Research

4th Research Project:
Innovative study designs of human brain in health and illness
Project leader: prof. dr hab. Alelsander Araszkiewicz

The Project is dedicated to studies of brain processes and detecting subtle structure, functional and biochemical changes in different pathologies. The purpose is to determine associations between results of experimental tests, clinical symptoms and neuropsychological assessment in CNS disorders and during excessive stress.

The main fields of research will be:

• Analysis of brain activity in different mental disorders, neurodevelopmental disorders and neurodegeneration

• Analysis of brain activity during psychotherapy and neurobiological changes due to psychotherapy

• Assessment of results of psychopharmacological treatment in patients with mental disorders

• Assessment of CNS structural and functional differences between patients with mental disorders and healthy subjects

• Assessment of CNS structural and functional differences between patients with mental disorders with and without somatic illnesses
  

The Project is launched to conduct studies on human brain functioning along several pathways pursued by interdisciplinary teams:

mental dysfunctions (mental disorders, psychosomatic disorders and stress): the team of the Chair of Psychiatry, Collegium Medicum of the Nicolaus Copernicus University, supervised by prof. dr hab. Aleksander Araszkiewicz and dr med. Beata Augustyńska.

Inventing new paradigms of tests of mental functions together with development of innovative methods of fMRI results’ analysis for enhanced understanding human psyche. Neuroimaging enables research on origin of brain processes and functional tests are applied to observe treatment outcomes in some diseases and also to evaluate the medications’ efficacy. For example, an assessment of subtle structural, functional and neurochemic brain changes induced by antipsychotics used in schizophrenia may be particularly challenging because in the course of the illness some alterations in brain morphology and some patterns of activation are trait or state markers. The other interesting field of research in schizophrenia may be possible associations between proton spectroscopy results and psychopathology or neuropsychological testing. Some previous studies showed linkage between metabolite profile in frontal cortex and clinical picture of schizophrenia. Other studies employing proton spectroscopy showed interesting results in Alzheimer disease, affective disorders and addictions. Brain fMRI may be helpful in studies on pathogenesis, the degree of CNS changes, in determining the prognosis and in prediction of outcomes in mental disorders.

neuroimaging the team of the Chair of Radiology, Collegium Medicum of the Nicolaus Copernicus University, supervised by dr med. Zbigniew Serafin

Technologically advanced MR scanner is crucial element of the Project. Its main characteristics are high magnetic field induction rate, high homogeneity, amplitude and speed of field gradients growth, 32-channel architecture and also sophisticated applications for diffusion tensor imaging plus functional MRI. Innovative software includes also different angiology programs, spectroscopy, evaluation of both tissue oxidation and tissue perfusion with z- method or without contrast medium.
Preliminary study of the diffusion tensor imaging (DTI) in patients with neurofibromatosis type 1 (NF1) showed associations between cognitive dysfunctions and brain structural changes. Application of the 3T MR scanning with advanced DTI analysis will allow for detailed analysis of the degree of anisotropy of corpus callosum and other white matter structures together with analysis of neurophysiology processes. This should permit better understanding of origin of cognitive decline in NF1.
Elaboration of new sequences and algorithms for brain blood vessels imaging. Advanced MR scanner will permit both anatomic imaging of vessels in high linear resolution and presentation of blood flow in lower than 1 second time resolution. This will allow for optimizing clinical protocols for example to observe patients after embolization of brain aneurysm and consequently abandon invasive DSA angiography from diagnostic schedule.
Application of the 3T DTI in neoplasms, inflammation and demyelination processes of ocular nerve and ocular path. This will facilitate elaboration short diagnostic algorithms in pathologies of ocular nerve and ocular path. These structures are difficult to visualize due to small sizes and location. Therefore disturbances detected clinically are often verified morphologically much later. The DTI in 3T MRI will permit much earlier recognition of pathologies of the ocular nerve and ocular path structure as well as quicker differentiation the changes of similar clinical course but demanding diverse therapeutic approach. In scientific meaning it will be important to recognize patterns of neural fibers’ anisotropy in different pathologies.
Comparison of proton spectroscopy, perfusion and diffusion in 3T MRI for differentiation between glioma recurrence and therapy outcomes. Despite significant technological progress, early detection of recurrence of multiform glioma remains clinical problem of critical importance. Both PET/CT and MR with contrast medium allow for precise differentiation between glioma recurrence and inflammatory-necrotic changes due to radiotherapy only in a fraction of cases. High-resolution proton spectroscopy combined with conventional 3T MRI should enhance diagnostic capability of neuroimaging in scrutinizing patients treated due to gliomas. The experimental problem will be optimizing the protocols to achieve most repeatable pattern of metabolites in pathologic tissue and delineation of thresholds of metabolites’ concentration appropriate to establish the diagnosis.

