[picture id="4KN7V2R_Matai_scanner_JPG" crop="16x10" layout="thumbnail"] The MRI scanner at the Mātai Medical Research Insitute. Photo: RNZ / Jimmy Ellingham
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Normally staying still is a key instruction for any MRI scan. But Professor Justin Fernandez has other ideas.
He wants people to fidget.
Fidgeting and ADHD
Justin is a professor at the Auckland Bioengineering Institute, part of the Musculoskeletal Modelling Group. He became interested in the fact that many people with ADHD walk slightly differently and tend to fidget more.
So, in collaboration with the Mātai Medical Research Institute in Gisborne, he set about investigating this using MRI.
Step one was to devise a way to allow fidgeting while also getting a good image of the person's brain. In the end, Justin and the Mātai team figured out a system where they could isolate a person's feet for fidgeting, while still being able to keep their head still enough for the MRI scan.
MRI plan in place, they recruited people with ADHD, and then recruited age- and gender-matched 'control' participants, which Justin refers to as neurotypical.
Mātai Institute magnetic resonance imaging machine at its brand new campus in Gisborne-Tairāwhiti. Photo: Mātai Institute
Once inside the scanner, they asked their recruits to do some psychology tests that get them to focus and make decisions. Both groups were asked to do these tests without fidgeting, and then again as they fidgeted, while the MRI looked at their brains.
When people are asked to focus, there's generally an increase in oxygenated blood flow to the frontal regions of their brain - in particular the prefrontal cortex, a part of the brain involved in decision-making. People with ADHD, Justin says, tend to have an under-activation in that part of the brain when they concentrate.
Justin Fernandez tests out how fidgeting in the MRI machine at Mātai Medical Research Institute works. Photo: Auckland Bioengineering Institute / University of Auckland
But in running this experiment, they got some really interesting results.
For people with ADHD, when they concentrated while fidgeting, the activation levels in that frontal region of the brain increased.
Whereas in contrast, Justin says, "we found that a lot of people who are more neurotypical, their activation levels went down. It's almost as if the fidgeting was distracting for them."
They are keen to explore this finding further, and for Justin, it's a reminder that our brains all work slightly differently.
"When you see people fidgeting at school or on the bus, rather than looking at it as an annoying activity, actually understanding that, maybe they're more movement diverse and this is how they're doing things to cope."
Professor Justin Fernandez. Photo: Auckland Bioengineering Institute / University of Auckland
MRI as a potential diagnostic tool
The research also has a wider goal and focus beyond fidgeting: investigating different indicators in the brain to develop an ADHD 'brain atlas', to better understand ADHD and help with diagnosis.
So, while participants are in the scanner, they also use the MRI to map the geometry, structure and chemical signatures of their brains. At the moment, the full research test takes 40 minutes, but for this to be useful for clinicians (because MRI time is not cheap) it needs to be much shorter.
Justin and the team are hoping to identify and home in on those important markers, with the goal of reducing the test time to 15 minutes.
All going well, they aim to do clinical tests across New Zealand at multiple MRI sites towards the end of this year.
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