From testing new treatments for brain tumors and epilepsy to improving surgical techniques, the neuroscience team at Children’s Research Institute works to enhance care for children with neurological disorders.
The neuroscience team is dedicated to translational research, taking clinical problems 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 at the Medical College of Wisconsin. The 25,000-square-foot lab includes eight doctorate-level researchers and 20 support staff who regularly collaborate with children’s hospitals across the country.
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, 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, 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.
He is also studying near-infrared light therapy for neurodegenerative diseases, such as Parkinson’s, and diseases of the visual system, such as diabetic macular edema. He 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.
Physicians and researchers joined a partnership of 14 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.
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.
Sean Lew, MD, and 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 team was the first to identify human intrinsic burster cells, which are brain cells thought to initiate seizures. Investigators further classified the mechanism underlying the bursting activity, allowing them not only to 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.
Neuroscience team members are involved in multiple investigational drug studies for epilepsy, including clinical trials that are looking at drugs that are approved for adult patients but have yet to be proven in pediatric medicine. 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.
John Jensen, MD, and Sean Lew, MD, 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, and Lew joined a multi-institutional ShuntCheck study to investigate a newly developed noninvasive device for assessing ventriculoperitoneal shunt function. The study aims 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.
Kaufman and Lew 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.
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.
Sachin Jogal, MD, is a lead investigator 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.