1
|
Domi T, Robertson A, Lee W, Wintle RF, Stence N, Bernard T, Kirton A, Carlson H, Andrade A, Rafay MF, Bjornson B, Kim D, Dowling M, Bonnett W, Rivkin M, Krishnan P, Shroff M, Ertl-Wagner B, Strother S, Arnott S, Wintermark M, Kassner A, deVeber G, Dlamini N. The development of the pediatric stroke neuroimaging platform (PEDSNIP). Neuroimage Clin 2023; 39:103438. [PMID: 37354865 PMCID: PMC10331307 DOI: 10.1016/j.nicl.2023.103438] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2023] [Accepted: 05/15/2023] [Indexed: 06/26/2023]
Abstract
Childhood stroke occurs from birth to 18 years of age, ranks among the top ten childhood causes of death, and leaves lifelong neurological impairments. Arterial ischemic stroke in infancy and childhood occurs due to arterial occlusion in the brain, resulting in a focal lesion. Our understanding of mechanisms of injury and repair associated with focal injury in the developing brain remains rudimentary. Neuroimaging can reveal important insights into these mechanisms. In adult stroke population, multi-center neuroimaging studies are common and have accelerated the translation process leading to improvements in treatment and outcome. These studies are centered on the growing evidence that neuroimaging measures and other biomarkers (e.g., from blood and cerebrospinal fluid) can enhance our understanding of mechanisms of risk and injury and be used as complementary outcome markers. These factors have yet to be studied in pediatric stroke because most neuroimaging studies in this population have been conducted in single-centred, small cohorts. By pooling neuroimaging data across multiple sites, larger cohorts of patients can significantly boost study feasibility and power in elucidating mechanisms of brain injury, repair and outcomes. These aims are particularly relevant in pediatric stroke because of the decreased incidence rates and the lack of mechanism-targeted trials. Toward these aims, we developed the Pediatric Stroke Neuroimaging Platform (PEDSNIP) in 2015, funded by The Brain Canada Platform Support Grant, to focus on three identified neuroimaging priorities. These were: developing and harmonizing multisite clinical protocols, creating the infrastructure and methods to import, store and organize the large clinical neuroimaging dataset from multiple sites through the International Pediatric Stroke Study (IPSS), and enabling central searchability. To do this, developed a two-pronged approach that included building 1) A Clinical-MRI Data Repository (standard of care imaging) linked to clinical data and longitudinal outcomes and 2) A Research-MRI neuroimaging data set acquired through our extensive collaborative, multi-center, multidisciplinary network. This dataset was collected prospectively in eight North American centers to test the feasibility and implementation of harmonized advanced Research-MRI, with the addition of clinical information, genetic and proteomic studies, in a cohort of children presenting with acute ischemic stroke. Here we describe the process that enabled the development of PEDSNIP built to provide the infrastructure to support neuroimaging research priorities in pediatric stroke. Having built this Platform, we are now able to utilize the largest neuroimaging and clinical data pool on pediatric stroke data worldwide to conduct hypothesis-driven research. We are actively working on a bioinformatics approach to develop predictive models of risk, injury and repair and accelerate breakthrough discoveries leading to mechanism-targeted treatments that improve outcomes and minimize the burden following childhood stroke. This unique transformational resource for scientists and researchers has the potential to result in a paradigm shift in the management, outcomes and quality of life in children with stroke and their families, with far-reaching benefits for other brain conditions of people across the lifespan.
