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Cleveland Clinic

17 ARTICLES PUBLISHED IN JoVE

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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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JoVE Journal

Identification of Homologous Recombination Events in Mouse Embryonic Stem Cells Using Southern Blotting and Polymerase Chain Reaction
Dan Zhou *1,2, Lei Tan *1, Jian Li *3, Tanbin Liu 1, Yi Hu 1, Yalan Li 1, Sachiyo Kawamoto 4, Chengyu Liu 5, Shiyin Guo 3, Aibing Wang 1
1Lab of Animal Models and Functional Genomics (LAMFG), The Key Laboratory of Animal Vaccine & Protein Engineering, College of Veterinary Medicine, Hunan Agricultural University (HUNAU), 2Department of Pathology, Georgetown University Medical School, 3College of Food Science and Technology, Hunan Agricultural University (HUNAU), 4Lab of Molecular Cardiology (LMC), National Heart, Lung, and Blood Institute (NHLBI)/National Institutes of Health (NIH), 5Transgenic Core, National Heart, Lung, and Blood Institute (NHLBI)/National Institutes of Health (NIH)

Here, we present a detailed protocol for identifying homologous recombination events that occurred in mouse embryonic stem cells using Southern blotting and/or PCR. This method is exemplified by the generation of nonmuscle myosin II genetic replacement mouse models using traditional embryonic stem cell-based homologous recombination-mediated targeting technology.

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Cancer Research

Repression of Multiple Myeloma Cell Growth In Vivo by Single-wall Carbon Nanotube (SWCNT)-delivered MALAT1 Antisense Oligos
Jianhong Lin *1,2, Yi Hu *1, Jian-Jun Zhao 1
1Department of Cancer Biology, Lerner Research Institute, Cleveland Clinic, 2Department of Medical Oncology, Dana-Farber Cancer Institute, Harvard Medical School

This manuscript describes the synthesis of a single-wall carbon nanotube (SWCNT)-conjugated MALAT1 antisense gapmer DNA oligonucleotide (SWCNT-anti-MALAT1), which demonstrates the reliable delivery of the SWCNT and the potent therapeutic effect of anti-MALAT1 in vitro and in vivo. Methods used for synthesis, modification, conjugation, and injection of SWCNT-anti-MALAT1 are described.

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Behavior

Characterization of the Sense of Agency over the Actions of Neural-machine Interface-operated Prostheses
Jonathon S. Schofield 1, Courtney E. Shell 1, Zachary C. Thumser 1,2, Dylan T. Beckler 1, Raviraj Nataraj 3, Paul D. Marasco 1,4
1Laboratory for Bionic Integration, Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, 2Research Service, Louis Stokes Cleveland Department of Veterans Affairs Medical Center, 3Department of Biomedical Engineering, Stevens Institute of Technology, 4Advanced Platform Technology Center, Louis Stokes Cleveland Department of Veterans Affairs Medical Center

Here we present a protocol which characterizes the sense of agency developed over the control of sensate virtual or robotic prosthetic hands. Psychophysical questionnaires are employed to capture the explicit experience of agency, and time interval estimates (intentional binding) are employed to implicitly measure the sense of agency.

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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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Neuroscience

Comprehensive Autopsy Program for Individuals with Multiple Sclerosis
Ranjan Dutta *1, Kedar R. Mahajan *1,3, Kunio Nakamura *3, Daniel Ontaneda *2, Jacqueline Chen 1, Christina Volsko 1, Jessica Dudman 1, Emilie Christie 1, Jordon Dunham 1, Robert J. Fox 3, Bruce D. Trapp 1
1Department of Neurosciences, Lerner Research Institute, Cleveland Clinic, 2Department of Biomedical Engineering, Lerner Research Institute, Cleveland Clinic, 3Mellen Center for Treatment and Research in Multiple Sclerosis, Neurological Institute, Cleveland Clinic

Multiple sclerosis is an inflammatory demyelinating disease with no cure. Analysis of brain tissue provides important clues to understanding the pathogenesis of the disease. Here we discuss the methodology and downstream analysis of MS brain tissue collected through a unique rapid autopsy program in operation at the Cleveland Clinic.

