Janet Soul

My research focuses on acquired brain injury in newborn infants. I am particularly interested in hypoxic-ischemic brain injury, involving a lack of oxygen and blood flow to the brain; the treatment of seizures in term newborns; and periventricular leukomalacia (injury to the white matter of the brain), intraventricular hemorrhage (bleeding into the ventricles of the brain) and hydrocephalus in preterm newborns. The broad goal of my research is to understand the causes of these brain injuries and to detect them at their earliest onset in order to develop and test neuroprotective therapies that prevent or minimize brain injury.

A current focus is improving the treatment and long-term outcomes of newborns with hypoxia-ischemia. Term age newborns with this condition can have serious long-term disabilities such as cerebral palsy and intellectual and visual disabilities resulting from brain injury. I am the Principal Investigator of a National Institutes of Health-funded clinical trial that is testing bumetanide for newborn seizures caused by hypoxia-ischemia. This is the first randomized, double-blind controlled trial of a new seizure medicine to be tested in newborns in decades, and the first to test a medicine that works specifically in the newborn brain, based on research conducted in animals. Results from this trial will be used to design larger multicenter trials of new medicines to treat newborn seizures and potentially to improve the long-term outcomes of these newborns.

Related studies are seeking to determine which newborns are most likely to develop seizures that are hard to control, the outcome of seizures and newer, more sensitive techniques to measure levels of bumetanide (or other seizure medications) in the blood and spinal fluid using very small volumes of these fluids.

In addition, I am collaborating with other investigators to study aspects of hypoxic-ischemic brain injury in term newborns. With colleagues in the Neonatal Intensive Care Unit at Boston Children's Hospital, I developed the induced hypothermia protocol used to treat these newborns to prevent or minimize brain damage from hypoxia-ischemia. Our studies include evaluation of the safety and efficacy of therapeutic hypothermia; use of advanced imaging to improve understanding of the causes, timing and prediction of long-term outcome; and evaluating the effects of treatment on the newborns' long-term neurodevelopmental outcomes.

I am also leading a project investigating the characteristics of cerebral visual impairment caused by white-matter injury to the brains of children born prematurely. Visual problems in these newborns are related to injury to the brain's visual centers, rather than eye disease. The visual perceptual problems can lead to other problems, such as learning difficulties in school and difficulties with orientation and mobility. Relatively little is known about these types of visual disorders. Our study is one of the first to look at the relationship between magnetic resonance imaging (MRI) evidence of brain injury and visual impairments detected by sophisticated tests of visual acuity and perception.