Bed-side assessment of brain injury using time-resolved near-infrared spectroscopy

• Project/Area Number: 15K09733
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Research Field: Embryonic/Neonatal medicine
• Research Institution: Nagoya City University (2017-2018); Kurume University (2015-2016)
• Principal Investigator: Iwata Sachiko 名古屋市立大学, 大学院医学研究科, 病院助教 (40465711)
• Co-Investigator(Kenkyū-buntansha): 岩田 欧介 名古屋市立大学, 大学院医学研究科, 准教授 (30465710)
• Project Period (FY): 2015-04-01 – 2019-03-31
• Project Status: Completed (Fiscal Year 2018)
• Budget Amount: ¥4,810,000 (Direct Cost: ¥3,700,000、Indirect Cost: ¥1,110,000); Fiscal Year 2017: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2016: ¥910,000 (Direct Cost: ¥700,000、Indirect Cost: ¥210,000); Fiscal Year 2015: ¥2,990,000 (Direct Cost: ¥2,300,000、Indirect Cost: ¥690,000)
• Keywords: 新生児 / 脳 / 近赤外線 / 画像診断 / 発達障害

Outline of Final Research Achievements

Newborn infants hospitalised at a neonatal intensive care unit (24-40 weeks gestation) were studied using time-resolved near-infrared spectroscopy (TR-NIRS). Of 150 infants studied, association between light scattering within 7 days of birth and clinical variables were assessed, where Apgar scores, cord blood pH, gestational age and requirement for mechanical ventilation showed robust relationships with light scattering. When light scattering was assessed in newborn infants, who underwent TR-NIRS measurement at term-equivalent period, light scattering still depended on variables associated with maturation at birth (e.g. gestational age and birth weight), whereas post-natal nutritional status, such as body weight gain and days before oral/tube feeding >100ml/kg/d was identified as additional independent variable of light scattering. Taken together, reduced light scattering coefficient might be determined by maturation status at birth and transitional, growth status after birth.

Academic Significance and Societal Importance of the Research Achievements

ハイリスク新生児の脳内微小病変は，MRIによる判定が一般的であるが，MRIは高額な検査であるだけでなく，新生児にとっては時に鎮静を要する信州の高い検査であるため，繰り返し撮影することは現状では不可能である．MRI上の微小病変を予測可能なベッドサイドツールが確立されれば，ローコストで安全に新生児の脳内微小病変を検出し，予後を予測することができるかもしれない．また，TR-NIRSによる微小病変の検出が，MRIに比べて大きく劣る場合にも，繰り返し多人数に施行することによって，これまでわかっていなかった微小病変のオンセットを突き止める強力なツールになり，ハイリスク児の予後向上に大きく寄与すると考える．

