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Basic & Clinical Research
Activities is our main Research@Neurosurgery
web site for research related information. It hosts summaries of information on
both Clinical and Basic Science
research activities that are being conducted by members of the Neurological Service
at MGH.
Information about programs,
projects, and laboratories in Neurosurgery that conduct Basic
Science Research and Clinical Research can be
found under either the name of the individual Principal Investigators or under
their Laboratories. Links to the research areas are always available on the left
of your screen. Please note: the information
is indexed by type of research, but many of the Neurosurgical Service Faculty
conduct both Clinical and Basic
Science research programs. Types
of Research Activities Within
the Department of Neurosurgery itself, the research activities can be grouped
in 5 major areas: - Cerebral
Blood Vessels
- Neural Growth and Regeneration
- Brain Tumors
- Intraoperative
Monitoring and Imaging
- Cellular Neurobiology
Cerebral
Blood Vessels Blood vessels are being studied
from several perspectives. A major research program concerns the biology of cerebral
stroke. Research in this area includes studies on imaging of cerebral blood flow
with a variety of modern imaging techniques. A basic laboratory program studies
in vitro systems toward the goal of learning what might protect nervous tissue
from interruptions of its supply of glucose and oxygen. Neuroprotective agents
such as cooling and neurotransmitter antagonists are currently under study. In
addition, laboratory studies aimed at extending the in vitro studies to the in
vivo situation are carried out. Commonly ischemia is caused in a neural region,
and agents that might reduce the severity of the infarct are tested. These studies
have led to introduction of certain therapeutic maneuvers in the operating room,
notably mild cooling in patients whose cerebral circulation must be interrupted
for surgical reasons. A major research area concerns
the biology of headache. In the laboratory, the innervation of the blood vessels
has been intensively studied. The sequence of events attending migraine have been
delineated using extravasation of tracers as a marker. A new series of anti-migraine
drugs is being developed and tested both in vitro and in vivo.
A major laboratory studies cerebral vasospasm. In the laboratory, isolated dog
arteries are perfused in vitro and the factors that constrict and relax them are
studied. In vivo, vasospasm may be experimentally induced in dogs by subarachnoid
injection of blood. This provides a model in which to test potential maneuvers
aimed at reducing the spasm. Recently, a major collaboration with the MGH Laser
Laboratories has resulted in a potential new therapeutic invention. High intensity
laser pulses are applied at the site of spasm. In dogs, these succeed in relaxing
the vessel. Phase 1 trials of this intervention are being planned.
Neural Growth and Regeneration A
major long-term goal for Neurosurgery is the restoration of damage of function
that has been lost due to damage to the nervous system. Two research areas aim
toward that goal. Work carried out in collaboration
with the Department of Neurology involves the attempt to implant cultured neurons
into the brains of animals following experimentally induced brain damage. The
basal ganglia are the focus of this work and dopamine-releasing neurons are
being implanted into the brain following experimental lesions of the dopamine-containing
brain neurons. Similar strategies can be applied to other brain models.
On the more fundamental level, we are trying to learn the factors
that promote the growth of neurons. This is being carried out using cultured cells.
A new factor released by immortalized cultured glia has been discovered. It promotes
a neurite outgrowth from a variety of projection neurons. Current studies are
aimed at identifying and cloning the factor. Brain
Tumors The natural history of brain tumors
is being studied in collaboration with the Department of Pathology. This work
focuses on the mutation or series of mutations that occur in glioblastomas. This
work concentrates on the use of PPCR methodologies to amplify the DNA of biopsy
specimens and of archival neuropathology slides. The latter are particularly useful
since the outcome is known. A series of mutations have been found to occur in
naturally occurring brain tumors. Many tumors have a mutation of the p53 gene.
Another common mutation is amplification of the EGFR (epidermal growth factor
receptor) gene. A second area of brain tumor research
is the use of retroviral therapy against glioblastomas. The goal is to use retroviruses
to introduce into the tumors genes that would either kill the tumor cells, later
their pattern of growth, or sensitize them to chemotherapeutic agents. One such
trial involves the introduction of a gene for thymidine kinase. A number of analogous
manipulations are being tested both vitro and in rats.
Intraoperative Monitoring and Imaging
A major area of clinical research concerns surgery for epilepsy. Candidates for
epilepsy surgery are intensively studied by electrophysiological and imaging techniques.
Electrophysiologically, implanted electrodes are used to monitor seizure activity
in awake patients. PET imaging is used to localize motor and language areas. New
technology allows superimposition of the PET images with MRI scans, providing
sharply defined landmarks during surgery. A further area of exploration is the
use of virtual imaging in the operating room. Cellular
Neurobiology Within the Department of Neurosurgery
there are also laboratories of fundamental neurobiology. These are concerned with
various aspects of neuroanatomy and neurophysiology.
One area of focus is the cell biology of the retina. The retina is used as a model
system for studies of how small neural networks operate computationally upon their
inputs. This laboratory uses anatomical methods and combined anatomy/physiology
studies of in vitro retinas. Another area of research
concerns the biology of membrane proteins, particularly the Na,K-ATPase. These
studies are aimed at understanding the heterogeneity of the Na,K-ATPases in the
brain and their regulation.
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THE
BERKOWITZ AND KNOTT FUND FOR Brain Tumor Research at
Massachusetts General Hospital | See
also: Berkowitz and Knott Fund for Brain Tumor
Research |