Cognitive Functions of the Fetus

Abstract

The human brain is intricately designed to execute cognitive functions, such as perception, attention, action, memory and learning. The complete nervous system is active during prenatal development and the aim of this review is to present data on fetal cognitive functions. The fetus processes sensory stimuli at a cortical level, including painful stimulus, from about 25 weeks of gestation onwards. At gestational week 34, the fetus is able not only to perceive complex acoustic external sounds but also to discriminate between different sounds. Fetal action planning is established by 22 weeks and investigations using four-dimensional ultrasound reveal that complexity of fetal motor action and behavior increases as pregnancy progresses. The capacity of the fetus to learn and memory are prodigious. At term, subcortical structures of the brain are well developed. There is high activity in primary cortical areas and low activity in association areas. Clinically relevant data on cognitive functions of the fetus could be important for the management of fetal pain and treatment of preterm infants as well as for improved neurodevelopmental outcome of fetuses from high-risk pregnancies. Finally, the brain’s developmental journey, including development of cognitive functions, continues with the same intensity in the postnatal period.

Zusammenfassung

Das menschliche Gehirn ist kompliziert gestaltet, um kognitive Funktionen, wie Wahrnehmung, Aufmerksamkeit, Handlungen, Gedächtnis und Lernen auszuführen. Das gesamte Nervensystem ist während der vorgeburtlichen Entwicklung aktiv. Ziel dieser Übersichtsarbeit ist es, die Datenlage bezüglich der kognitiven Funktionen des Feten darzustellen. Der Fetus verarbeitet etwa ab 25 Schwangerschaftswochen sensorische Reize, einschließlich schmerzhafter Stimuli, auf kortikaler Ebene. Mit 34 Schwangerschaftswochen kann der Fetus nicht nur komplexe akustische Außengeräusche wahrnehmen sondern auch zwischen verschiedenen Lauten unterscheiden. Der Fetus tritt ab 22 Wochen vermehrt in Aktion, und Untersuchungen mit vierdimensionalem Ultraschall zeigen, dass die Komplexität der fetalen Bewegungen und des Verhaltens im Verlauf der Schwangerschaft zunimmt. Die Lern- und Gedächtnisleistungen des Fetus sind erstaunlich. Um den Geburtstermin sind die subkortikalen Gehirnstrukturen gut entwickelt, es besteht eine hohe Aktivität in den primären Kortexarealen und eine geringe Aktivität in den Assoziationsarealen. Klinisch relevante Daten über kognitive Funktionen des Feten sind unter Umständen von Bedeutung bei der Behandlung fetaler Schmerzen, bei der Versorgung von Frühgeborenen, aber auch, um bei Risikoschwangerschaften die weitere neurologische Entwicklung des Feten zu verbessern. Schließlich geht die Entwicklung des Gehirns, einschließlich der kognitiven Funktionen, in der Zeit nach der Geburt genauso rasant weiter wie davor.

Key words

fetal cognitive functions - four-dimensional ultrasound - fetal sensory perception and motor action - fetal emotions

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