COOLING THE BRAIN
Recent research supported by Sparks has given new hope for babies damaged because of a difficult delivery. Results from a clinical trial of brain cooling treatment, reported in May showed significant improvements in many of the cooled babies.
Every Year ...
In the UK more than 1000 children in the UK die every year or suffer permanent brain injury because of shortage of oxygen around the time of birth. This disaster can strike any baby without warning, despite the very best medical and nursing care. The problem has been known about for many years, but until now, no treatment has been found to prevent or minimise the damage.
Bridge the Gap
A group of doctors and scientists at University College London has been tackling this devastating problem since the 1980s. Using state of the art brain scanning techniques we showed that, surprisingly, the brain damage didn't occur immediately at the time of delivery. There was often a window of several hours before the injury was permanent, in other words a brief window of time when protective treatment might be effective. In a series of experiments we found strong evidence that cooling the brain by several degrees might be helpful in protecting the brain cells. With support from Sparks, research teams at University College London and St Michael’s Hospital Bristol have recently been testing the use of a specially designed cooling cap to reduce brain temperature after birth.
Clinical Trials
Years of research effort have culminated in an international clinical trial involving more than 230 babies in UK, North America and New Zealand. All the babies were enrolled because they were at very high risk of brain damage. Once the problem was identified, parents were approached for consent to allow their babies to take part in the trial. Half of the babies were randomly allocated to 3 days of cooling treatment using the new cooling cap, and the other half were given standard intensive care. Following this the babies were intensively followed to see if the cooling treatment had brought any benefit.
Nearly all the babies have now been assessed at 18 months of age by independent doctors and psychologists and the results of the trial have been announced at a major scientific conference in USA. The research teams were delighted to find that there was a reduction in the rate of death and severe disability in a large subgroup of the babies who had received brain cooling. The rate of death and disability was reduced from 66% to 48% and the rate of cerebral palsy was halved. The treatment seemed to be particularly effective in the majority of babies with moderate brain injury rather than in the small number of babies with very severe injury, and there was no evidence of any serious complications from the cooling itself. The results will be published in a major scientific journal later in the year.
It will be a number of months before brain cooling treatment starts to become available for babies and more research is urgently needed; but we are excited that for the first time there is a treatment which can reduce brain damage after birth, with all its terrible consequences. It is only because of the generous support of Sparks and other medical research charities that this vital work has been possible. With your support, the Brain Protection and Repair Group at University College London is continuing to build on this work, finding new ways to protect precious and vulnerable babies at the beginning of life.