Week 1 - Charlie Heinke

Ahh..... the big apple. It is both exciting and overwhelming here in my new environment. Not only do I find myself in the trade capital of the world, but within the frenetic halls of the Hospital for Special Surgery. I am not used to hospital life, and the speed and energy with which each worker propels themselves is amazing to see.

I am shadowing Dr. Dale Lange's group, drawn in by their work with muscular dystrophy patients (I, myself, study muscle tissue back in Ithaca). While Dr. Lange's group does see dystrophic patients, the primary focus of their reserach is with Amyotrophic Lateral Sclerosis (ALS). ALS is a neurodegenerative disorder primarily affecting motor neurons. These motor neurons mysteriously die off, leaving the muscle to atrophy due to paralysis. I was quickly paired up with Dr. Adel Marei, "The Crazy Egyptian," who makes use of a technique called Transcranial Magnetic Stimulation (TMS) to diagnose and treat patients with neurological disorders.

TMS takes advantage of the fact that a pulsed magnetic field will stimulate nerve activity. Previous studies have confirmed that stimulating specific areas of the body can have a regenerative effect, enabling TMS to pass FDA approval for the treatment of conditions including depression and obsessive compulsive disorder (OCD).

A patient receives TMS therapy.

In repetitive TMS therapy, a magnetic field is pulsed in 40-pulse "trains," stimulating the patient's motor cortex. Although the mechanism is unclear, Dr. Marei is hopeful that activating motor pathways using TMS could help slow the progression of ALS.

To ensure accurate and precise targeting of brain regions, Dr. Marei uses the Neuronaviation system, which digitally tracks the position of the magnetic stimulating coil through the use of reflectors and a camera. The system works in the same way James Cameron uses motion capture technology to animate action scenes.

During my time here, I aim to make this Neuronavigation system even more precise by analyzing the coordinates at which stimuli are delivered and calculating their deviation. Once this data is able to be quantified, I will experiment with ways to decrease this error and ensure consistent and reproducible TMS.