UNDERSTANDING NEUROBEHAVIORAL DEFICITS IN PRETERM INFANTS THROUGH IMAGING

通过影像学了解早产儿的神经行为缺陷

基本信息

批准号：
7795134
负责人：
TERRIE E INDER
金额：
$ 55.83万
依托单位：
WASHINGTON UNIVERSITY
依托单位国家：
美国
项目类别：
财政年份：
2008
资助国家：
美国
起止时间：
2008-04-01 至 2013-03-31
项目状态：
已结题

来源：
https://reporter.nih.gov/project-details/7795134
关键词：
4 year old Address Age Anisotropy Anxiety Area Atlases Attention deficit hyperactivity disorder Autistic Disorder Behavioral Biological Markers Birth Brain Brain Injuries Brain region Cerebral Palsy Cerebrospinal Fluid Cerebrum Child Childhood Clinical Cognition Cohort Studies Corticospinal Tracts Data Data Set Delayed Memory Development Developmental Disabilities Diffusion Diffusion Magnetic Resonance Imaging Dorsal Enrollment Evolution Female Functional disorder Gestational Age Image Impaired cognition Impairment Incidence Infant Injury Language Development Lead Learning Disabilities Magnetic Resonance Magnetic Resonance Imaging Measurable Measurement Measures Mental Depression Mental Retardation Microscopic Motor Motor Cortex Nature Neonatal Neonatal Intensive Care Neurobiology Neurodevelopmental Impairment Neurologic Newborn Infant Nuclear Occipital lobe Outcome Perinatal Exposure Pharmaceutical Preparations Population Premature Birth Premature Infant Prevalence Public Health Radial Relative (related person)Research Design Risk Scanning Schizophrenia Sensitivity and Specificity Services Sex Characteristics Structure Surface Testing Time United States National Institutes of Health Visual Weight Withdrawal adverse outcome age group base brain volume clinical practice cohort comparison group design developmental disease disability executive function experience functional outcomes gray matter high risk imaging modality improved indexing infancy longitudinal design male morphometry neurobehavioral postnatal response to injury social social skills visual motor white matter

项目摘要

DESCRIPTION (provided by applicant): Preterm birth is a major public-health issue because of its increasing incidence combined with the frequent occurrence of subsequent behavioral, neurological, and psychiatric challenges faced by surviving infants. Approximately 10-15% of very preterm children (born < 30 weeks gestational age) develop cerebral palsy, and 30 - 60% of very preterm children experience cognitive impairments. These impairments include visual-motor problems, attentional difficulties, impaired memory, delayed acquisition of language, executive dysfunction, learning disabilities, poor social skills, and higher rates of social withdrawal, anxiety and depression. In addition, an increased prevalence of developmental disorders such as attention deficit/hyperactivity disorder, autism and schizophrenia, has been described in the preterm population. These adverse outcomes are related to white matter (WM) and grey matter (GM) injury sustained during the neonatal period and its effects on subsequent brain development. We seek to develop imaging biomarkers, measurable during infancy, that provide sensitivity and specificity in identifying infants at risk for poor neurodevelopmental outcome. The biomarkers will consist of the following magnetic resonance (MR) imaging measures: 1) conventional T1- and T2-weighted images, 2) volumetry (volumes for cortical GM, deep nuclear GM, myelinated WM, unmyelinated WM, and cerebrospinal fluid), 3) diffusion tensor imaging (apparent diffusion coefficient, relative anisotropy, axial and radial diffusivity), and 4) surface-based morphometry (integrated folding index, average sulcal depth, cortical surface area, percentage of buried cortex). The main cohort of this study will consist of 120 very preterm infants born < 30 weeks gestational age. They will undergo MR studies soon after birth, at 30 weeks postmenstrual age (PMA), 34 weeks PMA, and term equivalent. Infants enrolled during Year 1 (n = 30) will also be imaged at age 4 years. The MR indices listed above will be compared with MR data from healthy control subjects and clinical outcome data obtained at term equivalent and 2 and 4 years of age. The proposed studies are designed to engender a deeper understanding of the nature and timing of cerebral injury, laying the groundwork for the development of neuroprotective strategies and improving clinical practices. The longitudinal design will allow us to study both structural abnormalities and compensatory changes in response to injury. Identification during the newborn period of infants at high risk for poor developmental outcome will allow early targeting of therapy services to these infants. If successful, the proposed studies will lead to improved outcomes for prematurely-born infants. Project Narrative: This study is designed to use magnetic resonance imaging to improve our understanding of the brain injury sustained by prematurely-born infants. This understanding has the potential to improve clinical practices and assist with the development of medications to reduce injury in these babies, ultimately reducing disabilities. It will also help identify those infants who are at high risk for developing cerebral palsy or mental retardation so they can be provided early access to therapy services.

描述（由申请人提供）：早产是一个主要的公共卫生问题，因为它的发生率越来越多，再加上随后的行为，神经和精神病挑战的经常出现。大约10-15％的非常早产儿（胎龄<30周）出现脑瘫，而30-60％的早产儿则患有认知障碍。这些障碍包括视觉运动问题，注意力困难，记忆力受损，语言掌握延迟，执行功能障碍，学习障碍，社交技能差，社交戒断，焦虑和抑郁症的率更高。此外，在早产群体中已经描述了发育障碍的患病率增加，例如注意力缺陷/多动障碍，自闭症和精神分裂症。这些不良结果与新生儿期间及其对随后大脑发育的影响有关的白质（WM）和灰质（GM）损伤有关。我们试图开发在婴儿期可测量的成像生物标志物，以识别有差神经发育结果的婴儿的敏感性和特异性。生物标志物将由以下磁共振（MR）成像措施组成：1）常规T1和T2加权图像，2）体积（皮质GM的体积，深核GM，深核GM，髓鞘WM，无层状WM和无层状WM和脑脊髓流体），3）相对繁琐的扩散量（3）相对繁琐的扩散量相对繁殖量，扩散率）和4）基于表面的形态计（集成折叠指数，平均沟深度，皮质表面积，埋藏的皮质百分比）。这项研究的主要队列将包括120名非常早产的婴儿，胎龄<30周。他们将在出生后不久进行MR研究，在月经后30周（PMA），34周PMA和等同期。在第1年（n = 30）期间入学的婴儿也将在4岁时成像。上面列出的MR指数将与来自健康对照受试者的MR数据以及在期限等效期以及2岁和4岁时获得的临床结果数据进行比较。拟议的研究旨在使对脑损伤的性质和时机有更深入的了解，为发展神经保护策略的发展奠定了基础，并改善了临床实践。纵向设计将使我们能够研究结构异常和应对伤害的代偿性变化。在新生儿期间的鉴定，出现不良发育效果风险高风险的婴儿将允许早日针对这些婴儿的治疗服务。如果成功，建议的研究将导致过早出生的婴儿的结果改善。项目叙述：这项研究旨在使用磁共振成像来提高我们对过早出生的婴儿遭受的脑损伤的理解。这种理解有可能改善临床实践，并有助于开发药物以减少这些婴儿的损伤，最终减少残疾。它还将帮助确定那些患有脑瘫或智力低下的婴儿，因此可以尽早获得治疗服务。