Posts

Children's National employs 45 pediatric neurologists and 6 pediatric neurosurgeons.

Neuroscience at Children’s National

The Children’s National Division of Neurology and Neurosurgery is consistently recognized by U.S. News & World Report as one of the top neurology programs in the nation.

Children’s National ranked No. 6 overall and No. 1 for newborn care by U.S. News

Children’s National in Washington, D.C., is the nation’s No. 6 children’s hospital and, for the third year in a row, its neonatology program is No.1 among all children’s hospitals providing newborn intensive care, according to the U.S. News Best Children’s Hospitals annual rankings for 2019-20.

This is also the third year in a row that Children’s National has been in the top 10 of these national rankings. It is the ninth straight year it has ranked in all 10 specialty services, with five specialty service areas ranked among the top 10.

“I’m proud that our rankings continue to cement our standing as among the best children’s hospitals in the nation,” says Kurt Newman, M.D., President and CEO for Children’s National. “In addition to these service lines, today’s recognition honors countless specialists and support staff who provide unparalleled, multidisciplinary patient care. Quality care is a function of every team member performing their role well, so I credit every member of the Children’s National team for this continued high performance.”

The annual rankings recognize the nation’s top 50 pediatric facilities based on a scoring system developed by U.S. News. The top 10 scorers are awarded a distinction called the Honor Roll.

“The top 10 pediatric centers on this year’s Best Children’s Hospitals Honor Roll deliver outstanding care across a range of specialties and deserve to be nationally recognized,” says Ben Harder, chief of health analysis at U.S. News. “According to our analysis, these Honor Roll hospitals provide state-of-the-art medical expertise to children with rare or complex conditions. Their rankings reflect U.S. News’ assessment of their commitment to providing high-quality, compassionate care to young patients and their families day in and day out.”

The bulk of the score for each specialty is based on quality and outcomes data. The process also includes a survey of relevant specialists across the country, who are asked to list hospitals they believe provide the best care for patients with challenging conditions.

Below are links to the five specialty services that U.S. News ranked in the top 10 nationally:

The other five specialties ranked among the top 50 were cardiology and heart surgery, diabetes and endocrinology, gastroenterology and gastro-intestinal surgery, orthopedics, and urology.

Roger Packer

Roger J. Packer, M.D. presents keynote address for BRAIN 2019

Roger Packer

2019 Otto Lien Da Wong visiting professor in neuro-oncology at BRAIN 2019, Roger J. Packer, M.D. presented the keynote address.

 

More than 400 neurologists, neurosurgeons, pathologists, pediatricians, clinical and basic scientists gathered in Hong Kong for Brain 2019, a conjoint congress of the 3rd Asian Central Nervous System Germ Cell Tumour Conference (CNSGCT), the 9th Interim Meeting of the International Chinese Federation of Neurosurgical Sciences (ICFNS) and the 16th Asia Pacific Multidisciplinary Meeting for Nervous System Diseases (BRAIN) which is also jointly organized by The Chinese University of Hong Kong. This three-day convention discussed advances in pediatric neuro-oncology and neuro-rehabilitation.

Invited as the 2019 Otto Lien Da Wong (OLDW) visiting professor in neuro-oncology, Roger J. Packer, M.D., senior vice president for the Center of Neuroscience and Behavioral Medicine and director at the Gilbert Neurofibromatosis and Brain Tumor Institutes, presented a keynote address titled “Advances in Pediatric Brain Tumors.” Established in 2009, the purpose of the visiting professorship is to advance surgical knowledge and techniques in neuro-oncology between Hong Kong and major medical centers around the world. Dr. Packer was selected from an international field of acclaimed academic surgeons and scholars in the field of neuro-oncology. Two additional presentations included “Pediatric Brain Tumors in Molecular Era: Germ Cell Tumors” as an invited guest of the BRAIN conference and a presentation on “Treatment of Medulloblastoma and PNET” as a session presented by the ICFNS.

In addition to his presentations, Dr. Packer will participate in surgical teaching and scholastic exchange with local surgeons, surgical trainees and medical students.

