Why Does Medical Research Matter?
Medical research generates great value to us all. By understanding diseases we can improve health and extend life. At Penn Neurosurgery, we conduct research studies to understand the mechanisms of brain and nervous system injury so we can improve diagnoses and provide new treatment approaches. Many of the neurosurgery research we perform focuses on repairing injuries and restoring function that otherwise might be permanently affected. Here are a few innovative studies underway at Penn.
Brain and Spine Research Studies at Penn
Developing a Blood Test for Brain Damage
Collaborating with national and international institutions, Penn is developing a prognostic blood test that would detect and measure neuronal proteins in the cerebrospinal fluid. These neuronal proteins, or biomarkers, could help identify higher risks of problems with brain function including cognitive difficulties and structural damage. This study is building toward the day when an athlete, accident victim, soldier, or other brain injury sufferer could undergo blood tests to predict the severity of the long-term impact — just as we can now correlate a high blood cholesterol level with future cardiac risk, for example.
Focusing on Nervous System Pathways after Brain Injury
Penn Neurosurgery's Center for Brain Injury and Repair is a recognized leader in building the evidence base so critically needed to guide decision-making in the aftermath of mild traumatic brain injury. Led by Doug Smith, MD, research has been focused on understanding what happens in the brain at the moment of impact and what keeps happening in the 20 percent of those individuals who have long-term problems. Dr. Smith and his research colleagues were the first to show that the root cause of concussion is the stretching of the brain's axons. The team is working on the next generation of restorative therapies and mimicking the anatomy of what is missing to make people whole again including pioneering brain repair techniques that involve actually growing new axons outside the body in cell culture.
Unraveling the Physiology of Traumatic Brain Injury
Neurosurgeon Sean Grady, MD, and neuroscientist John A. Wolf, PhD, researched what changes are happening in important cognitive areas of the brain following a traumatic brain injury and whether we can predict who is likely to suffer long-term effects. To date, most research on the effects of brain injury has looked at the structural impact on the brains of deceased people or animals who suffered repeated head trauma. Dr. Grady focused on developing a deeper understanding of how communication is disrupted in the living brain after concussion. By implanting electrodes and tracking activity in individuals post-injury, the team can measure both brain wave activity in the hippocampus using EEG and as a single-neuron activity. By understanding the neurophysiology, neurosurgeons can intervene earlier and develop drug therapies for post-concussion symptoms.
Restoring Communication Between Brain and Body
Neurosurgeon Tim Lucas, MD, PhD, and senior investigative scientist Andrew Richardon, PhD, are paving the way toward more advanced treatments for paralysis by researching ways to "bypass" interrupted circuitry in the brain caused by conditions such as spinal cord injury or stroke. The team has created a system of small wearable devices that can communicate with each other wirelessly to generate sensations and movements artificially. This revolutionary approach holds forth the promise of a day when paralyzed people could move their limbs.
Brain-Mapping Technology at Penn
Neurosurgeons at the Penn Brain Tumor Center are using a revolutionary brain mapping technology that can visualize white matter tracts, the bundles of nerve fibers that carry messages throughout the brain. Diffusion Tensor Imaging, or DTI, works by measuring the direction in which fluid moves within the brain, gathering data to help determine the location and function of different brain fiber clusters. Advanced diffusion tractography software then uses that data to produce 2D or 3D maps of the brain that reveal its internal wiring. This technology is especially helpful for removing brain tumors and sparing healthy brain tissue in the process.
Glowing Tumor or Fluorescence-Guided Surgery
Neurosurgeon John Y.K. Lee, MD, is investigating the use of an injectable fluorescent material that is taken up by cancer cells and renders them visible using an infrared camera. Higher grade brain tumors such as glioblastomas are known for spreading throughout the brain even after the tumor is successfully removed. By injecting a fluorescent dye, surgeons will be able to see and remove the tiniest cancer deposits.