Neonatal encephalopathy is a heterogeneous condition and is rarely the result of an isolated acute intrapartum event. Hence a ‘one-size-fits-all’ approach will not work, and babies require specific treatment targeted at the underlying mechanism of brain injury.

Fortunately, we now have more than a dozen highly effective therapies from preclinical studies. What we need is a way to identify the specific therapy that may be most beneficial for an individual baby. We are developing bedside tools and point of care tests for rapid disease stratification in neonatal encephalopathy based on the host transcriptomic profile so that in future, doctors can provide a more personalised approach to neuroprotection.


Ongoing multi-centre studies

In the GENIE study, we will examine a combination of genomic/epigenomic biomarkers in 300 babies with neonatal encephalopathy (and their parents), recruited from 20 perinatal centres across the UK, and examine their relationship with brain injury assessed from MRI and their neurodevelopmental outcomes at 2 years. If successful, such a robust point-of-care test will result in a paradigm shift in neuroprotection research for such babies, particularly in addressing the interaction of perinatal brain injury and infection.

Funding: Medical Research Council, UK
Sponsor: Imperial College London

Genomic Imaging in Neonatal Encephalopathy: Protocol
Genomic Imaging in Neonatal Encephalopathy: Parent Information Leaflet

Genomic Imaging in Neonatal Encephalopathy: Consent Form (Baby)

Genomic Imaging in Neonatal Encephalopathy: Consent Form (Parents)

Genomic Imaging in Neonatal Encephalopathy: HRA approval

Genomic Imaging in Neonatal Encephalopathy: REC approval

GENIE

Participating centres
NoCentrePrincipal Investigator
 1  Imperial NHS Trust  Dr Gaurav Atreja
 2  Medway NHS Trust  Dr Aung Soe
 3  Royal Victoria Infirmary, Newcastle  Dr Sundeep Harigopal
 4  Coventry University Hospital Dr Prakash Satodia 
 5  Liverpool Womens Hospital Dr Kiran Yajmanyum 
 6  Birmingham Children Hospital  Dr Manobi Boorah
 7  Bolton NHS Foundation Trust   Dr Archana Mishra
 8  City Hospitals Sunderland Foundation NHS Trust  Dr Ruppa Geethanath
 9  South Tees Hospitals NHS Trust  Dr Mithilesh Lal
 10  Oxford University Hospitals NHS Foundation Trust  Dr Eleri Adams
11 Heart of England NHS Foundation Trust Dr Jaideep Singh
12 North Tees Hospital Dr C HariKumar
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The HeartBeat study will examine if heart rate variability (assessed using 2-compartment complexity analysis and machine learning) can disease-stratify encephalopathic infants soon after birth, and whether it corresponds to brain injury assessed on MRI and adverse neurodevelopmental outcomes at 2 years of age. This is a large multi-centre study recruiting from 8 NHS hospitals.

Funding: National Institute for Health Research (NIHR), UK
Sponsor: Imperial College London

Heart Beat Variability in Neonatal Encephalopathy: Protocol

HeartBeat