Epilepsy Infographic

By the Numbers: Comprehensive Pediatric Epilepsy Program

Children’s National Health System’s Comprehensive Pediatric Epilepsy Program is one of the largest and most experienced multidisciplinary epilepsy programs in the country. With a range of programs specializing in new onset epilepsy, the Ketogenic diet, intractable epilepsy, neuroinflammation, neurogenetics, epilepsy surgery and more. The epilepsy program at Children’s National is continuously working to improve care for patients through clinical innovation, active studies and utilizing the most advanced technologies in epilepsy surgery. Children’s National has one of the best surgical outcomes in the county, aided by advanced structural and functional imaging, minimally invasive techniques, deep brain stimulation, neuronavigation, neurorobotics using the ROSA stereotactic neurosurgical robot and intraoperative MRI.

Epilepsy Infographic

neuron

Children’s National to host 29th Annual Pediatric Neurology Update

neuron

The Children’s National Health System Center for Neuroscience and Behavioral Medicine is proud to host the 29th Annual Pediatric Neurology Update course.

This year’s course will focus on three critical areas in pediatric neuroscience and neurodevelopment: epilepsy with focuses on innovations in epilepsy surgery and new therapeutics; tuberous sclerosis including neurosurgical advances and transition to adulthood; and autism spectrum disorder with emphasis on new understandings and pre-requisites for an “Autism Friendly Hospital.”

We invite you to join us for presentations from renowned experts in the field in this full-day, CME accredited event on April 11, 2019 at the Bethesda North Marriott Hotel & Conference Center in Rockville, MD.

For more information and to register, visit ChildrensNational.org/NeurologyUpdate.

NeuroPace RNS x-ray

New brain “pacemaker” offers new hope for refractory epilepsy

NeuroPace RNS x-ray

Example of NeuroPace RNS System placement.

If a child’s refractory seizures – seizures that don’t respond to medication – are originating in a part of the brain that is central to function (for example, impacting memory or verbal skills) the standard next step – surgical resection – is not an option for seizure reduction or relief. In most cases, these children are followed, more medications are tried, and other strategies attempted, but few viable options exist to ease their symptoms.

It’s possible that the next generation of implantable neurostimulators, which act as a type of pacemaker for the brain, might make a difference for some children previously left with no answers. Children’s National neurosurgeon Chima Oluigbo, M.D., in collaboration with the Comprehensive Pediatric Epilepsy Program at Children’s National, is looking at how these devices might be used to reduce or eliminate refractory seizures in pediatric patients. One example of this type of device is the RNS System.

“The RNS has been FDA approved for adults since 2013,” says Dr. Oluigbo, who recently implanted a NeuroPace RNS in the first pediatric patient at Children’s National, and one of the first young patients in the country. “The safety and efficacy data in the adult population, now gathered from a cohort of more than 800 adults, is showing positive outcomes so far. That allows pediatric neurosurgeons to consider an off-label use of this device for patients under the approved usage age of 18, when no other treatments exist.”

The RNS operates differently from previous neuro pacemaker-style devices. It is a “closed-loop” system that doesn’t require external activation once a seizure has started. Instead, the precise location of seizure origination is identified via functional magnetic resonance imaging (fMRI). Leads are then placed at the seizure site via surgery, and once activated, the RNS monitors and self-activates when pre-seizure electrical impulses are detected. The device responds by emitting a series of its own electrical impulses to interrupt and reset the brain’s seizure activity. The RNS system’s ability to continuously monitor the patient also allows physicians to get an inside look at the ongoing brain function of these young patients.

“Children’s National is one of the first places to apply the use of this device in children, because we are one of the few locations on the East coast with the multi-disciplinary expertise to implement it safely and effectively,” says Dr. Oluigbo. “Our clinical epilepsy team has been imaging and treating children with epilepsy for almost 30 years. With one of the oldest neurosurgical programs in country and our technological capabilities, Children’s National becomes the perfect location to explore how technology like this can improve the quality of life for our patients, many of whom have previously been told there is nothing more we can do to help.”

