Neuroscience research at St. David’s HealthCare ranges from brain cancer, spine surgery, and epilepsy studies to investigations of basic neuroscience research. We currently have actively clinical studies in stroke and epilepsy, as well as neurosurgical studies investigating new devices and technology for spinal surgeries (see the Surgery page).
Stroke Clinical Trials
St. David’s Neuroscience and Spine Institute participates in many clinical trials and research studies addressing stroke, from novel treatment protocols to registries collecting vital information about stroke outcomes. The Institute is committed to being an active participant in improving treatment options and real-world outcomes for stroke patients. We are currently participating in the following stroke studies:
This study is evaluating treatment options for patients with mild and rapidly improving stroke symptoms in order to learn how to better manage these events.
This study is looking at the management of acute ischemic stroke patients who are taking novel oral anticoagulants in community practice. We anticipate this study will be significant because it may provide physicians with improved recommendations for stroke patients who are taking these medications.
PROSPER is a 3-year project to improve decision-making and patient-centered stroke outcomes through comparative effectiveness research in three therapeutic areas: statins, anti-coagulants and anti-depressants.
Stroke Informatics/Data Science
St. David’s Neuroscience and Spine Institute also maintains active research using advance statistics and big data to investigate a range of important questions in stroke epidemiology, diagnosis, treatments, and outcomes. Our scientists are investigating the incidence of ischemic and hemorrhagic strokes among atrial fibrillation patients taking novel oral anticoagulants (NOACs) in comparison to patients taking warfarin. We found a much higher incidence of hemorrhages generally and hemorrhagic strokes in particular among patients taking warfarin, while patients taking NOACs experienced a higher incidence of ischemic stroke. We are also working to identify biomarkers in routine data that can help distinguish stroke from stroke mimics. Using laboratory results from standard blood work and vitals measures, we constructed multivariable statistical models that identify statistically significant differences between stroke cases and stroke mimics. Our researchers are also studying workflows and process interventions to further improve clinical performance and quality in the triage and diagnosis of stroke patients.
Basic Neuroscience Research
Our brain has specific regions that help us know where we are in a physical space (our home, an office, a shopping mall, etc.) at any given time, and how to navigate a space (find a desired location). Our scientists are studying the key brain areas of spatial cognition, spatial navigation and spatial memory. Dr. Nadasdy and his team record the electrical activity of single neurons in regions of the brain involved in spatial cognition areas from patients whose brain is implanted by clinical electrodes for localizing epileptic seizures. To study spatial navigation and memory within the hospital setting, we use virtual reality. Our recent research has unraveled interesting differences between human and animal spatial cognition.
Our researchers are also interested in coordinate transformations in the human brain between egocentric (internally centered) and allocentric (externally centered) reference frames for physical spaces. Current research is studying whether these reference frames are active at the same time or whether using one reference frame depends on the particulars of the spatial navigation activity. Our researchers have developed virtual reality (VR) environments to investigate how humans use these different coordinate systems.
This research is relevant for the treatment of neurological diseases such as Alzheimer’s disease, dementia, epilepsy, TBI and stroke, affecting millions of people worldwide. With this research, we are joining quests for treatment to restore/improve memory function and our spatial-temporal sentience.
Exploration of insular cortical function
The insular cortex is one of the most enigmatic structures of the human brain. We are investigating the role of the insula from the higher sensory and multimodal integration to social perception, which are insula functions implicated by a number of recent reports. We are currently analyzing large data sets recorded from the insular cortex of epilepsy patients. Based on the spectral properties of electrical activity of different sub-regions of the insular cortex, we are able to correlate insular activity with different behavioral states.
Seizure localization and detection
For epilepsy patients that do not respond to medical treatment, surgery is an option that may be considered by patients and their physicians. In order to plan an epilepsy surgery, a surgeon must first map out where the seizure is occurring in the patient’s brain. This mapping typically proceeds by implanting electrodes on the surface of the cerebral cortex of patients, and then recording the brain’s electrical activity during seizure events. One of our neuroscience research areas is improving seizure localization methods that can be used on data routinely captured during mapping for surgery. This research could ultimately lead to safer and more effective surgeries for patients.
In addition to seizure localization, studying the electrical activity in the brain immediately before seizures suggests they can be predicted 1-2 s before the onset. We are utilizing EEG data to develop innovative new mathematical algorithms to better predict seizures before they occur. If seizure events can be reliably detected before the seizure onset, then this research will lead to more advanced implantable brain stimulator devices that can trigger stimulation of specific areas of the brain to stop a seizure from occurring.
Please contact the Office of Research if you have interest in collaboration: Info@stdavidsresearch.com