Supplement could prevent hydrocephalus

  • Deborah Condon

A vitamin supplement taken by women while they are pregnant could prevent one of the most common birth brain defects – hydrocephalus.

Sometimes referred to as ‘water on the brain’, hydrocephalus occurs when there is an abnormal build-up of fluid within the chambers of the brain. This fluid is cerebrospinal fluid, a clear fluid that surrounds the brain and spinal cord. This build-up can cause harmful pressure on the tissues of the brain. The condition affects around one in every 1,000 babies born.

Now, in laboratory tests, scientists from the University of Manchester and Lancaster University in the UK have shown that administering a combination of folate vitamins (tetrahydrofolate and folinic acid) dramatically reduces the risk of the condition.

“The fluid build-up – usually caused by a blockage in the fluid’s pathway due to trauma, infection or abnormal development – is associated with an increase in the pressure on the brain resulting in brain damage. When this happens, doctors can relieve this pressure only by performing surgery,” explained lead researcher, Dr Jaleel Miyan of the University of Manchester.

He said that their studies had revealed that hydrocephalus is associated with a change in the composition of the cerebrospinal fluid and it is this chemical change that prevents normal growth of the brain cells, resulting in arrested brain development. This occurs prior to any brain damage due to raised pressure.

The findings led the researchers to examine ways of stimulating cell division to encourage normal brain development.

“A combination of tetrahydrofolate and folinic acid – both naturally occurring substances – stimulated brain cell growth and had a significant positive effect on brain development in laboratory experiments on rats and reduced the incidence of hydrocephalus.

“In laboratory experiments, the combined folate supplement works at any stage during pregnancy, which means that it may be effective even if it is commenced after the diagnosis of hydrocephalus is made at an 18 to 20 week pregnancy scan,” Dr Miyan explained.

In other words, the researchers believe that this combination folate supplement could be given to a woman whose foetus has been scanned and shown to have hydrocephalus, ‘to improve brain development and perhaps rescue the child from hydrocephalus’.

However the team has yet to carry out experimental studies in the laboratory to test whether treatment at later stages of development, including after birth, would lead to any improvement in the condition.

“These are really exciting findings. However it is novel work showing, somewhat controversially, that cerebrospinal fluid is not a liquid which simply cushions the brain and carries chemicals around it. It is actively produced and transported and plays an essential biological role in developing the brain,” Dr Miyan said.

Women who are planning on becoming pregnant are already encouraged to increase their daily intake of another folate – folic acid – to help prevent birth defects, such as spina bifida and anencephaly.

“Folic acid – which is a synthetic substance – helps to preserve existing brain cells, but it doesn’t promote brain cell growth. However, since there is strong evidence that folic acid prevents birth defects, women who are planning on becoming pregnant should continue to take their folic acid tablets,” Dr Miyan added.

The combined folate supplement studied by the researchers is not currently available, however further studies are underway to translate this important laboratory finding so that patients can benefit from it.

The scientists are now actively seeking support from pharmaceutical companies to produce a stable form of the supplement and to explore the possibility of starting clinical trials in women pregnant with babies diagnosed with hydrocephalus.

Details of these findings are published in the Journal of Neuropathology and Experimental Neurology.

For more information on the condition, see the website of Irish patient support group, Spina Bifida Hydrocephalus Ireland, at…

For more information on pregnancy, see...


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