Stimulating the brains of pediatric stroke survivors | Brandon Craig | TEDxMacEwanU

I was first introduced to stroke after

I was first introduced to stroke after my very first year of university as a

my very first year of university as a

my very first year of university as a family liaison of the intensive care

family liaison of the intensive care

family liaison of the intensive care unit an emergency room at a local

unit an emergency room at a local

unit an emergency room at a local hospital I was able to meet people from

hospital I was able to meet people from

hospital I was able to meet people from all walks of life that shared one thing

all walks of life that shared one thing

all walks of life that shared one thing in common a loved one was sick or

in common a loved one was sick or

in common a loved one was sick or injured now as an 18 year old with no

injured now as an 18 year old with no

injured now as an 18 year old with no medical experience whatsoever I could

medical experience whatsoever I could

medical experience whatsoever I could not tell the difference between many

not tell the difference between many

not tell the difference between many diagnoses that occurred within the

diagnoses that occurred within the

diagnoses that occurred within the hospital however there was one that I

hospital however there was one that I

hospital however there was one that I could recognize just a little bit better

could recognize just a little bit better

could recognize just a little bit better strokes the weakness to one side of the

strokes the weakness to one side of the

strokes the weakness to one side of the body

body

body the slurred or jumbled speech it seemed

the slurred or jumbled speech it seemed

the slurred or jumbled speech it seemed clear to me that this patient has had a

clear to me that this patient has had a

clear to me that this patient has had a stroke a stroke occurs when the blood

stroke a stroke occurs when the blood

stroke a stroke occurs when the blood supply to the brain is interrupted or

supply to the brain is interrupted or

supply to the brain is interrupted or reduced and this can lead to a variety

reduced and this can lead to a variety

reduced and this can lead to a variety of impairments and disabilities now

of impairments and disabilities now

of impairments and disabilities now currently with the drastic increase in

currently with the drastic increase in

currently with the drastic increase in lifespan over the past 50 years a lot of

lifespan over the past 50 years a lot of

lifespan over the past 50 years a lot of the research in this area focuses on

the research in this area focuses on

the research in this area focuses on strokes and elderly populations in fact

strokes and elderly populations in fact

strokes and elderly populations in fact I spent two years of my life

I spent two years of my life

I spent two years of my life investigating geriatric strokes here at

investigating geriatric strokes here at

investigating geriatric strokes here at McEwen and at the University of Waterloo

McEwen and at the University of Waterloo

McEwen and at the University of Waterloo but what if I were to tell you that

but what if I were to tell you that

but what if I were to tell you that there’s an age group that has a higher

there’s an age group that has a higher

there’s an age group that has a higher risk of stroke than older adults

risk of stroke than older adults

risk of stroke than older adults what if I were to tell you that this

what if I were to tell you that this

what if I were to tell you that this group is babies babies having a stroke

group is babies babies having a stroke

group is babies babies having a stroke that seems a little weird well in fact a

that seems a little weird well in fact a

that seems a little weird well in fact a full-term newborn baby has tripled the

full-term newborn baby has tripled the

full-term newborn baby has tripled the weekly stroke risk of an adult that

weekly stroke risk of an adult that

weekly stroke risk of an adult that smokes and is a type 2 diabetic and has

smokes and is a type 2 diabetic and has

smokes and is a type 2 diabetic and has high blood pressure

10,000 Canadian children are currently

10,000 Canadian children are currently living with the consequences of having a

living with the consequences of having a

living with the consequences of having a stroke at birth clearly this is a

stroke at birth clearly this is a

stroke at birth clearly this is a substantial issue so on the Left we can

substantial issue so on the Left we can

substantial issue so on the Left we can see an MRI scan of a typically healthy

see an MRI scan of a typically healthy

see an MRI scan of a typically healthy newborn brain and on the right we see a

newborn brain and on the right we see a

newborn brain and on the right we see a scan of a one-day-old baby who has had a

scan of a one-day-old baby who has had a

scan of a one-day-old baby who has had a stroke at birth now if this stroke would

