Assessment of Cognitive Neurodevelopment in Children with Cerebral Palsy in China

描述(申请人提供)：这项计划拨款的目标是在加州大学圣地亚哥分校和中国人民共和国北京师范大学中国(中国)的科学家之间形成跨学科的合作，以提高中国教授对神经发育障碍的研究能力，并促进对早期神经功能障碍对儿童认知发展影响的基本理解。这笔赠款主要用于脑性瘫痪(CP)的神经发育障碍，其最常见的形式是痉挛双瘫(SDCP)。SDCP是一种下肢痉挛的运动障碍，由产前脑白质损伤导致皮质-脊髓运动纤维中断所致。由于SDCP是基于运动缺陷而诊断的，并且主要作为一种运动障碍进行研究，因此对其对认知和正在进行的大脑发育的影响知之甚少。CP在国际上普遍流行，在拥有世界上最多民族人口的中华人民共和国中国，3.250的发病率是一个亟待解决的问题。同时，人口规模和高发病率为研究SDCP提供了一个机会，作为神经发育病理学的模型，并检查早期和坦率的大脑发育中断对认知结果的影响。这笔赠款的具体目的是帮助在中国共和国的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，并进行试点研究，以论证在中国中华人民共和国评估SDCP儿童认知发展的可行性。这个项目研究了认知能力的概况，以及它们的功能和结构神经在明确定义的SDCP儿童群体中的相关性。这项研究的重点是儿童的视觉空间能力，显示出受到SDCP的影响，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是视觉空间处理所特有的，我们还将检查语言表现，这一表现被认为是SDCP所特有的。认知能力的测试使用标准化测试和实验测量的组合，这些测试是专门为探索视觉空间和语言能力而设计的。将使用功能磁共振成像(FMRI)检查大脑调节视觉空间过程的功能组织，并将使用扩散张量磁共振成像评估连接白质束的结构完整性。该项目的长期目标是为未来的R01赠款奠定基础，该赠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告诉我们关于早期侮辱后大脑发育和可塑性的基本原理的知识，使用CP作为一种探究模式。公共卫生相关性：这个项目旨在增加我们对一种国际流行的神经发育障碍--痉挛双瘫脑瘫--的认知和大脑发育的了解。由于对这种运动障碍所显示的认知障碍知之甚少，确定这些缺陷的特征是迈向干预的重要第一步。这个项目还将让我们了解大脑发育和早期侮辱后可塑性的一般原理。

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.