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What did the project achieve?
“We have shown that advanced MRI scans can provide valuable, extra information on what sort of damage a head injury has caused to a child’s brain – and the possible consequences of that damage,” says Professor David Sharp of Imperial College London. “This study could ultimately lead to the widespread adoption of these scans in the clinic, benefiting children with brain injuries across the UK and beyond.”
Around 35,000 children in the UK are admitted to hospital each year because of a traumatic brain injury (TBI).1,2 Thankfully, most are not serious – but sadly, some children will lose their lives or will be left with life-changing disabilities. They may experience problems with their thinking abilities – which, if unrecognised, can limit a child’s access to the right healthcare and educational support.
This research involved using two types of advanced brain scans to map out the pattern of brain damage in 42 children (aged 10 to 16 years old) with moderate to severe TBI and comparing the results with scans from 20 unaffected children. The children also underwent detailed tests to assess their concentration, memory and learning abilities.
“We found that two types of brain damage were very common in children with TBI and were associated with marked problems, especially affecting their ability to think quickly and remember things,” says Professor Sharp. “These types of damage, which are common after TBI but are often missed on conventional scans, are very likely to disrupt normal brain development.”
The impact of this work could be rapid, as most modern MRI scanners – which are widely available in hospitals across the UK – can perform these scans.
“We believe that improved diagnosis of the pattern of damage to a child’s brain is key to understanding the cause of their problems,” says Professor Sharp. “This will also allow doctors to rapidly identify children who need help, direct them to the appropriate treatment options and guide the development of new treatments.”
Action is now funding a follow-on study to this project looking at reducing the risk of long-term impact of TBI on children’s lives.
References
- Trefan L, et al. Epidemiology of children with head injury: a national overview. Archives of Diseases in Childhood 2016; http://adc.bmj.com/content/101/6/527.
- NHS England: NHS standard contract for paediatric neurosciences: Neurorehabilitation Section B Part 1 E09/S/d: https://www.england.nhs.uk/wp-content/uploads/2018/09/Paediatric-Neurorehabilitation.pdf.
This research was completed on
Estimates suggest at least 460,000 children under 15 years old go to emergency departments having suffered a head injury each year in the UK.1 Most recover well without needing specialist treatment. Sadly, some children have brain damage and go on to have lasting disabilities or even die. Professor David Sharp, of Imperial College London, is investigating whether sophisticated scans provide valuable, extra information on what sort of damage a head injury has caused to a child’s brain, and the possible consequences of that damage. This may help ensure children get the best care and improve their outlook for the future.
Action Medical Research and Great Ormond Street Hospital Children's Charity are jointly funding this research.
How are children’s lives affected now?
Head injuries are common in children. They often come out of the blue – for example, through falls, or accidents on the roads or during sports,
They are most dangerous if they damage the brain. Around 35,000 children are admitted to hospital each year in the UK with this type of injury.2 Sadly, some of these children lose their lives and those who survive can develop life-changing disabilities.
Professor Sharp explains: “After a head injury, children may have difficulties with their memory, concentration or learning, for example, or behavioural problems such as aggression. This can have a major impact on children’s academic performance and their quality of life.”
“A child’s problems don’t necessarily become apparent straight away and it’s difficult to predict exactly how they will be affected.” continues Professor Sharp. “This may limit a child’s access to the right healthcare and educational support.”
How could this research help?
“By using an advanced form of MRI scanning, we’ve shown that problems adults have with concentration, memory, learning and so on after head injuries are mainly caused by damage to the wiring of the brain,” says Professor Sharp. “In this project, we’re finding out whether the same is true in children.”
The team hopes to reveal links between different patterns of brain injury and different problems children can experience.
“We hope these advanced brain scans will one day enable more accurate diagnosis of children’s problems after head injuries,” says Professor Sharp. “They may enable doctors to identify which children need help, predict how their head injury is likely to affect them and identify what sort of treatment, and educational support, they need. This could improve children’s outlook for the future. Since most modern MRI scanners can perform these scans, our work could benefit children across the UK and beyond.”
References
1. National Institute for Health and Care Excellence. Head injury. Triage, assessment, investigation and early management of head injury in children, young people and adults. NICE clinical guideline 176. January 2014.
2. NHS England. 2013/14 NHS Standard contract for paediatric neurosciences: neurorehabilitation. Section B part 1 – Service specifications. http://www.england.nhs.uk/wp-content/uploads/2013/06/e09-paedi-neurorehabilitation.pdf Website accessed 12 September 2015.
| Project Leader | Professor David J Sharp BA MBBS MRCP PHD |
| Project Team | Professor Faraneh Vargha-Khadem BA MA PhD DClinPsyProfessor Daniel Rueckert PhDDr Sudhin Thayyil MD PhD FRCPCHDr Neil Wimalasundera MBBS MRCPCH MScDr Ben Glocker PhDDr Sara De Simoni BSc MSc PhDMr Peter J Lally MSc |
| Project Location | Department of Medicine, Imperial College London, Hammersmith Hospital |
| Project Location Other | Department of Paediatric Clinical Neuropsychology and Wolfson Neurodisability Service Great Ormond Street Hospital, LondonDepartment of Paediatrics, Imperial College London, Hammersmith HospitalDepartment of Computing, Imperial College London, South Kensington |
| Project duration | 3 years |
| Date awarded | 21 July 2015 |
| Project start date | 1 February 2016 |
| Project end date | 31 January 2020 |
| Grant amount | £199,814 |
| Grant code | GN2408 |
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