Multimodal Evaluation of Sensory Processing and Neurodevelopment in NICU Infants

NICU 婴儿感觉处理和神经发育的多模式评估

• 批准号: 8699941
• 负责人: Nathalie Maitre
• 金额: $ 12.54万
• 依托单位: VANDERBILT UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 2014
• 资助国家: 美国
• 起止时间: 2014-05-09 至 2017-04-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8699941
• 关键词: 2 year old; Address; Age; Age-Months; Algorithms; Area; Attention; Auditory; Behavior Disorders; Behavioral; Brain; Brain region; Career Choice; Caring; Child; Child Development; Clinic; Clinical Trials; Clinical Trials Design; Cognitive; Commit; Communication; Critical Illness; Development; Development Plans; Developmental Disabilities; Developmental Process; Disabled Children; Discrimination; Doctor of Philosophy; Electroencephalography; Enrollment; Ensure; Environment; Environmental Exposure; Evaluation; Faculty; Foundations; Future; Gestational Age; Goals; Hearing; Hospitals; Impaired cognition; Impairment; Individual; Infant; Infant Care; Intensive Care; Intensive Care Units; Interdisciplinary Study; International; Intervention; Knowledge; Language Development; Leadership; Learning; Life; Light; Measurement; Measures; Medical; Medicine; Mentored Patient-Oriented Research Career Development Award; Mentors; Mentorship; Methodology; Methods; Mind; Molecular Biology; Motion; Nature; Neonatal; Neonatal Intensive Care; Neurosciences; Newborn Infant; Noise; Outcome; Pediatrics; Perception; Perinatal; Perinatal Brain Injury; Physicians; Premature Infant; Prevalence; Problem behavior; Process; Process Measure; Rehabilitation therapy; Research; Research Design; Research Project Grants; Research Proposals; Resources; Risk; School-Age Population; Scientist; Sensory; Sensory Process; Speech Sound; Stimulus; Sum; System; Tactile; Term Birth; Testing; Therapeutic; Time; Touch sensation; Training; Translational Research; United States; Visual impairment; auditory stimulus; authority; career; career development; design; disability; early childhood; evidence base; experience; follow-up; functional outcomes; hearing impairment; high risk infant; improved; indexing; infancy; member; motor impairment; multisensory; neonate; nerve injury; neurobehavioral; neurodevelopment; neuroimaging; novel; patient oriented; post-doctoral training; professor; programs; public health relevance; relating to nervous system; research study; response; sensory system; skills; sound; success; tool

DESCRIPTION (provided by applicant): I am a physician-scientist, with a PhD in molecular biology and post-doctoral training in Pediatrics and Neonatal-Perinatal Medicine. I am completely committed to a career in translational research, with the goal of improving the long-term outcomes of former NICU infants with disabilities. I am currently in my fourth year on the faculty as an Assistant Professor at Vanderbilt, with 80% of my efforts focused on research thanks to generous departmental support. I am fortunate to have an institutional environment such as that at Vanderbilt, which is rich in career development opportunities, resources and multidisciplinary collaborations. The focus of my research has been the influence of intensive-care environmental exposures and neural injury on sensory function in infants and children. Sensory systems provide our view of the world, a view upon which all cognitive processes are dependent. Furthermore, our brain's ability to connect different sensory perceptions is what allows us to see the world and ourselves as more than just the sum of separate parts. I have focused my research on developing new methods of objectively measuring this aspect of brain function in children, in order to predict developmental outcomes and design therapeutic strategies for children with disabilities. While I have benefitted from the opportunities afforded o me thus far, I still need to complete my development towards independent research by filling in the gaps in my training in two specific areas: the neuroscience of multisensory systems and large-scale clinical trials design. My long-term career goal is to develop an independent research program in the evaluation of perinatal brain injury and to develop novel interventions for brain insults with origin in early life. The K23 Mentored Patient-Oriented Research Career Development Award will help me achieve this goal. My primary mentor, Dr. Elisabeth Dykens, is an international leader in patient-oriented developmental disabilities research. Dr. Dykens will guide my career progress to independence and, with my mentorship team, ensure my success in the design of large-scale clinical trials. My co-mentors, Dr. Mark Wallace, a world- renowned expert in multisensory systems neuroscience, and Dr. Jim Bodfish, an authority on objective neurobehavioral measures of sensory perception, will guide my development towards rigorous scientific study design in this field. The members of my mentoring committee have been carefully chosen for their experience and leadership in their chosen fields and represent complementary aspects of my career path. Similarly, my development plan will fill gaps in my training, while my research project will focus my efforts in the specific area of multisensory function. The goal of my K23 research proposal is to address the lack of quantitative tools to measure sensory function in vulnerable infants, by adapting novel tools I have developed and validated in older children over the last three years. The neonatal period is a critical time in brin development, when connections between brain regions are being formed; these connections are highly dependent upon the environment for input and stimulation. Because neonates in intensive care units often experience atypical stimuli, such as constant noise and frequent handling for medical care, their perception of touch and sound can be profoundly altered. We will first use methodologies to objectively measure the brain's perception of speech sounds and light touch in NICU infants across the full spectrum of viable gestational ages at birth, from full term to extremely preterm. We will use a portable methodology to deliver tactile and auditory stimuli at the bedside of infants and quantitatively measure the brain's response with electrical neuroimaging (EEG/ERP) prior to discharge from the hospital. We will test the hypothesis that individual and combined measures of tactile and auditory responses will allow us to identify and quantify deficits in unisensory and multisensory function. We will then validate the utility of the methods developed in the first part of the study to predict sensory and developmental outcomes at 6 and 24 months corrected age. We will evaluate the previously tested infants in the follow-up clinic with established measures of sensory, cognitive, communication and behavioral function, and develop predictive algorithms for outcomes. The information gained from this project will help us determine how deficits in multisensory perception contribute to the development of disabilities in early childhood and will allow us to design and assess effective neuroprotective and rehabilitative strategies.

