Tataranno Maria Luisa, Vijlbrief Daniel C, Dudink Jeroen, Benders Manon J N L
Department of Neonatology, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht University, Utrecht, Netherlands.
Front Pediatr. 2021 May 19;9:634092. doi: 10.3389/fped.2021.634092. eCollection 2021.
Despite advances in neonatal care to prevent neonatal brain injury and neurodevelopmental impairment, predicting long-term outcome in neonates at risk for brain injury remains difficult. Early prognosis is currently based on cranial ultrasound (CUS), MRI, EEG, NIRS, and/or general movements assessed at specific ages, and predicting outcome in an individual (precision medicine) is not yet possible. New algorithms based on large databases and machine learning applied to clinical, neuromonitoring, and neuroimaging data and genetic analysis and assays measuring multiple biomarkers (omics) can fulfill the needs of modern neonatology. A synergy of all these techniques and the use of automatic quantitative analysis might give clinicians the possibility to provide patient-targeted decision-making for individualized diagnosis, therapy, and outcome prediction. This review will first focus on common neonatal neurological diseases, associated risk factors, and most common treatments. After that, we will discuss how precision medicine and machine learning (ML) approaches could change the future of prediction and prognosis in this field.
尽管在预防新生儿脑损伤和神经发育障碍的新生儿护理方面取得了进展,但预测有脑损伤风险的新生儿的长期预后仍然困难。目前,早期预后基于特定年龄时评估的头颅超声(CUS)、MRI、脑电图、近红外光谱(NIRS)和/或全身运动,而预测个体的预后(精准医学)尚不可能。基于大型数据库和机器学习的新算法应用于临床、神经监测、神经影像数据以及基因分析和测量多种生物标志物(组学)的检测,能够满足现代新生儿学的需求。所有这些技术的协同作用以及自动定量分析的应用,可能使临床医生有机会为个体化诊断、治疗和预后预测提供以患者为目标的决策。本综述将首先关注常见的新生儿神经系统疾病、相关危险因素和最常见的治疗方法。之后,我们将讨论精准医学和机器学习(ML)方法如何改变该领域预测和预后的未来。