Publications

2026

Jeong, Seungyoon, Andrea Gondova, Hyuk Jin Yun, Sungmin You, Melquisideth Lagunas, Polina Golland, Ellen Grant, and Kiho Im. 2026. “Evaluating Reliability of Automated Quantitative Brain Morphometry from Fetal T2-Weighted MRI”. Frontiers in Neuroscience Volume 20 - 2026. https://doi.org/10.3389/fnins.2026.1817732.
IntroductionThree-dimensional assessment of fetal cortical morphology from MRI is essential for understanding early brain neurodevelopment. However, measurement can be affected by fetal imaging quality, number and selection of available stacks, and reconstruction methods.MethodsWe evaluated the within-session reliability of an automated cortical morphometry pipeline in 30 typically developing fetuses [22–36 weeks gestational age (GA)]. For each subject, two disjoint subsets of 2D T2-weighted stacks (no shared stacks) were independently reconstructed into 3D volumes using the Neural Slice-to-Volume Reconstruction (NeSVoR) and the Slice-to-Volume Reconstruction Toolkit (SVRTK). Cortical plate volume, surface area, mean sulcal depth, and absolute mean curvature were extracted, and measurement reliability was assessed using absolute percent difference (APD) and intraclass correlation coefficients (ICC). Multiple linear regression evaluated the effects of mean stack quality, quality difference between subsets, stack count, and GA on measurement reliability.ResultsNeSVoR-derived metrics showed high reliability for all measures (mean APD 3%, ICC > 0.99). SVRTK-derived metrics were also robust (mean APD 5%, ICC > 0.97). Reliability increased with greater stack count and older GA in NeSVoR, and with higher mean stack quality in SVRTK.DiscussionThese results demonstrate that automated cortical morphometry from fetal MRI yields highly consistent measurements of volumetric and surface metrics within the proposed within-session design, once minimum levels of image quality and stack count are met. This study proposes a within-session benchmark for automated fetal cortical measurements and underscores that systematic reliability assessment is essential for confident application of automated pipelines in fetal neuroimaging.
Hostalet, Noemí, Daniel Herrera-Escartín, Lluís Cobos-Aumatell, Mateo Berrío-Soto, Banu Ahtam, Amalia Guerrero-Pedraza, Pedro Canut, et al. 2026. “Hidden in the Cortical Folds: Sex-Specific Sulcal Pits Patterns in Schizophrenia”. NeuroImage: Clinical 51: 104034. https://doi.org/https://doi.org/10.1016/j.nicl.2026.104034.
Background Prenatal brain development represents a vulnerability window for schizophrenia (SZ). To explore early alterations related to the disorder, we examined sulcal pits —lifespan stable landmarks of fetal cortical folding— as markers of neurodevelopmental differences between SZ patients and healthy controls (HC). Methods T1-weighted MRIs (1.5 T) were obtained from 426 individuals (237 SZ patients: 173 males, 64 females; 189 HC: 93 males, 96 females). Sulcal pits were identified from white matter cortical surfaces reconstructed using FreeSurfer. Graphs were constructed for each lobe and hemisphere and compared based on sulcal pits (SP) features: SP-Position, SP-Depth, SP-SurfaceAreaBasin, SP-Topology, and all combined features (SP-Combined). We tested: i) group differences in the sulcal pits heterogeneity between patients and HC; ii) sulcal pits divergence in patients relative to HC; iii) the association between sulcal pits divergence and Positive and Negative Syndrome Scale (PANSS) scores; iv) regional covariation between the sulcal pits heterogeneity differences and transcriptional profiles across lobes using Partial Least Squared regressions (PLS-R). Analyses were performed in the sex-pooled