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Predicting the Outcome of ADHD in White Matter Injure Neonates With Multi-modality MRI

Multi-center Longitudinal Clinical Study on the Evolution of Neonatal White Matter Injure to ADHD Based on Multi-modality MRI

The goal of this bidirectional observational cohort study is to investigate the longitudinal relationship between neonatal white matter injury (WMI) and the subsequent development of attention-deficit/hyperactivity disorder (ADHD), and to identify early MRI-based markers associated with ADHD-related outcomes. The study includes both retrospective and prospective cohorts to dynamically evaluate the evolution of brain injury, brain development, and behavioral outcomes from infancy to childhood.

The main questions it aims to answer are:

Are neonatal WMI characteristics associated with the subsequent development of ADHD? Which MRI-derived features, including semi-quantitative WMI assessment, microstructural alterations, and structural disconnection patterns, are associated with ADHD-related outcomes?

Participants with neonatal WMI will undergo longitudinal clinical, neurodevelopmental, and behavioral follow-up. Researchers will analyze clinical information and MRI findings to characterize WMI evolution and identify imaging markers associated with ADHD risk. Participants will:

undergo brain MRI examinations according to clinical protocols; receive standardized neurodevelopmental and behavioral assessments during follow-up; have MRI-derived measures, including semi-quantitative WMI scores, white matter microstructural features, and structural disconnection measures, analyzed to investigate their associations with ADHD-related outcomes.

Studieöversikt

Detaljerad beskrivning

White matter injury (WMI) is a common form of neonatal brain injury and may be associated with altered brain development and later neurodevelopmental disorders. Previous studies have suggested that abnormalities in brain microstructure and connectivity after neonatal WMI may overlap with neural circuits involved in attention and executive function. However, the longitudinal evolution of neonatal WMI and its relationship with the development of attention-deficit/hyperactivity disorder (ADHD) remain incompletely understood.

This bidirectional observational cohort study will investigate the association between neonatal WMI characteristics and later ADHD-related outcomes through longitudinal clinical and neuroimaging follow-up. The study includes retrospective and prospective cohorts to characterize brain developmental trajectories after neonatal WMI.

Multimodal MRI analyses were performed to quantify WMI-related brain alterations, including conventional MRI-based semi-quantitative assessment, white matter microstructural measurements, and structural disconnection analysis. These MRI-derived features were evaluated in relation to subsequent neurodevelopmental and behavioral outcomes to identify early imaging markers associated with ADHD risk.

Studietyp

Observationell

Inskrivning (Faktisk)

348

Kontakter och platser

Det här avsnittet innehåller kontaktuppgifter för dem som genomför studien och information om var denna studie genomförs.

Studieorter

      • Hangzhou, Kina
        • Affiliated Hangzhou First People's Hospital, School of Medicine, Westlake University
      • Lanzhou, Kina
        • Gansu Province Maternity and Child Health Hospital
      • Qinghai, Kina
        • Qinghai Red Cross Hospital
      • Shijiazhuang, Kina
        • Hebei Children's Hospital
      • Suzhou, Kina
        • Children's Hospital of Soochow University
      • Wuxi, Kina
        • Wuxi Children's Hospital
      • Xi'an, Kina
        • Northwest Women's and Children's Hospital
      • Xianyang, Kina
        • The Second Affiliated Hospital of Shaanxi University of Chinese Medicine
    • Shaanxi
      • Xi'an, Shaanxi, Kina
        • First Affiliated Hospital of Xi'an Jiaotong University

Deltagandekriterier

Forskare letar efter personer som passar en viss beskrivning, så kallade behörighetskriterier. Några exempel på dessa kriterier är en persons allmänna hälsotillstånd eller tidigare behandlingar.

Urvalskriterier

Åldrar som är berättigade till studier

1 dag och äldre (Barn, Vuxen, Äldre vuxen)

Tar emot friska volontärer

Nej

Kön som är behöriga för studier

Allt

Testmetod

Icke-sannolikhetsprov

Studera befolkning

The study population is derived from a multicenter neonatal and infant clinical and multimodal MRI database established through a national research project. The database includes clinical information and multimodal MRI data collected from multiple clinical centers. This bidirectional observational cohort study includes neonates with white matter injury (WMI) identified on brain MRI and control neonates without apparent abnormalities on routine MRI. Eligible participants will be screened from the existing database, and clinical characteristics, MRI findings, and longitudinal neurobehavioral outcomes will be analyzed to investigate the association between neonatal brain injury patterns and later developmental outcomes.