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Medicine

Use of a Linear Accelerator for Conducting In Vitro Radiobiology Experiments
Jing Hao 1, Anthony Magnelli 2, Andrew Godley 2, Jennifer S. Yu 1,2
1Department of Cancer Biology, Cleveland Clinic, 2Department of Radiation Oncology, Cleveland Clinic

Clinical linear accelerators can be used to determine biologic effects of a wide range of dose rates on cancer cells. We discuss how to set up a linear accelerator for cell-based assays and assays for cancer stem-like cells grown as tumorspheres in suspension and cell lines grown as adherent cultures.

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Modeling Intestinal Development and Injury-Repair In Vitro Using Mouse Colonic Stem Cell Monolayer Culture Under Air-Liquid Interface
Brian D. Muegge *1, Yi Wang *2, Thaddeus S. Stappenbeck 2,3
1Division of Endocrinology, Diabetes, and Lipid Metabolism Research, Department of Medicine, Washington University School of Medicine, 2Department of Pathology and Immunobiology, Washington University School of Medicine, 3Department of Inflammation and Immunity, Lerner Research Institute, Cleveland Clinic

This protocol describes the generation of a long-lived self-renewing monolayer culture system for mouse colonic stem cells that contains all major epithelial cell types. This culture system can be used to study epithelial biology, intestinal wound repair, and host-pathogen interactions.

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Medicine

A Syngeneic Murine Model of Endometriosis using Naturally Cycling Mice
Elliott G. Richards *1, Jenna M. Rehmer *2, Melissa A. Mathes 3, Emily L. Esakov 1, Chad Braley 1, Amy Joehlin-Price 4, Andres Chiesa-Vottero 4, Ofer Reizes 1,5
1Cardiovascular and Metabolic Sciences, Lerner Research Institute; Women’s Health Institute, Cleveland Clinic, 2Women’s Health Institute, Cleveland Clinic, 3Department of Obstetrics and Gynecology, 983255 Nebraska Medical Center, University of Nebraska Medical Center, 4Anatomic Pathology, Cleveland Clinic, 5Gynecologic Oncology, Women’s Health Institute and Department of Molecular Medicine, Cleveland Clinic Lerner College of Medicine, Cleveland Clinic

Many rodent models of endometriosis are limited by technical complexity, reproducibility, and/or need for immunocompromised animals or special reporter mice. We present a simplified system of lesion induction using any experimental mouse with an independently verifiable, objective scoring system and with no requirement for ovariectomy or survival surgery.

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Neuroscience

Inter-Brain Synchrony in Open-Ended Collaborative Learning: An fNIRS-Hyperscanning Study
Nan Zhao 1,2, Yi Zhu 1,2, Yi Hu 1,2
1School of Psychology and Cognitive Science, East China Normal University, 2Shanghai Key Laboratory of Mental Health and Crisis Intervention, East China Normal University

The protocol for conducting fNIRS hyperscanning experiments on collaborative learning dyads in a naturalistic learning environment is outlined. Further, a pipeline to analyze the Inter-Brain Synchrony (IBS) of oxygenated hemoglobin (Oxy-Hb) signals is presented.

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Neuroscience

How to Calculate and Validate Inter-brain Synchronization in a fNIRS Hyperscanning Study
Yinying Hu 1, Zixuan Wang 1, Bei Song 2, Yafeng Pan 3, Xiaojun Cheng 4, Yi Zhu 1, Yi Hu 1
1Institute of Brain and Education Innovation, School of Psychology and Cognitive Science, East China Normal University, 2Department of Musicology, Harbin Conservatory of Music, 3Department of Clinical Neuroscience, Karolinska Institutet, 4School of Psychology, Shenzhen University

The dynamics between coupled brains of individuals have been increasingly represented by inter-brain synchronization (IBS) when they coordinate with each other, mostly using simultaneous-recording signals of brains (namely hyperscanning) with fNIRS. In fNIRS hyperscanning studies, IBS has been commonly assessed through the wavelet transform coherence (WTC) method because of its advantage on expanding time series into time-frequency space where oscillations can be seen in a highly intuitive way. The observed IBS can be further validated via the permutation-based random pairing of the trial, partner, and condition. Here, a protocol is presented to describe how to obtain brain signals via fNIRS technology, calculate IBS through the WTC method, and validate IBS by permutation in a hyperscanning study. Further, we discuss the critical issues when using the above methods, including the choice of fNIRS signals, methods of data preprocessing, and optional parameters of computations. In summary, using the WTC method and permutation is a potentially standard pipeline for analyzing IBS in fNIRS hyperscanning studies, contributing to both the reproducibility and reliability of IBS.

