Children's Hearts: MRI detects early damage following chemotherapy

Detecting early damage to a child's heart following chemotherapy is possible using MRI scans, says a study from Canada.

Even when children's heart function appeared to be normal, a new MRI method of mapping the heart was able to identify damage, University of Alberta researchers said.

A UK cardiologist said the impact of anthracycline treatment on children's hearts was only now being understood.

Early detection was crucial, he said.

While chemotherapy treatment with anthracyclines is known to be effective against many types of cancer, it can lead to irreversible changes to the heart muscle which may not become apparent until several years after treatment.

Writing in the Journal of Cardiovascular Magnetic Resonance, the researchers said they performed MRI scans on children and young adults aged seven to 19 who were in remission following this type of treatment.

Richard Thompson

Using an emerging MRI method called T1 mapping, they said they were able to identify the early effects on patients' hearts.

This happened even in children whose heart function appeared normal by ultrasound.

Dr Edythe Tham and Dr Richard Thompson, who led the study, said: "In childhood cancer survivors, MRI changes were related to anthracycline dose given to the children.

"These changes are also mirrored by thinning of the heart wall and a reduction in the exercise capacity."

Early protection
Dr Chris Plummer, consultant cardiologist at the Freeman Hospital in Newcastle, said the side effects of chemotherapy were well-known.

"Chemotherapy with anthracyclines is a very effective treatment for cancer but it can be quite toxic to the heart.

"We've known that for a long time but the number of children affected is only becoming appreciated now.

"We have to look for ways to protect the heart and intervene earlier when damage occurs.

"Waiting for visible heart damage to appear is too long to wait."

But Dr Plummer said carrying out an MRI scan of a child's heart was not an easy thing to do.

"Scanning the heart is more difficult than other organs because it is constantly in motion. But with modern scanners the images are fantastic.

"It's the best way of looking at the structure and function of the heart - and it's entirely safe.

"It is an excellent way of precisely monitoring heart function in children."

Related Stories:

• Half 'will get cancer in lifetime' 
• 'Our devastating experience of childhood cancer' 
• Cancer risk for child survivors

Dyslexia and Brain Anatomy: Differences in Men and Women, Boys and Girls

Using MRI, neuroscientists have found significant differences in brain anatomy when comparing men and women with dyslexia to their non-dyslexic control groups. 

Their study is the first to directly compare brain anatomy of females with and without dyslexia. 

Credit: © Lucian Milasan / Fotolia

Using MRI, neuroscientists at Georgetown University Medical Center found significant differences in brain anatomy when comparing men and women with dyslexia to their non-dyslexic control groups, suggesting that the disorder may have a different brain-based manifestation based on sex.

Their study, investigating dyslexia in both males and females, is the first to directly compare brain anatomy of females with and without dyslexia (in children and adults).

Their findings were published online in the journal Brain Structure and Function.

Guinevere Eden

Because dyslexia is two to three times more prevalent in males compared with females, "females have been overlooked," says senior author Guinevere Eden, PhD, director for the Center for the Study of Learning and past-president of the International Dyslexia Association.

"It has been assumed that results of studies conducted in men are generalisable (sic) to both sexes, but our research suggests that researchers need to tackle dyslexia in each sex separately to address questions about its origin and potentially, treatment," Eden says.

Previous work outside of dyslexia demonstrates that male and female brains are different in general, adds the study's lead author, Tanya Evans, PhD.

Tanya Evans

"There is sex-specific variance in brain anatomy and females tend to use both hemispheres for language tasks, while males just the left," Evans says.

"It is also known that sex hormones are related to brain anatomy and that female sex hormones such as estrogen can be protective after brain injury, suggesting another avenue that might lead to the sex-specific findings reported in this study."

The study of 118 participants compared the brain structure of people with dyslexia to those without and was conducted separately in men, women, boys and girls.

• In the males, less gray matter volume is found in dyslexics in areas of the brain used to process language, consistent with previous work. 
• In the females, less gray matter volume is found in dyslexics in areas involved in sensory and motor processing.

The results have important implications for understanding the origin of dyslexia and the relationship between language and sensory processing, says Evans.

Journal Reference:

1. Tanya M. Evans, D. Lynn Flowers, Eileen M. Napoliello, Guinevere F. Eden. Sex-specific gray matter volume differences in females with developmental dyslexia.Brain Structure and Function, 2013; DOI: 10.1007/s00429-013-0552-4

Differences in language circuits in the brain linked to dyslexia - VUCast: Vanderbilt University's News Network

Differences in language circuits in the brain linked to dyslexia - VUCast: Vanderbilt University's News Network

Children with dyslexia often struggle with reading, writing and spelling, despite getting an appropriate education and demonstrating intellectual ability in other areas. New neurological research from Vanderbilt University has found that these children’s difficulties with written language may be linked to structural differences within an important information highway in the brain known to play a role in oral language.

The findings were published in the June 2010 issue of Cortex.

