

    Yi Zhao

  4. Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN, USA

    Gregory M. Sokol

  5. Department of Obstetrics and Gynecology, Indiana University School of Medicine, Indianapolis, IN, USA

    David M. Haas

  6. Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, USA

    Senthilkumar Sadhasivam

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  1. Rupa Radhakrishnan
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  2. Ramana V. Vishnubhotla
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  3. Zoe Guckien
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  4. Yi Zhao
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  7. Senthilkumar Sadhasivam
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Correspondence to Rupa Radhakrishnan.

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Radhakrishnan, R., Vishnubhotla, R.V., Guckien, Z. et al. Thalamocortical functional connectivity in infants with prenatal opioid exposure correlates with severity of neonatal opioid withdrawal syndrome. Neuroradiology 64, 1649–1659 (2022). https://doi.org/10.1007/s00234-022-02939-4

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