In recent years, clinicians in the departments of neurosurgery and neurology in China have paid more and more attention to basic research in the field of brain function.
However, the so-called art industry has a specialty, what reasonable division of labor should clinical experts and basic scientists have, and how to cooperate in which fields can they exert their greatest advantages and value?
Recently, during the 2018 Temple of Heaven International Epilepsy Conference, (see [Participant Notes] Where is the Logic of Epilepsy Efficacy Progress - Remembering that the 2018 Temple of Heaven International Epilepsy Conference was held), Professor Hong Bo of the Department of Biomedical Engineering of Tsinghua University School of Medicine was interviewed by Shenwai Frontier.
Professor Hong Bo is committed to the basic research of brain functional networks, and his team cooperates with neurosurgery to obtain fine cerebral cortex electrical signals with the help of clinical electrophysiology, and combines imaging methods to reveal the fine collaboration between different functional areas of the brain in cognitive processes such as language.
The following is a transcript of the interview:
Research Topics
Frontiers: What are the main areas of clinical application in the basic research you do?
Hong Bo: We are concerned about brain function, including brain movement, language function, especially in recent years, the study of language function has been more in-depth, because it is difficult to avoid affecting the motor area or language area after the neurosurgery such as epilepsy surgery removes the epilepsy focus.
Previously, the idea was that brain movement and language areas were focal, but now research is gradually inclined to be a network system rather than a point. Therefore, it is necessary to accurately understand the functional boundaries and brain region connections, and this process requires the participation of basic research.
With the help of the electrophysiological means of epilepsy surgery, we place electrodes on the surface or deep part of the brain to obtain very important brain function signals, and use these signals to describe the functional network of the brain language area clearly, in order to provide a reference for epilepsy surgery and physician surgical planning and decision-making, and better balance between removing epilepsy foci and protecting the functional area.
Frontiers: Can your research be applied to gliomas? Or is it only for epilepsy surgery?
Hong Bo: The same, all have applications.
Divine Frontier: Glioma professional doctors seem to be more concerned about the protection of language areas?
Hong Bo: Yes, because a lot of gliomas overlap with language areas.
Frontiers: Have experts studied the language areas of English and the language of Chinese in different places?
Hong bo: It can be said that the core language function is the same. But Chinese is a tonal language that involves the processing of tone, which is rather special and may require the participation of movement and pre-exercise zones, which is a new discovery. Clinically, this finding may be used to promote the rehabilitation of surgical aphasia through activation of motor areas.
Prospects for clinical application
Frontiers: What is the medium through which the basic research you do guides clinical application?
Hong Bo: We mainly focus on intracranial EEG, which can be the surface electrode ECoG of the cerebral cortex or the deep electrode SEEG. The electrical activity of each point can be shown in a dynamic image, and the intensity of activity at each cortex location, as well as functional correlation, can be imported into the robot frameless stereotactic surgical assistance system, just like the introduction of epilepsy foci and brain tumor location information.
Frontiers: What stage is this research currently in?
Hong Bo: Now there is an intracranial EEG function localization and network analysis prototype, which is in the preclinical research stage, and it is really turned into a clinical device, and clinical trials need to be done to prove its effectiveness with a certain number of cases.
Frontiers: What are the visual results of your research? For example, the protection of the language area and the percentage reduction in the risk of postoperative aphasia.
Hong Bo: It is still in the basic stage, mainly the understanding and analysis of language networks, and the next stage will be combined with clinical cases to prove that this discovery is clinically valuable.
Opportunities outside God
Neurosurgeon Frontiers: Do you think there's an opportunity for neurosurgeons to get involved in brain science research?
Hong Bo: There are definitely greater opportunities in China. On the one hand, in neuroscience research based on animal models, we have gaps in talent, technology, discipline foundation and international level, and in recent years, we have developed rapidly and are trying to catch up. On the other hand, we must give full play to the advantages of the rich clinical resources of neurosurgery in our country and pay direct attention to the key area of human brain function. It can be seen that at present, domestic clinicians inside and outside the gods attach great importance to basic research and are willing to cooperate with basic scientists. If this trend continues, there is an emphasis on basic and clinical collaboration around the higher cognitive functions and diseases of the human brain. I believe that China can definitely surpass European and American countries in the field of brain science, or at least it can find another way and take a different path.
