A unique way to understand Lyme disease. The organism (Borrelia burgdorferi) that causes Lyme disease is tricky and elusive once it enters human tissue, making diagnosis difficult. In the past, scientists lacked a laboratory model to examine how the bacteria behave once they invade the body. NICHD scientists overcame this obstacle by creating a medium for successfully studying Borrelia burgdorferi in a research setting. Unlike a classical two-dimensional medium often used to study microorganisms—such as that contained in a Petri dish—the investigators simulated a three-dimensional human environment by placing tonsillar tissue in a rotating bioreactor that maintained the tissue’s structure. Then, using light and electron microscopic analysis and a very sensitive technique called polymerase chain reaction (PCR), the researchers confirmed that the system can successfully find and study the bacteria after invading human tissue. This creative “tissue environment” provides scientists with a unique way to observe the invasive nature of Lyme disease bacteria at the molecular level and to explore how they genetically adapt to the human host. Just as importantly, the system allows researchers to study the process by which the bacteria cause disease under a variety of controlled laboratory conditions, many of which could be difficult to replicate in human beings. With 16,000 new Lyme disease cases reported in the United States each year, [i] this new technology should help researchers discover how untreated infections can thrive undetected for long periods of time, leading to such complications as arthritis, cardiac abnormalities, meningitis, and serious neurological conditions.

A child’s ability to walk. Each year, parents of about 8,000 infants and 1,500 preschool-age children will learn that their child has cerebral palsy (CP), a condition that can impair a child’s ability to walk.[ii]   Children with CP cannot control their muscles normally, and some muscles, such as the hamstrings, become too short or too tight to move properly. Surgery to lengthen the hamstrings can dramatically improve some children’s gaits, but other children may receive little or no benefit. In fact, for some children, their walk actually worsens after surgery to a point where they can walk only with their knees and hips continuously bent. To identify which children with CP would benefit from hamstrings-lengthening surgery, researchers developed a three-dimensional computer model to simulate the musculoskeletal system, allowing them to study the underlying causes of abnormal gait in children with CP. This powerful new model is 100 times faster than previous means of studying human movement. The new computerized approach, which can be applied to other muscle and bone disabilities, allows clinicians to predict more accurately if surgery or an alternative treatment is best for improving an affected child’s gait. Enabling clinicians to pinpoint the best time in a child’s development at which to perform surgery should reassure parents that they are making the best decision to improve their child’s health.

Evaluating stroke patients. A key step in planning any large national clinical trial is to ensure that researchers have robust and valid tools with which to collect and analyze data about observed health outcomes. This step ensures the validity and reliability of data collected at multiple sites by different investigators. To that end, researchers recently assessed the Wolf Motor Function Test (WMFT) as a means of accurately measuring change in subacute stroke patients- those who experienced a stroke only three to nine months earlier. The WMFT is a laboratory-based evaluation instrument that previously had been used to measure progress in regenerating neural function in patients who had sustained chronic strokes; it had never been used to test function in the subacute stage after a stroke. This period is particularly important— while outside the window of most current rehabilitation services, it is still within the timeframe when it is possible to influence changes in neural cells and pathways. The WMFT proved to be reliable and accurate when used to measure change in subacute stroke patients. With this rigorous tool in hand, the researchers were able to plan and execute a large clinical trial that could change current rehabilitative practice and outcomes for stroke patients.