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A new university campaign called Brain and Mental Health at Oxford seeks to expand our understanding of the brain at a cellular level, exploring the impacts of mental health issues on the individual, and examining population-wide global health problems. From examining fetal neurodevelopment in pregnancy to analysing the impacts of parental psychosis, researchers at the University of Oxford are changing the way we think about parental and maternal mental health.

Our research on Intelligent Imaging in Fetal Health is led by Prof Aris Papageorghiou. It encompasses two key areas; Pregnancy Imaging Laboratory and Global Maternal and Fetal Health.

Understanding the early brain: fetal neuroscience

Oxford’s greatest minds are standardising global measurements for fetal brain growth and working with theatre directors to raise awareness of women’s lived experiences of mental illness during pregnancy and after birth.  Our experts are shaping global policy and – crucially – improving mental health outcomes for both parent and child.  

Fetal neuroimaging

The fetal brain undergoes significant changes as a baby develops, so Oxford researchers are working to improve fetal ultrasound analysis and better standardise global measurements for fetal brain growth.  The Noble Group at the Institute of Biomedical Engineering looks at questions such as why ultrasound scanning and interpretation is so hard to learn, whether AI can simplify ultrasound and whether computers can mimic what a skilled sonographer can do.  

A long-standing collaboration between colleagues from the Noble Group and the Oxford Maternal and Perinatal Health Institute (OMPHI), part of the Nuffield Department of Women’s and Reproductive Health, has led to a number of advancements in this area.  One such collaboration proposed an automated framework for predicting age and neurodevelopmental maturation of a fetus based on 3D ultrasound brain images. This is particularly important, as accurate estimation of gestational age is essential to prenatal care.  The team, which included Professor Ana Namburete (founder of the Oxford Machine Learning in Neuroimaging Lab), Professor Alison Noble and Professor Aris Papageorghiou, developed a new feature-based model that had never before been attempted. Their analysis showed that the model did not just estimate chronological age, but also the neurodevelopmental stage of the fetus based on brain structure. 


Neuroimaging - Any non-invasive means of generating images of a living brain. These are used for diagnosis of brain disease and injury and can also be obtained to show activity in the brain as various mental tasks are being performed. A later collaboration between these colleagues, which also included Postdoctoral Researcher Jianbo Jiao from the Department of Engineering Science, looked at second-trimester anomaly screening in the fetal brain.  While fetal brain magnetic resonance imaging (MRI) offers detailed images of brain development, they are not used in the second trimester due to time and cost limitations. In this case, ultrasound (US) is then employed.  Expert sonographers are adept at reading ultrasound images, but MR images are easier for non-experts to interpret. By developing methods to synthesise MR-like fetal brain images from ultrasound ones, the researchers hope their framework can be useful when communicating ultrasound findings to both obstetricians and patients. Working with Dr Lorenzo Venturini (DPhil 2022), Professors Namburete, Noble and Papageorghiou also co-authored a paper exploring the use of convolutional neural networks, or CNNs, for the segmentation of multiple fetal brain structures in 3D ultrasound images

Convolutional neural network (CNN) is a machine-learning technique that can learn to distinguish important boundaries and objects; they are increasingly popular in the segmentation of fetal ultrasound images .The proof-of-concept paper looked at whether the researchers could apply a machine-learning based method for automated segmentation of multiple fetal brain structures. This sort of accurate detection can track brain development through gestation, helping predict fetal health outcomes.  Additional work on the topic of CNNs has been conducted in collaboration with the Big Data Institute, the Wellcome Centre for Integrative Neuroimaging and the INTERGROWTH-21st Consortium.  Titled BEAN (Brain Extraction and Alignment Network), the collaborative paper presents a multi-stage CNN that allows for the actual shape of the brain to be analysed, which is fundamental to tracking how the brain matures.  


Setting standards for growth

The INTERGROWTH-21st (International Fetal and Newborn Growth) Consortium, which is dedicated to improving perinatal health, also looked at creating standards for five fetal brain structures. Fetal brain anatomy is assessed routinely as part of the 20-week anomaly scan. The measurements are assessed against one of several reference charts. However, these have limitations, and there can also be a lack of consistency in the interpretation of ultrasound images of the fetal central nervous system.  Using a study population consisting of women at low risk of adverse pregnancy and perinatal outcomes, the researchers produced international size standards for fetal brain ultrasound measurements.

Perinatal - Technically, the perinatal period starts at the onset of labour, and lasts until the restoration of the maternal uterus and the adjoining region. For statistical purposes, this period last from the 28th week of pregnancy until the end of the first week of the infant’s life. Alongside developing standards for fetal brain structures, researchers in the INTERGROWTH-21st project, which involved nearly 60,000 mothers and babies in eight urban areas in Brazil, China, India, Italy, Kenya, Omen, the UK and the USA, were also able to develop international standards for fetal cerebellar growth and Sylvian fissure maturation.  

CerebellarRelating to the part of the brain at the back of the skull that coordinates and regulates muscular activity 


Analysing fetal development

In addition to setting standards for fetal growth, experts at Oxford are analysing some of the ways in which fetal development can be affected.   For example, a paper co-authored by Professor Aris Papageorghiou looked at the development of the fetal nervous system, and how this could be affected by Brain-Derived Neurotrophic Factor (BDNF) levels in second trimester amniotic fluid. This is important as abnormalities in fetal growth can be linked to maternal, fetal and neonatal adverse outcomes.   A paper co-authored by Professor Aris Papageorghiou, Professor Ana Namburete and colleagues from Leiden University also analysed fetal brain development to help understand whether changes in fetal circulation contributes to the delay in maturation of the cortex in fetuses with congenital heart defect (CHD).  


Depression and anxiety in pregnancy

Experts at Oxford are not only working to improve aspects of fetal neuroscience, but also to improve the mental health and wellbeing of expectant mothers during pregnancy.   

Read more about this at the Brain and Mental Health at Oxford website

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