Functional plasticity before the cradle: A review of neural functional imaging in the human fetus

• The organization of the brain is highly plastic in fetal life.
• Recently, functional neuroimaging has directly examined and measured human fetal brain function.
• Biomarkers of neurological development may be defined through functional neuroimaging methods.
• Fetal programming asserts maternal environment directly influences later developmental outcomes.
• Improved future fMRI and MEG studies may lead to new diagnostic and clinical applications.

The organization of the brain is highly plastic in fetal life. Establishment of healthy neural functional systems during the fetal period is essential to normal growth and development. Across the last several decades, remarkable progress has been made in understanding the development of human fetal functional brain systems. This is largely due to advances in imaging methodologies. Fetal neuroimaging began in the 1950–1970's with fetal electroencephalography (EEG) applied during labor. Later, in the 1980's, magnetoencephalography (MEG) emerged as an effective approach for investigating fetal brain function. Most recently, functional magnetic resonance imaging (fMRI) has arisen as an additional powerful approach for examining fetal brain function. This review will discuss major developmental findings from fetal imaging studies such as the maturation of prenatal sensory system functions, functional hemispheric asymmetry, and sensory-driven neurodevelopment. We describe how with improved imaging and analysis techniques, functional imaging of the fetus has the potential to assess the earliest point of neural maturation and provide insight into the patterning and sequence of normal and abnormal brain development.