Research Products

• [Journal Article] Intrauterine growth and the maturation process of adrenal function (2019)
  • Author(s): Iwata Sachiko、Kinoshita Masahiro、Okamura Hisayoshi、Tsuda Kennosuke、Saikusa Mamoru、Harada Eimei、Saitoh Shinji、Iwata Osuke
  • Journal Title: PeerJ Volume: - Pages: e6368-e6368
  • DOI: 10.7717/peerj.6368
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Visual Function Scale for Identification of Infants with Low Respiratory Compliance (2019)
  • Author(s): Harada Eimei、Kinoshita Masahiro、Iwata Sachiko、Saikusa Mamoru、Tsuda Kennosuke、Shindou Ryota、Sahashi Takeshi、Kato Shin、Yamada Yasumasa、Saitoh Shinji、Iwata Osuke
  • Journal Title: Pediatrics & Neonatology Volume: - Issue: 6 Pages: 611-616
  • DOI: 10.1016/j.pedneo.2019.02.006
  • Peer Reviewed / Open Access
• [Journal Article] Body Temperature, Heart Rate, and Short-Term Outcome of Cooled Infants (2019)
  • Author(s): Tsuda Kennosuke、Iwata Sachiko、Mukai Takeo、Shibasaki Jun、Takeuchi Akihito、Ioroi Tomoaki、Sano Hiroyuki、Yutaka Nanae、Takahashi Akihito、Takenouchi Toshiki、Osaga Satoshi、Tokuhisa Takuya、Takashima Sachio、Sobajima Hisanori、Tamura Masanori、Hosono Shigeharu、Nabetani Makoto、Iwata Osuke
  • Journal Title: Therapeutic Hypothermia and Temperature Management Volume: 9 Issue: 1 Pages: 76-85
  • DOI: 10.1089/ther.2018.0019
  • Peer Reviewed / Open Access
• [Journal Article] Estimation of elevated intracranial pressure in infants with hydroce-phalus by using transcranial Doppler velocimetry with fontanel compression (2018)
  • Author(s): Yoshizuka Teiko、Kinoshita Masahiro、Iwata Sachiko、Tsuda Kennosuke、Kato Takenori、Saikusa Mamoru、Shindou Ryota、Hara Naoko、Harada Eimei、Takashima Sachio、Takeshige Nobuyuki、Saitoh Shinji、Yamashita Yushiro、Iwata Osuke
  • Journal Title: Scientific Reports Volume: - Issue: 1 Pages: 11824-11824
  • DOI: 10.1038/s41598-018-30274-3
  • Peer Reviewed / Open Access
• [Journal Article] Feeding-Induced Cortisol Response in Newborn Infants (2018)
  • Author(s): Kinoshita Masahiro、Iwata Sachiko、Okamura Hisayoshi、Tsuda Kennosuke、Saikusa Mamoru、Harada Eimei、Yamashita Yushiro、Saitoh Shinji、Iwata Osuke
  • Journal Title: The Journal of Clinical Endocrinology & Metabolism Volume: 103 Issue: 12 Pages: 4450-4455
  • DOI: 10.1210/jc.2018-01052
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Journal Article] Therapeutic hypothermia for neonatal encephalopathy: a report from the first 3 years of the Baby Cooling Registry of Japan (2017)
  • Author(s): Kennosuke Tsuda, Takeo Mukai, Sachiko Iwata, Jun Shibasaki, Takuya Tokuhisa, Tomoaki Ioroi, Hiroyuki Sano, Nanae Yutaka, Akihito Takahashi, Akihito Takeuchi, Toshiki Takenouchi, Yuko Araki, Hisanori Sobajima, Masanori Tamura, Shigeharu Hosono, Makoto Nabetani, Osuke Iwata
  • Journal Title: Scientific Reports Volume: 7, 39508 Issue: 1
  • DOI: 10.1038/srep39508
  • Peer Reviewed / Open Access
• [Journal Article] Dependence of nighttime sleep duration in one-month-old infants on alterations in natural and artificial photoperiod. (2017)
  • Author(s): Iwata S, Fujita F, Kinoshita M, Unno M, Horinouchi T, Morokuma S, Iwata O.
  • Journal Title: Sci Rep. Volume: Mar 17;7:44749. Issue: 1
  • DOI: 10.1038/srep44749
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Evacuation of a Tertiary Neonatal Centre: Lessons from the 2016 Kumamoto Earthquakes. (2017)
  • Author(s): Iwata O, Kawase A, Iwai M, Wada K.
  • Journal Title: Neonatology. Volume: 112(1) Issue: 1 Pages: 92-96
  • DOI: 10.1159/000466681
  • Peer Reviewed / Open Access
• [Journal Article] Insufficient Humidification of Respiratory Gases in Patients Who Are Undergoing Therapeutic Hypothermia at a Paediatric and Adult Intensive Care Unit. (2017)
  • Author(s): Tanaka Y, Iwata S, Kinoshita M, Tsuda K, Tanaka S, Hara N, Shindou R, Harada E, Kijima R, Yamaga O, Ohkuma H, Ushijima K, Sakamoto T, Yamashita Y, Iwata O.
  • Journal Title: Can Respir J. Volume: 2017:8349874. Pages: 1-6
  • DOI: 10.1155/2017/8349874