Divine Frontiers: Where is the most likely place for both your basic research and clinicians' research to interface?
Hong Bo: This has to be done in stages. First of all, we must focus on the combination of basic and clinical diagnosis and treatment, such as comparing the brain to a machine, and being able to repair the bad machine shows that the understanding of the principle of the machine is very deep. Taking the diagnosis and treatment of epilepsy as an example, the problem we face is how to repair a broken brain, which involves a neural mechanism that is not simple, you can first do a good job of "seeing a doctor" and "repairing the machine", I believe that the exploration on this road can also solve some fundamental problems of brain science. Looking back at the history of the development of brain science, important discoveries in advanced brain functions such as movement, memory, and language have all contributed by neurologists, and their new observations in clinical practice have become regular discoveries through cooperative exploration with basic scientists.
Finding problems is more important
Exophistication Frontier: So for clinicians, it's more important to find problems?
Hong Bo: Yes, clinicians ask questions and solve them with basic scientists. Two of these things are important: first, clinicians put forward problems that they can't solve, such as feeling that language positioning is difficult, and after proposing this problem, basic scientists can collaborate to solve it; second, clinicians have found new phenomena in clinical practice, such as special functional behaviors caused by intraoperative brain stimulation, if reported, can also bring a lot of inspiration to brain function research. Dr. Wilder Penfield, the originator of functional neurosurgery, revealed some important laws of motor and language function through such clinical observations. If we ask about new problems and new phenomena and make new diagnostic and treatment equipment, which are more valuable, the brain pacemaker is a successful example. This is something that basic scientists can't do and can't replace, after all, they can't get close to the human brain like doctors outside the gods and inside the gods.
Frontiers: How Do Clinical Experts Collaborate with Foundational Scientists? Are you welcome? What should we pay attention to in cooperation between the two sides?
Hong Bo: Compared with foreign countries, Clinicians in China have a heavy burden of clinical work, and it is not easy to free up time to do basic research, and it is not realistic to require doctors to invest more time and energy. So I think basic scholars need to be more proactive and invest more time in communicating with clinical experts, listening to their ideas, finding problems, and learning from them.
Respondent profiles
Hong Bo is a professor and doctoral supervisor at Tsinghua University School of Medicine. He received his Ph.D. in Biomedical Engineering from Tsinghua University in 2001 and was a visiting scholar at Johns Hopkins University School of Medicine and the MIT McGovern Brain Research Institute. He has been selected as a new star of science and technology in Beijing and an excellent talent of the new century of the Ministry of Education. His research focuses on the neural mechanisms of brain-computer interface and language. Its research team has developed new technologies of human brain function localization and brain network analysis in clinical cooperation with neurosurgery, which provides important functional information for brain surgery planning; designs and implements a minimally invasive brain-computer interface based on intracranial EEG, which opens up a new technical route for the study of implanted brain-computer interface; combines EEG signal analysis and neuroimaging technology to make progress in analyzing the language processing mechanism of human brain speech, providing new ideas for language rehabilitation and language intelligent processing. The results were published in Nature Neuroscience, PNAS, NeuroImage, etc. He currently serves on the editorial board of IEEE Transactions on Biomedical Engineering.
