Global perinatal neuroscience
The burden of life-long disabilities arising from brain injury during newborn period is far higher in low- and middle-income countries than in high-income countries. The vast majority results from perinatal asphyxia or infection, and often a combination of these.
Whilst cooling therapy reduces death and disability after neonatal encephalopathy in high-income countries, the safety and efficacy of cooling therapy in low and middle-income countries in unknown. Over the past decade, our work has been focused on understanding brain injury after neonatal encephalopathy in low- and middle-income countries and evaluating the safety and efficacy of cooling therapy in these settings. We have set up a consortium of large perinatal centres in South Asia with facilities for 3 Tesla MR imaging and spectroscopy for conducting this work.
Hypothermia for Encephalopathy in Low and Middle Income Countries (HELIX) Trial (Funding: NIHR and Weston Garfield Foundation)
Although cooling is the standard of care for neonatal encephalopathy in high-income countries, the safety and efficacy of cooling in low- and middle-income countries (LMICs) - which shoulder 99% of the disease burden - is unclear. A total of 408 encephalopathic babies will be randomised to cooling or usual care, from three countries (India, Sri Lanka and Bangladesh). Outcome measures are based on 3 Tesla MRI and MR spectroscopy at 2 weeks after birth, and death/neurodisability at 18 months after birth. HELIX is the largest ever cooling trial in the world, and the only such trial to use MR spectroscopy biomarkers across multi-vendor platforms.
See the HELIX trial video on the last trial baby (No:408) (Recruited in Feb 2019)
Bayley assessment of the final (408) baby at Bangalore at the roof top in a remote village in Karnataka (Sept 2020)
HELIX trial results in Lancet Global Health
Report of the HELIX trial by Nature and expert views
Prevention of Epilepsy by reducing Neonatal Encephalopathy (PREVENT) study - funding: NIHR
Please see the PREVENT study website for more details
Summary of the PREVENT study (watch the video link below: Courtesy Sandhya Ramesh, PRINT, Bangalore)