A large longitudinal analysis of children and adolescents born preterm has identified a possible neural pathway linking early birth to later difficulties in cognition: the brain’s major communication networks may take longer to develop the energetic efficiency needed for complex thinking. The study, published in Translational Psychiatry, reports that delayed maturation of brain network energy was associated with poorer cognitive performance among preterm youth tracked through the Adolescent Brain Cognitive Development, or ABCD, study. The findings offer a new way to understand why children born before full gestation can face elevated risks of attention, learning, memory and executive-function problems—even when conventional brain scans show no obvious structural injury.
Rather than examining only the size or shape of individual brain regions, the researchers focused on how efficiently the brain operates as an interconnected system. The brain is not a collection of isolated parts: perception, language, working memory, decision-making and motor control depend on constantly shifting communication among distributed networks. These networks consume energy as neurons exchange signals, maintain electrical gradients and coordinate activity. By studying the energetic demands of moving the brain from one functional state to another, scientists can estimate how flexibly and efficiently its architecture supports cognition. In this context, “network energy” refers to the theoretical or computational cost required to drive coordinated activity across the brain’s connectivity system.
Premature birth interrupts development during a period when the brain is undergoing rapid expansion and reorganization. In the final weeks of pregnancy, the cerebral cortex develops more complex folding, long-range connections become increasingly insulated by myelin, and communication between distant regions grows more coordinated. These processes help transform a relatively local and inefficient network into one capable of integrating information across multiple systems. When birth occurs early, exposure to the outside world arrives before that developmental sequence is complete. Medical complications, inflammation, fluctuating oxygen levels and the demands of neonatal intensive care may all influence how connections are formed and refined, although the effects vary widely from one child to another.
The new analysis suggests that the consequences of this altered timetable may remain visible years later, not simply as weaker connections but as a slower progression toward an energetically efficient brain. During typical development, the brain gradually becomes better at combining specialized and integrated modes of operation. Sensory and cognitive systems become more distinct, while high-level association networks increasingly communicate with one another. This balance allows the brain to concentrate activity where it is needed without wasting resources across the entire system. A delayed energy-development trajectory could mean that preterm youth require more neural effort to accomplish tasks that rely on planning, sustained attention, flexible reasoning or the coordination of several kinds of information.
The concept is closely related to network controllability, a framework from physics, engineering and computational neuroscience. In a controllability model, the brain is represented as a network of nodes—often corresponding to brain regions—and edges representing the strength of their structural or functional relationships. The model then estimates how much input, or “energy,” would be required to move the system from one pattern of activity to another. A mature network may reach certain useful states with relatively little energy because its connections have been efficiently organized. If development is delayed, transitions between cognitive states may be more costly or less reliable. Such calculations do not measure glucose consumption directly; instead, they provide a mathematical description of how the brain’s connectivity may constrain its ability to change state.
The ABCD study gives this question an unusually broad developmental setting. Its longitudinal design allows researchers to examine brain and behavioral measures across time rather than relying on a single snapshot. That distinction matters because brain development is dynamic: a child who appears behind at one age may catch up later, while another may show difficulties only as school and social demands become more complex. By relating developmental trajectories to cognitive outcomes, the researchers were able to ask not only whether preterm youth differed from their peers, but whether the rate at which their network energy characteristics changed was connected to performance. The reported association points toward development over time as a key feature of the biology of prematurity.
Cognition is especially sensitive to the coordination of large-scale networks. Working memory requires information to be held active while attention is directed toward a goal. Executive control depends on suppressing distractions, updating plans and switching strategies. Processing speed reflects how quickly information can be transmitted, integrated and used. Each of these abilities draws on communication among frontal, parietal, temporal and subcortical systems. If the brain’s network architecture remains energetically immature, these operations may demand greater effort, leaving fewer resources available for simultaneous tasks. The study’s central message is therefore not that preterm birth damages one single “intelligence area,” but that it may alter the efficiency and timing of system-wide coordination.
The findings also help explain why the cognitive effects of prematurity can be subtle, variable and difficult to predict from early clinical history alone. Some children born preterm perform within the typical range, while others experience persistent challenges that emerge most clearly in demanding academic environments. Differences in gestational age, neonatal complications, socioeconomic conditions, educational support, sleep, mental health and family resources can all shape developmental outcomes. A network-energy measure could eventually become one component of a more comprehensive risk profile, especially if future research confirms that it predicts which children are most likely to benefit from targeted support. At present, however, the results should be interpreted as evidence of an association, not as a diagnostic test or proof that altered network energy directly causes cognitive impairment.
The work may also influence how researchers think about intervention. If the problem involves delayed maturation and inefficient transitions between brain states, support might need to extend beyond conventional academic tutoring. Cognitive training, physical activity, sleep improvement, treatment of attention difficulties and carefully timed educational accommodations could potentially help strengthen the systems that support flexible brain activity. Yet the study does not establish which intervention would work, or whether network-energy patterns can be permanently changed. Future investigations will need to combine repeated brain imaging with detailed medical, environmental and behavioral information, while following participants into later adolescence and adulthood. Such studies could reveal whether the observed delay represents a temporary developmental lag, a persistent difference in brain organization or a trajectory that can be altered.
For now, the research provides a compelling biological narrative for a long-recognized clinical reality: being born too early can influence cognition long after the immediate dangers of premature birth have passed. By shifting attention from isolated brain structures to the energetic logic of whole-brain communication, the study gives scientists a more nuanced framework for understanding developmental vulnerability. The brain’s ability to think, learn and adapt depends not only on which regions are connected, but on how efficiently those connections can be recruited as circumstances change. In preterm youth, that efficiency may mature on a delayed schedule—and the timing of that development could help explain differences in cognitive function across childhood and adolescence.
Subject of Research: Brain network energy development and cognitive function in youth born preterm
Article Title: Delayed brain network energy development in preterm youth impairs cognitive function: evidence from the longitudinal ABCD study
Article References: Li, Q., Jensen, D., Jakim, T. et al. Delayed brain network energy development in preterm youth impairs cognitive function: evidence from the longitudinal ABCD study. Transl Psychiatry (2026). https://doi.org/10.1038/s41398-026-04326-6
Image Credits: AI Generated
DOI: https://doi.org/10.1038/s41398-026-04326-6
Keywords: prematurity, preterm birth, brain development, brain networks, network energy, cognitive function, ABCD study, developmental neuroscience, longitudinal research, neurodevelopment
