Multimodal Evaluation of Sensory Processing and Neurodevelopment in NICU Infants

简介（申请人提供）：我是一名医学科学家，分子生物学博士，儿科和新生儿围产期医学博士后。我完全致力于转化研究的事业，目标是改善前新生儿重症监护病房残疾婴儿的长期预后。我在范德比尔特大学担任助理教授已经是第四年了，由于系里的慷慨支持，我80%的精力都放在了研究上。我很幸运能拥有范德比尔特这样的制度环境，这里有丰富的职业发展机会、资源和多学科合作。我的研究重点是重症监护环境暴露和神经损伤对婴儿和儿童感觉功能的影响。感觉系统提供了我们对世界的看法，所有的认知过程都依赖于这种看法。此外，我们的大脑连接不同感官知觉的能力使我们看到的世界和我们自己不仅仅是各个部分的总和。我的研究重点是开发客观测量儿童大脑功能这方面的新方法，以预测残疾儿童的发育结果和设计治疗策略。虽然到目前为止我已经从提供给我的机会中受益，但我仍然需要通过填补我在两个特定领域的培训空白来完成我的独立研究发展：多感觉系统的神经科学和大规模临床试验设计。我的长期职业目标是在围产期脑损伤评估方面建立一个独立的研究项目，并为早期生命起源的脑损伤开发新的干预措施。K23指导患者导向研究职业发展奖将帮助我实现这一目标。我的主要导师，伊丽莎白·迪肯斯博士，是以患者为导向的发育性残疾研究领域的国际领导者。迪肯斯博士将指导我的职业发展走向独立，并与我的指导团队一起，确保我在大规模临床试验的设计中取得成功。我的共同导师Mark Wallace博士是世界著名的多感觉系统神经科学专家，Jim Bodfish博士是感官知觉客观神经行为测量方面的权威，他们将指导我在这个领域走向严谨的科学研究设计。我的指导委员会的成员都是根据他们在各自领域的经验和领导力精心挑选的，代表了我职业道路的互补方面。同样，我的发展计划将填补我训练中的空白，而我的研究项目将把我的精力集中在多感官功能的特定领域。我的K23研究计划的目标是解决缺乏定量工具来测量脆弱婴儿的感觉功能，通过采用我在过去三年中开发并在年龄较大的儿童中验证的新工具。新生儿期是大脑发育的关键时期，此时大脑区域之间的连接正在形成；这些连接高度依赖于输入和刺激的环境。由于重症监护病房的新生儿经常经历非典型刺激，例如持续的噪音和频繁的医疗护理，他们对触觉和声音的感知可能会发生深刻的改变。我们将首先使用方法客观地测量新生儿重症监护病房婴儿的大脑对语音和轻触的感知，这些婴儿出生时从满胎龄开始

DESCRIPTION (provided by applicant): I am a physician-scientist, with a PhD in molecular biology and post-doctoral training in Pediatrics and Neonatal-Perinatal Medicine. I am completely committed to a career in translational research, with the goal of improving the long-term outcomes of former NICU infants with disabilities. I am currently in my fourth year on the faculty as an Assistant Professor at Vanderbilt, with 80% of my efforts focused on research thanks to generous departmental support. I am fortunate to have an institutional environment such as that at Vanderbilt, which is rich in career development opportunities, resources and multidisciplinary collaborations. The focus of my research has been the influence of intensive-care environmental exposures and neural injury on sensory function in infants and children. Sensory systems provide our view of the world, a view upon which all cognitive processes are dependent. Furthermore, our brain's ability to connect different sensory perceptions is what allows us to see the world and ourselves as more than just the sum of separate parts. I have focused my research on developing new methods of objectively measuring this aspect of brain function in children, in order to predict developmental outcomes and design therapeutic strategies for children with disabilities. While I have benefitted from the opportunities afforded o me thus far, I still need to complete my development towards independent research by filling in the gaps in my training in two specific areas: the neuroscience of multisensory systems and large-scale clinical trials design. My long-term career goal is to develop an independent research program in the evaluation of perinatal brain injury and to develop novel interventions for brain insults with origin in early life. The K23 Mentored Patient-Oriented Research Career Development Award will help me achieve this goal. My primary mentor, Dr. Elisabeth Dykens, is an international leader in patient-oriented developmental disabilities research. Dr. Dykens will guide my career progress to independence and, with my mentorship team, ensure my success in the design of large-scale clinical trials. My co-mentors, Dr. Mark Wallace, a world- renowned expert in multisensory systems neuroscience, and Dr. Jim Bodfish, an authority on objective neurobehavioral measures of sensory perception, will guide my development towards rigorous scientific study design in this field. The members of my mentoring committee have been carefully chosen for their experience and leadership in their chosen fields and represent complementary aspects of my career path. Similarly, my development plan will fill gaps in my training, while my research project will focus my efforts in the specific area of multisensory function. The goal of my K23 research proposal is to address the lack of quantitative tools to measure sensory function in vulnerable infants, by adapting novel tools I have developed and validated in older children over the last three years. The neonatal period is a critical time in brin development, when connections between brain regions are being formed; these connections are highly dependent upon the environment for input and stimulation. Because neonates in intensive care units often experience atypical stimuli, such as constant noise and frequent handling for medical care, their perception of touch and sound can be profoundly altered. We will first use methodologies to objectively measure the brain's perception of speech sounds and light touch in NICU infants across the full spectrum of viable gestational ages at birth, from full term to extremely preterm. We will use a portable methodology to deliver tactile and auditory stimuli at the bedside of infants and quantitatively measure the brain's response with electrical neuroimaging (EEG/ERP) prior to discharge from the hospital. We will test the hypothesis that individual and combined measures of tactile and auditory responses will allow us to identify and quantify deficits in unisensory and multisensory function. We will then validate the utility of the methods developed in the first part of the study to predict sensory and developmental outcomes at 6 and 24 months corrected age. We will evaluate the previously tested infants in the follow-up clinic with established measures of sensory, cognitive, communication and behavioral function, and develop predictive algorithms for outcomes. The information gained from this project will help us determine how deficits in multisensory perception contribute to the development of disabilities in early childhood and will allow us to design and assess effective neuroprotective and rehabilitative strategies.