描述（由申请人提供）：我是医师科学家，在分子生物学和儿科和新生儿 - 周期医学的分子生物学和博士后培训中获得博士学位。我完全致力于转化研究的职业，目的是改善前NICU婴儿的长期结局。我目前正在范德比尔特（Vanderbilt）担任助理教授的第四年，其中80％的努力重点是研究，这要归功于慷慨的部门支持。我很幸运能够拥有一个机构环境，例如在范德比尔特（Vanderbilt），范德比尔特（Vanderbilt）拥有丰富的职业发展机会，资源和多学科合作。我的研究重点是强化环境暴露和神经损伤对婴儿和儿童感觉功能的影响。感觉系统提供了我们对世界的看法，这是所有认知过程依赖的观点。此外，我们大脑连接不同感官感知的能力使我们能够将世界和我们自己视为单独的部分的总和。我的研究重点是开发客观地衡量儿童大脑功能这一方面的新方法，以预测残疾儿童的发展结果和设计治疗策略。虽然我从到目前为止所能提供的机会中受益，但我仍然需要通过填补我在两个特定领域的培训的空白来完成我的独立研究的发展：多感官系统的神经科学和大规模临床试验设计。我的长期职业目标是在评估围产期脑损伤的评估中制定独立的研究计划，并为早期生命中起源的脑侮辱开发新的干预措施。 K23指导的以患者为导向的研究职业发展奖将帮助我实现这一目标。我的主要导师Elisabeth Dykens博士是以患者为导向的发育障碍研究的国际领导者。 Dykens博士将指导我的职业发展独立，并在我的指导团队中确保我在大规模临床试验设计方面的成功。我的联合给人员Mark Wallace博士是多感觉系统神经科学专家的Mark Wallace，以及有关感官感知的客观神经行为指标的权威Jim Bodfish博士，将指导我在该领域对严格的科学研究设计的发展。我的指导委员会成员在所选领域的经验和领导层被仔细选择，并代表了我职业道路的互补方面。同样，我的开发计划将填补我的培训空白，而我的研究项目将重点放在多感觉功能的特定领域。我的K23研究建议的目的是解决缺乏定量工具来测量弱势婴儿的感觉功能，通过调整我在过去三年中在大孩子中开发和验证的新颖工具。当形成大脑区域之间的连接时，新生儿时期是Brin发育的关键时期。这些连接高度取决于输入和刺激的环境。由于重症监护病房中的新生儿经常经历非典型刺激，例如持续的噪音和频繁处理医疗护理，因此可以深刻地改变其对触摸和声音的看法。我们将首先使用方法论来客观地衡量大脑对遍布全部可行胎龄的NICU婴儿对语音和轻微的感知，从满满 术语是非常早产。我们将使用便携式方法在婴儿的床边传递触觉和听觉刺激，并在出院前用电神经成像（EEG/ERP）定量测量大脑的反应。我们将检验以下假设：触觉和听觉响应的个人和联合度量将使我们能够识别和量化单性和多感官功能的缺陷。然后，我们将验证 在研究的第一部分中开发的方法可以预测6个月和24个月校正年龄的感觉和发育结果。我们将通过既定的感觉，认知，交流和行为功能的衡量标准来评估后续诊所中先前测试的婴儿，并开发结果的预测算法。从该项目中获得的信息将有助于我们确定多感觉感知的缺陷如何促进幼儿期残疾的发展，并使我们能够设计和评估有效的神经保护和康复策略。