Pediatric Hydrocephalus
PI: Strahle
Protocol ID: 202401143
Short study title: Amniotic Fluid & CSF Factors for Hydrocephalus and Altered Brain Development in Myelomeningocele.
Short description: Up to 85% of children born with myelomeningocele (MMC) develop hydrocephalus. The origin of this hydrocephalus is not known and there have been no large-scale preclinical studies addressing the mechanisms of this type of hydrocephalus. During MMC the amniotic fluid (AF) becomes in contact with important neurodevelopment cells. Even though this occurs, there have been no studies evaluating the consequences of AF exposure to the cerebrospinal fluid (CSF) and developing brain. We propose to analyze the AF and CSF in the control setting and the MMC setting to compare their contents. Successful completion of the study will determine the role of AF in ventricular expansion, CSF flow and the development of hydrocephalus, with identification of specific targets to interrupt the origin of hydrocephalus in children with MMC.
Key eligibility criteria:
- Pregnant mothers undergoing amniocentesis
Contact person: Diego Morales, 314-454-4688, d.morales@wustl.edu
PI: Strahle
Protocol ID: 202408130
Short study title: Functional Magnetic Resonance Imaging in Myelomeningocele
Short description: The most common form of spina bifida, myelomeningocele, is known to cause a constellation of structural brain abnormalities and can be treated before and after birth. However, the connectivity of brain regions in children in myelomeningocele is not known. This study uses functional magnetic resonance imaging to determine how the functional connectivity in the brain differs after treatment for myelomeningocele before and after birth.
Key eligibility criteria:
Contact person: Diego Morales, 314-454-4688, d.morales@wustl.edu
PI: Strahle
Protocol ID: 202408059
Short study title: Neuroimaging Analysis for Disorders Involving CSF Regulation
Short description:
The purpose of this study is to examine how the flow of CSF in pediatric patients with hydrocephalus compares to the flow in healthy individuals and other neurological diseases including Chiari type 1 malformation. Understanding the mechanisms of how CSF influences the developing central nervous system could provide insights on how to improve clinical care and the development of novel therapies. This project will conduct an analysis of CSF circulation and regulation outlined by advanced non-invasive MR diagnostic techniques. While other studies have begun to assess the relationship between CSF-mediated pathophysiology in other neurological diseases, few have focused on high resolution imaging of CSF flow in those with hydrocephalus, and none noted to date have investigated comparing CSF dysregulation within the brain systematically in children afflicted with Chiari type 1 malformation and hydrocephalus to the CSF flow of healthy children.
Key eligibility criteria:
- Qualified individuals are ages 0-99, can lay flat for an MRI without sedation, & have not yet had surgical treatment for hydrocephalus.
Contact person: Farrell Landwehr, 314-454-4709
PI: Strahle
Protocol ID: 202409151
Short study title: Longitudinal Imaging of CSF flow in Hydrocephalus
Short description: The purpose of the proposed study is to investigate the differences of cerebrospinal fluid (CSF) movement in patients with hydrocephalus before and after surgical treatment as well as how flow compares to healthy individuals. While prior research has begun to assess the relationship between CSF-mediated pathophysiology in various neurological diseases, none noted to date have observed the longitudinal changes of CSF circulation in relation to surgical intervention and how CSF flow differs from the physiologic patterns of CSF distribution after shunt placement. This study will be a longitudinal imaging analysis quantifying the differences of CSF circulation in patients with hydrocephalus and how surgical intervention of shunt placement impacts flow dynamics. The intention of this project is to improve CSF biomarkers and help define the relationship between CNS pathology and fluid dissemination.
Key eligibility criteria:
- Patients scheduled to undergo magnetic resonance imaging (MRI) for clinical purposes with suspected or diagnosed hydrocephalus of all ages, any sex
- Participants can be pre- or post-surgical intervention
- The post-surgical group will include participants who have received the surgical intervention of shunt placement in the past and are scheduled to have follow-up clinical imaging performed. Individuals included can have either a fixed or programmable shunt.
Contact person: Diego Morales, 314-454-4688, d.morales@wustl.edu
Pediatric Oncology
PI: Strahle
Protocol ID: 201103136
Short study title: Pediatric Neurosurgery Tissue Bank
Short description: The purpose of the Pediatric Neurosurgery Tissue Bank is to collect and store tissue samples from patients undergoing surgery. These samples include benign and malignant brain/spine tumors, normal/abnormal brain tissue, cerebrospinal fluid (CSF), bone, blood samples, and other related tissues. Specimens will be collected from the operating room or specialized procedure room in which said tissue is removed. Biological parents and siblings are also eligible to donate blood samples. Data from this tissue bank will be used to better understand disease progression, disease biology, generate realistic animal models of disease, and help to develop newer therapies.
Key eligibility criteria:
- Any sex, any age
- Patients scheduled to undergo surgical resection for brain/spinal tumor, seizure focus, or brain malformation
- Biological parents and siblings are also eligible to donate blood samples
- Patients at end-of-life are eligible to participate through the Legacy Brain Donation Program
Contact person: Diego Morales, 314-454-4688, d.morales@wustl.edu
Enrollment period: Current
Pediatric Epilepsy
PI: Roland
Protocol ID: 202002124
Short study title: MRI Predictors of Response to Vagal Nerve Stimulation
Short description: Patients with medically refractory epilepsy may be candidates for vagal nerve stimulation (VNS), which are implanted devices that alter the brain’s excitability and thereby decrease seizure frequency. However, it is not clear which patients will respond well to vagal nerve stimulation and will have an improved quality of life after surgery. The aim of this study is to analyze brain MRI scans for patients before and after surgery and to collect information relating to seizure frequency and quality of life in order to better identify patients who might benefit from this treatment.
Key eligibility criteria:
- Any sex, any age
- Patients undergoing VNS therapy
Contact person: Diego Morales, 314-454-4688, d.morales@wustl.edu
Enrollment period: Current