sample and stratified by sex. Results Patients showed increased heterogeneity compared to HC across hemispheres, frontal, temporal, and parietal lobes. Divergence analyses revealed reduced similarity relative to HC, in the left frontal SP-Combined in males (with a trend-level negative correlation with PANSS scores) and right parietal SP-Topology in females. PLS-R showed sex-specific molecular underpinnings related to the identified differences in the heterogeneity of sulcal pits. Conclusion This study provides novel evidence supporting sulcal pits as early neurodevelopmental markers of sex-specific structural brain variability in SZ.
Hostalet, Noemí, Mateo Berrio, Daniel Herrera-Escartín, Lluís Cobos-Aumatell, Maria Guardiola-Ripoll, Banu Ahtam, Ana Aquino, et al. 2026. “T111. SEX-SPECIFIC ASSOCIATIONS BETWEEN SCHIZOPHRENIA AND NEURODEVELOPMENTAL-EVOLUTIONARY FEATURES OF SULCAL PITS”. European Neuropsychopharmacology 111: 113368. https://doi.org/https://doi.org/10.1016/j.euroneuro.2026.113368.
Background Schizophrenia (SZ) is a neurodevelopmental disorder linked to evolutionary trade-offs for human-specific cognitive abilities, with sex-specific differences in clinical presentation. Cortical sulcal patterns, tightly linked to neurodevelopment and evolution, are shaped by the deepest and earliest-forming points of the cerebral cortex, named sulcal pits. In healthy individuals, sulcal pits patterns capture interindividual variability and are sensitive to sex-specific developmental differences (Hostalet et al., 2025); however, their spatial organization and sex-specific effects remain unexplored in SZ. Integrating sulcal pits patterns with genomic and transcriptomic data can reveal how genetic factors shape cortical architecture and SZ vulnerability. Human Accelerated Regions (HARs), conserved genomic regions with human-specific changes, may link evolutionary and developmental mechanisms, as their prenatal expression influences cortical morphology in SZ (Guardiola-Ripoll et al., 2023). Accordingly, we will present data on: i) divergence of sulcal pit patterns in SZ versus controls across lobes and hemispheres, highlighting sex-specific effects; and ii) the contribution of HARs-related gene expression to these differences. Methods The sample included 426 adults (237 SZ patients/189 healthy controls (HC)) with T1-w MRIs. Sulcal pits were extracted from FreeSurfer-derived white matter surfaces. Graphs were created for each lobe and hemisphere, considering sulcal pits as the nodes and their interconnections as the edges. Sulcal graphs were compared between patients with SZ and HC based on different sulcal pits features (position, depth, area and topology). Transcriptomic data (BrainSpan) included 179 HARs-related genes expressed in three specific prenatal stages: 13, 21, and 37 post-conception weeks. Covariation between transcriptomic data and the differences in sulcal pits patterns between patients and healthy individuals was tested by Partial Least Squares Regression (PLS-R) models. The analyses were performed separately in males and females. Results Males with SZ exhibited reduced sulcal pits similarity to HC in the left frontal lobe, while females showed reduced similarity in the right parietal lobe. PLS-R models identified that the expression of a gene tightly related to the emergence of human-specific abilities, FOXP2, was related to differences in the sulcal patterns between patients with SZ and HC across all prenatal stages, unveiling sulcal pits as neurodevelopmental and evolutionary markers of schizophrenia. Discussion Sulcal pits emerge as sex-specific early neurodevelopmental markers in SZ. These findings provide the first evidence of HARs-driven transcriptional influence on sulcal pits patterns, supporting the neurodevelopmental and evolutionary component of the disorder.
