Welcome to the COMIC Lab!

kristin guilliams
division of pediatric neurology
department of neurology
division of critical care medicine
division of neuroradiology
mallinckrodt institute of radiology
department of pediatrics
washington university in st. louis
st. louis children's hospital

Established in 2019, the COMIC lab uses non-invasive magnetic resonance imaging (MRI) techniques to understand how blood flow and oxygen use changes as the brain is growing and developing throughout the first several decades of life.

Blood vessels in the brain expand and contract naturally to regulate blood flow to different parts of the brain. Blood vessels expand and contract in response to brain activity (i.e. thinking or moving your hand) or to molecules in the blood (i.e. carbon dioxide). We know that some diseases impact the ability of blood vessels to expand and contract (also called cerebrovascular reactivity). We think that this reactivity may naturally vary in healthy children, based on their age and brain developmental stage. However, if the brain’s blood vessels have less ability to expand and contract than typical for their developmental stage, this may not allow the brain to function and grow normally and may even increase risk for small strokes.

The COMIC lab is able to measure the brain’s blood vessel reactions using an MRI machine and a special mask that regulates the amount of carbon dioxide an individual breathes over a short period of time. Carbon dioxide is a part of the natural makeup of the air we exhale (and it’s what makes bubbles in our carbonated drinks, like soda) and is not harmful in small amounts. Our bodies also produce carbon dioxide when we exercise. Using this mask technique generates the same feeling as the effect of walking up a flight of stairs or holding one’s breath for 10 seconds, without actually having the participant move (which would make using the MRI scan impossible). We are excited to be the first team to bring this new method of cerebrovascular reactivity research to Washington University in St. Louis.

We are particularly interested in understanding the blood flow, oxygen use and blood vessel reactivity in people with blood disorders, such as individuals with sickle cell disease, or individuals who have vascular variances, including children who may have required vascular surgery for extracorporeal membrane oxygenation (ECMO). By better understanding how blood vessels, blood flow and oxygen use may or may not be different in these individuals, we can provide new information to help build better interventions and treatment options.

Led by Dr. Kristin Guilliams, the study team works to turn neurology research and science into an experience of adventure for our pediatric participants. We are grateful to our wonderful participants who make our work possible by giving of their time and energy to advance the knowledge and improve the clinical care given through Washington University in St. Louis and beyond.

Find summaries of our studies on ClinicalTrials.gov