Week 2 - Rick Zirkel

Clinical: On Monday I met with my mentor, Dr. Kaplitt, for the first time in person. I shadowed him on a experimental bilateral Focused Ultrasound case. This is a non-invasive treatment using high-intensity focusing of ultrasound waves to heat or ablate tissue. In this case, the technique was used to ablate tissue that was the source of the patient's essential tremor. Focused Ultrasound is an FDA approved and used method unilaterally, whereas bilateral treatment is still experimental. The results were incredible as the patient was put in the MRI machine, the tissue was ablated, and a simple neurological test was conducted where the patient had to trace a drawing of a swirl and a straight line. Below are the results for the baseline of the patient's ability to complete the task with their left hand, as well as their results after the fourth ablative treatment.

    I also shadowed Dr. Kaplitt in the OR this week for a Deep Brain Stimulation surgery. This involves the implantation of a medical device known as a neurostimulator, placing electrodes within the region of interest. This region of interest depends on the patient, who may be suffering from Parkinson's disease, essential tremor, or other neurological conditions. The patient was awake during the surgery in order for the surgeon to conduct neurological testing during the implantation to determine if the device is stimulating the correct region of the brain. This was a bilateral surgery, and the patient had two electrodes implanted on each side of the brain, which will be connected to a battery pack inserted under the skin. The battery lasts from 5-7 years, and can be replaced. When testing stimulation, the patient showed immediate signs of tremor reduction.

Research: I have scheduled all of my necessary trainings and will be fully capable to start my mouse surgeries and experiments next Wednesday. Prior to then I have been preparing for the experiments learning the equipment and techniques I will be using to record neural activity of dopaminergic neurons in the dorsal striatum of mice during a state of magentogenetic-induced motionlessness.

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