Researching the Future of Pediatric Stroke Care

Posted on Aug 22, 2018

Avner Meoded, M.D., and Neil Goldenberg, M.D., Ph.D.

When a child has a stroke, everything shifts. Whether it occurs as a young child, an infant or while in utero, there is always the question of “how will this impact the child in the future?”

That is exactly what researchers at Johns Hopkins All Children’s Hospital are seeking to answer.

Under a grant from the Radiological Society of North America, Avner Meoded, M.D., pediatric neuroradiologist at Johns Hopkins All Children’s and assistant professor of radiology with the Johns Hopkins University School of Medicine, is leading a study investigating how children are able to recover after an arterial ischemic stroke.

Pediatric arterial ischemic stroke is a relatively rare condition that happens when there is an interruption in the supply of blood to the brain. Such a traumatic incident can have many implications on brain development in the future. Across both Johns Hopkins All Children’s Hospital in St. Petersburg, Florida, and The Johns Hopkins Hospital in Baltimore, Maryland, neurologists see about 40 children with this condition a year. Study participants come from this bi-campus pool of patients and are a variety of ages. These children are followed with additional neuroimaging at three time points over one year.

Using a MRI technique called diffusion tensor imaging, Meoded is able to map the networks of each child’s brain. This map can potentially show how the developing brain reacts, recovers and adapts to injury.

“Currently there is no match in the literature about how the pediatric brain recovers after stroke,” Meoded explains. “Many researchers have applied conventional MRI techniques, but with our advanced technique and connectomics and biomolecularomics, we want to shed more light on the mechanism for recovery.”

Connectomics is a major advancement in neuroimaging and understanding the networks of the brain is an initiative that many leading institutions are a part of. With the grant, Meoded has research time dedicated to this study for the next three years.

The pediatric brain is generally thought to have a greater ability to “bounce back” than the adult brain, however data on this subject is still limited. By using these new techniques to collect data as children recover from a stroke, researchers are hoping to gain more insight on how a brain that is still developing is able to rewire itself. This data will allow physicians to better provide rehabilitation, treatment and interventions for future children. Eventually the goal is to develop a model that will help predict how a child will behave many years after a stroke.

To reach these goals, neuroradiologists and neurologists in the Johns Hopkins All Children’s Institute for Brain Protection Sciences are working with researchers and biomolecular scientists across the St. Petersburg campus as well as colleagues in Baltimore.

“This project is a team effort,” Meoded says. “This advanced imagining technique together with the biomolecular core is something few institutes have the ability to process.”

What are –omics

Omics refer to fields of study in biology that look at the relationship between components of the body. Technological advances in biological data analysis may allow for more effective risk assessment, early diagnosis and rapid treatment.

This research study uses connectomics and other omics to study the effects of stroke in children.

  • Connectomics is an area of neurology looking at the networks in the brain and how it is wired together. 
  • Proteomics is a part of molecular biology that maps proteins and how they function in the body.

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