Press Release Dated: October 1, 2013 University of Houston

By: Toby Weber

Published on the website: http://www.eurekalert.org/pub_releases/2013-10/uoh-psr100113.php

Research on surgery to treat Parkinson's patients receives a research grant from the National Science Foundation NSF.

A member of the University of Houston engineering faculty is working on improving DBS surgery.

A researcher at the CULLEN College of Engineering at the University of Houston has won a research grant to improve brain surgery in severe Parkinson's patients, making them more effective and safer.

The research grant was given to Nori Insa, an assistant professor of biomedical engineering by the NSF and is worth $330000 for three years of work.

Insa, in collaboration with Dr. Aviva Abush, a brain surgeon from the University of Colorado School of Medicine will be used to fund ways to improve DBS surgery.

In this surgery, an electrode with a cross section of a few millimeters is inserted into the brain. When connected to a battery, a series of contact points on the electrode can be used to both stimulate and record electrical activity in nearby neurons. The goal is to bring the electrode to the subthalamic nucleus (STN), a small football-like area of ​​the brain that helps control movement. In Parkinson's patients this area is not stimulated, which is manifested in signs such as tremors and difficult mobility. In most patients this can be controlled with drug therapy, but in some there is no response to treatment. If symptoms become severe they are candidates for DBS surgery.

One of the main challenges in surgery is to precisely place the electrode in its intended place. The STN is located about 7.5 cm below the skull and is a tiny 6x4 mm, this makes it difficult to accurately insert the electrode into the STN says Insa and this is exactly the problem he intends to solve.

Today, surgeons insert several micro electrodes into the brain that will pick up electrical activity in the hope that this will reveal the location of the STN. But this electrical activity is difficult for surgeons to interpret, especially during surgery.

Today, the capabilities of the STN-directed electrode are also being ignored, says Insa. The contact points on the surface of the electrode can not only stimulate electrical activity, but also record such activity. Therefore I will try to develop methods for analyzing markers, which interpret the electrical activity recorded by the electrode. These methods give surgeons feedback on the position of the STN in real time. while giving the possibility of receiving the intention to place the electrode in its place. This will make it possible to shorten the analysis time and increase its accuracy more than ever. "Initially we will record the electrical activity in the brain and then by processing the signals we will try to understand if we are in the right position and which contact points of the electrode we should use," he says. "The electrical activity that we actually record from the contact points hints to us." This is especially important when considering what is happening today in DBS surgery. Patients should be awake throughout the operation to show how they respond to electrical stimulation. If for example, if the tremor decreases or increases, this can provide important information to the surgeons. Since the situation in which patients remain awake during the entire operation is traumatic, methods to shorten it are important. In addition, the new method can prevent repeated insertion of the electrode until the STN is found. Fewer insertions mean less bleeding, shorter surgeries and shorter recovery time, Insa says.

To carry out the research, Insa will be present at DBS surgeries where he will offer interpretation of the information and help guide surgeons in electrode placement.

Later, he will examine information recorded during the surgery and try to create methods for processing the signals that will automatically show the direction of the electrode. "We want to give the surgeon intelligent feedback. If the surgeon can get cues, that's extremely useful. It will lead to more efficient surgeries with better patient outcomes," he says.