Daniel Busso, MSc, is a doctoral student at the Harvard Graduate School of Education and a researcher in the Sheridan Laboratory at Boston Children’s Hospital.
More than 60 percent of teenagers have experienced a traumatic event in their lifetime, but only a minority will develop post-traumatic stress disorder (PTSD). For both researchers and clinicians, this raises an important question: Why are some youth at greater risk for mental health problems after trauma? As our lab reports in two recent studies, conducted after the 2013 Boston Marathon bombings, the answer may lie in our neurobiology.
PTSD, which includes intrusive memories, increased anxiety and difficulty concentrating or sleeping, has been linked to a variety of psychosocial and biological risk factors, such as prior experiences of trauma or a history of mental health problems. Other studies suggest that disruptions to the body’s stress response system, or in patterns of brain activity when responding to threat, may predispose people to the disorder.
However, a common problem in this research is that biological and mental health data are collected only once, usually long after the traumatic event itself, Full story »
Emmie Mendes was lucky enough to be diagnosed before age 3, but many families face a much longer journey.
At first, Corrie and Adam Mendes thought their daughter Emmie had an inner ear problem. She was late with several early milestones, including walking, and when she did walk, she often lost her balance. The family pediatrician sent them to a neurologist, who ordered a brain MRI and diagnosed her with pachygyria, a rare condition in which the brain is smoother than normal, lacking its usual number of folds.
Additionally, Emmie’s ventricles, the fluid-filled cushions around the brain, looked enlarged, so the neurologist recommended brain surgery to install a shunt to drain off fluid. He advised Corrie and Adam that Emmie’s life expectancy would be greatly reduced.
As Corrie recounts on her blog, Emmie’s Story, she went online and came across the research laboratory of Christopher Walsh, MD, PhD, at Boston Children’s Hospital. The lab does research on brain malformations and has an affiliated Brain Development and Genetics Clinic that can provide medical care.
After Walsh’s team reviewed Emmie’s MRI scan, genetic counselor Brenda Barry invited the family up from Florida. Full story »
You’d think drugs meant to be taken by children for years would be studied in children for a long time to measure their long-term safety.
You’d think drugs for a condition affecting millions of children would be tested in many, many children to catch any rare side effects.
You’d think all this would happen before the Food and Drug Administration, an agency known for its strict criteria, approved them for marketing.
But if a new PLoS ONE paper by Boston Children’s Hospital’s Florence Bourgeois, MD, MPH, and Kenneth Mandl, MD, MPH, is any indication, you’d be wrong.
In it, the pair reports that the FDA approved 20 attention deficit hyperactivity disorder (ADHD) drugs over the last 60 years without what would be considered sufficient long-term safety and rare adverse event data.
Their findings, they say, point to larger issues in how the FDA’s approval process addresses the long-term safety of drugs intended for chronic use in children. Full story »
Eugenia Chan, MD, MPH, is a developmental-behavioral pediatrician and health services researcher in the Division of Developmental Medicine at Boston Children’s Hospital. She runs the Developmental Medicine Center’s ADHD Program and is co-developer of ICISS Health, a web-based disease monitoring and management system.
A randomized trial will soon test whether web-based updates from parents and teachers improve outcomes in ADHD, autism and more.
When I set out with my collaborator Eric Fleegler, MD, MPH, to build a web-based tracking system for children with attention deficit hyperactivity disorder (ADHD), we focused on a single problem—getting parents and teachers to fill out symptom questionnaires in time to help doctors make informed clinical decisions at follow-up visits. We had no inkling of the possibilities that this kind of software platform could hold, or how it might grow in the future. Full story »
Prenatal cell therapy could avoid the need for invasive surgery to repair myelomeningocele.
The neural tube, which becomes the spinal cord and brain, is supposed to close during the first month of prenatal development. In children with spina bifida
, it doesn’t close completely, leaving the nerves of the spinal cord exposed and subject to damage. The most common and serious form of spina bifida, myelomeningocele, sets a child up for lifelong disability, causing complications such as hydrocephalus, leg paralysis, and loss of bladder and bowel control.
