Wearable neuroimaging technologies for the neonatal intensive care unit: mapping sensorimotor disruption in infants at risk of cerebral palsy.

新生儿极易受脑损伤的影响。新生儿脑损伤的原因和性质差异很大，但一个共同的因素是，出生时脑损伤的婴儿往往会发展为脑瘫。脑瘫是一组永久性的运动障碍，可以严重限制肌肉的控制，并可能对生活质量产生毁灭性的影响。脑瘫是欧洲最常见的儿童残疾形式，英国每年约有1800名儿童被诊断出患有这种疾病。脑瘫对家庭和社会也有重大影响。据估计，在英国，脑瘫患者的护理和支持费用每年超过14亿GB。脑瘫的早期诊断至关重要。虽然这种疾病无法治愈，但有许多治疗方法可以改善婴儿的长期运动能力。在生命的最初几周和几个月里，大脑的适应能力很强，这意味着它很可能处于最容易接受治疗的时候。如果运动发育异常的婴儿能够及早被发现，这些治疗方法将有最大的成功机会。目前，大多数脑性瘫痪婴儿要到1岁或2岁才能确诊。在这一点上，治疗可能已经太晚了，无法产生最好的效果。2015年，英国政府对围绕脑瘫的问题进行了调查，并强调了迫切需要更多的研究来支持对这种疾病的早期和客观诊断。在健康的儿童和成年人中，大脑中控制运动和接受体感输入(如触觉)的部分像身体地图一样组织起来。已有研究表明，这种组织在患有脑性瘫痪的儿童和成人中被破坏。如果我们能够在婴儿床一侧监测这种干扰，就有可能对发育异常的婴儿进行早期和客观的识别。目前，还没有技术可以提供实现这一目标所需的精确度、分辨率、患者舒适度或运动耐受性。该奖学金的目的是解决这些挑战，并开发一种新的可穿戴功能脑成像技术，使婴儿的体感和运动组织能够在婴儿床一侧绘制地图。我将使用柔性电子设备构建一个微型成像阵列，其中将包括数百个近红外光发射器和探测器，以安全地监测婴儿的大脑功能。这种成像阵列将被固定在一个柔软、有弹性的头帽中，新生儿可以舒适地戴上它。通过设计和集成高级形式的运动跟踪，以及开发新的信号处理方法，我将最大限度地提高这项成像技术的精度和运动容忍度，以便在触摸刺激和自然运动期间绘制大脑功能图。然后，我将使用精心控制的实验室实验和在健康成年人身上进行的全面功能成像研究来验证这个系统。最后，我将把这项技术应用到新生儿诊所，并研究健康和脑损伤婴儿从早产到6个月大的躯体感觉和运动功能的发展。在这样做的时候，我的目标是展示一种新的方法来客观地识别和监测患有脑瘫的婴儿。

Newborn infants are extremely vulnerable to brain injury. The cause and nature of newborn brain injuries varies widely, but one common factor is that infants who suffer a brain injury at birth often go on to develop cerebral palsy.Cerebral palsy is a group of permanent movement disorders that can severely limit the control of the muscles, and can have a devastating impact on quality of life. Cerebral palsy is the most common form of childhood disability in Europe and every year, approximately 1800 children in the UK are diagnosed with the condition. Cerebral palsy also has a significant impact on families and on society. It is estimated that the costs of care and support for people with cerebral palsy exceeds £1.4 Billion per year in the UK.The early diagnosis of cerebral palsy is critical. While there is no cure for the condition, there are a number of treatments that can improve an infant's long-term motor ability. During the first few weeks and months of life the brain is highly adaptable, which means it is likely to be at its most susceptible to treatment. If infants with abnormal motor development could be identified early, these treatments would have the greatest chance of success. At present, the majority of infants with cerebral palsy are not diagnosed until 1 or 2 years-of-age. By this point it is likely too late for treatment to have the best possible impact. In 2015, the government held an inquiry into issues surrounding cerebral palsy in the UK and highlighted the urgent need for more research to support the early and objective diagnosis of the condition.In healthy children and adults, the parts of the brain that control movement and receive somatosensory input (such as touch sensation) are organized like a map of the body. It has been shown that this organization is disrupted in children and adults with cerebral palsy. If we could monitor this disruption in the infant at the cot-side, it would be possible to provide an early and objective identification of infants who are developing abnormally. At present, there is no technology that can provide the precision, resolution, patient comfort or motion tolerance necessary to achieve this.The aim of this fellowship is to address these challenges and develop a new wearable functional brain imaging technology that will allow infant somatosensory and motor organization to be mapped at the cot-side. I will use flexible electronics to construct a miniaturized imaging array that will incorporate hundreds of emitters and detectors of near-infrared light to safely monitor infant brain function. This imaging array will be fixed into a soft, elastic head-cap that can be worn comfortably by a newborn baby. By designing and integrating an advanced form of motion tracking, and by developing novel signal processing approaches, I will maximize the precision and motion tolerance of this imaging technology to allow brain function to be mapped during touch stimulation and during natural movement. I will then validate this system using carefully controlled laboratory experiments and a comprehensive functional imaging study in healthy adults. Finally, I will translate this technology to the neonatal clinic and investigate the development of somatosensory and motor function in both healthy and brain-injured infants from preterm through to 6 months-of-age. In doing so, I aim to demonstrate a new approach to the objective identification and monitoring of infants with cerebral palsy.