The Neuroscience team is dedicated to engaging in translational research, where clinical problems are taken from patients' bedsides to study in the laboratory. Laboratory discoveries are then converted into new treatments, preventions and therapies for patients.
Neurosurgical research is conducted in collaboration with the Neuroscience Research Laboratory, a division of Neurosurgery at The Medical College of Wisconsin. The lab occupies more than 25,000 square feet of space and employs eight doctorate-level researchers and 20 support staff for federally and privately funded research.
Neurology and Neurosurgery research teams not only collaborate with local organizations such as Children's Research Institute and the Medical College, but also with children's hospitals across the country to enhance the care for children and adolescents with neurological disorders.
- Harry Whelan, MD, Bleser Family Chair in Neurology, has been inducted into the NASA Space Technology Hall of Fame for his research into the use of near-infrared LEDs for wound healing and the treatment of brain tumors. In a multiyear investigation approved by the Food and Drug Administration, Dr. Whelan found that diabetic skin ulcers and other wounds in mice healed much faster when exposed to the special LEDs in the lab. In a separate protocol, Dr. Whelan is studying the use of LEDs to promote healing of acute mouth ulcers resulting from chemotherapy and radiation used to treat cancer in children.
Dr. Whelan is the principal investigator on a grant from the National Institutes of Health studying near-infrared light therapy for neurodegenerative diseases, such as Parkinson's and diseases of the visual system. He also is conducting a pilot study supported in part by the Clinical Translational Science Institute of near-infrared light therapy for diabetic macular edema, a form of diabetic eye disease. Dr. Whelan presented this translational bench-to-bedside research to the United States Congress at the NASA Spin-off Day on Capitol Hill as an example of how space research is helping patients.
- Catherine Amlie-Lefond, MD, is participating in local, national and international studies in childhood stroke. Under Dr. Lefond's leadership, Children's Hospital is a contributor to the International Pediatric Stroke Study organized through the Hospital for Sick Children in Toronto. The IPSS has collected information on more than 1,800 children with stroke in 12 countries to understand childhood stroke, potential triggers and prevention.
Physicians and researchers have joined a partnership of 11 children's hospitals and universities across the country to find out which of two commonly prescribed medications is best for treating seizures in children in the emergency room. Because seizures can be life threatening if not stopped immediately, medication has to be given within five minutes of a child's arrival in the emergency department. There may not be time to talk to a child's parent or guardian about the study prior to treatment. In that case, a child may be enrolled in the study without a parent' s permission. For more information visit www.childrensnational.org/seizurestudy/ or call (866) 377-8557.
- Kurt Hecox, MD, PhD, and Michael Schwabe, MD, continue to investigate the use of advanced signal processing methods to extract information from the electroencephalography signal. This would allow the early detection of seizures, increase the effectiveness of computerized seizure detection systems and improve the accuracy of locating the site of onset of seizures in children with medication-resistant epilepsy. There are plans to apply these same techniques to the EEG data pool from the Food and Drug Administration's sponsored study trial examining childhood absence epilepsy in more than 300 children.
- Charles Marcuccilli, MD, PhD, director of Epilepsy at the Medical College, Sean Lew, MD, Andrew Tryba, PhD, and the epilepsy research team are collaborating with other researchers to study epilepsy using human brain tissue - one of only a few programs in the country capable of this technique. The epilepsy research team was the first to identify intrinsic burster cells in humans. These brain cells are thought to initiate seizures. These investigators further classified the mechanism underlying the bursting activity. Through this process, investigators not only can identify the source of the seizure, but also the entire network of abnormal tissue found throughout the brain. The goal of this research is to allow better localization of the seizure focus, improve efficacy of antiepileptic medication and prevent seizures.
Investigators are looking at the specific gene expression changes and testing drugs on certain brain tissues. This research will help identify the correct treatment options for patients on the first round, as well as identify drugs that could be harmful. This translational research will allow investigators to make recommendations to physicians on which medications to use within as little as 24 hours.
Neuroscience team members are involved in multiple investigational drug studies for epilepsy. Many of these clinical trials are looking at drugs that are approved for adult patients but have yet to be proven in pediatric medicine.
- Keri Hainsworth, PhD, is leading a study that evaluates the benefits of yoga on pediatric headaches. Through the Headache Clinic, children with any type of headache - from minor to severe - are eligible to participate. The eight-week yoga class will involve the Iyengar style of yoga and is based on the hypothesis that healing takes time. In the future, Dr. Hainsworth hopes to expand her research on the benefits of yoga to other conditions, such as obesity and anxiety.
- John Jensen, MD, and Dr. Lew are conducting a clinical study that monitors intracranial pressure and cerebral perfusion pressure during sagittal synostosis surgery in infants. Dynamic cranioplasty, or directly applied force on the exposed skull, is a surgical technique commonly used to remodel cranial vaults in infants with craniosynostosis. The study is evaluating whether this technique causes intracranial hypertension that has the potential to damage the brain. A secondary goal of the study is to evaluate a modified technique that accomplishes the same cosmetic effect without exposing the patient to a period of intracranial hypertension.
- Bruce Kaufman, MD, Dr. Lew and Marike Zwienenberg-Lee, MD, have joined a multi-institutional ShuntCheck study to investigate a newly developed noninvasive device for assessing ventriculoperitoneal shunt function. The study would aim to compare the diagnostic accuracy of the device to current diagnostic modalities used to evaluate shunt patency in symptomatic patients. The study also combines the device results with other diagnostic methods, including the neurosurgeon's clinical judgment, to improve the overall accuracy of diagnosing cases of suspected shunt failure.
Drs. Kaufman, Lew and Zwienenberg-Lee are examining surgical outcomes using nonpenetrating titanium clips for dural closure in pediatric intraspinal surgery. This novel technique can result in a less invasive surgical approach with potentially shorter operative time while continuing to achieve a low rate of postoperative complication from a cerebrospinal fluid leak.
Dr. Lew and colleagues published a review of their experience utilizing a modified osteoplastic orbitozygomatic craniotomy for pediatric neurosurgical cases that required improved visualization of the anterior and anterolateral skull base. This surgical technique proved advantageous in ease of use, achieved superior operative exposure that minimized risk to the patient by decreasing brain retraction, and lessened the risk of perioperative infection by maintaining a vascularized bone flap. It also resulted in improved cosmesis and function of the temporalis muscle anatomy.
- Dr. Zwienenberg-Lee and Sachin Jogal, MD, are lead investigators in a multidisciplinary preclinical study investigating the use of selenoproteins for the prevention of radiation-induced injury in pediatric brain tumors. Brain irradiation is a standard adjuvant treatment for many pediatric brain tumors after surgical resection and has resulted in long-term tumor control. However, many brain tumor survivors develop serious side effects, including decreased cognitive ability, visual perceptual skills, information processing and social skills, poorer memory and concentration skills, hormone deficiencies, hearing and growth impairment. Administration of selenoproteins immediately following radiation therapy may prevent the occurrence of some of these side effects. Mechanisms of cellular injury and cognitive decline after brain irradiation also are being explored in relation to this study.