Improving Care: Brain damage in Babies | Action Medical Research | Children's Charity

Brain damage in babies: could sophisticated computing allow earlier diagnosis and better care?

First published on 22 September 2010

Updated on 19 January 2016

What did the project achieve?

“Our work will make it easier to predict which babies are at highest risk of developing disabilities after being born prematurely, by enabling doctors to detect abnormalities in brain development,” says Professor Daniel Rueckert of Imperial College London.

The latest information suggests around 60,000 babies are born prematurely every year in the UK.1-5 Being born too soon puts babies at risk of developing lifelong disabilities, especially if they’re born very early. For example, babies can develop cerebral palsy, learning difficulties and hearing problems, which result from damage to the brain, but symptoms aren’t always obvious until later during childhood.

“We’ve developed computer-based tools that enable us to analyse MRI scans of premature babies’ brains in much more detail,” says Professor Rueckert. “We’ve created growth charts that show how babies’ brains develop during pregnancy, and after a premature birth, when visualised using MRI scans. We’ve also started using these tools and charts to develop ways of diagnosing possible future disabilities in babies who’ve been born early.”

“Difficulties predicting which babies will go on to develop disabilities have been a major issue for people who care for them,” says Professor Rueckert. “Better predictions will give us the chance to improve babies’ care sooner rather than later, which could greatly improve their lives.”

References

1. WHO Preterm birth. Fact sheet No 363. Updated November 2014. www.who.int/mediacentre/factsheets/fs363/en/ Website accessed 12 May 2015.

2. Office for National Statistics. Births in England and Wales, 2013. Table 1. http://www.ons.gov.uk/ons/rel/vsob1/birth-summary-tables--england-and-wales/2013/stb-births-in-england-and-wales-2013.html Website accessed 12 May 2015.

3. Births in Scottish Hospitals. Year ending 31st March 2013. Publication date – 26th August 2014. Table 1. http://www.isdscotland.org/Health-Topics/Maternity-and-Births/Publications/2014-08-26/2014-08-26-Births-Report.pdf Table 5 Website accessed 12 May 2015.

4. Northern Ireland Statistics and Research Agency. Births. Live births 1887-2014. http://www.nisra.gov.uk/demography/default.asp8.htm Website accessed 2 December 2015.

5. Office for National Statistics Gestation-specific Infant Mortality, 2012. Table 3 Live births, neonatal and infant mortality by birthweight and gestational age at birth, http://www.ons.gov.uk/ons/rel/child-health/gestation-specific-infant-mortality-in-england-and-wales/2012/stb-gestation-specific-infant-mortality--2012.html Website accessed 12 May 2015.

This research was completed on 30 September 2014

Around 50,000 babies are born prematurely each year in the UK, putting them at risk of developing brain damage.1,2,a,b This can cause serious, lifelong disabilities such as cerebral palsy, blindness and learning difficulties. However, brain damage often goes undiagnosed, sometimes for months or even years, until a child’s disability becomes apparent. Researchers are developing sophisticated new computer software, which analyses MRI scans of babies’ brains and helps diagnose abnormalities, so babies can get an earlier diagnosis and better care.

This award is part of a Healthcare Partnerships grant jointly funded by the Engineering and Physical Sciences Research Council (EPSRC) and Action Medical Research. The EPSRC has awarded £1,023,477 to the research team.

What's the problem and who does it affect?

Brain damage in babies can cause lifelong disability

Around 7% of births in the UK are premature.2,b Sadly, an early birth puts babies at risk of death and disability, often because of brain damage.

Damage to a tiny baby’s vulnerable brain can lead to lifelong difficulties such as cerebral palsy, blindness, hearing loss, speech problems, behavioural problems and learning disabilities.

The statistics make worrying reading: one in five babies born before 26 weeks of pregnancy – that’s about six months – develops severe disabilities and four in ten have learning difficulties at the age of six.3

It’s not easy to tell whether or not a baby has suffered brain damage, as their problems may not become apparent until months or even years later. MRI scans can sometimes help, particularly if brain damage is severe, but they are not normally available routinely – interpreting the scans is extremely time-consuming and complicated, and is dependent on the subjective assessment of trained experts.

Without accurate information from scans, parents can face an anxious wait to find out whether their baby is going to develop a disability, and babies can miss out on getting the right sort of help as early as possible.

What is the project trying to achieve?

Automated diagnosis and prediction

The researchers are developing computer software, which will automate the analysis of MRI information, helping interpret scans of babies’ brains, diagnose any brain damage and predict whether the babies are likely to develop disabilities as they grow and develop. MRI scanning is a well-established and safe technique that can provide detailed, three-dimensional pictures of inside the body.

