Dr. Alexandra Golby Receives Prestigious Young Clinician Research Award

BSF PI Alexandra Golby, MD, from the Neurosurgery Department at BWH, has received the Young Clinician Research Award presented by CIMIT and made possible through a generous gift by the Johnson & Johnson Corporation. The Young Clinician Research Award recognizes outstanding clinicians, early in their careers, who are also engaged in the development of breakthrough medical technologies. Dr. Golby was selected as a recipient for her research project focused on the development of advanced brain imaging and image-guided surgical techniques.

The BSF is currently supporting Dr. Golby’s work in using two-tensor tractography to resolve crossing fibers in the white matter in the brain to demonstrate the critical motor fibers for neurosurgical planning.

Her project uses advanced Magnetic Resonance Imaging (MRI) and analysis techniques to help define the underlying structural anatomy of white matter in the brain.  The white matter contains all of the axons which connect neurons to one another.  Knowing where major connection pathways run is critically important for surgical planning since disrupting them can cause major neurologic deficits.  A new MRI technique, Diffusion Tensor Imaging (DTI), is the first method able to demonstrate the underlying structure of the white matter in vivo.  DTI infers the primary direction of white matter fibers in each small region interrogated by measuring the preferential direction that water diffuses in that region. Since water diffuses preferentially parallel to white matter fibers, this allows the inference of principal direction of the fibers in that region. 

There has been considerable excitement about the prospects for DTI to provide important information to neurosurgeons pre-operatively.  Nevertheless, many technical hurdles remain in making this technique valid and useful. 

Golby’s project focuses on the problem encountered when major white matter tracts cross each other, as is the case in many areas of the white matter. In that case, there is no preferential direction of water diffusion, and there will be an inaccurate representation of the tracts in that region.  By modeling areas with this type of diffusion using two tensors, rather than one, Dr. Golby is enabling a more accurate picture of the ultrastructural anatomy.  Her and her team will apply this technique to the clinically relevant problem of defining the main motor fibers to the arm and face.  Since these motor tracts cross other tracts, demonstrating these critical fibers with conventional DTI has been hampered.  Dr. Golby is hopeful that this advanced modeling will provide better visualization of these tracts and hence give neurosurgeons more useful information for planning surgery in these regions.