De-personalized data from patients who receive the NeuroPace RNS will be shared with the company in the hopes that the data will assist the FDA in assessing the appropriateness of extending the age range of approval from 18 and above to 12 and above.

“Our hope is to contribute to the body of data about this device and determine if it will improve the lives of our younger patients the way it has already been done for adults,” Dr. Oluigbo concludes. “Kids’ brains may respond differently, however, sharing our patients’ experiences and outcomes will help us identify whether or not this is a viable and promising option for more children with refractory epilepsy.”

Children’s National Health System named as member of the Parent Project Muscular Dystrophy’s (PPMD) Certified Duchenne Care Centers

mitochondria

Children’s National Health System is now part of a growing Duchenne care network, becoming the newest member of the Parent Project Muscular Dystrophy’s (PPMD) Certified Duchenne Care Program.

The certification process to become a Certified Duchenne Care Center (CDCC) was grounded in the idea that comprehensive Duchenne care and services should be available and accessible to as many families as possible. By joining the network of PPMD Certified Duchenne Care Centers and standardizing care, Children’s National’s Neuromuscular Medicine Program is also improving Duchenne research and clinical trials by decreasing variability in care and increasing the quality of clinical trial outcome measures. This results in accelerating the time it takes therapies to reach the patients who need them.

By allowing neuromuscular patients of all diagnoses access to the comprehensive teams of sub-specialists serving the Duchenne population, Children’s National and other PPMD Certified Duchenne Care Centers will improve the care of all patients with neuromuscular diagnoses.

Making the grade: Children’s National is nation’s Top 5 children’s hospital

Children’s National rose in rankings to become the nation’s Top 5 children’s hospital according to the 2018-19 Best Children’s Hospitals Honor Roll released June 26, 2018, by U.S. News & World Report. Additionally, for the second straight year, Children’s Neonatology division led by Billie Lou Short, M.D., ranked No. 1 among 50 neonatal intensive care units ranked across the nation.

Children’s National also ranked in the Top 10 in six additional services:

For the eighth year running, Children’s National ranked in all 10 specialty services, which underscores its unwavering commitment to excellence, continuous quality improvement and unmatched pediatric expertise throughout the organization.

“It’s a distinct honor for Children’s physicians, nurses and employees to be recognized as the nation’s Top 5 pediatric hospital. Children’s National provides the nation’s best care for kids and our dedicated physicians, neonatologists, surgeons, neuroscientists and other specialists, nurses and other clinical support teams are the reason why,” says Kurt Newman, M.D., Children’s President and CEO. “All of the Children’s staff is committed to ensuring that our kids and families enjoy the very best health outcomes today and for the rest of their lives.”

The excellence of Children’s care is made possible by our research insights and clinical innovations. In addition to being named to the U.S. News Honor Roll, a distinction awarded to just 10 children’s centers around the nation, Children’s National is a two-time Magnet® designated hospital for excellence in nursing and is a Leapfrog Group Top Hospital. Children’s ranks seventh among pediatric hospitals in funding from the National Institutes of Health, with a combined $40 million in direct and indirect funding, and transfers the latest research insights from the bench to patients’ bedsides.

“The 10 pediatric centers on this year’s Best Children’s Hospitals Honor Roll deliver exceptional care across a range of specialties and deserve to be highlighted,” says Ben Harder, chief of health analysis at U.S. News. “Day after day, these hospitals provide state-of-the-art medical expertise to children with complex conditions. Their U.S. News’ rankings reflect their commitment to providing high-quality care.”

The 12th annual rankings recognize the top 50 pediatric facilities across the U.S. in 10 pediatric specialties: cancer, cardiology and heart surgery, diabetes and endocrinology, gastroenterology and gastrointestinal surgery, neonatology, nephrology, neurology and neurosurgery, orthopedics, pulmonology and urology. Hospitals received points for being ranked in a specialty, and higher-ranking hospitals receive more points. The Best Children’s Hospitals Honor Roll recognizes the 10 hospitals that received the most points overall.

