Advanced MR Imaging of Perinatal White Matter Injury

围产期脑白质损伤的高级 MR 成像

基本信息

批准号：
7789427
负责人：
Ashok Panigrahy
金额：
$ 16.11万
依托单位：
UNIVERSITY OF PITTSBURGH AT PITTSBURGH
依托单位国家：
美国
项目类别：
财政年份：
2009
资助国家：
美国
起止时间：
2009-04-01 至 2014-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7789427
关键词：
6 year old Age Arts Attention Autistic Disorder Autopsy Axon Basal Ganglia Biological Markers Brain Brain region Cells Cerebral Ischemia-Hypoxia Cerebral Palsy Cerebral cortex Cerebrum Child Childhood Clinical Management Clinical Research Cognition Cognition Disorders Cognitive Common Ventricle Data Databases Detection Development Diagnosis Diffuse Diffusion Diffusion Magnetic Resonance Imaging Early treatment Enrollment Evaluation Free Radicals Gliosis Glutamates Goals Gray unit of radiation dose Hypoplastic Left Heart Syndrome Hypoxia Image Imaging Techniques Impaired cognition Incidence Infant Injury Inositol Intelligence Knowledge Lead Learning Life Long-Term Survivors Longitudinal Studies Magnetic Resonance Magnetic Resonance Imaging Magnetic Resonance Spectroscopy Measurement Measures Mental disorders Metric Myelin N-acetylaspartate Nature Necrosis Neonatal Neurological outcome Neuronal Injury Neurons Oligodendroglia Osmolar Concentration Outcome Participant Pathogenesis Pathologic Patients Pediatric Neurology Perinatal Perinatal Brain Injury Periventricular Leukomalacia Physiology Population Premature Infant Principal Investigator Problem behavior Protons Psychology Publishing Research Research Design Risk Risk Factors Secondary to Services Survivors Techniques Testing Thalamic structure Time Toddler Toxic effect Transposition of Great Vessels United States astrogliosis axonal degeneration base career clinical practice congenital heart disorder cytokine density fetal follow-up gray matter high risk imaging modality improved motor deficit neonate neurobehavioral neurocognitive test neurodevelopment neuroimaging neuropathology neuropsychological oligodendrocyte precursor precursor cell premature programs skills statistics white matter white matter injury

项目摘要

DESCRIPTION (provided by applicant): PROJECT SUMMARY: Perinatal brain injury is a significant problem given the high incidence of prematurity in the United States, with an estimated increase of 28% over the past 20 years. It is now estimated that up to 40% of survivors of perinatal brain injury are compromised neurologically, including motor deficits, learning and behavioral problems. Our overall hypothesis is that magnetic resonance spectroscopy (MRS) may be a biomarker of the diffuse component of perinatal white matter injury and that altered neonatal NAA and NAA/myo-inositol ratio will correlate with long term neurodevelopmental outcome and thalamo-cortical abnormalities as assessed with advanced MR techniques at 6 years of age. We will specifically focus on premature infants at term equivalent age and term infants with congenital heart disease (transposition of the great arteries and single ventricle physiology). Our specific aims are: Aim 1: Determine "normative levels" of absolute concentration of NAA and myo-inositol in neonatal cerebral white matter using a longitudinal study design by (1a) performing MRS in term infants with no risk factors for perinatal white matter injury; (1b) performing longitudinal neurodevelopmental assessment at 18 months, 36 months and 6 years of age; (1c) performing DTI and VM MR imaging at 6 yrs of age. Aim 2: To determine the levels of absolute concentration of NAA and myo-inositol in the cerebral white matter using a longitudinal study design by (2a) performing MRS in term equivalent premature infants, (2b) performing longitudinal neurodevelopmental assessment at 18 months, 36 months and 6 years of age, and (2c) performing DTI and VM MR imaging at 6 yrs of age. Aim 3: To determine the levels of absolute concentration of NAA and myo-inositol in the cerebral white matter using a longitudinal study design by (3a) performing MRS in term infants with congenital heart disease (3b) performing longitudinal neurodevelopmental assessment at 18 months, 36 months and 6 years of age (3c) performing DTI and VM MR imaging at 6 yrs of age. As part of the career plan, the applicant will obtain skills in (1) advanced MR imaging techniques (2) clinical research outcome, advanced statistics and clinical management skills, and (3) neonatal neuropathology, pediatric neurology and pediatric neuro-psychology. RELEVANCE: This longitudinally designed study, using both advanced MR imaging and neurocognitive testing, will allow us to study the effects of perinatal white matter injury on long term neurodevelopmental function and thalamo-cortical structural plasticity in childhood. This project will help identify neonates with perinatal white matter injury at high risk for developing poor neurodevelopmental outcome for early intervention services.

描述（由申请人提供）：项目摘要：鉴于美国早产率很高，估计在过去 20 年中增加了 28%，因此围产期脑损伤是一个重大问题。据估计，高达 40% 的围产期脑损伤幸存者存在神经功能受损，包括运动缺陷、学习和行为问题。我们的总体假设是，磁共振波谱 (MRS) 可能是围产期白质损伤弥漫性成分的生物标志物，并且新生儿 NAA 和 NAA/肌醇比率的改变将与评估的长期神经发育结果和丘脑皮质异常相关。 6岁时就掌握了先进的MR技术。我们将特别关注足月相当年龄的早产儿和患有先天性心脏病（大动脉转位和单心室生理学）的足月儿。我们的具体目标是：目标 1：使用纵向研究设计确定新生儿脑白质中 NAA 和肌醇绝对浓度的“正常水平”，方法是 (1a) 对没有围产期白质损伤危险因素的足月儿进行 MRS ; (1b) 在18个月、36个月和6岁时进行纵向神经发育评估； (1c) 在 6 岁时进行 DTI 和 VM MR 成像。目标 2：使用纵向研究设计确定大脑白质中 NAA 和肌醇的绝对浓度水平，方法是 (2a) 对足月相当的早产儿进行 MRS，(2b) 在 18 个月时进行纵向神经发育评估，36个月和 6 岁时，(2c) 在 6 岁时进行 DTI 和 VM MR 成像。目标 3：使用纵向研究设计确定大脑白质中 NAA 和肌醇的绝对浓度水平，方法是 (3a) 对患有先天性心脏病的足月婴儿进行 MRS (3b) 在 18 个月时进行纵向神经发育评估， 36 个月和 6 岁 (3c) 在 6 岁时进行 DTI 和 VM MR 成像。作为职业计划的一部分，申请人将获得以下方面的技能：（1）先进的磁共振成像技术（2）临床研究成果、先进的统计和临床管理技能，以及（3）新生儿神经病理学、儿科神经病学和儿科神经心理学。相关性：这项纵向设计的研究使用先进的 MR 成像和神经认知测试，使我们能够研究围产期白质损伤对儿童长期神经发育功能和丘脑皮质结构可塑性的影响。该项目将帮助识别患有围产期白质损伤的新生儿，这些新生儿神经发育不良的风险较高，从而提供早期干预服务。