Study Reveals Noninvasive Method for Early Intraventricular Hemorrhage Detection in Preemies

“Physicians typically rely on ultrasound to diagnose these kinds of conditions, but ultrasound doesn't give you warning that a baby is likely to have a bleed, just that it’s already happened. If we can bring DCS into clinical practice, this could revolutionize neonatal care because physicians could do real-time brain monitoring at the bedside in neonatal intensive care units and potentially prevent IVH before it happens,” says senior author Jonathan Fisher, Ph.D., associate professor of physiology and director of the NYMC Neurosensory Engineering Lab, who collaborated on the study with Govindiah Vinukonda, Ph.D., assistant professor of pediatrics and of cell biology and anatomy, and Edmund F. La Gamma, M.D. ’76, professor of pediatrics and of biochemistry and molecular biology, and the clinical team in the Division of Newborn Medicine in the Department of Pediatrics.

Currently, because there are no established warning signs for IVH, there are few avenues to avert it. Hence, supportive care after the fact becomes the only treatment option. DCS measures blood flow in the microvasculature of the brain in real time by analyzing tiny changes in how light scatters off moving red blood cells, giving physicians a way to track changes in blood circulation, especially in the brain. DCS can be particularly useful in monitoring brain health in newborns and critically ill patients, helping detect circulation problems affecting the brain.

“Translating this new research to continuous bedside monitoring would afford us a window of opportunity to adjust our postnatal medical interventions and demonstrate that IVH is not a fait accompli but a modifiable risk,” says Dr. LaGamma, a neonatologist. 

“Imagine trying to develop a drug for a disease that is completely undetectable until it spontaneously appears—you don’t know if your experimental therapy has worked, failed, or, in the clinic, if the bleeding simply just happened when an ultrasound technician did the evaluation. That’s where continuous monitoring can save your research,” says Dr. Fisher. “By the time IVH is diagnosed by ultrasound, the major bleeding has already occurred and advanced. Our research, however, suggests that you can detect bleeding in its incipient stages when alterations in clinical care are still possible.” 

“Early detection may allow us to avert the problem entirely, mitigate the bleeding once it’s started, and open the door to earlier treatments using novel therapies like autologous cord blood stem cell therapy, a true bench-to-bedside step,” says Dr. La Gamma.

The study’s results highlight NYMC’s strong tradition of translational research, demonstrating the power of collaboration between basic scientists and clinicians to tackle public health challenges and improve patient outcomes. 

“In most medical schools, biomedical engineering and clinical research are siloed in separate buildings. My lab seeks out ‘moonshot’ biotechnology challenges. For diagnostics, we take inspiration from clinicians like Dr. La Gamma: if thought leaders like him have insight into what is happening inside the brains of their patients, then there must be a quantitative signal, a biomarker of some sort—somewhere—waiting for a new technology that can see it. There was a leap of faith when we started this study—if we shine a long coherence-length laser into the darkness of the cranium and ‘listen’ for photons that have ricocheted off red blood cells in the smallest vessels of the brain, can we detect a signature of IVH? Our study suggests that we can, and that is exciting and encourages us to take this further.”