A fieldworker in Peru administers cognitive tests to a 12-year-old girl. While socioeconomic circumstances can vary dramatically, how families perceive and adapt to them may be more critical in brain development.
Studies going back to the 1950s have linked objective socioeconomic factors—like parental income or education—to child health and achievement. Recent studies have extended this research, indicating that parental socioeconomic status (SES) also affects physiologic brain function in children. A new study, while small, is the first to suggest another potent factor: the mother’s self-perceived social status
Margaret Sheridan, PhD, at Boston Children’s Hospital’s Labs of Cognitive Neuroscience, and colleagues studied 38 children, ages 8 to 12 years. Each child gave a saliva sample to measure levels of the stress hormone cortisol, and 19 also underwent functional MRI of the brain focusing on the hippocampus, a structure responsible for long-term memory formation (required for learning) and for reducing stress responses.
Their mothers, meanwhile, were shown a picture of a ladder and were asked to rank their social status on a scale of 1 to 10 as compared with others in the United States. Full story »
Understanding asthma's different pathways may allow individualized treatments.
Existing asthma drugs don’t work well in many people, and a major reason is becoming clear: Asthma isn’t just one disease, but a collection of diseases that cause airways to constrict and become twitchy. Different types of asthma have different triggers that exacerbate the disease, each setting off a different part of the immune system, and each needing a different pharmacologic approach.
In this week’s Nature Medicine, a team led by Dale Umetsu, MD, PhD, and Lee Albacker, PhD, of Boston Children’s Hospital’s Division of Immunology and Harvard Medical School, describe a type of asthma triggered by the fungus Aspergillus fumigatus, a common mold.
Existing asthma control drugs, like inhaled corticosteroids, target allergic asthma, via pathways involving adaptive immunity and a group of T cells, known as Th2 cells. However, the new work, in live mice and in human cell cultures, suggests that Aspergillus triggers asthma through a faster process involving the innate immune system. In both mice and humans, Aspergillus activates a different set of T cells, known as natural killer T cells (NKT cells). Full story »
Invasive methicillin-resistant S. aureus bacteria (shown in green) cluster close to pain nerve fibers (in red) in infected skin tissue
It’s bad enough that invasive infections are painful. New work suggests that pain is only a means to an end for virulent bacteria: It’s how they suppress our immune system.
Previously, the pain from invasive infections like meningitis, necrotizing fasciitis, urinary tract infections, dental caries and intestinal infections was thought to be due to the body’s immune response, causing the infected tissue to become inflamed and swollen.
Not so, says Boston Children’s Hospital neuro-immunologist Isaac Chiu, PhD. Studying invasive skin infections caused by methicillin-resistant Staphylococcus aureus (MRSA) in live mice, his team’s research demonstrates that the pain is induced by the bacteria themselves, and kicks in well before tissue swelling peaks.
Adding outrage to insult, once the pain-sensing neurons are activated, they suppress the immune system, potentially allowing the bacteria to proliferate, finds the study, published last week in Nature.Full story »
Asperger’s syndrome vs. autism spectrum disorders:
This histogram separates children with Asperger’s (in red) from those with autism spectrum disorders (green) based on EEG coherence variables. Although there is overlap with high-functioning autism, the Asperger’s children clearly form a distinct group. (Courtesy BMC Medicine)
Is it Asperger’s syndrome or is it autism? Since there are no objective diagnostic measures, the diagnosis is often rather squishy, based on how individual clinicians interpret a child’s behavior. According to the Diagnostic and Statistical Manual, fourth edition (DSM-IV), early problems with language development are an indicator of autism; if there are behavioral symptoms but no early language problems, the child has Asperger’s. However, if the diagnosis is made late, parents’ recall of early language development may be fuzzy.
Under the new DSM-V, published in May, Asperger’s is included under the general “autism spectrum disorders (ASD)” umbrella. This has raised concerns among families who feel their children with Asperger’s have unique needs that won’t be met in classroom programs designed for autism.
Frank Duffy, MD, a neurologist at Boston Children’s Hospital, believes it’s possible to objectively differentiate Asperger’s from ASDs using a new wrinkle on an old technology. Originally trained as an engineer, Duffy is expert at interpreting electroencephalography (EEG) signals—the wiggly lines that represent electrical activity in the brain. Full story »
From the philosophical to the process-oriented to the curmudgeonly, here are more voices on innovation from our clinical and scientific community. Add your voice to the comments—or register for our National Pediatric Innovation Summit + Awards (Sept. 26-27) and join the conversation.