Past interviews
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[Interview no. 172] Jiao Baohua, Second Hospital of Hebei Medical University: The annual volume of craniotomy surgery in the Department of Divine Surgery has exceeded 3,000 units, and ten professional groups in three wards have been set up
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[Interview no. 168] Xuanwu Hospital Yu Tao: Discovering and confirming the principle of DBS's efficacy in the treatment of epilepsy makes neuromodulation "targeted" | Column of the Temple of Heaven International Epilepsy Conference
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[Interview no. 162] Beijing Chaoyang Hospital Li Jinping: Postcirculating Cerebrovascular Disease in the Quasi-Surgical Exclusion Zone Intervention and Craniotomy How to Choose (with relevant courseware)
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[Interview no. 158] Qiu Xiaoguang, Temple of Heaven Hospital: Low-grade glioma blindly delayed radiotherapy is afraid of post-treatment Central lymphoma should not be treated with radiotherapy first | Temple of Heaven Central Lymphoma Weekly No. 8
[Interview no. 157] Zhang Jianguo of Tiantan Hospital: Expansion of the new campus Three directions of the layout of functional scientific research outside the gods | Functional Divine Weekly No. 1
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[Interview No. 142] Zhongshan Tumor Mou Yongyao: Gliomas that cannot benefit from surgery can try radiotherapy and chemotherapy before surgery
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[129th issue interview] Peking Union Medical College Hospital Zhou Daobin: Central lymphoma has the possibility of cure Radiotherapy and chemotherapy are effective And do not advocate complete surgical resection
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[Interview no. 118] Qin Zhiyong of Huashan Hospital: Where is the room for glioma surgery to progress, when to be active and when to be conservative
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[Interview no. 116] 301 Hospital Qu Baolin: A New Exploration of Radiation Therapy for Glioma Reconstructing Fiber Bundles to Protect Brain Function Radiation Dose Reduction by 20-30%
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[Interview no. 110] Peking University Hospital Bao Shengde: Failed surgery is more worthy of learning and attention The department of neurology should not be blindly expanded
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[Interview no. 96] Jia Guijun, Temple of Heaven Hospital: Craniotomy for invasive pituitary adenoma "sharp knife class" How to protect the hypothalamus during high-risk surgery
[Interview no. 95] Hu Zhiqiang, Beijing Shijitan Hospital: Exploring neuroendoscopic treatment of ventricular infections, and its cure rate has reached 95%
[94th Issue Interview] Peking Union Medical College Hospital Wei Junji: China's neuro-acute sub-specialty has developed the fastest in the past five years
[93rd Issue Interview] 301 Hospital Ma Xiaodong: Surgical resection of functional area gliomas should dare to face minor dysfunction to improve the cure rate
[Interview no. 92] Tiantan Hospital Cao Yong: It is more important to protect the conduction tract in cerebral arteriovenous malformation surgery 5 mm is a safe distance
[91st Issue Interview] Liu Baiyun of Temple of Heaven Hospital: Improving the level of treatment of grass-roots cranial trauma should promote a broad alliance between nerve trauma units and hospitals
[Interview no. 90] Kamada, Asahikawa Medical University, Japan: How to protect brain functional areas and microcredulities to achieve a five-year GBM survival rate of 25%
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[Interview no. 87] Zhang Dong, Temple of Heaven Hospital: There is no difference between the bridge and patch treatment effect of Smoke Disease Nearly 700 sets of four cerebrovascular disease surgeries have been completed in the ward every year
[Interview no. 86] Hong Tao, First Affiliated Hospital of Nanchang University: From the bulk case of craniopharyngioma to the exploration of aneurysm Neuroenoscopy has opened up the territory in the past five years
[85th Interview] Xiao Fushun, Tianjin General Hospital: What are the advantages of interventional treatment of cerebrovascular diseases In trying to treat cerebrovascular stenosis in young people with simple balloon dilation
[84th Issue Interview] Pu Peiyu, Tianjin Medical University: Taking every patient seriously can improve the surgical ability of the doctor is more important than the SCI paper
[Interview no. 83] Sheng Xiaofang, Huashan Hospital: Radiation therapy problems and glioma MDT in young children
[Interview no. 82] Jiang Wei, Tianjin Huanhu Hospital: Long-term survival patients with glioma are all surgical total resection What is the correct logic for judging common problems such as false progression
[Interview no. 81] Tao Rongjie, Shandong Provincial Cancer Hospital: The comprehensive treatment of cystic and high-pressure meningeal metastases has accumulated a large number of cases How to treat gliomas with non-surgical treatment
[80th Interview] Xuanwu Hospital Park Yueshan: Objective and rational view of glioma molecular pathological testing Which cases will mislead doctors and patients
[79th Issue Interview] Kang Jun of Tongren Hospital: How to reduce the stress treatment of neglected optic nerve injury in head trauma Tongren Shenwai has accumulated more than 1,000 cases
[78th Interview] Zhang Guojun of Xuanwu Hospital: Resective surgery in pursuit of cure should still be the mainstream of epilepsy surgery Accounting for more than 95% of Xuanwu Hospital
[77th Interview] Xuanwu Hospital Zhu Hongwei: The Surgical Treatment of Pain is in the Ascendant What are the advantages and means of Shenwai?
