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: 9094127
• 负责人: Nathalie Maitre
• 金额: $ 10.32万
• 依托单位: RESEARCH INST NATIONWIDE CHILDREN'S HOSP
• 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/9094127
• 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; 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; Health; 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; cognitive process; 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）：我是一名医师科学家，拥有分子生物学博士学位，并接受过儿科和新生儿围产期医学博士后培训。我完全致力于转化研究的职业生涯，目标是改善前新生儿重症监护病房残疾婴儿的长期结果。我目前是范德比尔特大学助理教授的第四年，由于部门的慷慨支持，我 80% 的精力都集中在研究上。我很幸运能够拥有像范德比尔特这样的机构环境，这里拥有丰富的职业发展机会、资源和多学科合作。我的研究重点是重症监护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，所有认知过程都依赖于这种看法。此外，我们的大脑连接不同感官知觉的能力使我们能够将世界和我们自己视为不仅仅是各个部分的总和。我的研究重点是开发客观测量儿童大脑功能这一方面的新方法，以预测发育结果并为残疾儿童设计治疗策略。虽然我受益于迄今为止提供给我的机会，但我仍然需要通过填补两个特定领域的培训空白来完成我向独立研究的发展：多感觉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开发一个评估围产期脑损伤的独立研究项目，并开发针对生命早期脑损伤的新干预措施。 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。我的主要导师伊丽莎白·戴肯斯 (Elisabeth Dykens) 博士是以患者为导向的发育障碍研究领域的国际领导者。 Dykens 博士将指导我的职业生涯走向独立，并与我的导师团队一起确保我在大规模临床试验的设计中取得成功。我的搭档马克·华莱士博士（世界著名的多感觉系统神经科学专家）和吉姆·博德菲什博士（感官知觉客观神经行为测量方面的权威）将指导我在该领域朝着严格的科学研究设计方向发展。我的指导委员会的成员都是根据他们在各自领域的经验和领导力而精心挑选的，并且代表了我职业道路的互补方面。同样，我的发展计划将填补我的培训空白，而我的研究项目将集中我的精力在多感官功能的特定领域。我的 K23 研究计划的目标是通过采用我在过去三年中开发并在年龄较大的儿童中验证的新工具，解决缺乏测量脆弱婴儿感觉功能的定量工具的问题。新生儿期是大脑发育的关键时期，此时大脑区域之间的连接正在形成。这些连接高度依赖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的医疗护理，他们对触摸和声音的感知可能会发生深刻的改变。我们将首先使用方法客观地测量新生儿重症监护病房（NICU）婴儿的大脑对言语声音和轻触的感知，这些婴儿在出生时的整个可行胎龄范围内，从满 足月至极早产。我们将使用便携式方法在婴儿床边提供触觉和听觉刺激，并在出院前通过电神经成像 (EEG/ERP) 定量测量大脑的反应。我们将检验这样一个假设：触觉和听觉反应的单独和综合测量将使我们能够识别和量化单感觉和多感觉功能的缺陷。然后我们将验证该实用程序 研究第一部分开发的方法用于预测 6 个月和 24 个月校正年龄时的感觉和发育结果。我们将在后续诊所中通过既定的感觉、认知、沟通和行为功能测量来评估先前测试的婴儿，并开发结果预测算法。从该项目中获得的信息将帮助我们确定多感官知觉缺陷如何导致幼儿期残疾的发展，并使我们能够设计和评估有效的神经保护和康复策略。