Development of new bedside optical imaging methods for non-invasive assessment of brain injury in neonates

开发新的床边光学成像方法，用于新生儿脑损伤的无创评估

• 批准号: RGPIN-2015-04672
• 负责人: Dehaes, Mathieu
• 金额: $ 1.6万
• 依托单位: Université de Montréal
• 依托单位国家: 加拿大
• 项目类别: Discovery Grants Program - Individual
• 财政年份: 2016
• 资助国家: 加拿大
• 起止时间: 2016-01-01 至 2017-12-31
• 项目状态: 已结题
• 来源: https://www.nserc-crsng.gc.ca/ase-oro/Details-Detailles_eng.asp?id=613100
• 关键词: Development; new; bedside; optical; imaging

The neonatal brain is particularly vulnerable to the biological consequences of prematurity, to birth asphyxia, congenital heart disease and other neonatal metabolic disorders. Brain injury and altered or delayed brain development in the neonatal period are associated with devastating neurodevelopmental consequences such as significant cognitive, motor, language and behavioural disabilities. Although mortality rates have decreased due to advances in clinical care, neurodevelopmental deficits have emerged as the most significant co-morbidity. Currently the lack of bedside quantitative tools to monitor and assess brain health is a critical barrier to improve outcome in at-risk neonates. My approach is based on the development of novel brain imaging methods to explore and explain fundamental haemodynamic and metabolic effects of brain injury and therapy on neuroimaging data in at-risk neonates. It is based on non-invasive measure of the cerebral metabolic rate of oxygen with near infrared and diffuse correlation spectroscopies. Compared to existing techniques, my approach is innovative and unique because it allows the evaluation of brain health at the bedside by providing quantitative information on the amount of oxygen delivered and consumed by neurons. Current techniques do not provide direct information on brain oxygen metabolism non-invasively and are limited to specific populations. My short-term objective is to develop novel bedside non-invasive brain imaging methods to improve bedside assessment of haemodynamic and metabolic parameters at the bedside. In addition, physics-based biophysical models of the neonatal neurovascular response to therapy will be developed and validated against measured data in sick newborns and healthy controls. My long-term objective aims at developing normal reference charts for the cerebral metabolic rate of oxygen with age that can be used to differentiate normal and abnormal brain development and predict long-term outcomes. Non-invasive optical technology is the future for critical care in paediatrics. This work will provide a quantitative assessment of brain health in a very important population because of the high prevalence of long-term deficits. It will help to establish our bedside neuroimaging approach as a tool to characterize cerebrovascular health in the context of neonatology. Expected outcomes include a better understanding of normal brain development, which will allow to rapidly identify metabolic abnormalities at the bedside. By focusing on developing imaging methods to improve the quantification of measurements and a modelling framework, my program will provide a robust structure for interpreting neuroimaging data in neonates. As neonatal brain injury is a growing problem and should be considered a national priority, the impact of my program is unquestionable.

新生儿的大脑特别容易受到早产、出生窒息、先天性心脏病和其他新生儿代谢障碍的生物学后果的影响。新生儿期的脑损伤和脑发育改变或延迟与毁灭性的神经发育后果有关，例如严重的认知、运动、语言和行为残疾。虽然由于临床护理的进步，死亡率有所下降，但神经发育缺陷已成为最重要的并存疾病。目前，缺乏监测和评估大脑健康的床边量化工具是改善高危新生儿预后的关键障碍。 我的方法是基于开发新的脑成像方法来探索和解释脑损伤和治疗对高危新生儿神经成像数据的基本血流动力学和代谢影响。它是基于近红外和漫相关光谱对大脑氧气代谢率的非侵入性测量。与现有的技术相比，我的方法是创新和独特的，因为它允许在床边通过提供关于神经元输送和消耗的氧气量的定量信息来评估大脑健康。目前的技术不能非侵入性地提供有关脑氧代谢的直接信息，而且仅限于特定人群。 我的短期目标是开发新的床边非侵入性脑成像方法，以改进床边血流动力学和代谢参数的床边评估。此外，将开发基于物理学的新生儿神经血管对治疗反应的生物物理模型，并根据患病新生儿和健康对照的测量数据进行验证。我的长期目标是开发脑氧代谢率随年龄变化的正常参考图，可以用来区分正常和异常的大脑发育并预测长期结果。 非侵入性光学技术是儿科重症监护的未来。这项工作将在一个非常重要的人群中提供大脑健康的定量评估，因为长期缺陷症的高流行率。这将有助于建立我们的床边神经成像方法，作为在新生儿学背景下表征脑血管健康的工具。预期的结果包括更好地了解正常的大脑发育，这将使我们能够快速识别床边的代谢异常。通过专注于开发成像方法来改进测量的量化和建模框架，我的计划将提供一个强大的结构来解释新生儿的神经成像数据。由于新生儿脑损伤是一个日益严重的问题，应该被视为国家优先事项，我的计划的影响是毋庸置疑的。