Perinatal neuroscience – a new frontier in research

Advances in medical technology and expertise have dramatically improved survival rates for vulnerable babies over the past 30 years.

However, improvements in neurodevelopmental outcomes have lagged behind; half of preterm infants born before 26 weeks will suffer significant brain injury resulting in cerebral palsy, epilepsy and learning difficulties. Even for full-term births, shortage of blood flow and oxygen around delivery can lead to lifelong neurological problems. These outcomes place an enormous physical, psychological and financial burden on individuals, families and society; the cost of preterm birth to the public sector has been estimated at £2.9 billion/year and the additional lifetime cost of looking after a severely disabled child runs into millions of pounds.

The newborn brain is a remarkable organ, both vulnerable to injury yet sensitive to repair. A key challenge is to understand both the mechanism of brain injury and its functional consequences to inform the development of new neuroprotective treatments.

Current treatments include brain cooling for oxygen-starved infants, a significant number of whom will now go on to lead normal lives.

These developments have given new impetus for brain-oriented treatment of infants, and already grant bodies have funded neoLAB, a formal collaboration between the Biomedical Optics Research Laboratory at University College London and the Cambridge Centre for Perinatal Neuroscience.

Original 3D optical imaging scan from a preterm infant. The cranial ultrasound scan on the left shows a large bleed in the brain (arrow) – the optical image on the left shows the increase in blood on the side of the haemorrhage – and a specific area of very low oxygen in the damaged brain tissue. From: AustinT et al, Neuroimage, 2006

Action Medical Research has awarded £120,000 to develop an Optical-EEG system to investigate seizures in newborns and the Engineering and Physical Sciences Research Council (EPSRC) has provided £1m for the development of fast optical tomography to image the newborn brain.