UCLA Brain Imaging Research
Remote Access and Communication
Dr. Bookheimer often completes the testing process without stepping out of her second-floor office, while the fMRI scanners sit in a scanning room on the first floor. She communicates in real time with her research assistant via iChat AV, Mac OS X’s built-in instant messaging application, allowing her to either quickly send down text messages or conduct an instant video conference. She mounts the scanners fMRI hard disk in Mac OS X directly so she can analyze data in real time as it comes off the scanner, as if her MacBook Pro were directly acquiring results.
She explains, “I mount the disk so collecting the data is virtually instantaneous. While the patient is getting a second scan, I can analyze the first scan to make sure we get the data we need. I can just call or iChat down to my assistant operating the scanner and have things rerun.”
She analyzes the resulting images to create a color-coded map of the brain with the overlayMac application, which is given to a neurosurgeon prior to surgery. In her musician’s case, the colorized maps notated the areas of the brain responsible for reading music, transposing music, and general language skills. The map allowed Dr. Bookheimer and a team of neurosurgeons to enter the operating room to complete an awake craniotomy, stimulating the critical areas of the brain while precisely excising the lesion and avoiding the areas mapped in pre-surgical planning.
Dr. Bookheimer sums up the success, “He did great, the tumor came out, and he went back to work in a few months with his musical ability and language in tact. In most cases for a tumor like that, many surgeons would have called the case inoperable.”
Looking Ahead
New techniques in brain imaging including the use of fMRI are helping doctors and researchers better understand the relationship between structure and function in the human brain. Just a few years ago, a patient with an advanced tumor sitting close to a critical area of the brain would likely have been told their condition was inoperable. Today, such patients are greeted with hope when they receive brain mapping scans before heading to the operating table.
With advances in imaging, a robust compute platform, and the work of dedicated researchers, clinicians, and patients, Mark Cohen sees a great deal of promise for future patients; he comments, “The processes and the safety of brain surgery are improving so dramatically, it’s almost shocking.”
This is translational research at its finest. In cases where brain surgery patients formerly had little chance to live, and less chance to retain essential life skills – they are now continuing to converse with their families, take a walk in the woods, or simply play beautiful music on a French horn.
Dr. Cohen and Dr. Bookheimer would like to acknowledge the National Institutes of Health for their research support.
Translational Research
Cohen calls his work 90 percent research, but he and his colleagues use his work in clinical applications on a daily basis. Many of these techniques stemmed from his research on epilepsy, which is particularly difficult to deal with, as the disease does not present itself as visible lesions in traditional MRIs. Cohen and his colleagues are using an Xserve cluster with open source software solutions including CC Grinder, scanSTAT and FSL for epilepsy research. Their process combines fMRI with results from an EEG, which measures the electrical activity in the brain at a very high-temporal resolution, but low spatial resolution. By combining this data with fMRI’s high spatial resolution, researchers are able to “extend the spatio-temporal resolution and sensitivity of each method.”
Cohen’s hopes that his work will lead to a better understanding of epilepsy and new hope for patients. He says, “People will still have epilepsy, but in my lifetime epilepsy will be managed in new and improved ways – people will end up with effective interventions for the disease and be able to live normal lives.”
Dr. Susan Bookheimer uses fMRI, along with open source Mac OS X software to break new ground in pre-surgical planning. She uses her Mac to implement novel solutions in neuropsychology and neurosurgery including brain labs and awake craniotomies. Image courtesy of Wayne Gleeming.