Early Identification of Developmental Disorders in Infants

描述（由申请人提供）：由于产科和新生儿护理的改善，以及围产期死亡率的相关降低，以及体外受精程序相关风险的增加，早产（经后年龄< 37周）极低出生体重（<1，500 g）新生儿的数量正在增加[34]。在美国每年出生的约50，000名低出生体重新生儿中，约85%存活。这些婴儿患长期发育障碍的风险增加，其中5-15%表现出严重的神经发育障碍（例如，大脑性麻痹、智力迟钝）和另外25-50%表现出轻度至中度神经发育障碍（例如，学校的失败[40，74]。SBIR第二阶段拨款申请涉及在非常早期发现发育障碍。评估低出生体重、不良妊娠或复杂分娩对婴儿中枢神经系统（CNS）结构和功能及其发育的影响，对于获得有效的行为和神经系统状态评估、记录急性反应的恢复、预测后续结果以及针对任何注意到的问题提出具体干预策略是重要的。虽然脑成像，如颅超声，计算机断层扫描和磁共振成像，可以记录结构性脑损伤，评估婴儿的内源性（即，自发的）运动模式，称为“全身运动”（GM），提供了一种评估CNS功能的方法。在过去的25年里，大量的文献表明，胎儿和新生儿的运动作为脑功能和功能障碍的指标具有很强的临床意义。目前，GMs的评估是基于视频记录的婴儿运动模式的完形评估。GM的评估是标准神经学检查、原始反射检查以及肌肉力量和张力评估的有用辅助手段。然而，视频记录的使用并不理想;它繁琐、主观、劳动密集且昂贵，需要经过专门训练的从业者来评估存储的图像序列。提出的用于识别婴儿神经系统疾病的通用运动（GEMINI）系统是一种用于在医院和非医院环境中客观和自动评估婴儿GM的低成本工具，将克服这些局限性。GEMINI系统将利用巴伦公司专利的六自由度运动监测能力和复杂的信号处理来识别GM的关键定性和定量属性，从而自动评估GM。根据拟定的多阶段研究计划，将获得必要的知识，以实现低成本、低prole GEMINI产品，该产品可以可靠地执行所需的辨别，并作为记录和更好地理解神经系统疾病的运动和运动前兆的有价值的研究工具。

DESCRIPTION (provided by applicant): Due to improvements in obstetrical and neonatal care, and an associated decrease in perinatal mortality, as well as increased risks associated with in vitro fertilization procedures, the number of preterm (< 37 weeks postmenstrual age) very low birth weight (< 1,500 g) neonates born is growing [34]. Of the approximately 50,000 neonates born yearly in the United States with a low birth weight, approximately 85% survive. These infants have an increased risk of long-term developmental disabilities, with 5-15% exhibiting major neurodevelopmental disabilities (e.g., cerebral palsy, mental retardation) and an additional 25-50% exhibiting mild to moderate neurodevelopmental disabilities (e.g., school failure) [40, 74]. This SBIR Phase II grant application is concerned with the detection of developmental disorders at a very early age. Assessment of the consequences of low birth weight, adverse pregnancies, or complicated births on the structure and function of an infant's central nervous system (CNS) and its development is important for obtaining valid estimates of behavior and neurological status, documenting recovery from acute eects, predicting subsequent outcome, and suggesting specic intervention strategies for any problems noted. Although brain imaging, such as cranial ultrasound, computed tomography, and magnetic resonance imaging, can document structural brain damage, assessment of infants' endogenously-generated (i.e., spontaneous) movement patterns, known as \general movements" (GMs), provides a method by which to assess CNS function. In the past 25 years, an extensive body of literature has shown that motility, rst of the fetus and subsequently of the neonate, has strong clinical signicance as an indicator of brain function and dysfunction. Presently, assessment of GMs is based on the Gestalt evaluation of video-recorded infant movement patterns. Assessment of GMs is a useful adjunct to the standard neurological examination, primitive reex prole, and assessment of muscle strength and tone. However, the use of video recording is not ideal; it is tedious, subjective, labor intensive, and expensive, requiring specially-trained practitioners to evaluate stored image sequences o line. The proposed GEneral Movements for the Identication of Neurological disorders in Infants (GEMINI) sys- tem, a low-cost tool for objectively and automatically assessing infant GMs in hospital and non-hospital settings, will overcome these limitations. The GEMINI system will exploit Barron Associates' patented six degrees-of- freedom motion monitoring capability and sophisticated signal processing to identify the key qualitative and quantitative attributes of GMs, and thereby automate the assessment of GMs. Based on the proposed multi- phase research program, the requisite knowledge will be obtained to enable realization of a low-cost, low-prole GEMINI product that can reliably perform the required discrimination and serve as a valuable research tool in documenting and better understanding movements and movement precursors for neurological disorders.