MRI Mechanisms of Adverse Outcome in Preterm Infants with Seizures

早产儿癫痫发作不良后果的 MRI 机制

• 批准号: 8290057
• 负责人: Hannah Cranley Glass
• 金额: $ 17.59万
• 依托单位: UNIVERSITY OF CALIFORNIA, SAN FRANCISCO
• 依托单位国家: 美国
• 财政年份: 2010
• 资助国家: 美国
• 起止时间: 2010-07-01 至 2015-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8290057
• 关键词: Accounting; Anisotropy; Basic Science; Biostatistical Methods; Brain; Brain Injuries; California; Caring; Characteristics; Child; Childhood; Clinical; Clinical Research; Clinical Trials; Cognitive; Cohort Studies; Contralateral; Data; Detection; Development; Diffuse; Diffusion; Diffusion Magnetic Resonance Imaging; Electroencephalogram; Electroencephalography; Enrollment; Epilepsy; Evolution; Fellowship; Focal Seizure; Foundations; Frequencies; Future; Glass; Goals; Gold; Gray unit of radiation dose; Growth and Development function; Hemorrhage; Hippocampus (Brain); Imaging Techniques; Impact Seizures; Infant; Injury; Intensive Care; Ischemic-Hypoxic Encephalopathy; Knowledge; Lead; Lobar; Location; Longitudinal Studies; Magnetic Resonance; Magnetic Resonance Imaging; Magnetic Resonance Spectroscopy; Measurement; Measures; Mentored Patient-Oriented Research Career Development Award; Mentors; Metabolism; Methods; Modeling; Monitor; Motor; Neonatal; Neurology; Newborn Infant; Nurseries; Outcome; Parents; Pattern; Pediatric Neurology; Perinatal; Population; Pregnancy; Premature Birth; Premature Infant; Protocols documentation; Regression Analysis; Research; Research Design; Research Infrastructure; Research Personnel; Resolution; Risk; Risk Factors; SECTM1 gene; San Francisco; School-Age Population; Seizures; Severities; Structure; Subclinical Seizures; Subjects Selections; Surrogate Markers; Survivors; Testing; Time; Training; Translational Research; United States; Universities; adverse outcome; age group; career; career development; design; disability; experience; follow-up; high risk infant; improved; in vivo; injured; neurodevelopment; neuroimaging; neurophysiology; novel; patient oriented; patient oriented research; prevent; professor; programs; radiologist; response; spectroscopic imaging; white matter injury

DESCRIPTION (provided by applicant): Accumulating evidence suggests that seizures harm the developing brain, however little is known about their impact in preterm infants. Dr. Hannah Glass' proposed research will use the infrastructure of her mentor's ongoing longitudinal cohort study to examine magnetic resonance measures of brain injury, brain development, and outcome in preterm infants with seizures. This parent study enrolls infants born <32 weeks gestation, examines them with MRI at two neonatal time points and follows them through school age. There are currently no routine seizure measurements in this study, and seizures in this age group are difficult to detect clinically and without prolonged monitoring. Improving seizure detection for the parent study will allow Dr. Glass to use the high-quality MRI and follow-up data from that study to investigate whether seizures act to alter brain development and lead to impaired neurodevelopmental outcome in the preterm population. The specific aims for this proposal are to compare seizure characteristics (presence, ictal lobar onset, evolution, etc) in preterm newborns with: (1) qualitatitve patterns of injury on conventional MRI; (2) quantitative measures of the hippocampus (size, metabolism and microstructure); and (3) developmental outcome. To improve seizure detection, we will add gold standard video-EEG monitoring to the parent study. MRI data from the parent study will be used to examine novel measures of the hippocampus (volume, microstructure using diffusion tensor imaging, and metabolites using 3D MR spectroscopic imaging). This project is part of an application for a K23 award for Dr. Glass, an Assistant Professor in Neurology & Pediatrics at the University of California, San Francisco, who is establishing herself as a young investigator in patient-oriented clinical and translational research in neonatal neurology. This K23 award will enable her to accomplish the following career goals: (1) to become expert in patient-oriented research in neonatal neurology and to develop an independent clinical research career; (2) to conduct clinical investigations of seizures in preterm infants using advanced MRI methods and EEG; and (3) to implement advanced biostatistical methods in clinical studies. To achieve these goals, Dr. Glass has assembled a mentoring team comprised of Dr. Donna Ferriero, who conducts basic science and clinical investigations in neonatal neurology), and Dr. A. James Barkovich (a radiologist who focuses on neuroimaging in newborns), and two scientific advisors: Dr. David Glidden (an expert in study design and biostatistical analysis) and Dr. Joseph Sullivan (epileptologist with expertise in neonatal neurophysiology).

描述（由申请人提供）：越来越多的证据表明癫痫发作会损害发育中的大脑，但人们对其对早产儿的影响知之甚少。汉娜·格拉斯博士提议的研究将利用她的导师正在进行的纵向队列研究的基础设施来检查磁共振测量的脑损伤、大脑发育和早产儿癫痫发作的结果。这项家长研究招募了妊娠 <32 周出生的婴儿，在两个新生儿时间点对他们进行 MRI 检查，并跟踪他们整个学龄期。目前本研究中没有常规的癫痫发作测量，并且该年龄组的癫痫发作很难在临床上检测到且无需长期监测。改进母研究的癫痫发作检测将使 Glass 博士能够使用该研究的高质量 MRI 和后续数据来调查癫痫发作是否会改变大脑发育并导致早产儿群体的神经发育结果受损。该提案的具体目的是将早产儿的癫痫发作特征（存在、发作性脑叶发作、演变等）与以下各项进行比较：（1）传统 MRI 上的损伤定性模式； (2) 海马体的定量测量（大小、代谢和微观结构）； (3) 发展成果。为了改善癫痫发作检测，我们将在家长研究中添加金标准视频脑电图监测。来自母研究的 MRI 数据将用于检查海马体的新测量值（使用扩散张量成像的体积、微观结构，以及使用 3D MR 光谱成像的代谢物）。该项目是 Glass 博士申请 K23 奖的一部分，Glass 博士是旧金山加利福尼亚大学神经病学和儿科助理教授，正在将自己打造成新生儿神经病学以患者为导向的临床和转化研究领域的年轻研究者。这个K23奖项将使她能够实现以下职业目标：（1）成为新生儿神经病学以患者为导向的研究专家，并发展独立的临床研究生涯； （2）利用先进的MRI方法和脑电图对早产儿癫痫发作进行临床研究； (3)在临床研究中实施先进的生物统计学方法。为了实现这些目标，Glass 博士组建了一个指导团队，其中包括 Donna Ferriero 博士（从事新生儿神经病学基础科学和临床研究）和 A. James Barkovich 博士（专注于新生儿神经影像学的放射科医生），以及两名科学顾问：David Glidden 博士（研究设计和生物统计分析专家）和 Joseph Sullivan 博士（具有专业知识的癫痫病学家）。 新生儿神经生理学）。