MICA BRAINTOOLS Phase 1: Optimising neurodevelopmental outcomes for global health

Lead Research Organisation: Birkbeck College

Abstract

The Centre for Brain & Cognitive Development (CBCD) at Birkbeck has a world leading reputation for the multidisciplinary study of psychological development and mental health in early childhood, including development and application of new methodologies for large-scale longitudinal studies and trials. Our strategic vision is to bring this expertise in theory, study
design, and technology development to bear on LMIC early mental health. Child psychiatry has traditionally focused on treating children and adolescents with a diagnosis. However, post-diagnostic treatments are typically expensive and inaccessible to most patients in LMICs (Belfer, 2008), who may also lack access to diagnostic services in general (Saxena et al., 2007). To meet the needs of LMICs, we need a radical shift in our approach. Rather than focus resources on children
with a diagnosis, we need to shift towards direct measurement of the brain systems that are affected by early risk factors in infancy, and then use this information to develop low-cost, scalable and preventative treatments targeted towards those
brain systems. To do this, we have planned an integrated long-term programme of research to identify the infant brain markers that predict neurodevelopmental outcomes in LMICs; to use these markers to test which common modifiable risk
factors in LMICs affect key brain systems; and to identify protective factors that could represent targets for intervention to build resilience in LMIC settings. Directly assessing the effects of environmental risk factors in early childhood (rather than waiting for later neurodevelopmental outcome) enables rapid assessment of the efficacy of simple preventative
interventions. Directly measuring brain development allows us to identify the most vulnerable children as early as possible, allowing limited resources to be focused on those most likely to benefit from preventative approaches. Taken together,
focusing on brain development in early childhood is critical to revolutionising global mental health.
We are optimally suited to leading this challenge because of our combined expertise in developing infant neural markers of long-term mental health and our experience in deploying novel technologies to measure early childhood brain development in low-resource settings. While our long-term vision entails widespread dissemination of expertise, a key first step is close
engagement with selected LMIC sites for bi-directional knowledge exchange and feasibility assessments. Thus, we have carefully selected two LMIC partners who face contrasting challenges; MRC Gambia and Sangath India. Building on initial contacts, we will establish and consolidate a collaborative network with four short-term objectives (pump-priming projects);
(1) collaboratively develop a feasible protocol for assessing human functional brain development in LMIC settings, (2) prepare a Masters course in Developmental Neuroscience for Global Health, (3) develop a plan for parent education and family engagement in LMIC settings with partner SME BabyBrains, and (4) conduct a gap analysis of how to establish regional Centres of Excellence affiliated to CBCD. Taken together, our cohesive package is designed to provide the
foundation for our long-term strategy to bring early childhood brain development into global mental health.

Technical Summary

Our cohesive package of work involves four related pump-priming projects (PPP).
PPP-A: We will develop and field-test a toolkit for measuring early childhood brain markers associated with mental health outcomes, using combined EEG and eyetracking to enable a fully automated analysis pipeline suitable for large-scale deployment. The task battery will assess social brain development (e.g. videos of social dynamic scenes; face attention; dynamic gaze) and attentional control (e.g. gap-overlap attention-shifting; frontal EEG power and connectivity); tools are
designed to be applicable to other domains as novel findings emerge. After development, we will assess test-retest reliability and feasibility in two contrasting rural LMIC settings.
PPP-B: To boost human capital, we will develop a new Masters program in "Developmental Neuroscience for Global Health" and submit it for accreditation. This will foster expertise, collaboration, and training between the UK and LMICs.
PPP-C: Our tools are targeted at early childhood, and critically require engagement with families. To facilitate this, we will collaborate with a Birkbeck spin-off company, BabyBrains Ltd, that provides empowering parental education (www.babybrains.com).
The CEO of BabyBrains will visit the LMIC sites to consult on how their program can be best adapted, and
produce draft training materials for future work.
PPP-D: LMIC-based research requires local Centres of Excellence (CoE) that have the infrastructure, expertise and tools required to conduct large-scale studies of early development. A roadmap for creating two CoEs will be developed; West Africa (MRC-G) and India (Sangath). These CoEs will provide training for both local and UK-based researchers in applied global health research; and through a hub and spoke model enable our scientific advances at CBCD to be rapidly rolled out
to the broader global community.

Publications

10 25 50
 
Description Scalable TRansdiagnostic Early Assessment of Mental Health (STREAM)
Amount £3,743,775 (GBP)
Funding ID MR/S036423/1 
Organisation Medical Research Council (MRC) 
Sector Public
Country United Kingdom
Start 08/2019 
End 07/2024
 
Description Babylab Newsletter 
Form Of Engagement Activity A magazine, newsletter or online publication
Part Of Official Scheme? No
Geographic Reach Regional
Primary Audience Study participants or study members
Results and Impact Annual Babylab newsletter sent out to all participants on database who participate in research and to all new recruits (>4000 per year). Also sent to interested parties such as funders, clinicians, parent groups etc.

This helps with recruitment of new participants, and disseminates results of studies in which families have participated.
Year(s) Of Engagement Activity 2007,2008,2009,2010,2011,2012,2013,2014,2015,2016,2018,2019
URL http://www.cbcd.bbk.ac.uk/babylab/newsletter
 
Description Early Autism talk at Google 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Industry/Business
Results and Impact Jones, E.J.H. (May, 2018). Early Autism. Google, London, UK
Year(s) Of Engagement Activity 2018
 
Description Pregnancy and the Brain talk at Google 
Form Of Engagement Activity A talk or presentation
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Industry/Business
Results and Impact Jones, E.J.H. (Feb, 2018). Pregnancy and the Brain. Google, London, UK.
Year(s) Of Engagement Activity 2018
 
Description The Birkbeck One World Festival 2018 
Form Of Engagement Activity Participation in an activity, workshop or similar
Part Of Official Scheme? No
Geographic Reach Local
Primary Audience Postgraduate students
Results and Impact Project presentation during Birkbeck One World Festival
Year(s) Of Engagement Activity 2018