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Cleveland Clinic Foundation

9 ARTICLES PUBLISHED IN JoVE

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Medicine

Intra-Operative Behavioral Tasks in Awake Humans Undergoing Deep Brain Stimulation Surgery
John T. Gale *1,2, Clarissa Martinez-Rubio *1,2, Sameer A. Sheth 1,2, Emad N. Eskandar 1,2
1Nayef Al-Rodhan Laboratories for Cellular Neurosurgery and Neurosurgical Technology, Harvard Medical School, 2Department of Neurosurgery , Massachusetts General Hospital

Deep brain stimulation surgery offers a unique opportunity to examine information encoding in the awake human brain. This article will describe intra-operative methods used to perform cognitive and behavioral tasks while simultaneously acquiring physiological data such as EMG, single-unit neuronal activity and/or local field potentials.

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Bioengineering

Characteristics of Precipitation-formed Polyethylene Glycol Microgels Are Controlled by Molecular Weight of Reactants
Susan Thompson 1, Jessica Stukel 1, Abrar AlNiemi 1,2, Rebecca Kuntz Willits 1
1Department of Biomedical Engineering, The University of Akron, 2Saint Vincent Saint Mary's High School

This work describes the formation of poly(ethylene glycol) (PEG) microgels via a photopolymerized precipitation reaction. Increasing the PEG molecular weight increased microgel diameter and swelling ratio. Simple adaptations to the PEG microgel precipitation reaction are explored for future applications of microgels as drug delivery vehicles and tissue engineering scaffolds.

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Medicine

The Multiple Sclerosis Performance Test (MSPT): An iPad-Based Disability Assessment Tool
Richard A. Rudick 1, Deborah Miller 1, Francois Bethoux 1, Stephen M. Rao 2, Jar-Chi Lee 3, Darlene Stough 1, Christine Reece 2, David Schindler 4, Bernadett Mamone 1, Jay Alberts 4
1Mellen Center for Multiple Sclerosis Treatment and Research, Cleveland Clinic Foundation, 2Center for Brain Health, Cleveland Clinic Foundation, 3Quantitative Health Sciences, Cleveland Clinic Foundation, 4Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic Foundation

Precise measurement of neurological and neuropsychological impairment and disability in multiple sclerosis is challenging. We report methodologic details on a new test, the Multiple Sclerosis Performance Test (MSPT). This new approach to the objective of quantification of MS related disability provides a computer-based platform for precise, valid measurement of MS severity.

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Behavior

Performing Behavioral Tasks in Subjects with Intracranial Electrodes
Matthew A. Johnson 1, Susan Thompson 1, Jorge Gonzalez-Martinez 2, Hyun-Joo Park 1, Juan Bulacio 2, Imad Najm 2, Kevin Kahn 4, Matthew Kerr 4, Sridevi V. Sarma 4, John T. Gale 1,3
1Department of Neurosciences, Cleveland Clinic Foundation, 2Epilepsy Center, Cleveland Clinic Foundation, 3Department of Neurosciences and Center for Neurological Restoration, Cleveland Clinic Foundation, 4Department of Biomedical Engineering, Johns Hopkins University

Patients implanted with intracranial electrodes provide a unique opportunity to record neurological data from multiple areas of the brain while the patient performs behavioral tasks. Here, we present a method of recording from implanted patients that can be reproducible at other institutions with access to this patient population.

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Medicine

Stereo-Electro-Encephalo-Graphy (SEEG) With Robotic Assistance in the Presurgical Evaluation of Medical Refractory Epilepsy: A Technical Note
Jeffrey P. Mullin 1, Saksith Smithason 1, Jorge Gonzalez-Martinez 1
1Department of Neurosurgery, Cleveland Clinic

Stereo-electroencephalography (SEEG) aids in localization of epileptogenic zones, however, remains relatively underutilized in the United States. The goal of this abstract is to provide a brief introduction to the technique of SEEG and further a detailed technique of using robotic assistance in the placement of SEEG electrodes.

