Stories about: brain injury

Pediatric innovators showcase highlights inventions

Innovators Showcase Boston Children's HospitalSome great inventions were on view this week at the second annual Boston Children’s Hospital Innovators Showcase. Hosted by the hospital’s Innovation Acceleration Program and Technology & Innovation Development Office, the event featured everything from virtual reality goggles with gesture control to biomedical technologies. Below are a few new projects that caught Vector’s eye (expect to hear more about them in the coming months), a kid-friendly interview about the SimLab and list of inventions kids themselves would like to see. (Photos by Katherine Cohen except as noted)

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Mice don’t malinger: The effects of multiple concussions on the brain

On June 6, 2011, the Boston Bruins were playing the Vancouver Canucks in game 3 of the Stanley Cup finals. Bruins forward Nathan Horton had passed the puck to his teammate Milan Lucic when he was blindsided by the Canucks’s Aaron Rome, who buried his left shoulder into Horton’s face. Horton’s head was spun backwards, down towards the ice. The back of his head was the first part of his body to make contact with the ice. He was knocked unconscious. His arms became rigid. His eyes rolled back in his head. He had a convulsion.

Nathan Horton was concussed.

Concussion is all too common in sports, particularly those, like ice hockey, that involve body-to-body collisions. Yet it’s still somewhat of a medical mystery. Until the last 10 to 15 years, few physicians or scientists considered concussion significant enough to warrant scientific investigation. Thus, we know very little about it.

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A rising tide of neurologic impairment: Where’s the medical home for these children?

Many doctors feel unprepared to care for children with neurologic impairment. (Photo: Lindsey Hoshaw)

Jay Berry, MD, MPH, shown here with patient Kyler Quelch, is a pediatrician and hospitalist in the Complex Care Service at Children’s Hospital Boston. He leads the multi-institutional Complex Care Quality Improvement Research Collaborative.

As a general pediatrician, albeit one with experience in complex care, I find it extremely challenging to take care of children with neurologic impairment. A child’s nervous system can be “broken” for many reasons: a congenital brain or spinal cord malformation, severe head or neck trauma, a genetic condition or, like an increasing number of children, being born prematurely.

Most of the time, we can’t “fix” a broken nervous system. We can only try to support the body functions that are impaired as a result. Functions we take for granted: breathing, eating and digesting, moving, talking. We don’t have a lot of scientific evidence to guide us when doing this,

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Serendipity in science: Collaborating to build robotic clothing for brain-damaged children

A sequence of motion frames of a normally kicking baby's legs (shown in blue and green), illustrating changing joint angles at the hip and knee.

Countless scientific epiphanies never leave the bench – unless there’s the kind of serendipitous encounter that set Children’s Hospital Boston psychologist Gene Goldfield on a path he never expected to follow.

One in eight babies are born prematurely, putting them at greater risk for cerebral palsy, an inability to fully control their muscles. Goldfield saw these children being wheeled around the hospital, and was convinced that they did not have to be wheelchair-bound.

During early infancy, he knew, the developing brain naturally undergoes a rewiring of its circuits, including those that control the muscles. Could some type of early intervention encourage more typical motor development by replacing damaged circuits with more functional connections?

At Children’s Innovators’ Forum last week, Goldfield discussed his envisioned solution: the use of programmable robots

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Brains, babies and battlefields: Taking pediatric neurocritical care to the bedside

Evacuation of a soldier injured by a roadside bomb, June 17, 2011, Kandahar province of Afghanistan (DVIDSHUB/Flickr)

From the time he was 11, Robert Tasker knew he wanted to be a doctor. The son of a serviceman, he was drawn to battlefield surgery, evacuations and managing traumatic injuries. Instead, he ended up on a different kind of battlefield, where what’s at stake are the highly vulnerable, still developing brains of infants and children – and where it’s critical to be mobile and show up on time.

