Babies who have suffered a brain injury are at high risk of life-long difficulties.
Kimberley Whitehead and colleagues want to advance understanding of the newborn brain’s natural repair mechanisms so that they can try to boost these and reduce the risk of disability.
Following rigorous assessment as part of our competitive grant round, this project was recommended for funding because it addresses an important question in one of our priority research areas and has high potential for impact, with scope to reduce disability in brain-injured babies via a gentle, low cost intervention.
The consequences of brain injuries for newborn babies can be devastating. They occur as a result of the brain being starved of blood, and therefore oxygen and glucose, leading to the death of brain cells.
Such injuries occur in 2 to 3 births per 1,000 full- or near-term births, and around 60 per 1,000 very pre-term births (before 32 weeks).
These injuries are associated with severe disability and the risk increases with the extent of injury.
A brainwave is an electrical impulse in the brain – the transmission of a signal from one cell to the next. The size of brainwaves is an indication of how much the cells are communicating.
Straight after a brain injury, brainwaves become much flatter than usual. However, over the next several weeks, they subsequently become much bigger than usual. It is thought that these extra-large brainwaves are compensating for the reduced brainwaves straight after the injury and may be a natural repair mechanism. There is support for this from animal studies where it has been shown that bringing back brainwaves sets the brain working properly again.
In this project, Kimberley and colleagues first want to confirm whether the extra-large brainwaves are definitely a helpful thing for the injured brain. They will monitor the brainwaves of brain-injured babies, a process that involves placing electrodes on the scalp. This is safe, painless and non-invasive and many of the babies will already be having this done as part of routine monitoring. These babies will then be followed up to see if they are developing normally.
The team will then explore how they might help the babies to have even bigger brainwaves. In healthy infants they know that gentle touch and more time spent asleep both make brainwaves bigger. They will determine whether this is also true for infants with injury. If it is, they can tailor features of the babies’ environments to promote this – for example making simple modifications to how they are positioned in the incubator to maximise touch, and using methods to help soothe them to sleep.
The team is in a uniquely strong position to conduct this research.
Kimberley Whitehead has 13 years’ experience in EEG (measurement of brainwaves), including analysis of abnormal EEG activity secondary to brain injury, in both adults and children, and correlating the data with outcome measures.
She has the backing of an outstanding project team including Dr Lorenzo Fabrizi, who leads the research group at UCL focused on the use of non-invasive brain monitoring techniques such as EEG to understand brain development, and Dr Judith Meek and Professor Nikki Robertson, Consultant Neonatologists at UCLH, who will ensure a clear pathway to clinical translation.
Through this project, the team hopes to develop a new method to help babies recover from brain injury via a gentle, low-cost intervention, and without any drugs.
By the end of the three-year project, the team will know whether boosting brainwaves could help infants who have suffered a brain injury and, if this is the case, can quickly proceed to trial this.
Neonatal brain injury occurring in both preterm and term newborns is a common and devastating condition that leads to death or lifelong disability at significant cost to families and society. Understanding fundamental mechanisms of injury that impact normal developmental plasticity is critical to developing novel interventions to enhance recovery after neonatal brain injury.
- External reviewer
Acquired brain and spinal cord injury (including stroke) is one of our current research priorities, reflecting the large unmet need in this area. Our aim is to fund research to advance understanding of how to promote repair of the brain and spinal cord following injury.
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Find out about our other research in this area: