Cerebral palsy (CP) is the most common motor disability of childhood. The brain injury causing CP disrupts touch perception, a key component of motor function. In this brain image from a child with CP (click to enlarge), the blue lines show nerve fibers going to the sensory cortex. The colored cubes at the top represent the parts of the sensory cortex receiving touch signals from the thumb (red cube), middle finger (blue) and little finger (green). An injury in the right side of the brain (dark area) has reduced the number of nerve fibers on that side, reducing touch sensation in the left hand and resulting in weakness.
Imagine you’re a clinician or researcher and you want to find the source of a newborn’s seizures. Imagine being able to record, in real time, the neural activity in his brain and to overlay that information directly onto an MRI scan of his brain. When an abnormal electrical discharge triggered a seizure, you’d be able to see exactly where in the brain it originated.
For years, that kind of thinking has been the domain of dreams. Little is known about infant brains, largely because sophisticated neuroimaging technology simply hasn’t been designed with infants in mind. Boston Children’s Hospital’s Ellen Grant, MD, and Yoshio Okada, PhD, are debuting a new magnetoencephalography (MEG) system designed to turn those dreams into reality. …
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.
Surprisingly little is known about the brains of babies under age 2 — because of the challenges of safely imaging children so young. Head-circumference measures at the pediatrician’s office tell very little about what’s going on inside. But there’s much to know, because rapidly developing brains are vulnerable to injury.
Here, Ellen Grant, a neuroradiologist trained in theoretical physics, describes how advanced imaging techniques and computational science are providing a better understanding of the newborn and even fetal brain. With these tools, neurologists can watch the brain as it forms and folds, track the growth of individual brain structures, and detect problems in brain organization before anything can be noticed by parents or physicians — then correlate these measurements with child developmental measures.
Children’s Hospital Boston is building a neuroimaging facility with specially designed, baby-sized equipment — the only one in the world to be situated near a neonatal and pediatric intensive care unit. It will help answer questions like: What prenatal brain development is missed when a baby is born even two weeks shy of its due date? What does a brain structure growing out of synch at 6 months mean for language development in preschool? Are interventions for brain injury, such as hypothermia, effective? Grant’s ultimate goal is to get advanced neuroimaging into routine clinical care, to monitor infants and newborns with brain injury, predict their future course, and evaluate new treatments.