Using Brain MRI to Fight Delays in Preemies

When I started working as a neonatologist almost 15 years ago, I loved helping premature babies cope with the problems of being born too early. But I hated having to tell worried parents that they would just have to “wait and see” if their baby would have developmental problems.

That’s why I started looking into magnetic resonance imaging (MRIs) for preemies. Using carefully performed research, I wanted to be able to look at the brain images of a preemie and tell parents, “Your baby is at highest risk for problems with movement and coordination. But if you start occupational and physical therapy now, you can likely prevent those delays.”

How MRIs Can Help Preemies
With help from computer scientists, I started building a brain “atlas” — a map to the brain of premature babies. Basically, the atlas is a digital collection of images of the brains of preemies. The images are combined so that we know what is normal and what’s not normal for preemies. This is hard, because almost every preemie’s brain is underdeveloped compared to a healthy full-term baby—just like you would expect.

A normal preemie brain might not equal a healthy brain. The brain atlas will hopefully help us see the difference between normal (Does the brain image look like what we would expect for a 28-weeker?) and healthy (Does the brain image show anything that will likely cause problems?).

We collect the MRI images at multiple time points over the first few months after birth of preemies in our research studies. Then we look back to see whether certain brain images were related to certain developmental delays measured years later.

Preventing Delays by Intervening Early
We also plan to use this brain atlas to test early attempts to prevent those delays. For example, we may see a brain image that has obvious problems in the areas responsible for speech and language. Instead of waiting three years to find out that a child can’t speak well, I can tell parents to focus on language development and start speech therapy right away. Then we can take follow-up brain images to see if that part of the baby’s brain is improving. With the atlas, we hope to find out if that delay is being fixed well before we would have even known about it in the past.

We’re already using this imaging research to try to help patients in the Neonatal Intensive Care Unit (NICU) at Nationwide Children’s Hospital. Someday soon, though, I want to use this to empower parents and help preemies everywhere fight developmental delays before they even happen.

To learn more about the atlas and what we do here at Nationwide Children’s, watch Isabella’s Story or check out our Center for Perinatal Research.