Gondova, Andrea, Seungyoon Jeong, Nicole Stepovich, Wayne Tworetzky, Victoria R. Bradford, Anjali Sadhwani, Jennings Zhang, et al. 2026. “Fetal MRI Reveals Altered Subplate Development in Congenital Heart Disease”. BioRxiv. https://doi.org/10.64898/2026.08.18.745587.
Background The subplate is a transient fetal brain compartment that provides an early foundation for downstream cerebral development. Congenital heart disease (CHD) alters fetal circulation and cerebral substrate delivery, but its impact on subplate development and whether resulting alterations relate to later neurodevelopmental outcomes remain unclear.Methods In this retrospective observational cohort study, We used fetal MRI to quantify whole-brain, lobar, and regional (17 bilateral cortical regions) subplate volume and thickness to evaluate group differences between 76 fetuses with CHD and 62 typically developing (TD) fetuses scanned between 21-32 weeks of gestation, and estimated individualized deviations from TD developmental trajectories. Associations with fetal hemodynamic indices (substrate delivery score, cerebroplacental ratio [CPR]) and two-year neurodevelopmental outcomes (Bayley Scales of Infant and Toddler Development, N=46 CHD, N=37 TD) were explored.Results Whole-brain subplate volume was lower in CHD, corresponding to a 5.7% reduction relative to age- and sex-expected values (p=0.003), but this difference was substantially attenuated after accounting for global brain volume (p=0.090). In contrast, regional analyses identified persistent spatially structured deviations beyond global scaling, most consistently involving posterior parietal, occipital and temporal regions, with a left-hemisphere bias in subplate thickness. Normative modelling demonstrated bidirectional regional deviations and increased inter-individual variability in CHD, with extreme subplate volume deviations enriched across 73% of cortical regions (p=0.009). Higher CPR was associated with lower SP thickness deviations, with the association strengthening after accounting for cerebral substrate delivery (p=0.010), although these analyses were exploratory. In CHD fetuses with postnatal follow-up, prenatal subplate deviations showed modest associations with neurodevelopmental outcomes, with right precuneus subplate thickness associated with receptive (β=-11.87, q=0.017) and expressive (β=-14.50, q=0.039) communication on the Bayley, after correction for multiple comparisons.Conclusions Fetal subplate alterations in CHD are dominated by global reductions in brain growth but also include spatially heterogeneous and individually variable regional deviations beyond global scaling. Exploratory associations with fetal hemodynamics and postnatal neurodevelopment provide hypotheses for future studies investigating the developmental significance of these prenatal alterations.Competing Interest StatementThe authors have declared no competing interest.2Vtwo-ventricleAICAkaike Information CriterionANCOVAanalysis of covarianceBICBayesian Information CriterionCHDcongenital heart diseaseCPcortical plateCPRcerebroplacental ratioECHOechocardiogramFASfetal aortic stenosisFDRfalse discovery rateGAgestational ageHASTEhalf-Fourier single-shot turbo spin echoHLHShypoplastic left heart syndromeIZintermediary zoneMCA PImiddle cerebral artery pulsatility indexSPsubplateSVsingle-ventricleTDtypically developingTEecho timeTGAtransposition of the great arteriesTOFtetralogy of FallotTRrepetition timeUA PIumbilical artery pulsatility index.NIH, R01EB031170, K23NS101120,, R01NS114087, R01NS121334

