SHINE (Southampton Hypoxic Ischaemic eNcephalopathy rEsearch) involves several active research projects.
Project 1: Neurodevelopmental trajectories and neural correlates in children with neonatal HIE – NENAH study
In this stream of work we aim to characterise cognitive and behavioural abilities that are important for school success and socio-emotional function in school aged children with neonatal HIE who underwent hypothermia treatment, and their neural correlates (using advanced MRI to characterise brain networks). In addition, we aim to characterise neurodevelopmental trajectories from birth into school age with the aim to identify early predictors of outcome
Project 2: Testing perfusion and brain connectivity MRI for investigating and evaluating severity of HIE in the neonatal brain
Here, we investigate which structural and functional brain networks are impaired in HIE in the neonatal period, and whether alterations in specific brain networks are associated with cognitive long term outcome. In this study, we also examine brain perfusion following neonatal HIE, using a new MRI perfusion sequence (pCASL). Brain perfusion measures obtained at day 5 post delivery/presumed time of insult will be correlated with neurodevelopmental outcomes at age 3 months and then 2 years to examine whether patterns of brain perfusion can add to prediction of neurodevelopmental outcome.
Project 3: Clinical predictors of neurological and developmental outcomes at toddler age and school age in infants born preterm and infants with neonatal HIE
Prediction of long term neurological, cognitive and behavioural outcomes in infants and children born too early and/or with neurological problems in the perinatal period remains difficult. In this line of work, we are investigating the predictive value of clinical routine neonatal neuroimaging, neurophysiology, and routine neurological assessments in early infancy.
Project 4: EEG as biomarker for neurodevelopmental outcomes in neonatal HIE
We are investigating whether early electroencephalography (EEG) could serve as a biomarkers to predict neurodevelopmental outcomes in infants with neonatal HIE. In collaboration with Prof Koushik Maharatna’s group (Electronics and Computer Science, UoS), we focus on quantitative EEG analysis of early EEG, collected in clinical routine.
Project 5: Quantitative analysis of susceptibility weighted MRI (SWI) for assessment of hypoxia ischaemia in the neonatal brain
Susceptibility weighted MRI (SWI) can show abnormal cerebral venous contrast as a consequence of abnormal blood flow, perfusion and thus brain oxygenation. Therefore, using SWI, which is part of many clinical routine neonatal MRI protocols for radiological assessment of focal haemorrhage, may be a promising method to assess impaired brain oxygenation in neonatal HIE; it may also serve as an early biomarker for neurodevelopmental outcomes of HIE. In collaboration with Dr Sasan Mahmoodi’s group (Electronics and Computer Science, UoS), we are exploring whether SWI data can be used in quantitative and automated analysis to (1) classify SWI with regards to hypoxic-ischaemic changes, and (2) how SWI may serve as an early predictor of neuromotor outcome.
Project 6: Reliability and validity of the Hempel Neurological Examination
The risk of so-called "minor developmental problems" in infants is high. These minor developmental problems emerge with increasing age, especially around school-age. Being able to detect these children earlier offers an opportunity for early intervention and prevention of these disorders. In collaborations with Prof Mijna Hadders-Algra (University of Groningen, Netherlands) and Prof Jeanie Cheong (Royal Women’s Hospital, Melbourne, Australia), we are currently collecting data that investigate the reliability and validity of a neurological examination designed to identify minor neurological dysfunction (MND) at age 2 years.