Medical Student Research Fellowship for Summer 2009

Mentor: Darryl Miles, M.D.
Department: Pediatrics
Room number: C3.304
Mail Code: 9063
Phone number: (214) 456-7969
E-mail: darryl.miles@utsouthwestern.edu
Project title: Quantitative Assessment of Axonal Lesion Volume in Children after Traumatic Brain Injury

Human subjects IRB approved project number: 012005-010

Animal subjects IRB approved project number: (N/A)

Project Type: patient-based research

Brief Description of Project: Traumatic brain injury (TBI) is a leading cause of mortality and morbidity in children over the age of 1. Children who suffer moderate and severe TBI are often left with permanent sequelae resulting in lifelong disabilities affecting the individual, their family and society as a whole.

The developing brain is considered to be more "plastic" than adults and contain an augmented potential for self repair, but there is little data to support this theory. While there is a notion that CNS development is complete by birth, in fact, crucial areas of brain development only begin after birth such as maturation of neural connections and myelination of white matter tracts. Advanced imaging modalities, such as magnetic resonance imaging (MRI) has increased our sensitivity to identify lesions to axonal white matter tracts often referred to as diffuse axonal injury (DAI). Understanding the impact of injury to these structures may be particularly relevant in children after TBI as interruption of white matter development may compound cognitive and motor deficits.

Diffuse axonal injury results from high velocity deceleration and shear strain, and is believed to be a predominant mechanism of injury in TBI. In a separate prospective study of children with moderate and severe TBI at Children's Medical Center Dallas, we have prospectively collected data on injury severity, hospital course and neuropsychological outcome measures in over 100 children ages 0-13 and over 100 adolescents ages 13-17 with TBI.

The student will be primarily involved in analysis of MRI images collected in the above mentioned study. Using DICOM and MATLAB software, the student will learn how to accurately measure white matter lesion volume collected on FLAIR MRI sequences. The student will also become familiar with statistical methodologies to correlate DAI lesion volume or location with functional outcome measures. I have secured space in a computer room adjacent to my office in C3.325 complete with PC, monitor and desk. The student will also participate in bi-monthly meetings of our Brain Nerve and Injury Center encompassing other areas of research in pediatric neurologic injury. In addition, the student may attend weekly meetings at Parkland Memorial Hospital at the Center for Traumatic Brain Injury where research in adult TBI is presented and discussed.

Previous Research Activities or Publications with Medical Students: N/A