Innovation is the materialization of the notion that imagination is more important than knowledge. –Dario Fauza, MD, PhD, Associate Professor of Surgery, Boston Children’s Hospital
Innovation is the willingness to take the risk to embrace the unknown. –Clifford Woolf, MB, BCh, PhD, Director, F.M. Kirby Center and Program in Neurobiology, Boston Children’s Hospital
Innovation is the process of trying something new and the freedom to experiment—the antonym is to be stagnant. –Naomi Fried, PhD, Chief Innovation Officer, Innovation Acceleration Program, Boston Children’s Hospital Full story »
Is the realization of a good idea enough, or does innovation include getting others to adopt it? Atul Gawande, MD, considers this question in a thought-provoking New Yorker piece. In that spirit, our weekly series continues with some definitions of innovation that speak to the need for care in disseminating the idea or advance. (Gawande, by the way, will be keynoting at our National Pediatric Innovation Summit + Awards, September 26-27.)
Innovation is a disciplined approach by which a process or an object is improved, resulting in increased value. Central to this definition is rigorously identifying the essential stakeholders for whom the value will be generated and assuring the innovation takes into account their needs and preferences. Sometimes, these needs are implicit, and sometimes they are explicit. –Richard C. Antonelli, MD, Medical Director for Integrated Care; Medical Director Physician Relations and Outreach at Boston Children’s Hospital Full story »
A mechanosensory hair bundle in the cochlea. Each sensory cell, of which the human ear has about 16,000, has tiny hairs tipped with TMC1 and TMC2 proteins. When sound vibrations strike the bundle, it wiggles back and forth, opening and closing the TMC channels. When open, the channel allows calcium into the cell, initiating an electrical signal to the brain relayed by the 8th cranial nerve. (Image: Yoshiyuki Kawashima)
Ending a 30-year search by scientists, researchers have identified two proteins in the inner ear that are critical for hearing, which, when damaged by genetic mutations, cause a form of delayed, progressive hearing loss.
The proteins are essentially transducers: They form channels that convert mechanical sound waves entering the inner ear into electrical signals that talk to the brain. Corresponding channels for each of the other senses were identified years ago, but the sensory transduction channel for both hearing and the sense of balance had been unknown.
The channels are the product of two related genes known as TMC1 and TMC2. TMC1 mutations were first reported in people with a prominent form of hereditary deafness back in 2002 by Andrew Griffith, MD, PhD, of the National Institute on Deafness and Other Communication Disorders (NIDCD) and collaborators. Children with recessive mutations in TMC1 are completely deaf at birth. Full story »
Supreme Court justice Potter Stewart famously said in 1964, referring to hard-core pornography, “I know it when I see it.” It’s become a phrase we resort to when we have difficulty defining a term or category.
Is “innovation” such a category, or can we precisely define it? Continuing our weekly series, here’s a few definitions penned by our clinical and scientific leaders, as a run-up to our National Pediatric Innovation Summit + Awards on September 26-27. Read on, watch the trailer and add your thoughts to the Comment section below.
Innovation is a two-step process. The first step is the realization that the key in your pocket, which you thought only opened someone else’s toolbox, may actually unlock the gate in the wall that confines you to conventional thinking. The second step is walking to the gate and turning the key. —Joseph Madsen, MD, Director, Epilepsy Surgery Program, Boston Children’s HospitalFull story »
When we see a satellite image of a tropical depression in the Caribbean, we’ve come to expect that, within seconds, it will get incorporated into probabilistic models shown on our TVs at home, predicting where the hurricane will land and who it’s going to affect. Within minutes, we expect to see a personalized view of what we have to do in response to that public threat.
In this video just posted by TEDMED, Kohane envisions the capability to make our health data work for us—quickly spotting everything from serious side effects of drugs to whether a patient may be experiencing domestic abuse. Or, quickly defining what subtype of autism a patient has. By simply harnessing existing electronic medical records, we may be able to shave years off diagnostic time and improve health care.
A lab at Boston Children's Hospital hopes to make neurosurgery as minimally invasive as possible. (Photo: Katherine Cohen)
When Patrick Codd, MD, removed a toddler’s deep brain tumor not long ago at Massachusetts General Hospital, he first put a catheter inside the boy’s head to drain the excess fluid that had built up. He and the neurosurgery team then removed a large portion of the child’s skull, exposed the brain and dissected through the brain tissue, using a microscope, until he could reach the tumor, which the team then removed.
The boy is doing fine, but Codd and his mentors at Boston Children’s Hospital—Joseph Madsen, MD, and Pierre Dupont, PhD, chief of Pediatric Cardiac Bioengineering—had a vision: Could the tumor have been removed via the same catheter that he used to drain the fluid, leaving the rest of the brain intact?
Standard surgical techniques—and even newer ones that use lasers or go into the brain through the nose—require surgeons to bore through brain tissue to get to their destination. This carries a risk of injuring sensitive areas as they pass through, like the structures involved in language, as well as a risk for wound infections and complications from extended anesthesia times. Full story »