Collapse
Affiliation(s)
- Trish Domi
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Amanda Robertson
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Wayne Lee
- Research Operations, Research Institute, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Richard F Wintle
- The Centre for Applied Genomics, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nicholas Stence
- Pediatric Neuroradiology, Children's Hospital Colorado, Aurora, CO, United States; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Timothy Bernard
- Child Neurology and Hemophilia and Thrombosis Center, University of Colorado, Aurora, CO, United States; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Adam Kirton
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Helen Carlson
- Department of Pediatrics, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrea Andrade
- London Health Sciences Centre, London, United Kingdom; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Mubeen F Rafay
- Health Sciences Centre Winnipeg, Winnipeg, Manitoba, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Bruce Bjornson
- The University of British Columbia, Vancouver, British Columbia, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Danny Kim
- BC Children's Hospital Research Institute, Vancouver, British Columbia, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michael Dowling
- The University of Texas, Southwestern Austin, TX, United States; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Wilmot Bonnett
- The University of Texas, Southwestern Austin, TX, United States; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Michael Rivkin
- Department of Neurology, Boston, MA, United States; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Pradeep Krishnan
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Manohar Shroff
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Birgit Ertl-Wagner
- Department of Diagnostic Imaging, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Stephen Strother
- Department of Medical Biophysics Rotman Research Institute, Baycrest Hospital, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Steven Arnott
- Department of Medical Biophysics Rotman Research Institute, Baycrest Hospital, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Max Wintermark
- Department of Neuroradiology, MD Anderson, Houston, TX (M.W.), United States; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Andrea Kassner
- Translational Medicine, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Gabrielle deVeber
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nomazulu Dlamini
- Program in Neurosciences and Mental Health, The Hospital for Sick Children, Toronto, Ontario, Canada; Division of Neurology, The Hospital for Sick Children, Toronto, Ontario, Canada,.
| |
Collapse
|
5
|
Dlamini N, Wintermark M, Fullerton H, Strother S, Lee W, Bjornson B, Guilliams KP, Miller S, Kirton A, Filippi CG, Linds A, Askalan R, deVeber G. Harnessing Neuroimaging Capability in Pediatric Stroke: Proceedings of the Stroke Imaging Laboratory for Children Workshop. Pediatr Neurol 2017; 69:3-10. [PMID: 28259513 DOI: 10.1016/j.pediatrneurol.2017.01.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Revised: 01/05/2017] [Accepted: 01/06/2017] [Indexed: 12/22/2022]
Abstract
On June 5, 2015 the International Pediatric Stroke Study and the Stroke Imaging Laboratory for Children cohosted a unique workshop focused on developing neuroimaging research in pediatric stroke. Pediatric neurologists, neuroradiologists, interventional neuroradiologists, physicists, nurse practitioners, neuropsychologists, and imaging research scientists from around the world attended this one-day meeting. Our objectives were to (1) establish a group of experts to collaborate in advancing pediatric neuroimaging for stroke, (2) develop consensus clinical and research magnetic resonance imaging protocols for pediatric stroke patients, and (3) develop imaging-based research strategies in pediatric ischemic stroke. This article provides a summary of the meeting proceedings focusing on identified challenges and solutions and outcomes from the meeting. Further details on the workshop contents and outcomes are provided in three additional articles in the current issue of Pediatric Neurology.
Collapse
Affiliation(s)
- Nomazulu Dlamini
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada.
| | - Max Wintermark
- Division of Neuroradiology, Department of Radiology, Stanford University, Stanford, California
| | - Heather Fullerton
- Department of Neurology, University of California, San Francisco, San Francisco, California; Department of Pediatrics, University of California, San Francisco, San Francisco, California
| | - Stephen Strother
- Department of Medical Biophysics, Rotman Research Institute at Baycrest, University of Toronto, Toronto, Ontario, Canada
| | - Wayne Lee
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Bruce Bjornson
- Department of Pediatrics, University of British Columbia, Vancouver, British Columbia, Canada; Developmental Neurosciences and Child Health, Child and Family Research Institute, Vancouver, British Columbia, Canada
| | - Kristin P Guilliams
- Division of Pediatric Neurology, Department of Neurology, Washington University in St. Louis, St. Louis, Missouri; Division of Critical Care Medicine, Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri
| | - Steven Miller
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Adam Kirton
- Department of Pediatrics, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada; Department of Clinical Neurosciences, Alberta Children's Hospital Research Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Christopher G Filippi
- Department of Radiology, Northwell Health, Manhasset, New York; Department of Neurology, University of Vermont Medical Center, Burlington, Vermont
| | - Alexandra Linds
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Rand Askalan
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| | - Gabrielle deVeber
- Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
| |
Collapse
|