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Innovative methodologies : Using brain imaging to evaluate nutritional intervention strategies in resource-poor settings Sophie E. Moore Group Leader: Maternal & Child Nutrition MRC Human Nutrition Research.
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Innovative methodologies:Using brain imaging to evaluate nutritional intervention strategies in resource-poor settings Sophie E. Moore Group Leader: Maternal & Child NutritionMRC Human Nutrition Research
Cognitive development in infancy and early childhood has been associated with a range of socioeconomic indicators in later life Achieving optimal brain development during the early phases of development in thus critical for human capital Thompson RA & Nelson CA. Am Psychol. 2001:56;5-15.
Hypothesised relations between poverty, child development and school achievement Primary caretakerStress/depression Low responsivity Low education Poverty Poor care and home stimulation Poor school achievement Nutritional deficiencies/infections Poor cognitive, motor, socio-emotional development Growth failure Adapted from: Grantham-McGregor S. et al. Lancet 2007:369;60-70
Effect size for comparisons of children born with or without IUGR at term Walker S. et al, Lancet. 2007:369;145-57
Issues with behavioural assessments • Reliability and validity:Most assessment scales are normed on Western samples and may not translate directly to other settings • Early identification of pathology and evaluation of interventions:Must wait until it has reached the point of observable behaviour • Objectivity during administration:Differences between administratorsParents’ reports of behaviour are likely subjective • Administration time:Often 45+ mins
Optimising head circumference growth for brain development Mean (95% CI) HC for age z-scores. (males – blue; step curves show the mean at each time point). Data from the ENID Trial.
Functional Near Infrared Spectroscopy (fNIRS) 1. Source & detector probes 2. Shine & detect light 3. Measure changes in HbO2(red) and HHb (blue) in response to neuronal activation
0-2 months 4-8 months 12-16 months 18-24 months
Results from Gambian infants Activated Brain Region Response to Social Visual Stimuli Response to Social Auditory Stimuli • Optical Imaging demonstrated that Gambian infants showed significant brain activation in the temporal cortex in response to social visual and auditory stimuli • These results are the same as those seen in a UK study with infants of a similar age Lloyd-Fox et al. Nat Sci Reports. 2014:4;4740.
Benefits of fNIRS • Reliability and validity cross culturally • Early identification – can be administered with newborns • Objectivity during administration • Administration time – cap placement & acquisition in <15 min
Conclusions & future application of fNIRS research • fNIRS is an innovative means to measure neurocognitive function in infants and young children in a resource-poor setting • Cross-sectional and longitudinal studies revealed distinct regions of the posterior superior temporal and inferior frontal cortex activated by either visual or auditory social stimuli • fNIRS may be used to elucidate typical and atypical brain development from birth and hence investigate the effects of nutritional insults and interventions in global health studies
Global fNIRS www.globalfnirs.org