Clinical applications

I am leading a collaborative study together with Mr Thomas Santarius and Mr Michael Hart at Addenbrooke’s Hospital in Cambridge. We develop tools and techniques to improve mapping of cognitive function and brain networks for patients with brain tumours. Some patients with low grade gliomas (LGG) undergo awake neurosurgery to remove the tumour. During surgery, the patients are awakened and do some cognitive tasks, such as counting and saying what they see in pictures. The neurosurgeon then applied focal direct electrical stimulation to briefly impair function in small areas and map the functionality of the exposed brain tissue. This information is used by the neurosurgeon to determine how much of the tissue to remove in order to preserve essential cognitive function and ensure good quality of life post-surgery.

In this project, we aim to provide neurosurgeons and patients with comprehensive and detailed mapping of each patient’s brain networks and functionality. During surgery, we use electrocorticography (ECoG), or “listening” to brain cells, to track signals that are related to cognitive function. We are particularly interested in executive function which is hard to map with stimulation, and we develop tests for other cognitive functions as well. Connections between different brain areas and the communication between them are also critical to preserve function. We use neuroimaging data prior to surgery and develop tools to provide this information to neurosurgeons and patients. We use follow-up scans and neurocognitive assessment to learn about the relationship between all these measures and plasticity processes that occur over time.

We are a large group of researchers and clinicians working together on this project, including neurosurgeons, neurophysiologists, neuropsychologists and neuroscientists from the University of Cambridge and Cambridge University Hospital.

We bring our knowledge and expertise from basic cognitive neuroscience to clinical practice, and at the same time use the clinical data to answer basic science questions related to the networks that support executive function and cognition more generally.