Disease stratification in neonatal encephalopathy
Neonatal encephalopathy is a heterogeneous condition and is rarely the result of an isolated acute intrapartum event. Hence a ‘one-size-fits-all’ approach will not work, and babies require specific treatment targeted at the underlying mechanism of brain injury.
Fortunately, we now have more than a dozen highly effective therapies from preclinical studies. What we need is a way to identify the specific therapy that may be most beneficial for an individual baby. We are developing bedside tools and point of care tests for rapid disease stratification in neonatal encephalopathy based on the host transcriptomic profile so that in future, doctors can provide a more personalised approach to neuroprotection.
Ongoing multi-centre studies
Genomic Imaging in Neonatal Encephalopathy (GENIE) study (Funding: MRC)
In the GENIE study, we will examine a combination of genomic/epigenomic biomarkers in 300 babies with neonatal encephalopathy (and their parents), recruited from 20 perinatal centres across the UK, and examine their relationship with brain injury assessed from MRI and their neurodevelopmental outcomes at 2 years. If successful, such a robust point-of-care test will result in a paradigm shift in neuroprotection research for such babies, particularly in addressing the interaction of perinatal brain injury and infection.
Funding: Medical Research Council, UK
Sponsor: Imperial College London
Genomic Imaging in Neonatal Encephalopathy: Protocol
Genomic Imaging in Neonatal Encephalopathy: Parent Information Leaflet
Genomic Imaging in Neonatal Encephalopathy: Consent Form (Baby)
Genomic Imaging in Neonatal Encephalopathy: Consent Form (Parents)
Genomic Imaging in Neonatal Encephalopathy: HRA approval
Genomic Imaging in Neonatal Encephalopathy: REC approval
| No | Centre | Principal Investigator |
|---|---|---|
| 1 | Imperial NHS Trust | Dr Gaurav Atreja |
| 2 | Medway NHS Trust | Dr Aung Soe |
| 3 | Royal Victoria Infirmary, Newcastle | Dr Sundeep Harigopal |
| 4 | Coventry University Hospital | Dr Prakash Satodia |
| 5 | Liverpool Womens Hospital | Dr Kiran Yajmanyum |
| 6 | Birmingham Children Hospital | Dr Manobi Boorah |
| 7 | Bolton NHS Foundation Trust | Dr Archana Mishra |
| 8 | City Hospitals Sunderland Foundation NHS Trust | Dr Ruppa Geethanath |
| 9 | South Tees Hospitals NHS Trust | Dr Mithilesh Lal |
| 10 | Oxford University Hospitals NHS Foundation Trust | Dr Eleri Adams |
| 11 | Heart of England NHS Foundation Trust | Dr Jaideep Singh |
| 12 | North Tees Hospital | Dr C HariKumar |
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Heart Beat Variability in Neonatal Encephalopathy (HeartBeat) Study (Funding: NIHR)
The HeartBeat study will examine if heart rate variability (assessed using 2-compartment complexity analysis and machine learning) can disease-stratify encephalopathic infants soon after birth, and whether it corresponds to brain injury assessed on MRI and adverse neurodevelopmental outcomes at 2 years of age. This is a large multi-centre study recruiting from 8 NHS hospitals.
Funding: National Institute for Health Research (NIHR), UK
Sponsor: Imperial College London
Heart Beat Variability in Neonatal Encephalopathy: Protocol