cognitive functions the team supervised by dr. med. Monika Wiłkość from the Chair of Psychiatry, Collegium Medicum of the Nicolaus Copernicus University and the Institute of Psychology of the Kazimierz Wielki University Bydgoszcz, and by dr. Tomasz Komendziński from the cognitivistic faculty of the Nicolaus Copernicus University.

Planned research will cover:

• analysis of information processing, cognitive processing and emotional processing in healthy subjects and in patients with neurologic, psychiatric and geriatric illnesses

• analysis information processing, cognitive processing and emotional processing in patients after neurosurgery procedures

• information processing, cognitive processing and emotional processing in different developmental stages

• analysis of changes in brain activity under cognitive stimulation during and after both pharmacologic treatment (for example chemotherapy) and non-pharmacologic interventions (for example psychotherapy, neuropsychological rehabilitation)

• observation of processes of neurogenesis and neuroplasticity

• an assessment of the influence of environmental factors, for example stress, on cognitive capabilities

• an assessment of cognitive and emotional processes in circadian rhythms

• an assessment of cognitive and emotional processes in the genetic-molecular context

sense organ structure and function the team supervised by dr hab. Katarzyna Pawlak-Osińska, prof. UMK, head of the Unit of Pathophysiology of Organs of Hearing and Balance of the Chair of Otolaryngology Collegium Medicum of the Nicolaus Copernicus University and prof. dr hab. Henryk Kaźmierczak, head of the Chair of Otolaryngology Collegium Medicum of the Nicolaus Copernicus University.

The most important aim is multidimensional assessment of organ of hearing and balance. Of particular interest will be an effort to ascertain:

1. Origins and characteristics of hear noise

2. Location diagnostic of abnormalities of sense of balance to establish therapeutic algorithms that consider the place of impairment

The studies will focus on elder patients because disorders of balance (presbyastasis, presbyvertigo) and increasing hear loss are important problem in geriatry. Both pathologies may lead to serious social impairment. On the other hand, planned rising of retirement age requires preserving good condition of senior Polish population.
Research will be based on diagnostics considering both results of tests and subjective aspects of hearing and balance.

The tests of hearing will include:

• audiometry of clear tones

• audiometry of word

• over-the-threshold location tests for differentiation of mid-ear, internal ear, hearing nerve and cortical

• hearing center damage

• tympanometry

• acoustic otoemission test

• auditory evoked potentials of short, middle and long latency time

•  audiometric analysis of hearing noise

• electroencephalography (EEG) to search for epileptiform patterns in auditory cortex and other brain structures

Analysis of the sense of balance will be based on:

• an assessment of efficiency of three receptors of the sense i.e. sight, sensation and labyrinth in visual evoked potentials, somatosensory evoked potentials, electronystagmography and otolithe evoked potentials

• an assessment of efficiency of vestibular associative centers upon vestibular evoked potentials of long latency time

• an assessment of resultant effector upon static and dynamic posturography

The clinical aspects of the research described above will contribute significant clues to the therapy of hearing noise, i.e. pharmacotherapy, physiotherapy and prevention of auditory injuries. The studies on disorders of balance and vertigo will aim at adjusting treatments to age and general condition. Treatment of presbyvertigo with different methods of rehabilitation of the sense of balance selectively or universally (according to results of diagnostic tests) would be impeccable.