New research from Boston Children’s Hospital, though still in animal models, suggests that standard amniocentesis, followed by one or more injections of cells into the womb, could be enough to at least partially repair spina bifida prenatally.
Currently, the standard procedure is to operate on infants soon after delivery. Full story »
Alina Morris, Archivist, Boston Children’s Hospital, contributed to this post.
In 1914, Boston Children’s Hospital, then simply called The Children’s Hospital, constructed the 145-bed Hunnewell Building, joining Harvard Medical School as one of several founding members of the Longwood Medical Area.
As the hospital’s oldest continuously occupied building, Hunnewell has presided over many of the century’s great medical advances and innovations. We celebrate a portion of them in this slideshow honoring Hunnewell’s 100th anniversary—and invite you to help write the next 100 years of history October 30-31 at Boston Children’s Global Pediatric Innovation Summit + Awards 2014.
My daughter just surprised me by signing up for fifth grade band starting this fall. To my further delight, some new research—using both cognitive testing and brain imaging—suggests that as she practices her clarinet, she also may be honing her executive functions.
Like a CEO who’s on top of her game, executive functions—separate from IQ—are those high-level brain functions that enable us to quickly process and retain information, curb impulsive behaviors, plan, make good choices, solve problems and adjust to changing cognitive demands. While it’s already clear that musical training relates to cognitive abilities, few previous studies have looked at its effects on executive functions specifically.
The study, appearing this week in PLOS ONE, compared children with and without regular musical training, as well as adults. To the researchers’ knowledge, it’s the first such study to use functional MRI (fMRI) of brain areas associated with executive function and to adjust for socioeconomic factors. Full story »
John Kheir, MD, first envisioned an injectable form of oxygen eight years ago, the night one of his patients, a nine-month-old girl, died after catastrophic lung failure. Kheir, a cardiac intensive care specialist at Boston Children’s Hospital, spoke last night to WBZ-TV’s Mallika Marshall, MD, about his efforts to try to buy precious time for children whose lungs stop working:
Want to know more? Read Kheir’s own words about his hopes and challenges for intravenous oxygen in a post he penned for Vector.
The start of what promises to be a lengthy, multi-part endeavor has begun unfolding on Capitol Hill. It’s an attempt to reform the Medicaid program so that children with medical complexity (those with a single, serious medical condition, or multiple chronic conditions) can receive higher quality care with fewer emergency department visits and fewer hospital admissions.
When you think of medically complex children, think of children living with conditions such as spina bifida or cerebral palsy, children dependent on ventilators or feeding tubes, or children with genetic disorders. They represent just 6 percent of the 43 million children on Medicaid—yet they account for about 40 percent of Medicaid’s spending on children. Their care is often fragmented and poorly coordinated.
The reform effort, led by more than 60 participating pediatric hospitals and supported by the Children’s Hospital Association (CHA), focuses on Medicaid because it’s the single largest insurance provider for children. The backdrop is a cost-conscious Congress that’s the most politically polarized ever, passing the fewest bills ever. Full story »
Alexander Rotenberg, MD, PhD, is a pediatric neurologist and epileptologist at Boston Children’s Hospital and director of the hospital’s Neuromodulation Program.
In recent years, electrical devices stimulating the brain or peripheral nerves have emerged as clinical and scientific tools in neurology and psychiatry. In 2014, the Food and Drug Administration has approved three tools at this writing: a device for treatment of epileptic seizures via electrodes implanted beneath the skull; a device for shortening migraine headache via transcranial magnetic stimulation (TMS) of the brain; and a transcutaneous electrical nerve stimulation (TENS) device for migraine prevention. (Click image below for details.)
Stimulating the nervous system to treat neuropsychiatric symptoms is not new. In the first century AD, the Roman physician Scribonius Largus documented treating headaches by applying electric torpedo fish to the head. Full story »