This year’s rankings will be published in the U.S. News & World Report’s “Best Hospitals 2019” guidebook, available for purchase in late September.

drawing of neurons

Children’s National to host 28th Annual Pediatric Neurology Update

drawing of neurons

The Children’s National Health System Center for Neuroscience and Behavioral Medicine is proud to host the 28th Annual Pediatric Neurology Update course.

This year’s course will be focused on new understandings, molecular pathogenesis, novel treatment and outcomes of infections which affect the central nervous system; as well as the often indistinct boundaries between CNS infections and neuro immunologic diseases of the nervous system.

We invite you to join us for presentations from renowned experts in the field in this full-day, CME accredited event on May 3, 2018 at the Children’s National main campus in Washington, D.C.

For more information and to register, visit ChildrensNational.org/NeurologyUpdate.

Adolescent brain scan from obesity study

Imaging captures obesity’s impact on the adolescent brain

Adolescent brain scan from obesity study

For the first time, a team of researchers led by Chandan Vaidya, Ph.D., chair of the Department of Psychology at Georgetown University, has used functional magnetic resonance imaging (fMRI) to capture the brain function of a small population of adolescents with obesity, both before and after bariatric surgery.

Obesity affects the whole body, from more obvious physical impacts on bones and joints to more subtle, internal impacts on organs like the brain.

For the first time, a team of researchers has used functional magnetic resonance imaging (fMRI) to capture the brain function of a small population of adolescents with obesity, both before and after bariatric surgery. The goal is to better understand the neural changes that occur when an adolescent is obese, and determine the effectiveness of interventions, such as vertical sleeve gastrectomy, at improving brain function as weight is lost.

The study, published as the November Editors’ Choice in the journal Obesity, found that executive and reward-related brain functions of study participants with obesity improved following the surgical procedure and initial weight loss.

How bariatric surgery changes the teenage brain from Research Square on Vimeo.

“We’ve known for some time that severe obesity has negative consequences on some neurocognitive function areas for adults,” says Chandan Vaidya, Ph.D., chair of the Department of Psychology at Georgetown University and a senior author of the study. “But for the first time, we’ve captured fMRI evidence in young patients, and also shown that surgical intervention and the resulting weight loss can reverse some of those deficits.”

“For me, this early evidence makes a strong case that when kids are struggling with severe obesity, we need to consider surgical intervention as an option sooner in the process,” notes Evan Nadler, M.D., director of the Bariatric Surgery Program at Children’s National Health System, who also contributed to the study. “The question that remains is whether the neurocognitive function improves more if surgery, and thus weight loss, happens earlier – and is there a time factor that should help us determine when to perform a procedure that will maximize improvements?”

The preliminary study included 36 participants and was conducted using patients recruited from the Children’s National Bariatric Surgery program, one of the first children’s hospitals to achieve national accreditation by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program.

“We asked these questions because we know that in the kids we see, their behavioral, brain, and physical health are all very closely related to one another and have an impact on each other,” adds Eleanor Mackey, Ph.D., study senior author and co-principal investigator on the National Institute of Diabetes and Digestive and Kidney Diseases grant that funded the project. “We expected that as physical health improves, we might see corresponding improvements in brain and behavior such as cognitive and school performance.”

The study also pointed out some technical and practical challenges to studying this particular young population. Anyone with a BMI greater than 50 was not able to fit within the MR bore used in the study, preventing fMRI participation by those patients.

“In addition to future studies with a larger sample size, we’d like to see if there are neuroimaging markers of plasticity differences in a population with BMI greater than 50,” says Dr. Vaidya. “Does the severity of the obesity change how quickly the brain can adapt following surgery and weight loss?”

The abstract was selected by the journal’s editors as one that provides insights into preventing and treating obesity. It was featured at the Obesity Journal Symposium during Obesity Week 2017 in Washington, D.C., as part of the Obesity Week recognition, and a digital video abstract was also released about the findings.