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存活。尽管超声和核磁共振证实的解剖异常会导致不良的长期结局，但尚不清楚为什么病程简单且早产后没有脑损伤的婴儿比足月出生的婴儿患认知障碍的风险更高，反过来，为什么一些脑损伤的婴儿没有能力受损。因此，长期目标是确定一套补充的脑功能标志物，以帮助临床医生认识到哪些婴儿需要额外的干预才能获得更好的结果。感觉运动u节律活动与大脑皮层网络有关，大脑皮层网络对模仿技能、理解他人意图和额外的心理理论能力非常重要。本研究的目的是研究3个月和6个月调整后的早产儿相对于足月儿的感觉运动u节律和u节律抑制特征。中心假设是，大脑发育不典型的婴儿将出现感觉运动u节律发育受损，这些延迟将与认知发育受损相对应。这一假说是基于证明早产儿感觉运动区运动延迟和解剖异常的文献而发展起来的。此外，我们发表的结果提供了证据，证明了在非常年轻的年龄，u节律的频率快速发展，为跟踪大脑发育提供了一种测量方法。这一假设将通过以下具体目标来检验：在两个参与者组中，描述和比较校正年龄3个月和6个月的婴儿与运动活动相关的MU节律的发展：a)健康的足月儿和b)没有脑部异常或损伤证据的早产儿(胎龄28周)。本项目将使用同步脑磁图(MEG)和脑电图仪(EEG)，在休息、婴儿握手和婴儿观察三种情况下监测自发的u节律活动和u节律抑制。初步结果证明，这种范式可以快速执行，而不需要婴儿理解任务教学。这三个条件的比较使人们能够：a)识别u节律活动的频率；b)量化动作(挤压)和观察条件中的u节律抑制。这种方法是创新的，因为我们使用了一种多模式功能神经成像方法，吸取了每种技术的优势，测试了一种用于早产儿的新范式，这与模仿和更高的认知能力有关。这个项目意义重大，因为它将评估足月儿早产儿大脑发育迅速的特征，为非典型大脑提供一个潜在的标记物。 早产儿的发展，以帮助确定需要早期干预的儿童。 公共卫生相关性：早产是长期认知损害的风险因素，与公共健康相关，因为早产的发生率很高，早产后会出现严重的神经发育异常。该项目将描述足月儿和早产儿大脑发育的功能指标，可以用来确定最有可能受到损害的婴儿，以便优化干预机会。该项目与美国国立卫生研究院使命的组成部分有关，该使命呼吁采取方法帮助所有儿童充分发挥他们的潜力。

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.