Early Markers of Neurodevelopmental Risk in Congenital Heart Disease

先天性心脏病神经发育风险的早期标志

• 批准号: 8294408
• 负责人: Ismee A. Williams
• 金额: $ 13.11万
• 依托单位: COLUMBIA UNIVERSITY HEALTH SCIENCES
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2014-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8294408
• 关键词: Abdomen; Adult; Age; Age-Months; Attention; Award; Behavior; Biocompatible Materials; Biometry; Cardiology; Cerebrovascular Circulation; Cerebrum; Characteristics; Child; Child Mortality; Childhood; Clinical; Clinical Investigator; Clinical Research; Clinical Sciences; Clinical and Translational Science Awards; Cohort Studies; Collection; Complex; Computers; Congenital Abnormality; DNA; Data; Databases; Development; Development Plans; Devices; Diabetes Mellitus; Disabled Persons; Discipline of obstetrics; Doppler Ultrasound; Early identification; Early treatment; Echocardiography; Electrocardiogram; Electroencephalogram; Enrollment; Environment; Etiology; Exhibits; FDA approved; Feasibility Studies; Fellowship; Fetal Diseases; Fetal Heart Rate; Fetus; Funding; Future; Genetic; Genetic Determinism; Goals; Heart Rate; Hour; Hypertension; Hypoplastic Left Heart Syndrome; Infant; Infant Development; Infant Mortality; Investigation; K-Series Research Career Programs; Knowledge; Laboratories; Learning; Life; Measures; Mental Retardation; Mentors; Molecular Genetics; Monitor; Morbidity - disease rate; Names; Neonatal; Neonatology; Neurocognitive; Neurodevelopmental Disability; Neurologic; Neurological outcome; Neurosciences; Onset of illness; Operative Surgical Procedures; Outcome; Parents; Patients; Pattern; Perfusion; Perinatal; Physiological; Physiology; Population; Procedures; Protocols documentation; Public Health Schools; Regulation; Research; Research Personnel; Resources; Risk; Risk Factors; Risk Marker; SECTM1 gene; Sample Size; Sampling; Services; Supervision; Survivors; Techniques; Testing; Tetralogy of Fallot; Therapeutic; Toddler; Training; Translational Research; Transposition of Great Vessels; United States National Institutes of Health; Universities; base; biobank; career; career development; cohort; congenital heart disorder; density; design; early childhood; experience; fetal; genetic analysis; handicapping condition; heart rate variability; high risk; innovation; molecular marker; multidisciplinary; neonate; neurobehavior; neurobehavioral; neurodevelopment; patient oriented research; professor; programs; prospective; public health relevance; response; skills; tool

DESCRIPTION (provided by applicant): Ismee Williams is an Assistant Professor in the Division of Pediatric Cardiology at Columbia University with a long-term goal to become an independent clinical investigator of perinatal contributors to neurodevelopmental outcomes in the congenital heart disease (CHD) population. Dr. Williams' short-term goal is to acquire the skill set and experience needed to launch her career. To date, Dr. Williams has benefitted greatly from the clinical research environment of Columbia University which includes the resources made available by the NIH-funded Clinical and Translational Science Award (CTSA). Dr. Williams trained in the conduct of patient oriented research and received a Masters in Biostatistics from the Mailman School of Public Health during the last two years of her fellowship. Dr. Williams was named a K12 TRANSFORM scholar during her first year as an attending and received a $50,000 CTSA sponsored pilot award the following year. Over the past year, Dr. Williams has directed a multidisciplinary feasibility study that is the basis for the proposed protocol to investigate potential risk factors associated with neurocognitive outcomes in patients with complex CHD. The proposed study is innovative in its intent to investigate perinatal markers of risk. Using a prospective observational cohort design, Dr. Williams will enroll 50 fetuses with CHD and 25 normal controls in order to 1) further characterize autonomic regulation in CHD fetuses, 2) test associations between fetal autonomic regulation and fetal cerebral blood flow, and 3) test associations between these two fetal measures and infant and toddler neurologic outcomes including autonomic regulation, cerebral function measured by high-density EEG, and neurodevelopment assessed by the Bayley Scale of Infant Development-III at 18-months. The career development plan includes a closely mentored program under the supervision of Dr. William Fifer, a developmental psychobiologist, with focused training in perinatal autonomic assessment. In addition, Dr. Philip Grieve will train Dr. Williams in the procedure of infant high-density EEG assessment. Increased understanding of these topics will allow Dr. Williams to become a more effective clinical perinatal investigator of neurodevelopmental outcomes in CHD. PUBLIC HEALTH RELEVANCE: This study is important as: 1) CHD is the most common group of birth defects, 2) survival following CHD surgery is increasing, and 3) survivors of complex CHD often (>50%) have neurologic difficulties, including learning delay and mental retardation the causes of which are largely unknown. Identification of early markers of adverse neurologic outcomes will allow the implementation of timely preventative and therapeutic services.

描述（由申请人提供）：Ismee Williams是哥伦比亚大学小儿心脏病学系的助理教授，其长期目标是成为先天性心脏病（CHD）人群神经发育结果的独立临床临床研究者的独立临床研究者。威廉姆斯博士的短期目标是获得启动职业所需的技能和经验。迄今为止，威廉姆斯博士从哥伦比亚大学的临床研究环境中受益匪浅，其中包括由NIH资助的临床和转化科学奖（CTSA）提供的资源。威廉姆斯博士接受了以患者为导向的研究进行培训，并在她的奖学金的最后两年中获得了邮政公共卫生学院生物统计学的硕士学位。威廉姆斯博士在参加的第一年被任命为K12转型学者，并于次年获得了50,000美元的CTSA赞助飞行员奖。在过去的一年中，威廉姆斯博士指导了一项多学科的可行性研究，该研究是拟议方案研究复杂CHD患者中与神经认知结果相关的潜在危险因素的基础。拟议的研究旨在研究风险围产期标志。 Using a prospective observational cohort design, Dr. Williams will enroll 50 fetuses with CHD and 25 normal controls in order to 1) further characterize autonomic regulation in CHD fetuses, 2) test associations between fetal autonomic regulation and fetal cerebral blood flow, and 3) test associations between these two fetal measures and infant and toddler neurologic outcomes including autonomic regulation, cerebral function measured by高密度的脑电图和神经发育由婴儿发育的Bayley量表在18个月时评估。职业发展计划包括在发育心理学家威廉·菲尔德（William Fifer）博士的监督下进行的一项密切指导的计划，并重点培训了围产期自治评估。此外，菲利普·格里夫（Philip Grieve）博士还将培训威廉姆斯博士的婴儿高密度脑电图评估。对这些主题的越来越多将使威廉姆斯博士成为CHD中神经发育结果的更有效的临床围产期研究者。 公共卫生相关性：这项研究很重要，因为：1）CHD是最常见的先天缺陷群体，2）CHD手术后的存活率正在增加，并且3）复杂CHD的幸存者经常（> 50％）具有神经系统困难，包括学习延迟和智力障碍，其原因很大。对不良神经系统结局的早期标记的识别将允许实施及时的预防和治疗服务。