Written by Alan Barker, Freelance Writer, British Science Festival 

Detecting brain damage in newborns is notoriously difficult. Gemma Bale of UCL is helping to develop an innovative method for investigating brain activity – using infrared light. Alan Barker followed her into an area of research that promises to give new hope to babies and their families.

Think of engineering and you might think of the mighty achievements of Isambard Kingdom Brunel: railways, bridges, ships and tunnels. Gemma Bale of UCL, however, who gave the Brunel Award Lecture at this year’s British Science Festival, is taking engineering into a very different environment: the intensive care unit.

In every 2000 newborn babies, three will be born with some kind of brain injury. Doctors desperately need a way to monitor the metabolism in their brains: the complex cellular chemical reactions that create energy to fuel body functions. At the moment, the only way to do that is by using an MRI scan, but these babies are simply too ill to go into a scanner for at least a week. Instead, they’re treated with cooling therapy: the body temperature is reduced to 33.5 degrees, which slows metabolism down. The treatment reduces the risk of death or disability, but hypothermia is pretty extreme, and the success rate isn’t great.

Enter CYRIL (CYtochrome-c-oxidase Research Instrument and appLication). CYRIL exploits a basic fact of life: our bodies are see-through. Different substances reflect different wavelengths: take your phone torch and shine it through your finger, you’ll see that red light will pass easily through flesh, and, more importantly, bone. That means we can shine infrared through the skull and see what’s going on in the brain. CYRIL uses an old-fashioned halogen lightbulb at one end – filtered to emit very low-powered infrared light – and a spectroscope at the other, to analyse what’s reflected back, particularly from the bloodstream. Blood itself becomes less red as it becomes deoxygenated.

Isabel de Roever and Dr Gemma Bale (left), working with the optical instrument, CYRIL (Picture: News Medical)

CYRIL’s USP is that is can also measure changes in brain metabolism in the same way. Cytochrome-c-oxidase is an enzyme that changes colour as it contributes to metabolism, so its activity can be used as a marker for metabolism as a whole. CYRIL translates that change in colour into a screen trace indicating metabolic rate in exactly the same way that monitors display heart rate or blood pressure. The device is completely non-invasive and extremely safe.

Gemma demonstrated the tech using a wired-up volunteer doing mental maths while her brain was scanned. The results were dramatic: we could see Jess’s brain working as she calculated.

The red line shows levels of oxygenated blood, the blue line levels of deoxygated blood, and the green line metabolic rate.

CYRIL allows doctors to identify newborns at particular risk of long-term injury. 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. In addition, CYRIL can help doctors understand the effect of brain seizures, which precipitate sudden leaps in metabolic rate.

And the tech might well have applications beyond neonatal care.

As she brought her lecture to a close, Gemma showed us a still from Kubrick’s 2001: A Space Odyssey. In the movie, a group of scientists are put into deep-cooled in cryogenic pods to carry them to Jupiter. Each pod has a monitor, displaying their vital signs. And there it is: a trace marked ‘METABOLIC LEVELS’. In 1968, that tech was pure scifi: no such monitor was available. CYRIL – along with Gemma and her team at UCL – are making it a reality. That’s cool.

(Picture: Still from 2001: a Space Odyssey Metro-Goldwyn-Mayer)