[76th Issue Interview] Tsinghua Chang gung hospital Wang Jin: Father Wang Zhongzhong academician gave me three enlightenments Tsinghua Chang Gung extra-mythological spinal cord spine is developing rapidly
[75th Issue Interview] Chen Ling, 301 Hospital: DC-iNKT vaccine combined with immune checkpoint blockers for the treatment of glioma clinical trials are about to start three steps of immunotherapy
[Interview no. 74] Interview with Xia Yunfei, Cancer Hospital of Sun Yat-sen University: Whether low-grade gliomas require radiation therapy Why there are false progressions
[Interview No. 73] Chen Zhifeng, Queen Mary Hospital, University of Hong Kong: The new chemotherapy regimen can allow most children to "heal themselves" after a "long-term standstill" to avoid overtreatment
[Interview no. 72] Yan Guangmei, Sun Yat-sen University: M1 oncolytic virus can cross the blood-brain barrier and is highly sensitive to glioma stem cell killing Strive for clinical trials next year
[71st Issue Interview] Sanjiu Brain Department Zhu Dan: The hospital's extratherapy volume has exceeded 5400 SETS per year, and the development of SEEG technology has promoted the progress of epilepsy surgery to a certain extent
[Interview with Wang Xinsheng of Temple of Heaven Hospital: The annual surgical volume of the endoscopic team is more than 1,000 units The intracranial arachnoid cyst should be the first choice for endoscopic surgery
[69th Issue Interview] Wang Xinsheng, Temple of Heaven Hospital: Ventricular microscopic surgery to treat hydrocephalus Prevention of infection and opening of the liliequist membrane is the key
[68th Interview] Zhao Yadu, Temple of Heaven Hospital: What is the most important thing in extra-divine surgery Is that the surgeon is equally important as scientific research and teaching
[Interview with Wang Rong, Temple of Heaven Hospital: The opening rate after the use of the compound operating room after the blockage of carotid artery stenosis has reached more than 70%.
[66th Interview] Wang Rong, Temple of Heaven Hospital: CEA surgery is the gold standard for the treatment of carotid artery stenosis, the long-term effect is better and the cost is lower, but why is China's implementation far behind
[Interview no. 65] Luan Guoming of Sanbo Brain Department: The average efficiency of 400 VNS treatment of refractory epilepsy is 76% How to look at neuromodulation and resection surgery
[Update/64th Interview] Jiang Yuwu, Peking University First Hospital: Pediatric epilepsy surgery can "promote" brain development Center 200 units of surgery per year to work towards the world's first-class children's epilepsy center
[63rd Interview] Yu Yanbing, China-Japan Hospital: The obvious improvement rate of children with cerebral palsy can reach more than 95% And nearly 10,000 surgeries have been completed
[Interview no. 62] Yu Yanbing, China-Japan Hospital: How to Achieve Intraoperative "No Bleeding" in Microvascular Decompression The team has accumulated nearly 40,000 surgical experience
[Interview with Wang Lei, Temple of Heaven Hospital: Take the difference in the level of glioma surgery as an example to see if patients choose and faithfully follow the doctor
[60th Issue Interview] Ruijin Hospital Sun Bomin: Functional God expands the frontier in the treatment of diseases Surgical treatment of anorexia nervosa has been at the forefront of the world
[59th Issue Interview] Zhao Yuanli, Peking University International Hospital: Less than two years after the opening of the divine clinic Last year, the number of surgeries exceeded 1,000 neurological rehabilitation is one of the characteristics
[58th Interview] Wang Lei, Tiantan Hospital: From the 18-year "war of resistance" case of a glioma patient, see which low-grade gliomas are not necessarily in a hurry for surgery
[57th Interview] Ge Ming, Beijing Children's Hospital: More than 850 sets of surgery in children's gods, where is the most appropriate for medulla/craniopharyngioma/optic glioma
