Tomo Tarui, MD is an Assistant Professor of Pediatrics and Neurology at Tufts University School of Medicine and Director of the Fetal-Neonatal Neurology Program at the Tufts Medical Center. Dr. Tarui has a unique clinical expertise and has been actively involved in the prenatal diagnosis and management of fetal brain disorders as well as long-term follow up after birth. Dr. Tarui’s patients and their families have inspired his research.
Goal of the Tarui Laboratory
The goal of Dr. Tarui’s research is to develop novel fetal neuroimaging and genetic diagnostic technologies for brain malformations that are detected in fetuses by second trimester prenatal ultrasound examination. Findings from this study will develop better ways to understand the long-term prognosis for fetuses that are identified as having brain malformations. The data will also be used to ultimately develop novel fetal treatments that could potentially improve neurodevelopmental outcomes in these affected children.
Research in the Tarui Laboratory
- Brain malformations - Agenesis of corpus callosum, cerebral ventriculomegaly, cerebellar malformations (cerebellar hypoplasia, Dandy-Walker malformation), lissencephaly, polymicrogyria
- Spinal cord malformations - Myelomeningocele
- Genetic disorders - Down syndrome
- Others - Twin-twin tranfusion syndrome
A Novel imaging technology with Fetal MRIs for 3-D Images of the Brain
Clearer and more accurate than ultrasound examinations, fetal MRI poses no risk to the baby. Fetal MRI technology is used in everyday clinical work as part of advanced obstetrical care such as prenatal diagnosis of fetal brain malformations. Dr. Tarui’s team will utilize these imaging data for further analysis using an innovative computer software program to reconstruct a three-dimensional image of the brain, allowing them to determine structure, measure volume, calculate shape and analyze surface, curvature and slopes.
By measuring the fetal brain volume – both as a whole and in individual pieces - and reconstructing the brain surface, Dr. Tarui will examine the cerebral cortex, cerebellum which controls intellect and movement, and record any changes in the latter half of the pregnancy.
Examples of fetal neuroimaging analysis at Tarui Lab (right). Agenesis of corpus callosum (ACC): The original fetal MR images will be labeled for individual pieces (first row) to measure each volume. Surface of the brain is then reconstructed from these data to analyze how surface folding is different between fetuses with brain malformations (in this case agenesis of corpus callosum) and healthy fetuses (second and third rows). The figure also shows how brain surface folding matures through the pregnancy (from 19 to 33 weeks of pregnancy).
The Tarui Lab tries to detect such alterations in brain surface development more precisely than may be detected in the usual manner of imaging.
Fetal Gene Expression Analysis Using Discarded Amniotic Fluid Samples
Dr. Tarui’s team will also analyze amniotic fluid from women pregnant with fetuses with brain malformations. Amniotic fluid tests are used in everyday clinical work to diagnose fetal genetic anomalies. The remaining amniotic fluid sample (supernatant of amniotic fluid) is usually discarded. Using advanced genetic analysis technologies such as whole genome microarrays, researchers can analyze gene expression patterns of the samples to determine which genes are turned on or off in living fetuses with brain malformations.
By examining specific changes in gene expression associated with the malformations, Dr. Tarui’s aim is to develop hypotheses for treatments to correct these diseases in affected fetuses in order to potentially improve neurodevelopmental function after these children are born.
If you would like to learn more about the study, please contact:
Dr. Vidya Iyer (Study coordinator)