Helen Jaques: Reporting from the front line of research

Helen JaquesMonday morning. Wake up, drag yourself into town . . . and spend 45 minutes or so in a magnetic resonance imaging machine. That’s how I spent my Monday morning at least.

I was volunteering as a research subject at the Wellcome Trust Centre for Neuroimaging, just round the corner from the BMJ offices in London. The centre is home to about 100 clinicians, scientists, and support staff who study higher cognitive function using neuroimaging techniques.

My role was to take part in a functional MRI study of how brain activity changes during pitch perception. The aim of the study was to localise the region in the temporal cortex responsible for determining changes in pitch.

On my arrival at the centre, Sukhbinder Kumar, a research fellow and a member of the institute’s Neurobiology of Sound Group, explained the study to me. I was to lie prone in a head and neck MRI machine and listen through headphones to sets of four noises. Every now and then the fourth noise would be a different pitch to the previous three noises, at which point I was to press a button to indicate the change.

Throughout this process the functional MRI scanner would be monitoring the levels of oxygen in the various parts of my brain to determine blood flow and, therefore, activity in specific regions. Dr Kumar had already carried out promising pilot tests of this process and was now hoping to study the brains of 15-16 individuals, me being his first subject.

Before we could get started I had to answer a long list of questions to identify whether I had any metal in my body that might be attracted to the giant MRI magnets. This encompassed earrings and other jewellery, but also medical chunks of metal like plates and pins in fracture repairs and less obvious bits like coronary stents. I was also asked if I had ever worked on a building site and thus been exposed to metal shards or slithers, or if I had been exposed to shrapnel during warfare—no stone left unturned here.

I then met the radiologist and got my first glimpse of the MRI machine. I’ve seen countless MRI images and read about all sorts of MRI studies, but I’ve never seen the actual machine. It was huge but initially not that intimidating . . . until I saw the rabbit hole I was about to be poked in to.

I was laid down on the bed that would insert me into the machine and given a pair of headphones to wear. The radiologist and Dr Kumar were going to be in a control room behind a big heavy door during the study, so I was relieved to be given an emergency button as well the button I would press in response to pitch changes. I also had a pulse rate monitor attached to my index finger so they could tell empirically whether I was panicking.

Finally, once my head and shoulders had been wedged firmly into an immovable position, a rather disconcerting cage structure with a backwards facing mirror on it was put over my face. The mirror would reflect to me a screen on the back wall of the MRI machine so I could read the study instructions and focus on the screen while the study was taking place. The cage? Not so sure. Presumably to further make sure I didn’t move an inch.

I was inserted into the ominous darkness of the machine and we were off. Almost. I hadn’t clocked that the belt on my skirt had metal in it and the minute the machine was switched on the buckle duly leapt into the air and headwards, so we had a brief interlude while the offending item was removed.

Finally we started the study proper. I had been warned that MRI machines are a bit on the noisy side; in fact, most subjects at the Centre for Neuroimaging are given earplugs to wear during scanning. Given that I was taking part in a study on sound perception I didn’t have this luxury, and was subjected to quite a cacophony during the study.

To start with the machine made a constant slow thudding background noise that sounded like someone a few doors down was having a really good party. Once the machine started scanning a noise rather like a pneumatic drill kicked off, accompanied by what sounded like a helicopter circling above. To top things off, the varying pitch sounds I was listening to for the study weren’t pleasant beeps but rather bursts of white noise, which gave the impression that I was intermittently being shot with lasers.

I must confess I found the first 10 minute test quite frightening—the racket plus the fact I was in a small confined space was not a recipe for a relaxing lie down. I made a deliberate effort to breathe deeply and slowly though, as I was conscious that the pulse rate monitor on my finger could give away the fact I was on the verge of losing it and would make me look like a bit of a wimp to say the least.

We bashed straight through the four 10 minute tests that made up the functional MRI part of the study. I was then on the home straight and had just a two minute and a 12 minute sagittal structural MRI to get through.

I was pretty relieved when the study was over and I was drawn out of the MRI machine. I was quite surprised at how unsettling I had found the process and was a little shell shocked as I made my way to the control room to have a look at my scans.

The radiologist was able to run through my sagittal scans so it appeared that we were reversing quickly from the right side of my head through to the left. Familiar structures like the corpus callosum and cerebellum were bright and clear, as were smaller, finer structures like the lenses in my eye. I was promised copies of my scans so am looking forward to studying them in more detail.

Overall the experience was a bit disquieting but a novel one that has given me a rare first hand perspective of the coal face of medical research. I left the centre with a complimentary mug in my hand and a warm glow in my heart knowing that I had made my own small contribution to neuroscience.

• If you are over 18 years of age and want to take part in a neuroimaging study, you can sign up at the Centre for Neuroimaging website: http://www.fil.ion.ucl.ac.uk/Volunteers/

Helen Jaques is a technical editor for the BMJ