Neurodevelopment and Neuroimaging in Parenterally-fed Infants and Young Children
| Status: | Archived |
|---|---|
| Conditions: | Colitis, Women's Studies, Gastrointestinal |
| Therapuetic Areas: | Gastroenterology, Reproductive |
| Healthy: | No |
| Age Range: | Any |
| Updated: | 7/1/2011 |
Manganese (Mn) is an essential metal required for normal growth and development. However,
exposure to high Mn levels can be toxic to the brain. The objectives of this project are to
identify neonatal and young pediatric populations that are at increased risk of excessive
brain Mn deposition and altered cognitive and motor development based on their dietary
parenteral Mn exposure, and to make sound and evidence-based recommendations for appropriate
Mn supplementation and monitoring of infants and young children receiving parenteral
nutrition (PN). Our studies are designed to test the hypotheses that, compared with
unexposed age-matched controls, infants and young children receiving prolonged
Mn-supplemented PN will have increased deposition of Mn in their brains and lower scores on
neurodevelopmental, cognitive and psychophysiological assessments.
Specific Aims have been designed to test these hypotheses in three developmentally distinct
populations:
1. preterm infants and
2. full term infants in the Neonatal Intensive Care Unit (NICU) requiring prolonged PN and
3. older infants and young children on home PN.
Mn neurotoxicity will be investigated by longitudinal assessments of cognitive (executive
functioning battery), neurodevelopmental (Bayley III Scales of Infant Development), and
psychophysiological (event-related potential) measures and will be correlated with brain
deposition of Mn using the technique of magnetic resonance (MR) relaxometry in a vulnerable
population of infants receiving Mn-supplemented PN and age-matched controls. This proposal
addresses a clinically relevant and unexplored link between nutritional practices, brain Mn
deposition and neurodevelopmental sequelae in an at-risk population of infants and young
children utilizing state-of-the-art magnetic resonance imaging (MRI) technology and
neurodevelopmental assessment techniques. The potential for increased brain Mn accumulation
in infants, and by inference, the potential health risks associated with elevated brain Mn
burden, represents crucial, unexplored issues of exposure and susceptibility. The potential
contribution of Mn toxicity to the poor outcomes of infants dependent for an extended time
on PN has not been fully acknowledged or studied. Improved understanding of the
relationships between Mn exposure and developmental outcomes will undoubtedly lead to
altered clinical practices and more careful monitoring of Mn intake and blood and/or brain
Mn levels in high risk infants. Our studies will also contribute to an improved
understanding of the value of non-invasive MR imaging in the monitoring of pediatric
patients on PN.
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