Assessment of Cognitive Neurodevelopment in Children with Cerebral Palsy in China

描述（由申请人提供）：本计划资助的目标是在美国加州大学圣地亚哥分校和中国北京师范大学的科学家之间建立一个跨学科的合作关系，以提高中国神经发育障碍研究的能力，并促进对早期神经紊乱对儿童认知发展影响的基本认识。这项资助的重点是脑瘫（CP）的神经发育障碍，其最常见的形式，痉挛性双瘫（SDCP）。SDCP是一种下肢痉挛的运动障碍，由产前白质损伤破坏皮质-脊髓运动纤维引起。由于SDCP是基于运动缺陷诊断的，并且主要作为一种运动障碍进行研究，因此对其对认知和持续大脑发育的影响知之甚少。CP在国际上普遍存在，在拥有世界上最多人口的中华人民共和国，3.250的发病率是一个紧迫的问题。同时，人群的规模和高发生率提供了一个机会来研究SDCP作为神经发育病理学模型，并检查早期和坦率的大脑生长中断对认知结果的影响。该资助的具体目的是协助在中国儿科患者群体中建立神经心理学和发展认知神经科学研究的基础设施，并开展试点研究，以证明评估中国SDCP儿童认知发展的可行性。本项目研究认知能力的概况，以及他们的功能和结构神经相关性在一个明确界定的SDCP儿童人群。这项研究的重点是儿童的视觉空间能力，显示出与SDCP受损，并将检查视觉空间过程的潜在功能组织。为了确定儿童的认知障碍是否与视觉空间处理有关，我们还将研究语言表现，语言表现被认为与SDCP无关。认知能力的测试采用标准化测试和实验测量相结合的方式，专门用于探测视觉空间和语言能力。脑功能组织对视觉空间过程的调解将通过功能性磁共振成像（FMRI）进行检查，结缔性白质束的结构完整性将通过扩散张量磁共振成像进行评估。该项目的长期目标是为未来的R01拨款奠定基础，该拨款将提出可以进行经验测试的干预措施，旨在促进SDCP儿童的认知发展。这个项目的发现也将使我们了解早期侮辱后大脑发育和可塑性的基本原理，使用CP作为一种调查模式。公共卫生相关性：该项目旨在增加我们对国际上普遍存在的神经发育障碍痉挛性双截瘫脑瘫的认知和大脑发育的理解。由于对这种运动障碍的认知障碍知之甚少，表征这些缺陷是干预的重要第一步。这个项目也将告诉我们大脑发育的一般原则和早期损伤后的可塑性。

DESCRIPTION (provided by applicant): The goal of this planning grant is to form an interdisciplinary collaboration between scientists at the University of California, San Diego and Beijing Normal University, People's Republic of China (P.R. China) to increase the capacity for the study of neurodevelopmental disorders in P.R. China and advance the basic understanding of the effect that early neural disruption has on cognitive development in children. This grant focuses on the neurodevelopmental disorder of cerebral palsy (CP) in its most common form, spastic diplegia (SDCP). SDCP is a motor disorder of spasticity in the lower limbs that results from prenatal white matter lesions that disrupt cortical-spinal motor fibers. Since SDCP is diagnosed based on motor deficits and has been mainly studied as a motor disorder, relatively little is known about its effects on cognitive and ongoing brain development. CP is internationally prevalent and in P.R. China, which has the world's largest national population, an incident rate of 3.250 presents an urgent problem. At the same time, the scale of the population and high occurrence provides an opportunity to study SDCP as a model of neurodevelopmental pathology and to examine the effects of early and frank disruption of brain growth on cognitive outcome. The specific aims of this grant are to assist in building an infrastructure for neuropsychology and developmental cognitive neuroscience research with pediatric patient populations in P.R. China and to conduct pilot studies to demonstrate the feasibility of assessing cognitive development in children with SDCP in P.R. China. This project studies the profile of cognitive abilities, and their functional and structural neural correlates in a well defined population of children with SDCP. The study focuses on children's visuospatial abilities, shown to be compromised with SDCP, and will examine the underlying functional organization of visuospatial processes. To determine whether or not children's cognitive impairments are specific to visuospatial processing, we will also examine language performance, which has been characterized as being spared with SDCP. The examination of cognitive abilities uses a combination of standardized tests and experimental measures that are specifically designed to probe visuospatial and language abilities. The functional organization of the brain for mediation of visuospatial processes will be examined with functional magnetic resonance imaging (FMRI) and the structural integrity of connective white matter tracts will be assessed with diffusion tensor magnetic resonance imaging. The long-term goal of the project is to lay the foundation for a future R01 grant that will propose interventions that can be tested empirically and are designed to facilitate cognitive development in children with SDCP. The findings from this project will also inform our knowledge of the fundamental principles of brain development and plasticity following early insult using CP as one model of inquiry. PUBLIC HEALTH RELEVANCE: This project aims to increase our understanding of cognitive and brain development in an internationally prevalent neurodevelopmental disorder, spastic diplegia cerebral palsy. Since little is known about the cognitive impairments indicated in this motor disorder, characterizing these deficits is an important first step toward intervention. This project will also inform our knowledge of the general principles of brain development and plasticity following early insult.