Study brings hope for well­be­ing of pre­ma­ture ba­bies

The Weekend Australian - Travel - - Health -

re­quire com­pli­cated in­for­ma­tion trans­fer tween both hemi­spheres of the brain.

The cere­bel­lum, lo­cated at the base of the brain and play­ing a cru­cial role in mo­tor co-or­di­na­tion, mus­cle tone and dif­fer­ent types of cog­ni­tive func­tion­ing, in­clud­ing plan­ning abil­ity, also seems sus­cep­ti­ble to the ef­fects of early birth.

The hip­pocam­pus is fur­ther im­pli­cated in the learn­ing dif­fi­cul­ties, par­tic­u­larly me­mory im­pair­ments, that chil­dren born pre­ma­turely may demon­strate upon reach­ing school age.

Yet the rea­sons why pre­ma­tu­rity causes th­ese changes in the brain re­mains some­thing of a mys­tery.

What is known is that dur­ing the third trimester, the brain is ma­tur­ing at a rapid rate and the de­vel­op­men­tal events that are oc­cur­ring

be- dur­ing this pe­riod are likely to ex­plain why some parts are more vul­ner­a­ble than oth­ers to al­ter­ation by pre-term birth.

Fever, in­fec­tions, breath­ing dif­fi­cul­ties and hy­poxic episodes (dur­ing which the ba­bies’ brains re­ceive in­suf­fi­cient oxy­gen) are also sus­pected to play a part.

Even the med­i­cal in­ter­ven­tions de­signed to save their lives and the en­vi­ron­ment of the neona­tal in­ten­sive care unit — typ­i­cally in­volv­ing bright lights, loud noises and painful med­i­cal pro­ce­dures — might ex­pose frag­ile bod­ies and brains to dam­ag­ing stim­uli.

Their sen­sory sys­tems are im­ma­ture and just aren’t ready for all of that in­put,’’ An­der­son says.

What im­pact it all has on the brain is not known but it is likely to be neg­a­tive.’’

But there’s no sim­ple or sin­gle thing that’s caus­ing th­ese ab­nor­mal­i­ties in pre-term ba­bies’ brains . . . It’s clear that there are a num­ber of fac­tors that are in­volved, and many of th­ese are in­ter-re­lated.’’

While MRI has been in use for many years, it is still not used rou­tinely with very pre­ma­ture in­fants, de­spite the high rates of brain ab­nor­mal­i­ties and neu­rode­vel­op­men­tal prob­lems. This is partly be­cause it is dif­fi­cult to scan very sick in­fants.

Be­fore An­gus went for a re­peat scan at two years old, we recorded all the screeches and grinds and other aw­ful sounds from the ma­chine and played that to him at bed-time, so he was more com­fort­able,’’ says Krieger. But she says it was worth all the trou­ble: There was huge de­vel­op­ment in his brain right up to the skull... he’s per­haps still be­hind his peers, but I could see the dif­fer­ence.’’

Now aged 5, and look­ing for­ward to kin­der­gar- ten, An­gus’ life is not with­out its chal­lenges. His mus­cle tone re­mains low — which means, for in­stance, that pro­duc­ing the sounds re­quired for speech is dif­fi­cult for him, and as a re­sult he con­tin­ues to have speech ther­apy and phys­io­ther­apy. But as chil­dren like An­gus start to be sched­uled for the scans due when they turn seven, and the as­so­ci­ated neu­ropsy­cho­log­i­cal as­sess­ments, An­der­son is hope­ful of gain­ing in­sight into some of the fac­tors that fa­cil­i­tate brain de­vel­op­ment in this vul­ner­a­ble group of chil­dren.

The group that we’re fol­low­ing up is the largest group of chil­dren any­where in the world to un­dergo neona­tal scans and fol­low-up,’’ says An­der­son. While most in­fants with se­vere brain in­jury de­velop marked dis­abil­i­ties, oth­ers have rea­son­able out­comes, (and so) iden­ti­fy­ing the pro­cesses as­so­ci­ated with such re­cov­ery is of ma­jor im­por­tance.’’

Newspapers in English

Newspapers from Australia

© PressReader. All rights reserved.