  • Peer Reviewed / Open Access
• [Journal Article] Paradoxical diurnal cortisol changes in neonates suggesting preservation of foetal adrenal rhythms. (2016)
  • Author(s): Kinoshita M, Iwata S, Okamura H, Saikusa M, Hara N, Urata C, Araki Y, Iwata O.
  • Journal Title: Sci Rep. Volume: Oct 18;6:35553. Issue: 1
  • DOI: 10.1038/srep35553
  • Peer Reviewed / Open Access / Int'l Joint Research / Acknowledgement Compliant
• [Journal Article] Region-specific growth restriction of brain following preterm birth. (2016)
  • Author(s): Iwata S, Katayama R, Kinoshita M, Saikusa M, Araki Y, Takashima S, Abe T, Iwata O.
  • Journal Title: Sci Rep. Volume: Sep 23;6:33995. Issue: 1
  • DOI: 10.1038/srep33995
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] Physiological and pathological clinical conditions and light scattering in brain. (2016)
  • Author(s): Kurata T, Iwata S, Tsuda K, Kinoshita M, Saikusa M, Hara N, Oda M, Ohmae E, Araki Y, Sugioka T, Takashima S, Iwata O.
  • Journal Title: Sci Rep. Volume: Aug 11;6:31354. Issue: 1
  • DOI: 10.1038/srep31354
  • Peer Reviewed / Open Access / Acknowledgement Compliant
• [Journal Article] An Embodied Brain Model of the Human Foetus. (2016)
  • Author(s): Yamada Y, Kanazawa H, Iwasaki S, Tsukahara Y, Iwata O, Yamada S, Kuniyoshi Y.
  • Journal Title: Scientific Reports Volume: 15;6 Issue: 1 Pages: 27893-27893
  • DOI: 10.1038/srep27893
  • NAID: 120006349332
  • Peer Reviewed / Open Access / Int'l Joint Research
• [Presentation] ハイリスク新生児の高次脳機能をまもるために生体リズムの知識が果たす役割 (2017)
  • Author(s): 岩田幸子
  • Organizer: 第59回日本小児神経学会学術集会
  • Invited
• [Presentation] 子宮外環境への適応過程に見るあかちゃんの知られざる能力 ～健やかな発達を支援するために (2017)
  • Author(s): 岩田欧介
  • Organizer: 日本赤ちゃん学会第17回学術集会
  • Invited
• [Presentation] 臨床現場の観察が家族を幸せにする？～生体リズムから見た脳機能の獲得 (2017)
  • Author(s): 岩田欧介
  • Organizer: 日本小児科学会東海地方会
  • Invited
• [Presentation] 進化を続ける脳保護戦略・・・現時点でのベストは？ (2015)
  • Author(s): 岩田欧介
  • Organizer: 東北新生児医療カンファランス
  • Place of Presentation: 仙台マークワン（宮城県・仙台市）
  • Year and Date: 2015-11-14
  • Invited
• [Presentation] 低体温療法に続くもの・・脳保護からこころを育む集中治療へ (2015)
  • Author(s): 岩田欧介
  • Organizer: 第133回新潟新生児懇話会
  • Place of Presentation: MEDIA SHIP日報ホール（新潟県・新潟市）
  • Year and Date: 2015-10-09
  • Invited
• [Presentation] 新生児低体温療法の現在 (2015)
  • Author(s): 岩田欧介
  • Organizer: 平成27年度第2回周産期医療研修会
  • Place of Presentation: 大阪府医師会館（大阪府・大阪市）
  • Year and Date: 2015-09-26
  • Invited
• [Presentation] 低体温中の異常加湿の検討1：呼吸器回路と加温加湿器の影響 (2015)
  • Author(s): 七種 護，原 直子，海野光昭，津田兼之介，木下正啓，田中祥一朗，岡田純一郎，久野 正，岩田幸子，神田 洋，前野泰樹，岩田欧介
  • Organizer: 第51回日本周産期・新生児医学会総会および学術集会
  • Place of Presentation: ヒルトン福岡シーホーク（福岡県・福岡市）
  • Year and Date: 2015-07-10
• [Presentation] 低体温療法中の異常加湿の検討2：異常加温加湿の原因に迫る (2015)
  • Author(s): 津田兼之介，七種 護，原 直子，海野光昭，木下正啓，田中祥一朗，岡田純一郎，久野正，岩田幸子，神田 洋，前野泰樹，岩田欧介
  • Organizer: 第51回日本周産期・新生児医学会総会および学術集会
  • Place of Presentation: ヒルトン福岡シーホーク（福岡県・福岡市）
  • Year and Date: 2015-07-10
• [Presentation] 低体温療法施行中の至適循環サポートを求めて：急性期バイオマーカーと循環動態の検討 (2015)
  • Author(s): 進藤亮太，岡田純一郎，田中祥一朗，久野 正，岩田欧介
  • Organizer: 第51回日本周産期・新生児医学会総会および学術集会
  • Place of Presentation: ヒルトン福岡シーホーク（福岡県・福岡市）
  • Year and Date: 2015-07-10
• [Presentation] Assessment of cerebral blood flow in infants using pulse Doppler flow of middle cerebral artery and superior vena cava. (2015)
  • Author(s): Hirose A, Iwata S, Shindou R, Saikusa M, Hara N, Kinoshita M, Tsuda K, Unno M, Kanda H, Maeno Y, Iwata O
  • Organizer: Pediatric Academic Societies
  • Place of Presentation: San Diego convention center (California, United states)
  • Year and Date: 2015-04-25
  • Int'l Joint Research
• [Presentation] Humidity of Respiratory Gasses during Therapeutic Hypothermia in the Newborn Infant. (2015)
  • Author(s): Shindo R, Tanaka S, Tsuda K, Kinoshita M, Hirose A, Saikusa M, Okada J, Hisano T, Kanda H, Maeno M, Iwata O
  • Organizer: Pediatric Academic Societies
  • Place of Presentation: San Diego convention center (California, United states)
  • Year and Date: 2015-04-25
  • Int'l Joint Research