Banca de QUALIFICAÇÃO: VALERIA AZEVEDO DE ALMEIDA

Uma banca de QUALIFICAÇÃO de DOUTORADO foi cadastrada pelo programa.
STUDENT : VALERIA AZEVEDO DE ALMEIDA
DATE: 17/10/2023
TIME: 14:00
LOCAL: Remoto
TITLE:

Assessment of high-risk infants in resource-limited environments: a case study with brain assessment tools

 

KEY WORDS:

Infants; Newborns; Visual recognition model; Eye-tracking technology; Low and middle-income countries; Low-income country.

PAGES: 30
BIG AREA: Ciências da Saúde
AREA: Fisioterapia e Terapia Ocupacional
SUMMARY:

Infants residing in low and middle-income countries face the potential challenge of not reaching their ideal developmental milestones. While the behavioral consequences of growth in such socioeconomic contexts are widely recognized, our understanding of the neural mechanisms that underlie these undesirable outcomes remains relatively incomplete, especially in resource-limited environments. In this regard, the next step in the evolution of their applications involves investigating the effects of complex and interactive socioeconomic and environmental adversities on brain development. To achieve these comprehensive mechanisms, it is necessary to take technologies out of research laboratories and study at-risk populations in resource-limited environments. In this perspective, the aim of the study was to incorporate the assessment of processing of social and non-social stimuli through functional near-infrared spectroscopy (fNIRS) and eye-tracking (ET) in a low-resource clinical setting. Methods: This is a cross-sectional observational study of a series of cases. fNIRS and ET were removed from the research laboratories of the Edmond and Lily Safra International Institute of Neuroscience (IIN-ELS) and transferred to the clinical outpatient clinic of the Anita Garibaldi Education and Research Center in Health (CEPS). Infants aged 1 to 11 months were included, followed by the CEPS outpatient clinic, which is a reference for the follow-up of children at risk for growth and development in the region and serves approximately 18 children per month. Infants whose NIRS data presented excessive motion artifacts resulting in signal loss, difficulty obtaining the optical signal, equipment intolerance, infants without fixation time recording during eye-tracking stimulus presentation, and those who cried and became agitated during the experiment compromising the data were excluded. Initially, a clinical assessment of overall development and family context was carried out through an interview with the mother or legal guardian, using the SWYC (Screening to Watch for Young Children) questionnaire, in this study, the "Developmental Milestones" and "Parental Concerns" questionnaires were used. Next, an interview with the mother was conducted regarding maternal comorbidities history. Finally, brain function assessment was performed, consisting of the simultaneous use of fNIRS and the ET paradigm to assess the processing of social and non-social stimuli. Visual stimuli were displayed in a 3-5s window interspersed with a figure with a neutral background and a circle in the center for 12s, the time required for the hemodynamic response to return to its original/baseline values. The fNIRS records were temporally synchronized with the displayed stimuli. For this, the fNIRS synchronization device was used, with triggers marking the beginning and end of each stimulus. Eye-tracking data were aligned with these triggers to determine when the infant was looking at each stimulus. This made it possible to assess the specific hemodynamic behavior of all infants individually for each of the stimuli presented. When there was no eye movement recording for some of the stimuli presented, the hemodynamic behavior for those specific stimuli was discarded. Results: Between October 2021 and October 2022, 43 infants met the inclusion criteria, and 19 were evaluated by fNIRS and ET. Of these, 53% directed their gaze to only one social or non-social stimulus, and 47% directed their gaze to two or more stimuli. SWYC data showed that six of the mothers were concerned about the child's development; five were at risk for behavioral disorders, and two families were at risk for tobacco, alcohol, or drug abuse. Furthermore, 100% of the mothers had high-risk pregnancies, and 58.8% experienced threatened abortion. Brain function assessment revealed hemodynamic responses in channels positioned in the left temporal lobe S3_D6 (z = -2.366, p = 0.018) that significantly increased during the display of social stimuli compared to non-social stimuli. Conclusion: It was possible to transfer technologies such as fNIRS and ET out of research laboratories and study infants in at-risk situations in resource-limited environments. Although face recognition is highly complex and involves several regions of the brain, we found an increase in metabolic demand in the left temporal cortex during the display of facial stimuli.

COMMITTEE MEMBERS:
Interno - 2646619 - RODRIGO PEGADO DE ABREU FREITAS
Presidente - 1803907 - SILVANA ALVES PEREIRA
Externo à Instituição - SUELLEN MARY MARINHO DOS SANTOS ANDRADE - UFPB