stroke at birth now if this stroke would

stroke at birth now if this stroke would occur to anyone of us in this room it

occur to anyone of us in this room it

occur to anyone of us in this room it would be devastating but since this baby

would be devastating but since this baby

would be devastating but since this baby is only one day old it has the

is only one day old it has the

is only one day old it has the opportunity to develop around this

opportunity to develop around this

opportunity to develop around this injury and have a better life these

injury and have a better life these

injury and have a better life these strokes can be classified as peri

strokes can be classified as peri

strokes can be classified as peri stroke that is a stroke that occurs

stroke that is a stroke that occurs

stroke that is a stroke that occurs prior to our soon after birth and can

prior to our soon after birth and can

prior to our soon after birth and can lead to a variety of the disabilities

lead to a variety of the disabilities

lead to a variety of the disabilities these can be a weakness to one side of

these can be a weakness to one side of

these can be a weakness to one side of the body an intellectual disability

the body an intellectual disability

the body an intellectual disability behavioral disorders as well as epilepsy

behavioral disorders as well as epilepsy

behavioral disorders as well as epilepsy now since there is no preventative

now since there is no preventative

now since there is no preventative measure to prevent these from occurring

measure to prevent these from occurring

measure to prevent these from occurring most research in this area focuses on

most research in this area focuses on

most research in this area focuses on how to improve outcomes following stroke

currently I’m a graduate student at the

currently I’m a graduate student at the Alberta Children’s Hospital and my lab

Alberta Children’s Hospital and my lab

Alberta Children’s Hospital and my lab is dedicated to understanding perinatal

is dedicated to understanding perinatal

is dedicated to understanding perinatal stroke and how to optimize results

stroke and how to optimize results

stroke and how to optimize results following stroke my supervisor has

following stroke my supervisor has

following stroke my supervisor has created a team that is dedicated and can

created a team that is dedicated and can

created a team that is dedicated and can use a very vast number of different

use a very vast number of different

use a very vast number of different cutting-edge techniques and equipment to

cutting-edge techniques and equipment to

cutting-edge techniques and equipment to look at perinatal stroke for example we

look at perinatal stroke for example we

look at perinatal stroke for example we have an MRI scan that can take in-depth

have an MRI scan that can take in-depth

have an MRI scan that can take in-depth pictures of the child’s brain while they

pictures of the child’s brain while they

pictures of the child’s brain while they go on a magical journey into space the

go on a magical journey into space the

go on a magical journey into space the kids can become astronauts and receive

kids can become astronauts and receive

kids can become astronauts and receive training certificates by completing an

training certificates by completing an

training certificates by completing an MRI scan so we can use this to answer a

MRI scan so we can use this to answer a

MRI scan so we can use this to answer a variety of questions for example we can

variety of questions for example we can

variety of questions for example we can track the diffusion of water to look at

track the diffusion of water to look at

track the diffusion of water to look at different pathways within the brain and

different pathways within the brain and

different pathways within the brain and then we can correlate these pathways to

then we can correlate these pathways to

then we can correlate these pathways to how well they do clinically additionally

how well they do clinically additionally

how well they do clinically additionally we can look at the functional activity

we can look at the functional activity

we can look at the functional activity in the brain and as well look at how

in the brain and as well look at how

in the brain and as well look at how this correlates with how well they do

this correlates with how well they do

this correlates with how well they do clinically now additionally our lab is

clinically now additionally our lab is

clinically now additionally our lab is one of a few labs across the world that

one of a few labs across the world that

one of a few labs across the world that deals with pediatric non-invasive brain

deals with pediatric non-invasive brain

deals with pediatric non-invasive brain stimulation now if you haven’t heard of

stimulation now if you haven’t heard of

stimulation now if you haven’t heard of brain simulation before it might seem a

brain simulation before it might seem a

brain simulation before it might seem a little weird at first but I assure you

little weird at first but I assure you

little weird at first but I assure you it is completely safe there is a slight

it is completely safe there is a slight

it is completely safe there is a slight tingling feeling but the kids really do

tingling feeling but the kids really do

tingling feeling but the kids really do not seem to mind so our lab uses

not seem to mind so our lab uses

not seem to mind so our lab uses multiple different types of non-invasive

multiple different types of non-invasive

multiple different types of non-invasive brain stimulation such as this robotic

brain stimulation such as this robotic

brain stimulation such as this robotic TMS machine but for the purposes of this

TMS machine but for the purposes of this

TMS machine but for the purposes of this talk I’m only going to discuss one which

talk I’m only going to discuss one which

talk I’m only going to discuss one which is called transcranial direct current

is called transcranial direct current

is called transcranial direct current stimulation or tDCS for short so as you

stimulation or tDCS for short so as you

stimulation or tDCS for short so as you can see this device is lot smaller and

can see this device is lot smaller and

can see this device is lot smaller and easier to use when activated the two

easier to use when activated the two

easier to use when activated the two electrodes on the scalp send a weak

electrodes on the scalp send a weak

electrodes on the scalp send a weak electrical career

electrical career

electrical career that goes through the skull and onto the

that goes through the skull and onto the

that goes through the skull and onto the surface of the brain now the stimulation