Beskrivning

Inclusion Criteria:

  • Neonates diagnosed with white matter injury (WMI) or neonates without obvious abnormalities on routine MRI examination from the multicenter database.
  • Brain MRI examination performed within 28 days after birth, with gestational age ≤42 weeks at examination.
  • Complete MRI data available, including T1-weighted imaging (T1WI), T2-weighted imaging (T2WI), and diffusion tensor imaging (DTI).
  • Complete maternal and pregnancy history information, neonatal demographic characteristics, and clinical information available.

Exclusion Criteria:

  • Congenital nervous system developmental malformations or suspected genetic or metabolic diseases.
  • Obvious MRI artifacts affecting image evaluation.
  • Inability to complete follow-up neurobehavioral assessments.

Studieplan

Det här avsnittet ger detaljer om studieplanen, inklusive hur studien är utformad och vad studien mäter.

Hur är studien utformad?

Designdetaljer

  • Observationsmodeller: COHORT
  • Tidsperspektiv: OTHER

Kohorter och interventioner

Grupp / Kohort
White matter injure group

Neonates presented with punctate, linear, or clustered white matter lesions at the center of the semiovale and lateral ventricles, with TIWI hyper-intensive s and with or without T2WI hypointensity.

Control group

No abnormal signals are found on both conventional and diffusion images. SWI and ASL are also considered when necessary.

Vad mäter studien?

Primära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Attention-Deficit/Hyperactivity Disorder (ADHD) Diagnosis
Tidsram: At 3-5 years of age

ADHD diagnosis will be determined according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) criteria, combined with standardized behavioral assessment using the Swanson, Nolan, and Pelham (SNAP) questionnaire. The number of participants meeting the diagnostic criteria for ADHD at follow-up will be recorded.

At 3-5 years of age

Sekundära resultatmått

Resultatmått
Åtgärdsbeskrivning
Tidsram
Cognitive Developmental Outcome
Tidsram: During infancy follow-up assessments (6 months to 5 years of age)

Cognitive development will be assessed using standardized developmental assessment tools, including the Bayley Scales of Infant Development, Second Edition (BSID-II), Gesell Developmental Schedules, and the Developmental scale for children aged 0~6 years, according to participant age and assessment availability. Cognitive developmental scores will be recorded, and cognitive impairment will be defined according to predefined criteria. The associations between early MRI findings, including semi-quantitative WMI assessment, white matter microstructural features, and structural disconnection measures, and cognitive developmental outcomes will be evaluated.

During infancy follow-up assessments (6 months to 5 years of age)
Motor Developmental Outcome
Tidsram: During infancy follow-up assessments (6 months to 5 years of age)

Motor development will be assessed using standardized developmental assessment tools, including the Bayley Scales of Infant Development, Second Edition (BSID-II), Gesell Developmental Schedules, and the Developmental scale for children aged 0~6 years, according to participant age and assessment availability. Motor developmental scores will be recorded, and motor impairment will be defined according to predefined criteria. The associations between early MRI findings, including semi-quantitative WMI assessment, white matter microstructural features, and structural disconnection measures, and motor developmental outcomes will be evaluated.

During infancy follow-up assessments (6 months to 5 years of age)

Samarbetspartners och utredare

Det är här du hittar personer och organisationer som är involverade i denna studie.

Utredare

  • Studiestol: Jian Yang, Ph.D.,M.D., First Affiliated Hospital Xi'an Jiaotong University

Studieavstämningsdatum

Dessa datum spårar framstegen för inlämningar av studieposter och sammanfattande resultat till ClinicalTrials.gov. Studieposter och rapporterade resultat granskas av National Library of Medicine (NLM) för att säkerställa att de uppfyller specifika kvalitetskontrollstandarder innan de publiceras på den offentliga webbplatsen.

Studera stora datum

Studiestart (Faktisk)

29 januari 2023

Primärt slutförande (Faktisk)

23 augusti 2024

Avslutad studie (Faktisk)

30 maj 2025

Studieregistreringsdatum

Först inskickad

28 december 2022

Först inskickad som uppfyllde QC-kriterierna

19 september 2026

Första postat (Faktisk)

23 september 2026

Uppdateringar av studier

Senaste uppdatering publicerad (Faktisk)

23 september 2026

Senaste inskickade uppdateringen som uppfyllde QC-kriterierna

19 september 2026

Senast verifierad

1 december 2022

Mer information

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