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Autism and ADHD: using state-of-the-art brain scanning techniques to spot problems early

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What did the project achieve?

“Our work has advanced the use of state-of-the-art scanning techniques to study what’s going on inside the developing brain during the first few weeks after birth,” says Dr Tomoki Arichi at King’s College London. “For the first time in the UK, we have demonstrated the huge potential of the most cutting-edge technology to reveal insights into how neurodevelopmental conditions develop, which could help diagnose these conditions earlier so children can get the right support sooner.”

Autism spectrum conditions (ASC) and attention deficit hyperactivity disorder (ADHD) are common neurodevelopmental conditions, with ASCs affecting more than one in 100 children in the UK and ADHD up to five in every 100.[1][2] Understanding what causes these conditions and leads to their challenges is crucial, as children can experience lifelong difficulties.

Dr Arichi and his team have used specialised MRI scans to measure key chemicals in newborn babies’ brains – to understand their role in shaping early neurodevelopment and look for changes in children who go on to develop problems.

The researchers developed and used a technique called magnetic resonance spectroscopy (MRS) to measure the levels of these chemicals in the brains of 56 healthy newborn babies born at full term. They then compared these levels to those found in the brains of preterm babies born before 37 weeks of pregnancy.*

“We found the levels of these chemicals were lower in preterm babies, which could help to explain why these children tend to experience more difficulties with their learning and have an increased incidence of neurodevelopmental conditions compared to those born at full term,” says Dr Arichi.

The method has also now been taken up by a major project in the USA, where they will be scanning thousands of babies to understand how their brain chemical levels are altered by poverty and substance abuse.

The team also scanned 12 babies using an ultra high-field strength 7T MRI scanner, which is the first time this has been done in the UK. The resulting images show the brain in much more detail and can provide extra information and more accurate measurements of brain chemical levels than those acquired with a standard MRI machine. These scans are providing new diagnostic information that is already helping to guide the care of these babies.

“We are incredibly excited about acquiring these first images from babies on the 7T MRI scanner” says Dr Arichi. “Moving forwards, acquiring images from babies at 7T, which is a very safe procedure, will present enormous opportunities for improving our ability to understand how the brain develops during the first crucial weeks after birth and how this is altered in disease. These scans have enormous potential to really advance clinical diagnosis and research into early brain development.”

*Due to restrictions put in place during the COVID-19 pandemic, the researchers had to amend their original plan to scan babies at higher risk of developing a neurodevelopmental condition due to their family history.

This research was completed on

Autism spectrum condition (ASC) and attention deficit hyperactivity disorder (ADHD) are neurodevelopmental disorders. Both are common conditions, with ASC affecting around one in 100 UK children – and ADHD up to five in every 100.1,2 With no cures, children can experience lifelong difficulties. Dr Tom Arichi at King’s College London is using specialised scans to measure key chemicals in newborn babies’ brains – to understand their role in shaping early neurodevelopment and look for changes in children who develop problems. He hopes this could lead to ways for doctors to identify which children will develop these conditions earlier so that they can get the help they need sooner.

How are children’s lives affected now?

A child with ASC may have difficulties in communicating with and relating to other people. They often see, hear and feel the world differently from others. Children with ADHD tend to have a short attention span, find it hard to concentrate and are often restless and impulsive.

“Neurodevelopmental conditions like ASC or ADHD will have a long-term, wide-ranging impact on the lives of children and their families,” says Dr Arichi.

Although ASC and ADHD are distinct, they show considerable overlap and many children have symptoms of both conditions – and so they may have shared roots in early brain development. Identifying which children are vulnerable to developing difficulties as early as possible is crucial so that they can get the correct care and support.

“Developing tests that can help doctors to identify children with neurodevelopmental difficulties at an earlier age will enable families to get help sooner and may even help us develop new treatments,” says Dr Arichi.

How could this research help?

“Our aim is to improve our understanding of early brain development – and to identify changes in newborn babies’ brains that can help doctors spot problems sooner,” says Dr Arichi.

The researchers are exploring the role of two brain chemicals – glutamate and GABA – in shaping the developing brain.

“We think that imbalances could play a role in the differences in brain processing which underlie the issues experienced by children with ASC or ADHD,” explains Dr Arichi.

The researchers will use a cutting-edge, non-invasive scanning technique called magnetic resonance spectroscopy to precisely measure the levels of these chemicals inside the brains of newborn babies – around half who are at a higher risk of developing a neurodevelopmental condition due to their family history.

 “If we can spot changes to these brain chemicals in babies’ who later develop difficulties, this could lead to new tests that can identify them as early as possible – and also lay the foundations for identifying and testing new life-changing treatments in the future,” says Dr Arichi.

References

  1. National Institute for Health and Care Excellence, Clinical Knowledge Summaries: Autism in Children https://cks.nice.org.uk/autism-in-children#!backgroundsub:2 [website accessed 26 August 2018]
  2. Sayal, K., et al, ADHD in children and young people: prevalence, care pathways, and service provision. Lancet Psychiatry. 2018; 5(2): 175-186.

 

 

 

 

Project Leader Dr Tom Arichi, MBChB MRCPCH PhD
Project Team Dr Enrico De Vita, PhDDr Grainne McAlonan, MBBS PhD
Project Location Department of Perinatal Imaging and Health, Centre for the Developing Brain, King’s College London, St Thomas’ Hospital, London
Project Location Other Department of Biomedical Engineering and Imaging Sciences, King’s College LondonDepartment of Forensic and Neurodevelopmental Sciences, Institute of Psychiatry, King’s College London
Project duration 3 years
Date awarded 30 July 2018
Project start date 1 October 2018
Project end date 6 December 2022
Grant amount £199,968
Grant code GN2728

 

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