Written by Alan Barker, Freelance Writer, British Science Festival 

Brain injury is a leading cause of mortality in newborn babies. Early detection and monitoring is difficult, but Dr Gemma Bale’s pioneering work could make a dramatic difference. Gemma, from University College London, is delivering this year’s Isambard Kingdom Brunel Award Lecture at the 2018 British Science Festival.

Alan Barker followed her into an area of research that promises to give new hope to babies and their families.

Medical physicist Dr Gemma Bale will discuss her pioneering work which will help early detection of infant brain injury

The Isambard Kingdom Brunel Award Lecture is for engineering, technology and industry. Where’s the medical connection?

I’m an medical physicist. I’m using light to monitor brain metabolism in newborn babies who have suffered brain injury during birth.

How does your device work?
Well, if you take your phone torch and shine it through your finger, you’ll see that red light will pass through quite easily. If we shine red and infrared light into the brain, we can use some of the reflected light to understand something about its physiology. We’re hoping that the technology we’re developing will help doctors to assess the brain from the first day of life, to redirect treatment and potentially save lives.

How is your device different to the ones doctors already use?
We’re monitoring the brain’s metabolism: how it’s running all the complicated chemical reactions that make energy to allow it to develop and function. Oxygen is an essential element in metabolism, and there are devices that can monitor oxygen levels; but the only way to monitor metabolism in these babies directly at the moment is with an MRI scan.

This pioneering technology could help babies who are too ill to currently have an MRI scan

And newborns can’t have an MRI scan?
The ones we’re interested in are simply too ill to go into a scanner until they have finished treatment, which is at least 4 days after birth. The babies are treated with cooling therapy - their body temperature is reduced to 33.5 degrees, which slows down metabolism. This reduces the risk of death or disability – for every 7 babies treated with cooling, 1 will have a better outlook.. But a lot of babies aren’t benefiting, and hypothermia is an intense treatment.

Doctors are interested in having a way to monitor metabolism at the cot side from the first day of life so that they might be able to tailor treatment to the individual babies.

Is your device safe?
Yes, and non-invasive. We use an old-fashioned tungsten halogen light bulb and it’s filtered so that it emits only infrared with very low power. Obviously, safety has the highest priority in medical device development.

The device uses an old-fashioned tungsten halogen lightbulb and is filtered so that it emits only infrared with very low power

And what can you learn?
Looking at the colour coming out of the brain, we can tell how oxygenated the blood is. Well, oxygenated blood is bright red; deoxygenated blood is more purplish. But here’s the clever bit: there’s an enzyme in metabolism that also changes colour when it does its work.

And an enzyme is – ? Just remind me!
It’s a chemical that facilitates a reaction between other chemicals, a catalyst for reactions. And this particular enzyme – it’s called cytochrome-c-oxidase – changes colour when it facilitates one of the final reactions in oxygen metabolism. We can monitor this colour-changing enzyme to give us an indication of metabolism levels.

And what have you found?
The way that the brain’s metabolism functions in babies with more severe injuries – babies at risk of death or cerebral palsy – is really different to that of less severely injured babies. We think that having a way of monitoring important parameters, such as oxygenation and metabolism, will give doctors a better understanding of the brain and the injury, so this technology has the potential to influence the management and treatment of brain injury.

Shedding light on baby brain injury takes place on Thursday 13 September, at 13.00 at Middleton Hall, University of Hull.

Book your tickets here