Abstract
Infants and children in low- and middle-income countries (LMICs) are frequently exposed to a range of environmental risk factors which may negatively affect their neurocognitive development. The mechanisms by which factors such as undernutrition and poverty impact development and cognitive outcomes in early childhood are poorly understood. This lack of knowledge is due in part to a paucity of objective assessment tools which can be implemented across different cultural settings and in very young infants. Over the last decade, technological advances, particularly in neuroimaging, have opened new avenues for research into the developing human brain, allowing us to investigate novel biological associations. This paper presents functional near-infrared spectroscopy (fNIRS), electroencephalography (EEG) and eye tracking (ET) as objective, cross-cultural methods for studying infant neurocognitive development in LMICs, and specifically their implementation in rural Gambia, West Africa. These measures are currently included, as part of a broader battery of assessments, in the Brain Imaging for Global Health (BRIGHT) project, which is developing brain function for age curves in Gambian and UK infants from birth to 24 months of age. The BRIGHT project combines fNIRS, EEG and ET with behavioural, growth, health and sociodemographic measures. The implementation of these measures in rural Gambia are discussed, including methodological and technical challenges that needed to be addressed to ensure successful data acquisition. The aim is to provide guidance to other groups seeking to implement similar methods in their research in other LMICs to better understand associations between environmental risk and early neurocognitive development.
Highlights
Children growing up in low- and middle-income countries (LMICs) are at increased risk of compromised neurocognitive development due to exposure to a range of adverse environmental factors
Methods implemented in Brain Imaging for Global Health (BRIGHT) project: functional near-infrared spectroscopy (fNIRS), EEG and eye tracking (ET) Functional Near Infrared Spectroscopy In the BRIGHT project, fNIRS data is collected using the NTS optical imaging system
A subset of the fNIRS tasks included in this protocol has already been taken up and are currently being implemented in The BEAN Project in Dhaka, Bangladesh, in the study of infectious disease and nutrition in infants and children (Storrs, 2017) and in Uttar Pradesh, India, in the context of exposure of environmental risk factors
Summary
Children growing up in low- and middle-income countries (LMICs) are at increased risk of compromised neurocognitive development due to exposure to a range of adverse environmental factors. In addition to high rates of stunting in this region, the rate of young children who fail to achieve ageappropriate developmental levels of cognitive and social emotional functioning has been estimated to lie between 38–60% (McCoy et al, 2016). This indicates that currently there is a significant but largely unexplored co-occurrence between early-life adversity and cognitive functioning, affecting a vast number of children. Despite the scope of the problem, our understanding of how environmental risk factors affect early brain and cognitive development is poor and limits our ability to develop appropriate interventions to address these outcomes
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