CHF 51444 / Year
Region
The Project in a Nutshell:
Acute traumatic spinal cord injury (SCI) is a severe neurological condition caused by mechanical trauma that results in severe motor loss (i.e., paralysis), impaired sensation, and autonomic dysfunction. Degenerative cervical myelopathy (DCM) can show similar symptoms and is related to chronic progressive spinal canal stenosis. The resulting lifelong deficits associated with paralysis and sensory loss have a substantial effect on individuals, caregivers, and society. Timely and sufficient surgical decompression is a critical objective with many pre-clinical and clinical studies focused on surgical timing. However, quantifying the degree of cord compression and providing intraoperative guidance in decompression surgery remains a challenge. New diagnostic approaches are needed to improve treatment decisions. Measurement of cerebrospinal fluid (CSF) dynamics is a potential tool to reduce these diagnostic gaps. As part of an international translational-clinical network, CSF pressure will be monitored in patients undergoing surgery, at bedside, and in a large-animal model. This cutting-edge research has the potential to improve care for patients with SCI and DCM.
The Project in Detail:
Increased resistance to CSF flow through spinal stenosis and spinal cord compression in SCI and DCM results in differing infra- and supra- stenotic CSF pressure dynamics. Our previous work indicates that infra-stenotic CSFP dynamics could provide a quantitative measure for the degree of spinal cord compression. The ultimate goal of the research is to evaluate the value of CSF pressure indices as a preoperative diagnostic and perioperative monitoring approach. Intraoperatively, we will investigate the pulse curve morphology and decompression-related changes. Additionally, all patients will be characterized with neurological examinations, magnetic resonance imaging (MRI) and electrodiagnostic studies, allowing correlation to CSF parameters. In the large-animal model, CSF pressure will be acquired continuously before and after CSF space ligation and correlated to phase-contrast MRI.
The core task of the PhD student will be:
1. Data analysis focusing on phase-contrast MRI readouts correlated with CSF pressure metrics.
2. Training in CSF pressure signal analysis and PC-MRI evaluations.
3. Participating in data acquisition in large animals, including adapting the data acquisition program for the new measurements (LabView), surgical assistance, and animal handling.
4. Assisting with clinical data acquisition, including the use of pressure monitors and signal monitoring in the operating theatre.
If the overall project is successful, insight into yet unknown CSF dynamics in cord compression will be obtained, laying the groundwork for advancing management of spinal cord injuries, and discovering entirely novel avenues that improve diagnosis and monitoring of spinal cord disease.
The Research Team:
Our team consists of the Spinal Cord Injury Center Group at Balgrist University Hospital (https://www.sci-research.uzh.ch/en/aboutus.html) and The Interface Group at the University of Zurich (interfacegroup.ch). The Spinal Cord Injury Center provides highly specialized treatment for spinal cord injury patients by an interdisciplinary team of surgeons and neurologists. The Interface Group provides a creative, cross-disciplinary international work environment with outstanding infrastructure for computational research in biomedicine, physiology and biophysics. This unique constellation of clinical and basic sciences enables fast translation of research findings to benefit patients.
The Applicant:
Your goal is to have an immediate impact on the lives of patients. You are intrigued by the potential of combining neuroimaging and biomechanical proxies for evaluating spinal cord compression. You have a background in biomedical engineering, physiology with technical know-how in data acquisition, or a comparable background. You are comfortable with working alongside medical doctors in the operating theater, with veterinarians for data acquisition on large animals, and in consultation with engineers on the analysis of image and signal analysis. You are open to spending part of your PhD with the collaborators in the United Kingdom and Australia.
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