Tasker directs the Pediatric NeuroCritical Care program at Children’s Hospital Boston, the first of its kind in the world. His goal is to protect brain function not only in children suffering direct head injury, but children undergoing major surgery, children with stroke, children hospitalized for critical illness, children on ventilators, children with nervous-system infections like meningitis and more.

Born in Hong Kong and raised throughout the globe,

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Early brain checkups for dyslexia, autism and more

Researchers are seeking to track the brain at earlier and earlier ages (here, the brain of a newborn baby born 10 weeks prematurely). © FNNDSC 2011

For the third year running, my daughter is participating in a dyslexia study she entered at age 5, just after finishing preschool. Thinking she was part of a game, she spent about 45 minutes lying still in a rocket ship (in reality, an MRI scanner), doing mental tasks she believed would help lost aliens find their way back to their planet.

All the while, her brain was being imaged, helping a team led by Nadine Gaab of Children’s Laboratories of Cognitive Neuroscience to find a pattern indicating that she might be at risk for dyslexia. Such signatures might flag children who could benefit from early intervention, sparing them the frustration of struggling with dyslexia once in school.

Getting brain MRIs from young childrenwithout resorting to sedation — is a difficult feat (Gaab and colleagues shared their protocol in the Journal of Visualized Experiments). But as reported in today’s Boston Globe, Gaab and Children’s neuroradiologist Ellen Grant are pushing the envelope even further, trying to find MRI signatures of dyslexia in infants.

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Treating traumatic brain injury with a nasal spray?

Could an extract from this Chinese club moss have a neuroprotective effect?

Severe traumatic brain injury — such as that associated with military head wounds — is basically untreatable. In addition to cognitive and motor impairments, it leads to epilepsy about 20 to 50 percent of the time; anticonvulsants given after trauma have been tried as a preventative but have not worked. “After head trauma, physicians often watch symptoms evolve, and there’s nothing we can do to prevent them,” says Alexander Rotenberg, a neurologist and neurobiology investigator at Children’s Hospital Boston.

The brain damage begins within seconds of the actual trauma, but a punishing series of biochemical events in the brain unfold over the subsequent days and weeks, making matters worse

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TEDMED here we come

Move over, Ozzy Ozbourne. Next Wednesday, October 27th, Children’s neurologist-neuroscientist and TEDMED speaker Frances Jensen will compare and contrast the developing infant brain with the highly paradoxical teen brain – which is also developing rapidly, all the way to age 25 or so. Infant and teen brains are at opposite ends of the developmental spectrum — almost different species, Jensen says – but they’re both extremely dynamic and exquisitely sensitive to environmental factors (drugs and alcohol in teens and brain injury and seizures in infants).

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Could clothing teach babies with brain injury how to move?

 

 

The seemingly random flailing of a newborn’s arms and legs is more important than it looks – it’s how babies begin to explore the physical world and their place in it. This motion-capture movie shows the normal kicking of a 5-month-old, but when a baby’s muscles are weakened by brain injury, this exploration is curtailed. It becomes a vicious cycle: the motor parts of the brain can’t develop properly, impairing mobility even further. Psychologist Eugene Goldfield, PhD, of the Center for Behavioral Science at Children’s Hospital Boston, with a team of engineers and scientists at the Wyss Institute, is in the early stages of a project that could help break this cycle for babies with cerebral palsy.

Goldfield calls it the “second skin” – smart clothing whose fabric, studded with tiny sensors, would pick up attempts at motion.

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Networking: the mother of invention

Infant kicking data being captured for the "second skin"

Two or three years ago, seeing all the children in wheelchairs coming to Children’s Hospital, I asked myself whether I might be able to contribute something tangible to help restore their mobility. A psychologist by training, I had published some academic articles on how young children become independently mobile. But I’ve also always liked to build things.

It became clear that anything I wanted to build would require skills I didn’t have. I envisioned a form-fitting, electronic garment that a child with a brain injury could wear to assist his or her biological muscles, teaching the brain how the body should move. How on earth could I get the money to build such a garment, and who could help me?

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