surface of the brain now the stimulation

surface of the brain now the stimulation alone might not be enough to cause any

alone might not be enough to cause any

alone might not be enough to cause any change itself but the idea here is that

change itself but the idea here is that

change itself but the idea here is that you would use this brain stimulation

you would use this brain stimulation

you would use this brain stimulation when doing a certain task and it might

when doing a certain task and it might

when doing a certain task and it might help you learn this task better or

help you learn this task better or

help you learn this task better or faster so brain stimulation is on the

faster so brain stimulation is on the

faster so brain stimulation is on the horizon and it’s gaining a lot of

horizon and it’s gaining a lot of

horizon and it’s gaining a lot of traction in a lot of different fields

traction in a lot of different fields

traction in a lot of different fields Olympic athletes are using tDCS other

Olympic athletes are using tDCS other

Olympic athletes are using tDCS other researchers are using tDCS to look at

researchers are using tDCS to look at

researchers are using tDCS to look at things like depression or schizophrenia

things like depression or schizophrenia

things like depression or schizophrenia even surgeons are beginning to take a

even surgeons are beginning to take a

even surgeons are beginning to take a look at this

look at this

look at this my first tDCS experience was actually

my first tDCS experience was actually

my first tDCS experience was actually here at the university in dr. chris

here at the university in dr. chris

here at the university in dr. chris dreamers lab where we use tDCS as a

dreamers lab where we use tDCS as a

dreamers lab where we use tDCS as a potential therapeutic device to

potential therapeutic device to

potential therapeutic device to rehabilitate people from a certain type

rehabilitate people from a certain type

rehabilitate people from a certain type of stroke seen in older adults so our

of stroke seen in older adults so our

of stroke seen in older adults so our lab back in Calgary has used tDCS and

lab back in Calgary has used tDCS and

lab back in Calgary has used tDCS and has actually shown that it improves

has actually shown that it improves

has actually shown that it improves motor function in healthy killed and

motor function in healthy killed and

motor function in healthy killed and healthy kids so what you can see is that

healthy kids so what you can see is that

healthy kids so what you can see is that what’s highlighted in blue is the

what’s highlighted in blue is the

what’s highlighted in blue is the placebo version of tDCS where it feels

placebo version of tDCS where it feels

placebo version of tDCS where it feels like it’s sending up current but it’s

like it’s sending up current but it’s

like it’s sending up current but it’s not actually doing anything compared to

not actually doing anything compared to

not actually doing anything compared to in the green where there is you can see

in the green where there is you can see

in the green where there is you can see the improvement by itself an important

the improvement by itself an important

the improvement by itself an important thing to note is that this change was

thing to note is that this change was

thing to note is that this change was still evident six weeks after testing

still evident six weeks after testing

still evident six weeks after testing the brain stimulation literally changed

the brain stimulation literally changed

the brain stimulation literally changed their brains so let’s go back to the

their brains so let’s go back to the

their brains so let’s go back to the child with a perinatal stroke since the

child with a perinatal stroke since the

child with a perinatal stroke since the stroke has occurred to the right side of

stroke has occurred to the right side of

stroke has occurred to the right side of their brain they will have some weakness

