My areas of research and clinical interests include surgical treatment of pediatric brain tumors, craniofacial disorders, epilepsy, cervical spine disease, Chiari malformation, and pediatric vascular disease.
Mayo Clinic has a long history of management of brain tumors, and the Department of Neurosurgery has research programs in the clinical, translational and basic science of brain tumors.
Cancer is the second leading cause of death in children in the United States, with brain tumors' lethality second to only leukemia. Brain cancer poses a unique challenge to cancer research and neuroscience, and its study demands a unique research environment; one that recognizes the special nature of the central nervous system and the tumors that develop there. Mayo Clinic Cancer Center is one of only four cancer centers to receive a National Cancer Institute-sponsored Specialized Program of Research Excellence (SPORE) grant for brain cancer research.
Special areas of basic science research in our department include investigations into the cellular and molecular mechanisms of underlying immune suppression directed by Ian Parney, M.D., and regulation of invasiveness and migration in malignant brain tumors by John R. Henly, Ph.D. Efforts are underway to investigate the immunologic characteristics of astrocytoma and other pediatric malignant brain tumors. We are members of the Children's Oncology Group, the only cooperative group in the US for childhood cancer.
Currently, there are ongoing research projects investigating the natural history and clinical presentation of Chiari malformation in the pediatric and adolescent age groups. There is significant variability in the clinical presentation in patients with a Chiari malformation.
Our research evaluates headaches, voice and swallowing function, sleep disorders, autonomic dysfunction, scoliosis, quality of life, and risk factors for recurrent symptoms and repeat surgery in a multidisciplinary clinic. Our goal is to better define which patients improve following surgery by developing clinical prediction rules. Some components of this research involve collaboration with multi-institutional registries including the Pediatric Craniocervical Society.
Epilepsy surgery research is directed at the investigation of electrophysiological signatures of epileptogenic brain and the transition from normal brain activity to seizures (ictogenesis) in collaboration with adult and pediatric neurology colleagues. Electrophysiological biomarkers of epileptogenic brain and precursor signals that precede the onset of clinical seizures may make seizure warning devices possible, as well as lead to improvements in the efficacy of epilepsy surgery and brain stimulation.
Other research areas include the investigation of gene regulation in the pathophysiology of craniosynostosis, development of the pediatric skull base, occipitocervical junction, and pediatric cervical spine, operative and non-operative management of congenital cervical spine disorders, concussion in hockey and motocross racing, surgical management of pediatric vascular malformations and moyamoya disease, and sports participation in children who have underwent neurosurgical procedures.