Vanderbilt researchers Sheryl Rimrodt and Laurie Cutting and colleagues at Johns Hopkins University and Kennedy Krieger Institute used an emerging MRI technique, called diffusion tensor imaging (DTI), to discover evidence linking dyslexia to structural differences in an important bundle of white matter in the left-hemisphere language network. White matter is made up of fibers that can be thought of as the wiring that allows communication between brain cells; the left-hemisphere language network is made up of bundles of these fibers and contains branches that extend from the back of the brain (including vision cells) to the front parts that are responsible for articulation and speech.

“When you are reading, you are essentially saying things out loud in your head,” Cutting said. “If you have decreased white matter integrity in this area, the front and back part of your brain are not talking to one another. This would affect reading, because you need both to act as a cohesive unit.”

Rimrodt and Cutting used the DTI technique to map the course of an important white matter bundle in this network and discovered that it ran through a frontal brain region known to be less well-organized in the dyslexic brain. They also found that fibers in that frontal part of the tract were oriented differently in dyslexia.

“Finding a convergence of MRI evidence that goes beyond identifying a region of the brain that differs in dyslexia to linking that to an identifiable structure and beginning to explore physical characteristics of the region is very exciting,” Rimrodt said. “It brings us a little bit closer to understanding how dyslexia happens.”

Rimrodt is assistant professor of developmental medicine. Cutting is Patricia and Rodes Hart Chair at Vanderbilt’s Peabody College of education and human development and an investigator in the Vanderbilt Kennedy Center for Research on Human Development. The researchers completed the work at the Kennedy Krieger Institute with their colleagues there before moving to Vanderbilt.

The research was funded by the Johns Hopkins School of Medicine General Clinical Research Center, the Kennedy Krieger Institute’s Learning Disability Research Center and F.M. Kirby Research Center for Functional Brain Imaging, the National Institute for Neurological Disorders and the Eunice Kennedy Shriver National Institute of Child Health and Human Development.

For more information about Vanderbilt’s Peabody College, visit http://peabody.vanderbilt.edu

Brain waves and meditation

Brain waves and meditation

Forget about crystals and candles, and about sitting and breathing in awkward ways. Meditation research explores how the brain works when we refrain from concentration, rumination and intentional thinking. EEG, Electrical brain waves suggest that mental activity during meditation is wakeful and relaxed.

"Given the popularity and effectiveness of meditation as a means of alleviating stress and maintaining good health, there is a pressing need for a rigorous investigation of how it affects brain function," says Professor Jim Lagopoulos of Sydney University, Australia.

Lagopoulos is the principal investigator of a joint study between his university and researchers from the Norwegian University of Science and Technology (NTNU) on changes in electrical brain activity during nondirective meditation.

Autism - Children with autism 'have problem with self-awareness'

It is well known that children suffering from Autism struggle in social situations. Scientists have produced evidence that self-awareness is a big problem for people with autism.

Sophisticated scans showed the brains of people with autism are less active when engaged in self-reflective thought. The findings provide a neurological insight into why people with autism tend to struggle in social situations.

The study, by the University of Cambridge, appears in the Oxford neurological journal Brain.

Navigating social interactions with others requires keeping track of the
relationship between oneself and others - Michael Lombardo, University of Cambridge,

Autism has long been considered a condition of extreme egocentrism.

But research has shown the problem is children with the condition have trouble thinking about, and making sense of, themselves.

The researchers used functional magnetic resonance scans (MRI) to measure brain activity in 66 male volunteers, half of whom had been diagnosed as being within the autistic spectrum.

The volunteers were asked to make judgements either about their own thoughts, opinions, preferences, or physical characteristics, or about someone else's, in this case the Queen.

By scanning the volunteers' brains as they responded to these questions, the researchers were able to visualise differences in brain activity between those with and without autism.

They were particularly interested in part of the brain called the ventromedial pre-frontal cortex (vMPFC) - known to be active when people think about themselves.

The researchers found this area of the brain was more active when typical volunteers were asked questions about themselves compared with when they were thinking about the Queen.

However, in autism this brain region responded equally, irrespective of whether they were thinking about themselves or the Queen.

Researcher Michael Lombardo said the study showed that the autistic brain struggled to to process information about the self.

He said: "Navigating social interactions with others requires keeping track of the relationship between oneself and others.

"In some social situations it is important to notice that 'I am similar to you', while in other situations it might be important to notice that 'I am different to you'.

"The atypical way the autistic brain treats self-relevant information as equivalent to information about others could derail a child's social development, particularly in understanding how they relate to the social world around them."

Dr. Gina Gómez de la Cuesta, of the National Autistic Society, described the study as "interesting". "We know many children with autism do want to interact with others and make friends but they have difficulty recognising or understanding other people's thoughts and feelings.

"This research has shown that children with autism may also have difficulty understanding their own thoughts and feelings and the brain mechanisms underlying this."