The research, led by Dr Nadia Cerminara, a Research Fellow, and Richard Apps, Professor of Neuroscience in the University’s School of Physiology and Pharmacology and Dr Richard Edwards, Consultant Paediatric and Adult Neurosurgeon at the Institute of Clinical Neuroscience in the University’s School of Clinical Sciences, aim to make brain surgery more accurate, reducing associated brain injury and lifelong disabilities.
The main treatment for life-threatening childhood tumours located in cerebellum is by surgical removal. The operation has a one in four risk of adverse side effects, including cerebellar mutism syndrome. This post-operative condition is characterised by a transient loss of speech and persistent language deficits. If, before surgery, the child has difficulties with movement these problems can also be made worse. Most children recover to some extent but the duration of the syndrome is variable. One year after diagnosis 92 per cent of children have ataxia, 66 per cent have speech and language dysfunction, and 59 per cent have some degree of global intellectual handicap. The condition therefore has a severe long-term impact on all aspects of daily life.
The project aims to see if the underlying reason is that specific regions of the cerebellum important in language or limb control are sometimes damaged during tumour removal. To locate these regions with sufficient accuracy it is necessary to use techniques that record brain activity directly from the cerebellum during surgery. An individual’s map will be used by the surgeon to guide tumour removal whilst minimising damage to language- and limb-related regions of the cerebellum. The researchers will then be able to see if this reduces the risk of language and movement problems occurring after the operation.
Dr Cerminara said: ”It is not known why some children suffer these serious side effects while others do not. Moreover, there is no known method to reduce the risk of these complications arising. This project is the first important step by seeing if it is possible to do this. If successful the next step will be to use the recording method in future operations to produce a ‘brain map’ for each patient during surgery.
“It is also important to understand how the cerebellum operates normally so, ultimately we know how to repair brain circuits damaged by disease.”
Professor Apps and Dr Cerminara have also been awarded a major grant from the Medical Research Council to investigate the way information flows through cerebellar circuits
Professor Apps said: “How the internal circuitry of the cerebellum ensures that movements are performed smoothly and accurately remains unknown. An important reason for this is our lack of understanding of how cerebellar output is generated. This fundamental research will provide new insights into the cerebellum’s role in normal brain function, which is an essential prerequisite to understanding how cerebellar dysfunction leads to various neurological impairments.”