Assessing neonatal brain fuction wit fMRI

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Brain injury before or during birth can lead to cognitive and behavioural deficits that have long-term implications. If care is to be provided when it is most effective, these deficits must be detected early. Neonates, however, have a limited range of neurobehavioural responses and current tests are inadequate. Although a substantial literature now exists on using neuroimaging to measure brain function in adults, this work has not been translated effectively to assessing function and dysfunction in the neonatal brain. A first key challenge is that neonates are different from adults, both behaviourally and physiologically; they cannot be asked to remain still during the imaging process and the chemical structure of their brain differs significantly from that of the adult brain. We will apply new acquisition and analysis methods to solve these problems, thereby establishing reliable neuroimaging protocols for the neonatal brain. A second challenge is to sensitively and reliably assess cognitive function in neonates. We will identify suitable stimulation protocols, drawing on a hierarchical design that has been previously applied by our team to the problem of assessing cognitive function in adult patients who are diagnosed as vegetative. In the first weeks of life, we will use functional neuroimaging to characterize basic sensory processing, recognition and memory, and acquire state-of-the-art neuroanatomical measures. A third challenge is to evaluate how to combine these measures to best predict later developmental outcome. In collaboration with the Children's Hospital and London Health Sciences Centre, we will develop a tool for clinical practice that combines anatomical, functional and neurobehavioural assessments to improve diagnostic accuracy and facilitate early intervention