Two authors were not included in the authorship list though they both had relevant contributions to the study performance and results. Dr. Metsäranta is a neonatologist who was crucial in the patient recruitment and much of the clinical data collection. Dr. Lano is a pediatric neurologist who was crucial in the neurological outcome studies. The author names, affiliations, and contributions have been corrected in the article.

Sleep architecture carries vital information about brain health across the lifespan. In particular, the ability to express distinct vigilance states is a key physiological marker of neurological wellbeing in the newborn infant although systems-level mechanisms remain elusive. Here, we demonstrate that the transition from quiet to active sleep in newborn infants is marked by a substantial reorganization of large-scale cortical activity and functional brain networks. This reorganization is attenuated in preterm infants and predicts visual performance at two years. We find a striking match between these empirical effects and a computational model of large-scale brain states which uncovers fundamental biophysical mechanisms not evident from inspection of the data. Active sleep is defined by reduced energy in a uniform mode of neural activity and increased energy in two more complex anteroposterior modes. Preterm-born infants show a deficit in this sleep-related reorganization of modal energy that carries novel prognostic information.

Large-scale coupling in neuronal activity is essential in all cognitive functions, but its emergence and functional correlates are poorly known in the human newborn. This study aimed to characterize functional connectivity in the healthy human newborn, and to identify the changes in connectivity related to vigilance states and to maturation during the early postnatal weeks. We recorded active and quiet sleep of 38 sleeping newborn babies using multichannel electroencephalography (EEG) at 2 neonatal time points. Functional connectivity between brain areas was quantified with 3 different metrics: phase-phase correlations, amplitude-amplitude correlations (AACs), and phase-amplitude correlations. All functional connectivity measures changed significantly between vigilance states and matured rapidly after normal birth. The observed changes were frequency-specific, most salient in AAC coupling, and their development was compatible with the known development of structural cortico-cortical connectivity. The present findings support the view that emerging functional connectivity exhibits fundamental differences between sleep states months before the onset of genuine EEG signatures of sleep states. Moreover, our findings also support the idea that early cortical events entail different mechanisms of functional coupling needed to provide endogenous guidance for early activity-dependent development of brain networks.