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Biology

Scalable Isolation and Purification of Extracellular Vesicles from Escherichia coli and Other Bacteria
Dionysios C. Watson 1,2,3, Sadie Johnson 1, Akeem Santos 1,4, Mei Yin 5, Defne Bayik 1, Justin D. Lathia 1,3, Mohammed Dwidar 1,3,4
1Department of Cardiovascular & Metabolic Sciences, Lerner Research Institute, Cleveland Clinic, 2University Hospitals Cleveland Medical Center, 3Case Western Reserve University, 4Center for Microbiome & Human Health, Cleveland Clinic, 5Electron Microscopy Core, Lerner Research Institute, Cleveland Clinic

Bacteria secrete nanometer-sized extracellular vesicles (EVs) carrying bioactive biological molecules. EV research focuses on understanding their biogenesis, role in microbe-microbe and host-microbe interactions and disease, as well as their potential therapeutic applications. A workflow for scalable isolation of EVs from various bacteria is presented to facilitate standardization of EV research.

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Cancer Research

Maintaining Human Glioblastoma Cellular Diversity Ex vivo using Three-Dimensional Organoid Culture
Swetha J. Sundar 1, Sajina Shakya 2, Violette Recinos 1, Christopher G. Hubert 2
1Department of Neurological Surgery, Cleveland Clinic, 2Cardiovascular and Metabolic Sciences, Lerner Research Institute, Cleveland Clinic

Here, we describe a method of generating glioblastoma (GBM) organoids from primary patient specimens or patient-derived cell cultures and maintaining them to maturity. These GBM organoids contain phenotypically diverse cell populations and recreate tumor microenvironments ex vivo.

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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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Bioengineering

Equipment Setup and Artifact Removal for Simultaneous Electroencephalogram and Functional Magnetic Resonance Imaging for Clinical Review in Epilepsy
Jihye Bae 1, Jordan L. Clay 2, Bhoj Raj Thapa 1, David Powell 3, Heidi Turpin 3, Saghi Tasori Partovi 3, Rachel Ward-Mitchell 3, Balu Krishnan 4, Andreas Koupparis 5, Meriem Bensalem Owen 2, Flavius D. Raslau 2,6,7
1Department of Electrical and Computer Engineering, University of Kentucky, 2Department of Neurology, University of Kentucky, 3Department of Neuroscience, University of Kentucky, 4Cleveland Clinic, 5Cyprus Institute of Neurology and Genetics, 6Department of Radiology, University of Kentucky, 7Department of Neurosurgery, University of Kentucky

This article details simultaneous electroencephalogram and functional magnetic resonance imaging (EEG-fMRI) recording procedures that can be used in both clinical and research settings. EEG processing procedures to remove imaging artifacts for clinical review are also included. This study focuses on the example of epilepsy during the interictal period.

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Neuroscience

A Simplified Method for Isolation and Culture of Retinal Pigment Epithelial Cells from Adult Mice
Alyssa Hubal 1,2, Amelia Pfaff 2, Sarah Vos 2, Mala Upadhyay 3, Vera Bonilha 3, Carlos S. Subauste 1,2
1Department of Pathology, Case Western Reserve University, 2Division of Infectious Diseases and HIV Medicine, Department of Medicine, Case Western Reserve University, 3Cole Eye Institute, Ophthalmic Research, Cleveland Clinic

Retinal pigment epithelium (RPE) acts as a crucial barrier between the choroid and retina, promoting the health and function of retinal cell types, such as photoreceptors. Herein, we describe a simple and effective protocol for isolating and culturing adult murine RPE.

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