Chin Theresa I, An Winko W, Yibeltal Kalkidan, Workneh Firehiwot, Pihl Stephen, Jensen Sarah K G, Asmamaw Gellila, Fasil Nebiyou, Teklehaimanot Atsede, North Krysten, Troller-Renfree Sonya V, Nelson Charles A, Berhane Yemane, Lee Anne Cc
Division of Biology and Medicine, Warren Alpert Medical School of Brown University, Providence, RI, United States.
Harvard Medical School, Boston, MA, United States.
Front Hum Neurosci. 2025 Jun 10;19:1552410. doi: 10.3389/fnhum.2025.1552410. eCollection 2025.
Children living in low- and middle-income countries (LMIC) are at disproportionately higher risk of neurodevelopmental delays due to exposure to adverse biological and environmental hazards. In infancy, global developmental assessments, such as the Bayley Scales, are insensitive, do not strongly correlate with later cognitive outcomes, and require adaptation for different populations and cultural contexts. Electroencephalography (EEG) objectively measures electrical brain activity and may provide early neural markers predictive of long-term cognitive outcomes. The visual evoked potential (VEP) interrogates the efficiency of visual cortical processing and reflects neural processing speed. Mobile EEG enables the assessment of neural processing in settings where such technologies were historically inaccessible. This paper describes the experiences and lessons learned from implementing mobile EEG and VEP in rural Amhara, Ethiopia as part of the Longitudinal Infant Growth and Development (LIDG) study (NCT06296238). We describe adaptations and strategies to address and optimize data capture (e.g., dry electrode tips to improve scalp contact, tailored protocols, and adequate equipment specifications), environmental challenges (e.g., space constraints, lack of water supply, power outage) and cultural factors (e.g., hair type) unique to the study setting and population. Our formative research underscored the importance of creating awareness among community members (e.g., mothers, fathers, and religious leaders) and local clinicians to improve community engagement and buy-in. Culturally sensitive child behavior management techniques were also critical to ensure EEG completion and high data quality. With community sensitization, we had high consent rates for EEG/VEP (>90%). We completed EEG recordings within an average ± standard deviation of 20 ± 11 minutes. After data processing, approximately 90% and 70% of participants met predefined data quality thresholds for resting EEG and VEP, respectively. Implementing mobile EEG/VEP was feasible and acceptable in rural Ethiopia, with a relatively high proportion of recordings meeting quality standards.
生活在低收入和中等收入国家（LMIC）的儿童，由于暴露于不良生物和环境危害中，面临神经发育迟缓的风险高得不成比例。在婴儿期，全球发育评估，如贝利量表，并不敏感，与后期认知结果的相关性不强，并且需要针对不同人群和文化背景进行调整。脑电图（EEG）客观地测量大脑电活动，并可能提供预测长期认知结果的早期神经标志物。视觉诱发电位（VEP）检测视觉皮层处理的效率，并反映神经处理速度。移动脑电图能够在历史上无法使用此类技术的环境中评估神经处理情况。本文描述了在埃塞俄比亚阿姆哈拉农村地区实施移动脑电图和视觉诱发电位作为纵向婴儿生长与发育（LIDG）研究（NCT06296238）一部分的经验和教训。我们描述了为解决和优化数据采集（例如，使用干电极尖端改善头皮接触情况、定制方案和适当的设备规格）、环境挑战（例如，空间限制、缺水、停电）以及研究环境和人群特有的文化因素（例如，发型）而采取的调整措施和策略。我们的形成性研究强调了在社区成员（例如，母亲、父亲和宗教领袖）和当地临床医生中提高认识对于改善社区参与和支持的重要性。具有文化敏感性的儿童行为管理技术对于确保脑电图检查完成和高质量数据也至关重要。通过社区宣传，我们获得了很高的脑电图/视觉诱发电位同意率（>90%）。我们在平均20±11分钟（平均值±标准差）内完成了脑电图记录。经过数据处理后，分别约有90%和70%的参与者达到了静息脑电图和视觉诱发电位的预定义数据质量阈值。在埃塞俄比亚农村地区实施移动脑电图/视觉诱发电位是可行且可接受的，相当比例的记录符合质量标准。
