Touching Lives - June 2004
Rewiring the brain
Can the brain be ‘re-wired’ to help children overcome disability? Remarkably, a two-year research programme at the Sir James Spence Institute of Child Health at Royal Victoria Hospital, Newcastle, has shown that if damage occurs to a baby’s or young infant’s brain, its functions can be reorganised.
Led by Professor Janet Eyre, a team has studied a large number of children under the age of seven and proved that where brain damage has been caused either before birth or at birth, the infant brain has a natural capacity to transfer vital functions away from the damaged area.
It means that the belief that the right side of the brain controls the left side of the body and vice versa is not necessarily true — some children have shown that functions can be moved from a damaged area to the other side of the brain entirely.
The good news is that this capacity for the brain to ‘re-wire’ gives babies with brain injury, often caused by a stroke before birth, a much more promising outlook than would otherwise be the case.
A remarkable organ
Professor Eyre explained, “The brain is a remarkable organ and we have known for some time that it has this plasticity which allows one part of the brain to take on the functions of a damaged area.
“The grant from Action Medical Research allowed us to look more closely at the motor cortex — the part of the brain that controls movement — and see if it could be relocated somewhere else following damage.
“Babies can suffer the effect of stroke whilst still in the womb, and can literally have part of their brain so badly damaged that it will not function. What’s remarkable is that ^we have shown how another area of the brain can compensate and take over functions such as movement control^. We have seen children where the part of the brain usually dedicated to vision has taken over motor function completely.”
In adults this ability is generally much reduced, which is why older stroke patients can face an uphill struggle in regaining lost movement. For tiny babies, the repair mechanism can just start naturally.
The team funded by Action Medical Research has built on studies conducted over the past 15 years and has charted the progress of over 100 children. It has collaborated in the study with hospitals in London and Italy and the results have attracted wide media attention.
Electronic imaging was used to ‘scan’ the children’s brains to see just what degree of reorganisation had taken place.
Now the next step is to look at ways of actively encouraging this natural re-organisation in the brain, and the implications are enormous. It could mean that rehabilitation programmes are devised for tiny babies known to have suffered brain damage in the womb.
Professor Eyre explained, “Because we can see that this natural re-wiring takes place, we will be able to look at how tiny babies with brain damage should be handled. ^Perhaps even the way a drip is put into their arm or the way they are placed in an incubator could have an effect on the brain’s ability to re-organise^. What’s critical is to act as early as possible, before the brain’s plasticity diminishes.
“We have to be cautious at this stage, but by finding out how we can actively encourage the process, perhaps we can give brain damaged or cerebral palsy children the chance to recover lost movement control in the first few weeks of life.
“It is a complex issue, but I’m delighted by the results we have had. It’s very exciting to be involved in a project like this and marvellous that donations from Action Medical Research supporters can make it all possible.”
Soon after Luke Johnson was born it was clear that something was badly wrong with one side of his body. Luke had suffered a stroke while still in the womb, leaving his right arm and leg seriously affected. But Luke, part of Professor Eyre’s study group, now has full use of his arms and legs after his brain ‘re-wired’ itself.
The motor functions from the damaged left side of his brain were taken over by the part of the brain that usually controls only vision. Luke underwent physiotherapy and speech therapy as part of the study and his recovery made national news headlines. With his parents Pat and John, he has even appeared on daytime television!
Luke’s mother Pat said, “It’s only by exploring brain function in a child like Luke that doctors will be able to help him and others reach their full potential. I look at Luke and sometimes I can barely believe he is still alive. What he has achieved is incredible.”