Research Round-up

From the Summer 2018 edition of Vanderbilt Medicine Magazine

Restoring silenced voices

A swarm of cicadas that left thousands of insect carcasses across the Vanderbilt University campus in 2011 is leading to transinstitutional research at the Vanderbilt Institute for Surgery and Engineering (VISE) and Vanderbilt University Medical Center to develop a surgical planning tool to help restore speech for people with vocal fold paralysis.

Haoxiang Luo, PhD, brought some of those cicadas back to his Computational Flow Physics and Engineering Laboratory and created a model of their wing movements. Luo and his VUMC collaborator, Bernard Rousseau, PhD, MMHC, found similarities in the way the cicada wings moved and the movement of human vocal folds, leading them to wonder how the model might be used to improve surgical techniques for paralyzed vocal folds.

This has culminated in the National Institutes of Health awarding a five-year, $2.4 million research grant to a multidisciplinary Vanderbilt team to design a software tool to help surgeons develop more precise surgery plans for the most common surgical intervention for unilateral vocal fold paralysis, type 1 laryngoplasty.

 

Telemedicine effective way to evaluate autism 

Researchers at Vanderbilt University Medical Center have found that autism spectrum disorder (ASD) can be accurately diagnosed in young children via remote, telemedicine assessments, a method that could significantly increase access and reduce wait times for autism services.

In a first-of-its-kind study, the researchers compared the accuracy of rapid telemedicine evaluations to in-person evaluations for ASD and found that in most cases, remote evaluators could accurately identify children with ASD with high levels of confidence.

These findings were released March 10 in the Journal of Autism and Developmental Disorders by Zachary Warren, PhD, Amy Nicholson, MA, Anna Pasternak, BASc, Neill Broderick, PhD, Jeffrey Hine, PhD, BCBA-D, and J. Alacia Stainbrook, PhD, BCBA-D.

 

Underappreciated role of brainstem in epilepsy

New research from Vanderbilt suggests that repeated seizures reduce brainstem connectivity, a possible contributor to unexplained neurocognitive problems in epilepsy patients.

The brainstem has been rarely studied in epilepsy because seizures typically originate in the temporal lobe or other areas of the cortex. Noting that people with temporal lobe epilepsy often lose consciousness even though the temporal lobe does not control wakefulness, Dario Englot, MD, PhD, surgical director of epilepsy at Vanderbilt University Medical Center, said he decided to focus on the region that does control wakefulness — the brainstem. He hypothesized that connectivity disruptions with the brainstem resulting from a history of seizures might play a role in diminished cognitive functions that are not related to the temporal lobe.

The research, published online May 30 in Neurology, is the first to investigate how epilepsy affects the ascending reticular activating system (ARAS) — circuitry that is responsible for regulating wakefulness — within the brainstem. Functional magnetic resonance imaging revealed that ARAS disruptions occurred, with decreases in circuitry being quantitatively associated with disease severity.