2025

Gondová, Andrea, Jennings Zhang, Sungmin You, Seungyoon Jeong, Milton O Candela-Leal, Caitlin K Rollins, Ellen Grant, Hyuk Jin Yun, and Kiho Im. (2025) 2025. “Typical Development of the Human Fetal Subplate: Regional Heterogeneity, Growth, and Asymmetry Assessed by in Vivo T2-Weighted MRI.”. BioRxiv : The Preprint Server for Biology. https://doi.org/10.1101/2025.10.06.680743.

The subplate (SP) is a transient fetal brain compartment supporting neuronal migration, axonal ingrowth, and early cortical activity, yet the dynamics of its regional development remain poorly understood in vivo. Using T2-weighted fetal MRI of 68 typically developing fetuses (22-32 weeks gestational age, GA), we developed a semi-automated pipeline to quantify regional SP morphology (thickness, surface area, and volume). SP characteristics scaled strongly with GA and residual brain volume and showed marked regional differences. After correcting for geometric confounds, regional variation of SP thickness persisted, with highest values in parietal and perisylvian regions, suggesting that SP thickness may serve as a sensitive marker of intrinsic developmental differences. Between late 2nd and early 3rd trimester, mean SP thickness increased by 39.2% with large variation across regions (±11.0 SD), whereas surface area growth was more uniform (64.3% ±0.7 SD). Continuous growth trajectories clustered into distinct spatiotemporal profiles: early-developing regions (e.g., pericentral and medial occipital cortices) contrasted with later-developing regions (prefrontal, temporal, and parietal cortices). These patterns partially recapitulate primary-to-association, medial-to-lateral, and posterior-to-anterior maturational hierarchies, pointing to organized developmental program. SP development also showed region-specific hemispheric asymmetries, including leftward thickness and volume asymmetry in superior temporal and precentral gyri. Some asymmetries amplified, others attenuated or reversed with age, suggesting both transient states and potential precursors of postnatal lateralization. Together, these findings provide a framework for regional SP quantification and position SP morphology, particularly thickness, as a promising early biomarker that might link fetal SP changes to subsequent cortical development and neurodevelopmental outcomes.

You, Sungmin, Andrea Gondova, Carlos Simon Amador Izaguirre, Guillermo Tafoya Milo, Seungyoon Jeong, Han-Jui Lee, Tomo Tarui, et al. (2025) 2025. “Conditional Deep Generative Normative Modeling for Structural and Developmental Anomaly Detection in the Fetal Brain.”. NeuroImage 319: 121442. https://doi.org/10.1016/j.neuroimage.2025.121442.

Fetal brain development is a complex and dynamic process, and its disruption can lead to significant neurological disorders. Early detection of brain aberrations during pregnancy is critical for optimizing postnatal medical intervention. We propose a deep generative anomaly detection framework, conditional cyclic variational autoencoding generative adversarial network (CCVAEGAN), that can identify structural brain anomalies using fetal brain magnetic resonance imaging. CCVAEGAN leverages covariate conditioning on gestational age and cyclic consistency training to generate high-fidelity normative fetal brain images to enhance anomaly detection across various neurodevelopmental stages and diagnoses. Using MRI data from typically developing and clinically abnormal fetuses across multiple sites, CCVAEGAN achieves superior image generation quality and anomaly detection accuracy than other comparable models, consistently producing anatomically precise images with lower reconstruction errors and higher structural similarities. Anomaly detection experiments yielded near-perfect AUROC values (>0.99) across various anomaly score metrics, and visual assessments confirmed the model's ability to localize and characterize structural abnormalities. Additionally, external validation on separated-site cohorts demonstrated the generalizability of the CCVAEGAN framework, showing robust detection performance despite data variations. These findings demonstrate CCVAEGAN's potential as a powerful tool for automated, objective anomaly screening, that could significantly enhance the efficiency of clinical workflows for early diagnosis of fetal brain anomalies. Furthermore, this approach has the potential universality to apply to other medical imaging not limited to specific organs or imaging modalities in the future.

Takeoka, Emiko, April A Carlson, Neel Madan, Afshin Azimirad, Taysir Mahmoud, Rie Kitano, Shizuko Akiyama, et al. (2025) 2025. “Impact of High Maternal Body Mass Index on Fetal Cerebral Cortical and Cerebellar Volumes.”. Journal of Perinatal Medicine 53 (3): 376-86. https://doi.org/10.1515/jpm-2024-0222.

OBJECTIVES: Maternal obesity increases a child's risk of neurodevelopmental impairment. However, little is known about the impact of maternal obesity on fetal brain development.

METHODS: We prospectively recruited 20 healthy pregnant women across the range of pre-pregnancy or first-trimester body mass index (BMI) and performed fetal brain magnetic resonance imaging (MRI) of their healthy singleton fetuses. We examined correlations between early pregnancy maternal BMI and regional brain volume of living fetuses using volumetric MRI analysis.