their brain they will have some weakness

their brain they will have some weakness to the left side of their body and this

to the left side of their body and this

to the left side of their body and this leads to the well-known idea that the

leads to the well-known idea that the

leads to the well-known idea that the right side of the brain and all of us

right side of the brain and all of us

right side of the brain and all of us here controls the left side of the body

here controls the left side of the body

here controls the left side of the body but this is not always the case when we

but this is not always the case when we

but this is not always the case when we were first born the right side of our

were first born the right side of our

were first born the right side of our brain controlled not only the left hand

brain controlled not only the left hand

brain controlled not only the left hand of our body but the right side of our

of our body but the right side of our

of our body but the right side of our body as well the idea here is that

body as well the idea here is that

body as well the idea here is that throughout development these same side

throughout development these same side

throughout development these same side pathways degrade and allow for these

pathways degrade and allow for these

pathways degrade and allow for these natural crossing pathways to form but in

natural crossing pathways to form but in

natural crossing pathways to form but in perinatal stroke kids sometimes have to

perinatal stroke kids sometimes have to

perinatal stroke kids sometimes have to rely on these same side pathways because

rely on these same side pathways because

rely on these same side pathways because it might be the only connection that

it might be the only connection that

it might be the only connection that they have from their brain to their

they have from their brain to their

they have from their brain to their weakened hand

weakened hand

weakened hand now you may think that these same side

now you may think that these same side

now you may think that these same side pathways are doing some good for these

pathways are doing some good for these

pathways are doing some good for these kids but in fact they’re actually doing

kids but in fact they’re actually doing

kids but in fact they’re actually doing the opposite research has shown that

the opposite research has shown that

the opposite research has shown that kids with fewer same-side pathways have

kids with fewer same-side pathways have

kids with fewer same-side pathways have a better clinical motor ability so

a better clinical motor ability so

a better clinical motor ability so therefore our lab tries to use tDCS to

therefore our lab tries to use tDCS to

therefore our lab tries to use tDCS to inhibit these same side pathways and in

inhibit these same side pathways and in

inhibit these same side pathways and in turn improve their motor function to

turn improve their motor function to

turn improve their motor function to date our lab has completed one clinical

date our lab has completed one clinical

date our lab has completed one clinical trial in perinatal stroke using tDCS

trial in perinatal stroke using tDCS

trial in perinatal stroke using tDCS this trial showed that tDCS and

this trial showed that tDCS and

this trial showed that tDCS and perinatal stroke was safe and feasible

perinatal stroke was safe and feasible

perinatal stroke was safe and feasible additionally we asked kids to come up

additionally we asked kids to come up

additionally we asked kids to come up with a specific goal that they had prior

with a specific goal that they had prior

with a specific goal that they had prior to the trial this could be something

to the trial this could be something

to the trial this could be something like tying their shoes with both of

like tying their shoes with both of

like tying their shoes with both of their hands or fixing a pedal bike after

their hands or fixing a pedal bike after

their hands or fixing a pedal bike after the trial we asked them you know do you

the trial we asked them you know do you

the trial we asked them you know do you think you were successful of your goal

think you were successful of your goal

think you were successful of your goal the kids that received brain stimulation

the kids that received brain stimulation

the kids that received brain stimulation reported a higher chance of success

reported a higher chance of success

reported a higher chance of success compared to the kids who received the

compared to the kids who received the

compared to the kids who received the placebo version this gave our lab hope

placebo version this gave our lab hope

placebo version this gave our lab hope and it also leads to our second clinical

and it also leads to our second clinical

and it also leads to our second clinical trial that is happening right now in

trial that is happening right now in

trial that is happening right now in this clinical trial we decided since the

this clinical trial we decided since the

this clinical trial we decided since the last clinical trials so that tDCS was

last clinical trials so that tDCS was

last clinical trials so that tDCS was safe in children with perinatal stroke

safe in children with perinatal stroke

safe in children with perinatal stroke we decided to increase the amount of

we decided to increase the amount of

we decided to increase the amount of stimulation just to see if we can

stimulation just to see if we can

stimulation just to see if we can improve outcomes even more now this

improve outcomes even more now this

improve outcomes even more now this clinical trial is still going on right

clinical trial is still going on right

clinical trial is still going on right now so I’m not able to discuss how the

now so I’m not able to discuss how the

now so I’m not able to discuss how the findings are but it appears so far that

findings are but it appears so far that

findings are but it appears so far that all the kids have attended have shown a

all the kids have attended have shown a

all the kids have attended have shown a really positive benefit so being at the

really positive benefit so being at the

really positive benefit so being at the Children’s Hospital has really shown me

Children’s Hospital has really shown me

Children’s Hospital has really shown me the importance of research just the

the importance of research just the

the importance of research just the other day I was able to observe a

other day I was able to observe a

other day I was able to observe a neurosurgery and got to see a live human

neurosurgery and got to see a live human

neurosurgery and got to see a live human brain inches away from my face and then

brain inches away from my face and then

brain inches away from my face and then I got to see that same patient speak few

I got to see that same patient speak few

I got to see that same patient speak few hours later this would not be possible

hours later this would not be possible

hours later this would not be possible without research for me and my research

without research for me and my research

without research for me and my research I loved being able to interact with

I loved being able to interact with

I loved being able to interact with perinatal stroke survivors and survive

perinatal stroke survivors and survive

perinatal stroke survivors and survive in stroke survivors of all ages they are

in stroke survivors of all ages they are

in stroke survivors of all ages they are all gladiators

all gladiators

all gladiators to me they give me and my lab motivation

to me they give me and my lab motivation

to me they give me and my lab motivation to come up with innovative ways of using

to come up with innovative ways of using

to come up with innovative ways of using brain stimulation to develop the

brain stimulation to develop the

brain stimulation to develop the rehabilitation even more there is one

rehabilitation even more there is one

rehabilitation even more there is one thing that I can tell you about the

thing that I can tell you about the

thing that I can tell you about the clinical trial right now is that it is

clinical trial right now is that it is

clinical trial right now is that it is giving hope to perinatal stroke

giving hope to perinatal stroke

giving hope to perinatal stroke survivors and if there’s one thing that

survivors and if there’s one thing that

survivors and if there’s one thing that I’ve learned in my relatively short

I’ve learned in my relatively short

I’ve learned in my relatively short research career is that hope inspires

research career is that hope inspires

research career is that hope inspires research and research inspires hope

research and research inspires hope

research and research inspires hope thank you

thank you

thank you [Applause]