A Multimodality Approach to Estimating Newborn Brain Oxygen Metabolism (CMRO2)

描述（由申请人提供）：围产期脑损伤仍然是婴儿死亡和发病的重要原因，每1,000例活产婴儿中有6例以上发生。它是脑瘫、癫痫、复杂行为障碍和智力障碍的常见原因。现在认为，大多数围产期脑损伤是由于氧化代谢受损，神经元损伤是由于缺血，随后是再灌注或在围产期表达的代谢途径中的遗传缺陷。由于神经元活动在时间上与氧的代谢或消耗密切相关，脑氧消耗的直接测量可能提供神经元健康的最直接测量。我们相信，在生命的第一周内测量氧消耗量有可能改善脑损伤的早期分层，并更好地预测结果。正电子发射断层扫描（PET）可以提供关于氧消耗的直接信息，但是辐射暴露和缺乏可用性使得常规使用不切实际。我们的目标是建立一个安全，无创的多模式方法来估计新生儿局部脑氧耗量。我们提出将联合收割机频域近红外光谱（FD-NIRS）技术与磁共振（MR）动脉自旋标记（ASL）技术相结合，无创、真实的评估新生儿脑耗氧量。为了实现这一目标，需要技术进步：1）构建针对新生儿头部定制的多通道MRI线圈，以优化SNR并减少扫描时间; 2）构建兼容的光学探头，以与MRI同时测量血红蛋白氧饱和度; 3）利用MRI结构信息优化用于量化脑光学参数和估计氧消耗的算法。为了验证我们测量的耗氧量作为脑损伤的指标，我们将在20名有围产期脑损伤风险的婴儿中测试我们测量的耗氧量，并将耗氧量与3个月时的脑体积相关联。公共卫生相关性：耗氧代谢率（CMRO2）是衡量受伤后大脑健康的最佳指标，但目前还没有无创方法可用。结合32通道MRI和频域近红外光谱，可以安全地对我们最脆弱和最难以评估的人群之一：新生儿进行快速无创的绝对CMRO2估计。

DESCRIPTION (provided by applicant): Perinatal brain injury remains a significant cause of infant mortality and morbidity, occurring in over 6 out of every 1,000 live births. It is a common cause of cerebral palsy, seizures, complex behavioral disorders and intellectual impairment. It is now believed that the majority of perinatal brain injury is due to impairment of oxidative metabolism, with neuronal injury due to ischemia followed by reperfusion or inherited defects in metabolic pathways expressed in the perinatal period. With neuronal activity closely linked in time to the metabolism or consumption of oxygen direct measures of cerebral oxygen consumption likely provide the most direct measure of neuronal health. We believe that a measure of oxygen consumption during the first week of life has the potential to improve early stratification of brain injury and better predict outcome. Positron Emission Tomography (PET) can provide direct information on oxygen consumption but the radiation exposure and lack of availability make routine use impractical. Our goal is to establish a safe, noninvasive multimodal method to estimate newborn regional cerebral oxygen consumption. We propose to combine Frequency Domain Near Infrared Spectroscopy (FD-NIRS) and the Magnetic Resonance (MR) technique of Arterial Spin Labeling (ASL) to estimate newborn cerebral oxygen consumption noninvasively and in real time. To do achieve this goal, technical advances are needed: 1) build a multichannel MRI coil tailored to the newborn head to optimize the SNR and reduce the scanning time; 2) build a compatible optical probe to measure hemoglobin oxygen saturation simultaneously with MRI; 3) take advantage of the MRI structural information for optimization of the algorithms used to quantify brain optical parameters and estimate oxygen consumption. To validate our measurement of oxygen consumption as an indicator of brain injury we will test our measure of oxygen consumption in 20 infants at risk for perinatal brain injury and correlate oxygen consumption with brain volume at 3 months. PUBLIC HEALTH RELEVANCE: The metabolic rate of oxygen consumption (CMRO2) is the best measure of brain health after injury yet there are no non-invasive methods available. Combined 32-chanel MRI and frequency domain near infrared spectroscopy offer the potential to safely perform fast noninvasive estimates of absolute CMRO2 in one of our most vulnerable and difficult to assess populations: newborns.