[56th Interview] Ge Ming, Beijing Children's Hospital: Brain tumors are not diverted before surgery to avoid lifelong tubes in children Established a children's nerve center to open up medical and surgical procedures
[55th Interview] Sun Tao, Ningxia Medical University: What breakthroughs will be made in epilepsy treatment Ningxia Brain Plan focuses on the Temporal Island network
[54th Issue Interview] Temple of Heaven Hospital Gui Songbai: Pituitary tumors and other skull base tumors more than 200 times a year Surgery Extraterrestrial surgery has quantitative changes in order to have qualitative changes
[Interview no. 53] Sanjiu Brain Department Cai Linbo: The use of psychological intervention to let children with brainstem glioma successfully complete radiotherapy and effectively alleviate symptoms
[52nd Issue Interview] Liu Pinan, Temple of Heaven Hospital: Pituitary tumor surgery has accumulated more than 1500 cases Endoscopic technology development irreversible Surgical treatment will eventually be internalized
[Interview no. 51] Sanbo Brain Department Yu Chunjiang: Experience and Thoughts on the Treatment of Glioma Pituitary Tumor and Acoustic Neuroma The total resection rate of acoustic neuroma is 98%
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[Interview no. 47] Lu Yuntao of Southern Hospital: Diseases in the Huan-Pillow Junction Area Neurosurgery has advantages
[Interview no. 46] Wang Qun, Beijing Temple of Heaven Hospital: The treatment of deep brain epilepsy and tumors should pay attention to the new technology of local laser surgery (LITT).
[45th Interview] YU Xinguang, PLA General Hospital: More than 4,000 units of surgery per year through DSI and other technologies to develop brain function research and establish a precision neurosurgical system
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[43rd Issue Interview] Zhang Jianning of the Naval General Hospital (Part 1): Based on stereotactic technology, brain tumor interstitial radiotherapy brain tissue biopsy and gamma knife treatment have accumulated the largest cases in China
[Interview no. 42] Tianjin Cancer Hospital Li Wenliang: Glioma treatment has not yet found a real entry point Surgery is still the main means
[Interview no. 41] Meng Fangang of Tiantan Hospital: Neuromodulation surgery has a wide range of indications, but it should be carried out actively and steadily
[Interview No. 40] Batchelor: Targeted therapy for gliomas cannot rely on just one targeted drug
[Interview no. 39] Southern Hospital Qi Songtao: There are misunderstandings in the treatment of craniopharyngiomas And the concept of membranous neurosurgery was proposed
[38th Interview] Li Jianyu, Xuanwu Hospital: Parkinson's disease surgery team has an annual surgical volume of more than 300 lesions
[37th Issue Interview] Hu Yongsheng of Xuanwu Hospital: Functional neurosurgery has obvious advantages in the treatment of refractory pain Has accumulated the largest number of cases in China
[36th Interview] Qiao Hui, Temple of Heaven Hospital: More than 20,000 cases of monitoring in 20 years How the intraoperative neuroelectrophysiology monitoring team of Beijing Tiantan Hospital has gone to the forefront of the world
[Interview no. 35] Zhang Zhiwen, The First Affiliated Hospital of the PLA General Hospital: The technical level of cerebrovascular surgery is high The emphasis on comprehensive treatment of glioma is emphasized
[Interview with Issue 34] Zhongshan Tumor Chen Zhongping: The Development Path of Neurosurgery in Cancer Hospital The 5-year survival rate of gyroplasm with the highest degree of malignancy of glioma reached 28%
[33rd Issue Interview] Wang Weimin, General Hospital of Guangzhou Military Region: 14 years of experience of the pioneers of intraoperative wake-up surgery The total resection rate of glioma reaches 77.8% Epilepsy and cerebrovascular malformations in functional areas have broad application prospects
