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Brain Scans Could Be Routine Pediatrician Tool

September 10, 2010
Written by: , Filed in: Neuroradiology, Pediatric Radiology
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“OK, let’s start the exam by getting the child’s routine measurements—height, weight, brain networks scan . . .”

No, that’s not how a visit to the pediatrician usually goes. But it soon might, say researchers at Washington University School of Medicine in St. Louis. A five-minute fMRI scan, they say, can show the progress of a child’s brain along the path to maturity—and perhaps provide early warning of psychological or developmental disorders.

Their study, published in today’s issue of Science, used fMRI to measure “resting state functional connectivity.” That describes which brain regions work together in networks. The networks in children’s brains involve regions that are physically close together. In adult brains, networks connect distant regions.

“Pediatricians regularly plot where their patients are in terms of height, weight, and other measures, and then match these up to standardized curves that track typical developmental pathways,” said senior author Bradley Schlaggar, MD, PhD, as quoted in a Washington University news release. “When the patient deviates too strongly from the standardized ranges or veers suddenly from one developmental path to another, the physician knows there’s a need to start asking why.”

Dr. Schlaggar, a pediatric neurologist who is an associate professor of neurology at Washington University, said doctors could do the same thing with the brain scan results.

The researchers did five-minute functional MRI brain scans of 238 normal subjects ranging in age from 7 to 30. The scientists analyzed brain connections and plotted the results on a chart that roughly formed a curving line that represents the normal progression of brain development.

The researchers said they suspect that readings from patients with brain disorders will be outliers along this curve—and probably in places specific to each disorder. “The beauty of this approach,” said Dr. Schlaggar, “is that it lets you ask what’s different in the way that children with autism, for example, are off the normal development curve versus the way children with attention deficit disorder are off that curve.”

Of course, most pediatricians’ offices don’t include MRI machines. “MRI scans are expensive, so this may not be what we use for everyone right now,” said lead author Nico Dosenbach, MD, PhD, a pediatric neurology resident at St. Louis Children’s Hospital. “But many children with these types of disorders already receive regular structural MRI scans [to look for abnormalities in the structure of the brain itself], and five more minutes in the scanner won’t add that much to the cost.”

Related seminar: Pediatric Radiology—Clinical and Radiology Perspectives (just released)

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