Mechanical engineers at the University of Akron are trying to improve the lives of patients with a potentially debilitating brain disorder by going with the flow.
A nonprofit patient support group called Conquer Chiari recently selected the university as the site of its new national Conquer Chiari Research Center.
UA mechanical engineers are exploring the role of fluid flow and pressure in causing excruciating headaches, balance problems, limb weakness and other symptoms suffered by some of the estimated one in 1,000 people with a Chiari malformation.
The congenital malformation occurs when the bottom part of the brain — the cerebellum — hangs below the base of the skull into the spinal canal, crowding the spinal cord.
MRI tests can confirm the presence of the malformation. But the amount of crowding in the spinal canal doesn’t always correspond with the severity of symptoms, making it challenging for doctors to determine who is a candidate for surgery to correct the defect.
“The appearance doesn’t always tell us the story,” said Dr. Mark Luciano, a pediatric and adult neurosurgeon at the Cleveland Clinic who specializes in treating Chiari malformations. “We know that there’s something else dynamic going on.”
Frank Loth, an associate professor of mechanical engineering at the University of Akron, is working with fellow mechanical engineer Bryn Martin, director of the new research center, to develop enhanced MRI methods to measure the flow of cerebrospinal fluid, the liquid that protects the brain and spine from injury.
With every heartbeat, a tiny amount of cerebrospinal fluid — about a fifth of a teaspoon — moves up and down between the brain and spinal canal, Loth said.
The malformation “clogs it up like a drain,” Loth said. “It all connects together — flow and pressure.”
Along with helping patients with Chiari malformations, the research could benefit patients with other conditions that are affected by fluid flow in the brain, including hydrocephalus and traumas, said Luciano, who is working with Loth and Martin on their research.
The research center will be “the engineering eyes of the doctors,” providing information that could be used to help evaluate and treat patients, Loth said.
Loth and his team have received nearly $500,000 from the National Institutes of Health for their research.
Improved tools could help doctors customize surgery for patients by determining the optimal amount of decompression needed to eliminate symptoms, Luciano said.
The research advances are welcomed by patients such as Brenda Langston.
The 59-year-old from Sidney in western Ohio recently underwent a second operation at the Cleveland Clinic to correct her Chiari malformation.
She suffered headaches, difficulty focusing, leg pain, choking and other mysterious symptoms that started in the 1980s and weren’t properly diagnosed until she got an MRI in 2003.
“They basically tried to make me sound like I was crazy,” she said. “You know your body better than anybody. If you think something is wrong, you push until you get to the bottom of it.”
She needed a second operation this year after her symptoms returned following a car accident.
“I just felt like the back of my head and neck were going to explode,” she said.
Conquer Chiari provided $275,000 in initial funding — $135,000 to establish a dedicated lab within the University of Akron’s new engineering research facility and $140,000 for salaries. The group also has pledged $140,000 annually for the research initiative.
Pittsburgh-area resident Rick Labuda started the nonprofit foundation after struggling to find information about Chiari malformations when his was diagnosed in 1998.
“The University of Akron has been a tremendous partner for us to work with,” he said. “The intent is to grow.”
Cheryl Powell can be reached at 330-996-3902 or firstname.lastname@example.org. Follow Powell on Twitter at twitter.com/abjcherylpowell.