The researchers’ ambitious plan of action involves several steps:

  1. developing computerised ‘growth charts’, which show how babies’ brains develop both during pregnancy and after a premature birth, using MRI images from 100 unborn babies in the womb and over 1000 premature babies
  2. identifying salient differences between normal, and abnormal, patterns of brain development as evident in MRI images; these differences, known as biomarkers, will be used to diagnose brain damage and predict whether babies will develop disabilities
  3. developing computer software, for use by doctors, which analyses MRI scans, helping diagnose brain damage and predict how babies will be affected
  4. assessing the software’s performance – in two clinical trials of possible new treatments for babies with brain damage, for example
  5. informing doctors, radiographers, nurses and parents about the research, and providing training in how to use the new technique.

What are the researchers' credentials?

Project LeaderProfessor D Rueckert PhD MSc
Project team
  • Professor A David Edwards FMED SCi
  • Professor Joseph Hajnal PhD
  • Professor Mary A Rutherford MD FRCPCH FRCR
  • Dr Paul Aljabar PhD MSc
LocationDepartment of Computing and Division of Clinical Sciences, Imperial College and Hammersmith Hospital, London
Other locations
  • Division of Clinical Sciences, Imperial College London and Hammersmith Hospital
  • Division of Imaging Sciences & Biomedical Engineering, King's College London
Duration4 years
Grant awarded22 June 2010
Start date1 October 2010
End date30 September 2014
Grant amount£50,000.00
Grant codeSP4578, GN1772

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Several world-leading researchers with complementary expertise – in computer science, taking MRI scans of babies’ brains and caring for newborns – are working together on this ambitious project.

The project leader, Professor Daniel Rueckert is a computer scientist with an established track record in developing computer programs that analyse and interpret MRI scans of the brain automatically. Dr Paul Aljabar also specialises in this area of research.

Professor Jo Hajnal is a physicist with extensive experience of researching new and better ways of acquiring MRI scans. He is particularly interested in obtaining high-quality images of newborn babies, and babies within the womb, who cannot be told to stay still during the scanning procedure.

Professor Mary Rutherford is a renowned expert, with over 20 years’ experience of using MRI scans to assess babies’ developing brains, both after birth and during pregnancy. Professor David Edwards is a neonatologist – a doctor who specialises in caring for newborn babies. He has led ground-breaking research into the causes of brain damage in babies and has a track record of innovation in developing new therapies.

The team has access to state-of-the-art facilities, including a dedicated MRI scanner within a neonatal intensive care unit.

Who stands to benefit from this research and how?

Helping babies combat brain damage

The researchers hope to improve the lives of premature babies and their families. They are developing a new, computer-aided way of interpreting MRI scans of babies’ brains. This could help doctors to tell whether or not a baby has suffered brain damage, what sort of damage it is, and whether the baby is likely to develop a disability as he, or she, grows and develops.

This information can be invaluable for parents, who generally want to know what sort of outlook their baby has for the future. It could also mean babies stand a better chance of getting earlier and more appropriate care, which could improve their quality of life. The new technique could also help researchers assess the pros and cons of possible new therapies.

Babies born at full term could benefit too, as the new technique could help all babies who are suspected of having a brain injury, whatever the cause. That includes babies with a serious condition called birth asphyxia, who can develop brain damage after being starved of oxygen at birth, and babies who suffer a brain injury during pregnancy, who account for a significant proportion of all children with cerebral palsy.4

References

  1.  Office for National Statistics. Health Statistics Quarterly 43 (Autumn 2009), Table 2.1 http://www.statistics.gov.uk/downloads/theme_health/HSQ43.pdf
  2. The Information Centre, Community Health Statistics. NHS Maternity Statistics, England: 2006-07, 2007-08, 2008-09 http://www.ic.nhs.uk/statistics-and-data-collections/hospital-care/mater...
  3. Marlow N, Wolke D, Bracewell MA, Samara M. Neurologic and developmental disability at six years of age after extremely preterm birth. N Engl J Med 2005; 352:9-19.
  4. Surman G., Newdick H. and Johnson A. Cerebral palsy rates among low-birthweight infants fell in the 1990s. Developmental Medicine & Child Neurology 2003; 45: 456-462.
    a. Calculation made by Action Medical Research based on figures in references 1 and 2 for the number of births a year in the UK and the number of preterm deliveries in England, respectively.
    b. Estimate assumes incidence of premature birth is the same for the UK overall as it is for England.
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