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You Can Recover from a Brain Injury

Massachusetts attorney Thomas M. Kiley, concentrates on legal issues regarding birth injuries. Recent research funded by the National Institute of Neurological Disorders and Strokes (NINDS), shows that mice with brain injuries similar to that of premature babies can actually make new neurons to help repair brain damage. This study shows that actual recovery from a brain injury at birth can occur in the developing brain. This research explains why many babies born prematurely with very low birth weight are able to overcome those early problems.

Lead Researcher Dr. Flora Vaccarino of Yale University School of Medicine said that the study shows the brain has intrinsic ability to recover after injury. She said the research shows that the neuron is not lost forever; there are progenitor cells, specialized stem cells, that can generate the proper type of cells that lead to recovery.

Babies born prematurely with very low birth weight have an increased risk of problems like attention deficit hyperactivity disorder, cerebral palsy, or mental retardation. Research by Dr. Laura Ment, also of Yale, has shown that low birth weight babies improve on tests of brain function during early childhood. This research also indicates these children can even eventually reach normal range on tests of verbal understanding and intelligence by age eight. In addition, reports show that two-thirds of premature babies require no special assistance in school by the ages of 14 or 15. This suggests the brain improves in plasticity and this leads to changes in brain function.

Dr. Ment said that premature birth can cause significant disability but the evidence shows there is improvement over time. With more research, Dr. Ment said, doctors will be able to understand how the young brain can recover from injury, and also will gain insight into why recovery doesn't happen for some babies.

Dr. Voccarino and her fellow researchers developed a neonatal mouse model of oxygen deprivation that mimics the problems that premature babies show. This model shows adaptive changes in the developing brain after it is injured. The animal model has an injury similar to that of babies born prematurely with hypoxia, which is a reduction in the oxygen passing through the blood that often results from being born with immature lungs. Dr. Vaccarino says the behavioral and physiological effects in the baby mouse brain are similar to those in premature babies, including atrophy in brain weight, brain volume, and loss of cortical neurons after the hypoxia treatment. The same behavioral effects of hyperactivity and cognitive problems are also found in the mice in the study.

The study shows that in only one week after the hypoxia ended the brains all recovered from the loss in brain weight, cortical volume, and the number of cortical neurons. This recovery is due to neurogenesis and suggests that the developing brain has the ability to recover from or compensate from early brain injury. This could indicate that the damage that premature babies suffer from lack of oxygen or if they stop breathing may be reversible. Recovery depends on the severity of the damage and a critical period or window of opportunity that affects the brains' ability to repair itself.

Further research is being done to identify the category of the newly generated cells and to establish how those new cells interact with the older cells of the first neurons. The researchers are also studying if the new generation of cells is directly involved in the recovery seen in the behavior of both the mice and human babies. Once the evidence that the cerebral cortex can repair itself by making new neurons is proven doctors will understand brain development in premature babies who are at risk for brain injury.

The NINDS is part of the National Institutes of Health in the Department of Health and Human Services and is the main producer of biomedical research on the brain and nervous system. For more information about NIH and its programs, go to http://www.nih.gov.