The incidence of fetal alcohol syndrome (FAS) in the Cape Coloured (mixed ancestry) community of Cape Town is the highest reported in the world (65-74 per 1000 first grade children compared to 0.33-2 in the US and 0.97 average in the developed world) and this has increased in the last five years. The University of Cape Town (UCT) has been conducting a longitudinal study in a well-characterized cohort of 165 children with FAS and FASD (FA spectrum disorder) since 1999, in collaboration with Wayne State University. They have identified a potential sensitive biomarker for alcohol-related CNS impairment and have observed morphometric changes in cerebellum and subcortical structures based on magnetic resonance imaging (MRI) data. We feel that it is the perfect time to establish a collaboration with UCT on brain imaging techniques due to the recent convergence of several interests. In November 2006, the Cross-University Brain and Behavior Initiative (CUBBI) was launched by UCT and several collaborating South African institutions. Dr. Meintjes is a principal investigator on the brain imaging component of the initiative. Concurrently, the Cape Universities Brain Imaging Center (CUBIC) was formed through the collaboration of UCT, Stellenbosch University and Siemens Medical Solutions (SMS). A 3T Siemens Allegra scanner was installed in March and Dr. Spottiswoode is lead physicist at the center. The Martinos Center at the Massachusetts General Hospital (MGH) is the primary US academic research partner of SMS on MRI, having developed technologies such as AutoAlign and 128 channel RF coils. We will focus on the FAS work as a catalyst for our collaboration. The Martinos Center and one of its collaborators, the Oxford FMRIB, offer several training opportunities including courses on fMRI, morphometry analysis, multimodal imaging and advanced neuroimaging techniques. We will organize opportunities for UCT personnel to attend these training events and for a post-doctoral research fellow to collaborate on site with Dr. van der Kouwe on sequence projects. We will share existing motion and distortion correction technology and collaborate at the source code level. We will develop a specialized protocol for imaging children in the presence of motion on the Allegra. This scanner has unique strengths and issues related to its high performance gradients, such as gradient and B0 distortions and frequency drift, and the UCT investigators will optimize the sequences for their platform and subject population. We will incorporate real-time motion correction using cloverleaf navigators and spiral navigators into the sequences in the pediatric brain morphometry protocol. We will test the protocols in phantoms, healthy volunteers and individuals in the FAS cohort with the aim of developing local expertise in Cape Town and providing an improved protocol to obtain the best quality images for this and other studies using the Allegra. Since neuropsychiatric disorders account for the second largest proportion of disease burden in South Africa after HIV/AIDS, we anticipate that advanced neuroimaging capabilities will contribute greatly to healthcare in South Africa in the future.
Neurospychiatric disorders account for the second largest proportion of disease burden in South Africa after HIV/AIDS. The incidence of fetal alcohol syndrome (FAS) in particular communities in the Western Cape is the highest reported in the world. In this project, the University of Cape Town and the Massachusetts General Hospital will jointly develop expertise and technology for pediatric neuroimaging in the Cape population with specific interest in FAS, using newly installed state-of-the-art magnetic resonance equipment. Advanced neuroimaging capabilities in Cape Town can potentially further the understanding and treatment of brain disorders that are of great societal importance in this area of the world and also relevant in the developed world.
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