Rewiring the brain
Firing neurons sound a lot like dial-up modems: the noise of static, pulses, clicks. It is, in fact, the same language. Like modems, neurons communicate in binary: on, off, on, off.
“You can listen and see the pattern,” says Children’s Hospital Colorado Neurologist and Movement Disorder Specialist Abbie Collins, MD. “The frequency of spikes tells you what part of the brain you’re in.”
The part of the brain that interests Dr. Collins is the basal ganglia — the center, at the core of the brain, of voluntary movement.
Studying deep brain stimulation
Wiring problems in the basal ganglia can lead to adult diseases like Parkinson’s and essential tremor, both of which benefit from a treatment called Deep Brain Stimulation (DBS), which implants electrodes deep in the basal ganglia to stimulate or inhibit misfiring neurons — and gets impressive results. Pediatric neurologists and neurosurgeons are increasingly exploring DBS as a treatment for kids with diseases like dystonia, a serious motor impairment that causes stiffening of the muscles.
“When you raise your arm,” Dr. Collins says, “your bicep has to contract, your tricep has to relax, and your deltoid needs to hold the position. In dystonia, because of faulty wiring in the basal ganglia, your tricep doesn’t get the signal to relax. You’re just constantly fighting your own muscles to make even basic movements.”
DBS can help, but the results have been inconsistent. “We’re trying to understand who’s going to respond to DBS, and how they’re going to respond.”
Gaining insight into a complex disorder
To address that question, Dr. Collins and neurosurgeon Aviva Abosch, MD, are working to correlate brain-imaging data with clinical data gathered through dozens of means.
Many of those means are unique to Children's Colorado's program, including the use of the Center for Gait and Movement Analysis, where researchers can study nuances of movement using ultra-sensitive instruments.
So doing, Drs. Collins and Abosch hope to gain much-needed insight into a complex disorder — and into the workings of the growing brain.
“So much has to happen to execute even a simple motor command,” Dr. Collins says. “The concept ‘move’ is actually very complicated.”