Transformer la trajectoire neurologique des enfants à risque en améliorant le monitorage cérébral, identifiant des biomarqueurs quantitatifs sur le cerveau en développement qui soient capables d'évaluer, en temps réel, de nouvelles stratégies neuroprotectrices: un programme translationnel

 

Gregory Anton Lodygensky

Centre hospitalier universitaire Sainte Justine

 

Domaine : neurosciences, santé mentale et toxicomanies

Programme Chercheurs-boursiers cliniciens - Junior 2

Concours 2019-2020

Very premature infants are at risk of major disabilities. Fetal exposure to placental infection and postnatal infections are known to be major risk factors for neurologic impairment. To date there are no tools to quantify early acute inflammatory injury in the very immature brain. In the case of overt brain injury, there is no robust imaging biomarker user-independent to predict very long term and determine therapeutic efficiency.

Multimodal Magnetic resonance imaging (MRI) is a powerful tool with quantification abilities, yet its ability to determine a positive response to therapy remains to be validated. Furthermore it is  not a bedside technique that can't be performed daily. New optical technics such as intrinsic optical imaging and ultrafast ultrasound imaging allow precise measurement of cerebral oxygenation, vascular density and the evaluation of neuronal network with a high translational potential. The combination of monitoring at bedside and accurate lesion load assessment by multimodal MRI carries promising perspectives. We propose to evaluate advanced MRI technics, intrinsic optical imaging and ultrafast ultrasound imaging as complementary quantitative biomarkers in two model of brain injury in the developing brain. This new and combined approach will allow faster determination of drug efficacy.

Moreover, it will help us in the design of neuroprotective drug trials in human children at risk where tissue sample is not available and where conventional neurocognitive evaluation can only be performed 2 to 8 years after treatment. Finally it will help us in creating robust tools to evaluate the brain of the most instable preterm infants with the purpose of improving their outcome now possible thanks to the Canadian Neonatal Brain Platform that I have put together and recently funded by Brain Canada (cnbp.ca).