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Developmental Biology

Analysis of Retinoic Acid-induced Neural Differentiation of Mouse Embryonic Stem Cells in Two and Three-dimensional Embryoid Bodies
Junning Yang 1, Chuanshen Wu 2, Ioana Stefanescu 1, Arie Horowitz 1,3
1Department of Medicine, Cardeza Vascular Research Center, Sidney Kimmel Medical College, Thomas Jefferson University, 2Department of Molecular Cardiology, Cleveland Clinic Foundation, 3Department of Cancer Biology, Cardeza Vascular Research Center, Sidney Kimmel Medical College, Thomas Jefferson University

We describe a technique for using murine embryonic stem cells for generating two or three dimensional embryoid bodies. We then explain how to induce neural differentiation of the embryoid body cells by retinoic acid, and how to analyze their state of differentiation by progenitor cell marker immunofluorescence and immunoblotting.

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Cancer Research

Modeling Osteosarcoma Using Li-Fraumeni Syndrome Patient-derived Induced Pluripotent Stem Cells
Ruoji Zhou 1,2, An Xu 1, Jian Tu 1,3, Mo Liu 1, Julian A Gingold 4, Ruiying Zhao 1, Dung-Fang Lee 1,2,5,6
1Department of Integrative Biology and Pharmacology, McGovern Medical School, The University of Texas Health Science Center at Houston, 2Graduate School of Biomedical Sciences, The University of Texas MD Anderson Cancer Center UTHealth, 3Department of Musculoskeletal Oncology, The First Affiliated Hospital of Sun Yat-sen University, 4Women's Health Institute, Cleveland Clinic Foundation, 5Center for Stem Cell and Regenerative Medicine, The Brown Foundation Institute of Molecular Medicine for the Prevention of Human Diseases, The University of Texas Health Science Center at Houston, 6Center for Precision Health, School of Biomedical Informatics and School of Public Health, The University of Texas Health Science Center at Houston

Here, we present a protocol for the generation of induced pluripotent Stem Cells (iPSCs) from Li-Fraumeni Syndrome (LFS) patient derived fibroblasts, differentiation of iPSCs via mesenchymal stem cells (MSCs) to osteoblasts, and modeling in vivo tumorigenesis using LFS patient-derived osteoblasts.

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Medicine

Development and Implementation of a Multi-Disciplinary Technology Enhanced Care Pathway for Youth and Adults with Concussion
Jay L. Alberts 1,2,3,4, Michael T. Modic 3, Belinda Udeh 3,5, Tanujit Dey 6, Kay Cherian 1, Xiaoyang Lu 3, Richard Figler 4, Andrew Russman 4, Susan M. Linder 1,4
1Department of Biomedical Engineering, Cleveland Clinic Foundation, 2Center for Neurological Restoration, Cleveland Clinic Foundation, 3Office of Clinical Transformation, Cleveland Clinic Foundation, 4Concussion Center, Cleveland Clinic Foundation, 5Neurological Institute Center for Outcomes Research, Cleveland Clinic Foundation, 6Quantitative Health Sciences, Cleveland Clinic Foundation

A multidisciplinary carepath to standardize disparate concussion care was developed and implemented at the Cleveland Clinic. The Cleveland Clinic Concussion (C3) mobile application was used to enable the carepath through biomechanical outcomes characterizing cognitive and motor function. Patient outcomes improved while cost of care was reduced following implementation.

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Engineering

The Immersive Cleveland Clinic Virtual Reality Shopping Platform for the Assessment of Instrumental Activities of Daily Living
Jay L. Alberts 1,2, Morgan McGrath 1,3, Mandy Miller Koop 1, Colin Waltz 1, Logan Scelina 1, Kathryn Scelina 1, Anson B. Rosenfeldt 1
1Department of Biomedical Engineering, Cleveland Clinic, Lerner Research Institute, 2Neurological Institute, Center for Neurological Restoration, Cleveland Clinic, 3Case Western Reserve University, School of Medicine

Virtual reality (VR) is a powerful yet underutilized approach to advance the diagnosis and treatment of neurological disease. The Cleveland Clinic Virtual Reality Shopping platform combines state-of-the-art VR content with an omnidirectional treadmill to quantify instrumental activities of daily living-a proposed prodromal marker of neurological disease.

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