By Crystal Mackay, MA ‘05
It’s called the Zona Incerta, and its name literally means the ‘uncertain region’ because it is so small and deep in the brain that no one has ever been able to see it using conventional imaging techniques.
Using a combination of expertise in engineering, imaging and neuroscience, Dr. Jonathan Lau is using MRI to visualize and characterize this structure in a living person. “The Zona Incerta has only ever been seen directly in pathology,” said Dr. Lau. “It’s less than a centimetre in size, and being able to pinpoint its exact location has implications for reducing debilitating tremors.”
Working with a team at Robarts Research Institute, Dr. Lau is on the hunt for new ways to use ultra high-field imaging to see parts of the living brain with precision accuracy. The end goal is to create a kind of digital 3D map that is able to pinpoint even the tiniest structures like the Zona Incerta in the brain to help guide neurosurgeons in their work.
With an undergraduate degree in Computer Science and nearing the completion of his residency in neurosurgery, Dr. Lau also made the rare move of simultaneously completing a PhD in Biomedical Engineering.
Despite the long haul, he says it has been easy for him to stay motivated and he owes it to his patients.
“Rather than innovating for the sake of innovating, I look to innovate in ways that improve patient care,” he said. “Helping to solve problems for patients has always been a driver for me.”
Working hand-in-hand with Robarts scientists Terry Peters, PhD, and Ali Khan, PhD, Dr. Lau’s research focuses on developing MRI techniques to improve surgery for patients with neurological problems like epilepsy or Parkinson’s disease.
“With his extensive experience in Computer Science, Biomedical Engineering, Medicine and Neurosurgery, Jon is in a unique position to guide interdisciplinary projects that bridge the gap between engineering, computer science and Neurosurgery,” said Peters, who mentored Dr. Lau through his PhD. “Undertaking his PhD studies during his residency meant that he was in constant contact with the clinical problems he addressed during his research.”
Using state-of-the art imaging equipment at Robarts, the team is able to get a better picture of the structures, vessels and targets in the brain to help plan surgery in a way that is more focused and more personalized from patient to patient.
“The basic idea is that if we can see things better, then we can target them better,” said Dr. Lau. “As a neurosurgery resident, I know what I need to see to be able to help plan the surgery, and the scientists at Robarts are the experts in imaging physics, so the collaboration has been amazing.”
A deep brain stimulation procedure, for example, to treat movement disorders like Parkinson’s or essential tremor, usually takes up most of an operating room day. The surgeons need to keep the patient awake and alert in order to determine if the placement of the deep brain stimulation electrode is improving symptoms. But by improving imaging, Dr. Lau says they should be able to be more confident in targeting exactly where the electrode needs to go. This should reduce the time in surgery and potentially take it from an awake surgery to an asleep surgery.
With an interest in education and teaching, Dr. Lau is also taking this same concept and bringing it to the education space. Using open science data, he used hundreds of brain scans to create a better and more standardized ‘digital GPS’ of the brain that can pinpoint specific structures on any MRI scan within millimetres of accuracy.
“We used data that others had made available, and from this described a set of brain landmarks that could be accurately and consistently placed, then gave this back to the open science community,” he said.
The next stage of this project involves creating a digital app so that anyone in the world can use it to teach or learn the anatomy of the brain.
Next for Dr. Lau will be board exams in the spring, followed by a fellowship in the United States in Epilepsy and Functional Neurosurgery. His end goal is to become an academic clinician-scientist so he can continue his work in research, education and patient care.