Cedars-Sinai Medical Center in Los Angeles keeps on developing innovative research programs designed to improve the health of people of all ages. On September 30, 2021, the hospital announced the beginning of its participation in a major study of childhood neurological growth.

Working toward healthier brains

This HEALthy Brain and Child Development (HBCD) Study, administered under the auspices of the National Institutes of Health (NIH), represents a major advancement in the field, since scientists have to date learned comparatively little about brain development during the first 10 years of life. The study is planned to follow participants, currently pregnant people and their children, for the entirety of that first decade.

Cedars-Sinai, one of the leading research and teaching hospitals in the nation, is one of 25 medical institutions actively participating in the project. Boston Children’s Hospital, Johns Hopkins University, Emory University, and Pennsylvania State University are among the other participants. All these institutions are located in regions especially hard-hit by the opioid epidemic.

We know that the first few years of a child’s life are a time when the brain and nervous system are in a state of constant growth. What we don’t completely understand is how exposure to various environmental toxins and stressors, immediately before and after birth, affect the course of development over the long term.

A new way to address the opioid crisis

The HBCD study grew out of the realization that the current opioid crisis is having major adverse effects not only on the individuals struggling with addiction, but on the development of their young children. From 2010 to 2017, the number of pregnant people who received diagnoses related to opioid use at the time they delivered their babies increased by 131 percent. And an estimated 2 million people in the United States are living with ongoing opioid addiction.

These tragic outcomes are in large part due to practices on the part of the pharmaceutical industry over the decades. In promoting their opioid-based pain medications, the companies downplayed their potential for causing addiction. Alongside each individual tragedy of this epidemic is the impact on entire communities in the form of lower economic productivity and growth, and the effects of lasting intergenerational trauma in families.

A new framework for understanding the brain

The HBCD researchers hope to develop a template that outlines normal neurological development in children, and to measure the extent to which exposure to substances (including tobacco, alcohol, and opioids) and traumatic environments, both before and immediately after birth, contribute to moving children’s brain development away from these norms. A greater understanding of normal brain development trajectories will be central to gaining knowledge of how exposure to toxic substances and other negative environmental influences can alter them.

The researchers’ ultimate goal is to discover factors that can help develop innovative interventions, and that can promote greater resilience in children negatively affected by early exposure to opioids and other harmful substances.

Researching for the future

The study’s results should also be able to contribute to a better understanding of critical public health issues, including any potential effects on development due to the SARS-CoV-2 pandemic, and to any analogous health or environmental crises that emerge. The results of the researchers’ work will likely become a valuable repository of information for future scientists, as well as for practicing physicians, child development experts, and community leaders, for generations.

Specific study activities that offer potential for practical applications include the creation of technological advances in neuroimaging and infant neurological assessment, and multi-pronged means for assessing all aspects of early neurological development, including emotional development.

An expert leader

Wei Gao, PhD, serves as the director of Neuroimaging Research with Cedars-Sinai’s Biomedical Imaging Research Institute. On the occasion of the hospital’s announcement of its participation, Gao told reporters that the sooner that physicians can identify young children with an elevated risk of developmental problems, the faster and more efficiently these young patients can receive the best possible treatment. Gao is the principal investigator and director of the Los Angeles area component of the HBCD project. Cedars-Sinai and other local medical facilities will use NIH grant funding totaling almost $6 million to work with pregnant people and their children in the study. Over the course of his previous scientific work, Gao has gained a global reputation for his expertise in using MRI (magnetic resonance imaging) technology to trace previously unknown aspects of early childhood brain development. Among his signal research achievements is a study demonstrating how the growth rates of a baby’s brain cells can help physicians infer the degree of emotional and intellectual capacity that child might develop by age 4. This is the type of information that can lead to increased timely interventions to offset early developmental problems. Gao is also well-known for his design of a special crib to be used in MRI imaging facilities. The crib is more compatible with the MRI process, allowing for greater ease and accuracy of imaging.

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