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[30th Issue Interview] Peking University Medical College Evergreen: The first to discover the molecular marker of medulloblastoma Mir-449a can help obtain accurate diagnosis and precise treatment opportunities
[29th Issue Interview] Zhang Kai, Temple of Heaven Hospital: Let the high incidence of frontal lobe epilepsy no longer be "confused" The progress of imaging has made its surgical treatment effect comparable to temporal lobe epilepsy
[28th Interview] Temple of Heaven Hospital Xie Jian: More than 300 sets of high-difficulty island leaf glioma surgery experience Total resection rate 96.1% Disability rate 11.0% Protection of lateral bean vein arteries is the top priority
[27th Issue Interview] 301 Hospital Ling Zhipei: Pioneered in the application of multi-channel microelectrode electrophysiological recording technology to help Parkinson's surgery more accurately positioned
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[Interview with The 25th Issue] Yang Xuejun of Tianyi General Hospital: The first to apply transcranial magnetic stimulation technology The total resection rate of glioblastoma imaging is more than 95%.
[24th Issue Interview] Gao Zhixian of Tiantan Hospital: Advice on nearly 2,000 glioma surgery experience
[Interview with Zhang Jianguo, Beijing Temple of Heaven: Where will the technological breakthrough of DBS in the treatment of Parkinson's disease appear?
[Interview no. 22] Zhang Yazhuo: Surgery is still the preferred treatment method for chordoma, and it remains to be seen that drugs such as proton radiotherapy are still under development
[Interview with Issue 21] Wu Jinsong of Huashan Hospital: Low-grade gliomas can exceed 70% in 10 years after rational treatment
[20th Issue Interview] Xuanwu Hospital Xu Geng: Application of fiber peeling challenges the surgical treatment of island leaf glioma
[Interview with Zhang Jianguo, Temple of Heaven Hospital: Neuromodulation can "replace" some surgeries
[Interview no. 18] Lin Song: Treatment of gum mother (GBM) through electrophysiological monitoring and ultra-early chemotherapy
[Interview no. 17] Lin Song: Surgery is the decisive factor in the treatment of glioma How to achieve accurate resection
[Interview no. 16] Xiao Xinru: Only surgery can bring a cure to the skull base meningioma
[15th issue interview] Xiao Xinru: Surgery is impossible to cure glioma Molecular targeting and immunotherapy are the most promising
[Interview with Wang Renzhi] Wang Renzhi: Although pituitary adenoma is a common tumor in neurosurgery, it should be coordinated by multiple departments
[Interview with Wang Renzhi] Wang Renzhi: Opposing the abuse of gamma knife pituitary adenoma treatment requires multi-disciplinary collaboration
[Interview no. 12] Ma Wenbin: This year will carry out clinical trials of immunotherapy for glyblastoma
[11th Interview] Ma Wenbin: How international cutting-edge technology can benefit glioma patients in China
[Interview with Jiang Tao: New drugs for recurrent GBM this year's clinical trials Immunotherapy has great prospects
[Interview no. 9] Zhang Yuqi: Treatment of glioma mainly depends on the degree of surgical resection rather than chemotherapy
[Interview with Zhang Yuqi: Answering hot questions such as craniopharyngiomas and brain tumors in children
[Interview no. 7] Temple of Heaven Yu Shuqing: Image guidance techniques such as intraoperative B-ultrasound angiography make glioma surgery more accurate
[Interview no. 6] Temple of Heaven Yu Shuqing: Gene therapy has a good effect on glioblastoma Clinical trials are underway
[Interview no. 5] Beijing Temple of Heaven Ji Nan: The latest progress in the treatment of gliomas such as genetic technology
[Interview no. 4] Beijing Temple of Heaven Ji Nan: Molecular testing may be one of the breakthroughs in glioma
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