RESULTS: Of 20 fetuses, there were 8 males and 12 females (median gestational age at MRI acquisition was 24.3 weeks, range: 19.7-33.3 weeks, median maternal age was 33.3 years, range: 22.0-37.4 years). There were no significant differences in clinical demographics between overweight (OW, 25≤BMI<30)/obese (OB, BMI≥30 kg/m2) (n=12) and normal BMI (18.5≤BMI<25) (n=8) groups. Fetuses in the OW/OB group had significantly larger left cortical plate (p=0.0003), right cortical plate (p=0.0002), and whole cerebellum (p=0.049) compared to the normal BMI group. In the OW/OB BMI group, cortical plate volume was larger relative to other brain regions after 28 weeks.

CONCLUSIONS: This pilot study supports the concept that maternal obesity impacts fetal brain volume, detectable via MRI in living fetuses using quantitative analysis.

Mondragon-Estrada, Enrique, Jane W Newburger, Steven R DePalma, Martina Brueckner, John Cleveland, Wendy K Chung, Bruce D Gelb, et al. (2025) 2025. “Noncoding Variants and Sulcal Patterns in Congenital Heart Disease: Machine Learning to Predict Functional Impact.”. IScience 28 (2): 111707. https://doi.org/10.1016/j.isci.2024.111707.

Neurodevelopmental impairments associated with congenital heart disease (CHD) may arise from perturbations in brain developmental pathways, including the formation of sulcal patterns. While genetic factors contribute to sulcal features, the association of noncoding de novo variants (ncDNVs) with sulcal patterns in people with CHD remains poorly understood. Leveraging deep learning models, we examined the predicted impact of ncDNVs on gene regulatory signals. Predicted impact was compared between participants with CHD and a jointly called cohort without CHD. We then assessed the relationship of the predicted impact of ncDNVs with their sulcal folding patterns. ncDNVs predicted to increase H3K9me2 modification were associated with larger disruptions in right parietal sulcal patterns in the CHD cohort. Genes predicted to be regulated by these ncDNVs were enriched for functions related to neuronal development. This highlights the potential of deep learning models to generate hypotheses about the role of noncoding variants in brain development.

Yun, Hyuk Jin, Han-Jui Lee, Sungmin You, Joo Young Lee, Jerjes Aguirre-Chavez, Lana Vasung, Hyun Ju Lee, et al. (2025) 2025. “Deep Learning-Based Brain Age Prediction Using MRI to Identify Fetuses With Cerebral Ventriculomegaly.”. Radiology. Artificial Intelligence 7 (2): e240115. https://doi.org/10.1148/ryai.240115.

Fetal ventriculomegaly (VM) and its severity and associated central nervous system (CNS) abnormalities are important indicators of high risk for impaired neurodevelopmental outcomes. Recently, a novel fetal brain age prediction method using a two-dimensional (2D) single-channel convolutional neural network (CNN) with multiplanar MRI sections showed the potential to detect fetuses with VM. This study examines the diagnostic performance of a deep learning-based fetal brain age prediction model to distinguish fetuses with VM (n = 317) from typically developing fetuses (n = 183), the severity of VM, and the presence of associated CNS abnormalities. The predicted age difference (PAD) was measured by subtracting the predicted brain age from the gestational age in fetuses with VM and typical development. PAD and absolute value of PAD (AAD) were compared between VM and typically developing fetuses. In addition, PAD and AAD were compared between subgroups by VM severity and the presence of associated CNS abnormalities in VM. Fetuses with VM showed significantly larger AAD than typically developing fetuses (P < .001), and fetuses with severe VM showed larger AAD than those with moderate VM (P = .004). Fetuses with VM and associated CNS abnormalities had significantly lower PAD than fetuses with isolated VM (P = .005). These findings suggest that fetal brain age prediction using the 2D single-channel CNN method has the clinical ability to assist in identifying not only the enlargement of the ventricles but also the presence of associated CNS abnormalities. Keywords: MR-Fetal (Fetal MRI), Brain/Brain Stem, Fetus, Supervised Learning, Machine Learning, Convolutional Neural Network (CNN), Deep Learning Algorithms Supplemental material is available for this article. ©RSNA, 2025.