Diffusion-MRI-based regional cortical microstructure at birth for predicting neurodevelopmental outcomes of 2-year-olds

Cerebral cortical architecture at birth encodes regionally differential dendritic arborization and synaptic formation. It underlies behavioral emergence of 2-year-olds. Brain changes in 0–2 years are most dynamic across the lifespan. Effective prediction of future behavior with brain microstructure at birth will reveal structural basis of behavioral emergence in typical development and identify biomarkers for early detection and tailored intervention in atypical development. Here we aimed to evaluate the neonate whole-brain cortical microstructure quantified by diffusion MRI for predicting future behavior. We found that individual cognitive and language functions assessed at the age of 2 years were robustly predicted by neonate cortical microstructure using support vector regression. Remarkably, cortical regions contributing heavily to the prediction models exhibited distinctive functional selectivity for cognition and language. These findings highlight regional cortical microstructure at birth as a potential sensitive biomarker in predicting future neurodevelopmental outcomes and identifying individual risks of brain disorders.