Preterm Infants' Mu-rhythm Suppression Evaluation Study (PrIMES)

描述（由申请人提供）：早产作为长期认知障碍的风险因素越来越重要，因为早产率已经上升，婴儿在逐渐降低的胎龄下存活。尽管超声和MRI检查发现的解剖异常已被证明会导致不良的长期结局，但目前尚不清楚为什么早产后病程简单且无脑损伤的婴儿相对于足月出生的婴儿仍有更高的认知障碍风险，相反，为什么一些脑损伤的婴儿不会受到能力受损的影响。因此，长期目标是确定一组补充的功能性大脑标记物，以帮助临床医生识别哪些婴儿需要额外的干预来实现改善的结果。感觉运动mu节律活动与皮质网络有关，该网络对于模仿技能、理解他人意图和额外的心理理论能力非常重要。本项目的目的是纵向描述3个月和6个月校正年龄时早产儿相对于足月儿的感觉运动μ节律和μ节律抑制。中心假设是，具有非典型脑发育的婴儿将呈现感觉运动μ节律发育受损，并且这些延迟将与认知发育受损相对应。这一假设是根据文献提出的，这些文献证明了早产儿感觉运动区的运动延迟和解剖异常。此外，我们发表的结果提供了证据，证明在非常年轻的时候，mu节律的频率迅速发展，这为跟踪大脑发育提供了一种措施。将通过以下具体目标来检验这一假设：表征和比较两个参与者组中3个月和6个月矫正年龄的幼儿与运动活动相关的mu节律的发展：a）健康足月婴儿和B）早产儿（胎龄<28周），无脑异常或病变的证据。本项目将使用同步脑磁图（MEG）和脑电图（EEG），在三种条件下监测自发mu节律活动和mu节律抑制：休息、婴儿手挤压和婴儿观察研究者手挤压。初步结果提供的证据表明，这种范式可以快速执行，而不需要婴儿理解任务指令。比较这三种条件可以：a）识别mu节律活动的频率;和B）量化动作（挤压）和观察条件下的mu节律抑制。这种方法是创新的，因为我们正在使用多模式功能神经成像方法，利用每种技术的优势，来测试早产儿的新范式，这与模仿和更高的认知能力有关。这个项目意义重大，因为它将评估早产儿大脑的一个特征，即在足月婴儿中迅速发育，提供一个非典型大脑的潜在标记 早产儿的发育，以帮助确定需要早期干预的儿童。 公共卫生相关性：早产作为长期认知障碍的一个危险因素，与公共卫生有关，因为早产的发生率很高，早产后发生明显的神经发育异常。该项目将描述足月儿和早产儿大脑发育的功能测量，可用于识别最有可能受损的婴儿，以优化干预机会。该项目与国家卫生研究院使命的组成部分有关，该使命要求采取方法帮助所有儿童充分发挥其潜力。

DESCRIPTION (provided by applicant): Prematurity as a risk factor for long-term cognitive impairment is increasingly important, as the rate of prematurity has risen and infants are surviving at progressively lower gestational ages. Although anatomical abnormalities, identified with ultrasound and MRI, have been shown to lead to poor long-term outcomes, it is not clear why infants with an uncomplicated course and no brain lesions after premature birth are still at higher risk for cognitive impairment relative to infants born at term, and conversely why some infants with brain lesions do not suffer from impaired abilities. Therefore, the long-term goal is o identify a complimentary set of functional brain markers to help clinicians recognize which infants will need additional intervention to achieve improved outcomes. Sensorimotor mu rhythm activity has been associated with a cortical network which is important for imitation skills, understanding other's intentions, and additional theory of mind abilities. The objective of the current project is to characterize the sensorimotor mu rhythm and mu rhythm suppression in preterm relative to term infants longitudinally, at 3 and 6 months adjusted age. The central hypothesis is that infants with atypical brain development will present with impaired sensorimotor mu rhythm development and these delays will correspond with impaired cognitive development. This hypothesis was developed based on literature demonstrating motor delays and anatomical abnormalities in the sensorimotor region in prematurely born infants. Furthermore, our published results provide evidence for a rapid progression of the frequency of the mu rhythm at very young ages providing a measure to track brain development. This hypothesis will be tested through the following specific aim: To characterize and compare the development of the mu rhythm associated with motor activity in young infants at 3 and 6 months corrected-age in two participant groups: a) healthy full-term infants and b) premature infants (<28 weeks gestational age) without evidence of brain abnormalities or lesions. This project will use simultaneous magnetoencephalography (MEG) and electroencephalography (EEG), to monitor spontaneous mu rhythm activity and mu rhythm suppression using three conditions: rest, infant hand squeeze, and infant observation of investigator hand squeeze. The preliminary results provide evidence that this paradigm can be performed quickly and without the need for infants to understand task instruction. Comparison of the three conditions allows one to: a) identify the frequency of mu rhythm activity; and b) quantify mu rhythm suppression in the action (squeeze) and observation conditions. This approach is innovative because we are using a multimodal functional neuroimaging approach, drawing on the strengths of each technique, to test a novel paradigm for preterm infants, which has been linked to imitation and higher cognitive abilities. This project is significant because it will evaluate a characteristic of the preterm brain that develops rapidly in term infants, providing a potential marker of atypical brain development in preterm infants, to help identify children in need of early intervention. PUBLIC HEALTH RELEVANCE: Prematurity as a risk factor for long-term cognitive impairment is relevant to public health because of the high incidence of premature birth and significant neurodevelopmental abnormalities occurring after premature birth. This project will characterize a functional measure of brain development in term and preterm infants, which could be used to identify the infants at the greatest risk of impairment in order to optimize opportunities for intervention. This project is relevant to the component of the NIH mission that calls for methods to help all children to achieve their full potential.