Precision medicine in action

Using games to support personalized treatment of children born preterm

Every year, more and more children in Canada are being born early, with thousands born more than two months before they are considered full-term.

While we are better today than ever at caring for these children, we know some will struggle, particularly as they enter school age. While some do amazingly well, others find it difficult to pay attention and socialize with peers. Being born more than two months early is a risk factor for mental health issues and Autism Spectrum Disorder.

What puts one child at greater risk compared to another child? Which kids benefit the most from early interventions and how can we identify those kids as early as possible?

A precision medicine approach is critical to answering these questions and guiding understanding of why two children born very preterm — two or three months before their due date — may have very different outcomes. 

My lab — the Bray Neuroimaging Lab at the Cumming School of Medicine’s (CSM) Alberta Children’s Hospital Research Institute’s Owerko Centre — uses magnetic resonance imaging (MRI) to measure microstructural and dynamic functional differences in brain networks that may explain differences in risk for kids. 

To help make a challenging and stressful experience more accessible to children, kids who come for MRIs at the Alberta Children’s Hospital (ACH) practice in our spaceship and earn an MRI astronaut certificate.

It’s one of the techniques we developed to make the process a little more fun for kids while helping us get the data necessary to measure the structure and function of the brain at millimetre precision. 

Brain imaging data is rich and complex. With a single scan we generate a huge amount of relevant data. We use mathematical models to find associations between brain and behaviour.

When it comes to our brains, we all know the phrase, “Use it or lose it.” It holds true for the brain and the body — how we use it is important for shaping it. That’s why we teamed up with a group from the University of Victoria to test brain-training games they developed, to see how the games may help support brain plasticity in young children. One video game involves flying a pterodactyl as it sails above the ocean, paying attention to catch the occasional fish while ignoring other things that are not so edible.
 

This study is just starting but we believe it is an important step for personalizing treatments for children who are born early. Being born very early or very small should not limit a child’s potential.

The ACH also boasts a research-dedicated 3T MRI System that is a hub for pediatric neuroimaging in Western Canada. MRI provides high resolution three-dimensional pictures of the structure and function of the brain. My lab uses the MRI to chart the typical development of brain networks and how brain network changes help to explain maturation of cognitive and social skills. 

We also use the MRI to measure the brain in children with neurodevelopmental conditions, like Autism Spectrum Disorder and preterm birth. We use brain measures to better understand symptoms and to look for targets that we may be able to treat.

My group includes two postdoctoral scholars, three PhD students, a research assistant and six undergraduate researchers. We are a mix of engineers, biologists, psychologists and aspiring medical professionals, with a common goal to better understand the developing brain. We are part of the Child and Adolescent Imaging Research (CAIR) Program that I also direct. The CAIR group is an interdisciplinary team of scientists who conduct brain imaging research and collaborate extensively to support research across UCalgary faculties, including the CSM, Faculty of Arts and Werklund School of Education. 

 

The data we gather is collected and analyzed by our team. The results help us to learn more about the cognitive risks of being born very preterm and eventually may inform educational policies. 

Our mission is to develop and apply the most advanced imaging technologies, train the next generation of pediatric imaging scientists, improve brain health for children and adolescents and have a lasting impact on the lives of Calgarians, Albertans and Canadians.