Overview

Our research is focused on understanding the immature brain and its response to injury and other conditions early in life, with the goal of helping infants and children. Traumatic brain injury is the single most common cause of death and disability in children in the United States, and in many other countries as well. An infant’s brain is different from that of a grade-school child, which is different from that of an adolescent, and we are working to understand these differences and how they influence both response to injury and to repair and recovery.  Children who are injured may have lifetime problems which we don’t know yet how to prevent or help. Our work is aimed at learning how to better treat the millions of children with this and similar problems, now and in the future.

Current Projects focus on:

  • Studying the neuropathogenesis of traumatic brain injury
  • Using MRI to non-invasively screen and evaluate brain injury
  • Characterization of biomarkers after brain injury
  • Using instrumented helmets to study what mechanisms are linked to specific brain problems in young athletes
  • Studying the mechanisms of brain injury after non-accidental trauma in infants and children
  • The effect of age and gender on lesion development after injury
  • The ability of the brain to make new neurons after brain injury
  • Evaluating cyclosporin A as a therapeutic after brain injury
  • The effect of anesthetics on the developing brain

Research Projects

Common Data Elements: Clinical researchers in pediatric neurosurgery at MassGeneral Hospital for Children are participating in national studies designed to gather sophisticated data on traumatic brain injury from large numbers of adults and children. Information gleaned from these studies will ultimately be integrated into stratified, multidisciplinary treatment trials for infants, children and adults with various types of traumatic brain injuries, as well as investigating host factors, such as genetics, which influence outcome.

Evaluation of Cyclosporin A as a therapeutic after traumatic brain injury. Cyclosporin A blocks the opening of the mitochondrial transition pore. After brain insults, when the cell senses that conditions are poor, the pore opens eliminating  the proton gradient and initiating apoptosis. Cyclosporin A may prevent injury on a cellular level after traumatic brain injury. The project is in collaboration with researchers at the University of Pennsylvania

The postnatal brain makes new neurons in a process called neurogenesis. We are studying the areas of the brain where neurogenesis occurs: the subventricular zone and the dentate gyrus of the hippocampus and are determining if neurogenesis increases after traumatic brain injury and if these new neurons aid in the repair process or perhaps, do not migrate properly and become foci for seizure development.  This project is in collaboration with pediatric neuropathologists located at the University of Edinburgh and Georgetown University

We are evaluating peripheral proteins in the serum that may serve as serum markers for traumatic brain injury indicating the degree of injury and predicting outcome. Serum markers in the pediatric population present a particular challenge as body composition differs from adults

Unfortunately, not all traumatic brain injury is accidental in infants and toddlers, but inflicted. These children develop similar injuries that often results in a subdural hematoma, apnea and development of seizures. When evaluated via magnetic resonance imaging, the hemisphere underlying the hematoma will often regress resulting in a large black area where the brain has regressed: “big black brain”. We are using advanced magnetic resonance imaging to determine the early mechanisms of the processes of the injured hemisphere and hope to develop treatments to combat this devastating condition. This project is in collaboration with scientists at the Martinos Institute at Massachusetts General Hospital, with a pediatric neuroradiolgist at Texas Children’s Hospital, and a pediatric anesthesiologist at The Children’s Hospital at Dartmouth

In collaboration with Symbex and scientists at Dartmouth College, we are using helmets fitted with accelerometers to characterize the number contacts and the forces that football players experience during football practice and games at the high school and college level. We are also in the process of using these accelerometer-fitted helmets in toddlers to characterize the actual forces involved in real falls

We are developing rapid sequences of MRI to screen for head injury to replace screening with CT scans in order to reduce exposure of children to radiation

All neurosurgeries and many clinical procedures in children require anesthesia. The immature brain is unique in that γ-aminobutyric acid (GABA) is the major neurotransmitter and is required for normal synaptic development and dendrite outgrowth making the immature brain potentially susceptible to anesthetic agents that target the GABA receptor