Patrick Ciechanski

University of Alberta | UAlberta · Division of Urology

Introduction Perinatal stroke (PS) is a focal vascular brain injury and the leading cause of hemiparetic cerebral palsy. Motor impairments last a lifetime but treatments are limited. Transcranial direct-current stimulation (tDCS) may enhance motor learning in adults but tDCS effects on motor learning are less studied in children. Imaging-based simu...

Objective Although relatively costly and non-scalable, non-invasive neuromodulation interventions are treatment alternatives for neuropsychiatric disorders. The recent developments of highly-deployable transcranial electric stimulation (tES) systems, combined with mobile-Health technologies, could be incorporated in digital trials to overcome metho...

Background Non-invasive brain stimulation is being increasingly used to interrogate neurophysiology and modulate brain function. Despite the high scientific and therapeutic potential of non-invasive brain stimulation, experience in the developing brain has been limited. Objective To determine the safety and tolerability of non-invasive neurostimul...

Transcranial direct-current stimulation (tDCS), an increasingly applied form of non-invasive brain stimulation, can augment the acquisition of motor skills. Motor learning investigations of tDCS are limited to simple skills, where mechanisms are increasingly understood. Investigations of meaningful, complex motor skills possessed by humans, such as...

Purpose: Survivors of childhood stroke incur lifelong physical disability. Treatment options are limited, however, models of motor reorganization after stroke are revealing cortical targets for neuromodulation. Transcranial direct-current stimulation (tDCS) enhances motor learning and may improve motor recovery in adult stroke, but remains uninvest...

Introduction: Symptoms following a mild traumatic brain injury (mTBI) usually resolve quickly but may persist past 3 months in up to 15% of children. Mechanisms of mTBI recovery are poorly understood, but may involve alterations in cortical neurophysiology. Transcranial Magnetic Stimulation (TMS) can non-invasively investigate such mechanisms, but...

Background: Major depressive disorder (MDD) is common in youth and treatment options are limited. We evaluated the effectiveness and safety of repetitive transcranial magnetic stimulation (rTMS) in adolescents and transitional aged youth with treatment resistant MDD. Methods: Thirty-two outpatients with moderate to severe, treatment-resistant MDD,...

Background: Transcranial direct current stimulation (tDCS) can improve motor learning in children. High-definition approaches (HD-tDCS) have not been examined in children. Objectives/Hypothesis: We hypothesized that primary motor cortex HD-tDCS would enhance motor learning but be inferior to tDCS in children. Methods: Twenty-four children were recr...

Background: Clinical trials are suggesting efficacy of intensive therapy combined with brain stimulation to improve hand function in hemiparetic children with perinatal stroke. However, individual variability exists and the underlying neuroplasticity mechanisms are unknown. Exploring primary motor cortex (M1) neurophysiology, and how it changes wi...

Background: The human motor cortex can be mapped safely and painlessly with transcranial magnetic stimulation (TMS) to explore neurophysiology in health and disease. Human error likely contributes to heterogeneity of such TMS measures. Here, we aimed to use recently pioneered robotic TMS technology to develop an efficient, reproducible protocol to...

Transcranial direct-current stimulation (tDCS) is a form of non-invasive brain stimulation that induces electric fields in neuronal tissue, modulating cortical excitability. Therapeutic applications of tDCS are rapidly expanding, and are being investigated in pediatrics for various clinical conditions. Anatomical variations are among a host of fact...

Introduction Perinatal stroke causes hemiparetic cerebral palsy (CP) and lifelong disability. Treatments are limited but non-invasive brain stimulation, such as transcranial direct-current stimulation (tDCS) can alter cortical excitability, providing a unique opportunity for therapeutic neuromodulation in CP. We have demonstrated that application o...

Introduction Perinatal stroke is the leading cause of hemiparetic cerebral palsy (CP). We have shown non-invasive brain stimulation enhances motor learning in healthy and hemiparetic children using transcranial-direct-current-stimulation (tDCS). High-definition (HD-tDCS) may offer additional potential but is unstudied in pediatrics. Motor maps are...

Introduction Non-invasive brain stimulation can interrogate neurophysiology and therapeutically modulate brain function. Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are the primary modalities. Despite such potential, experience in the developing brain has been limited. We conducted a large, prospective...

Fig. S1. Example of the transcranial direct‐current stimulation setup for a right‐hand‐dominant participant. The anode (blue sponge, red cable) is positioned on the scalp overlying the approximate area of the left primary motor cortex. The cathode (yellow sponge, black cable) is positioned on the right supraorbital area. The sponges are held in pla...

Background: Changes in medical education may limit opportunities for trainees to gain proficiency in surgical skills. Transcranial direct-current stimulation (tDCS) can augment motor skill learning and may enhance surgical procedural skill acquisition. The aim of this study was to determine the effects of tDCS on simulation-based laparoscopic surg...

Objective: Brain stimulation and constraint therapy may enhance function after perinatal stroke but mechanisms are unknown. We characterized interhemispheric interactions (IHI) in hemiparetic children and explored their relationship to motor function and neuromodulation. Methods: Forty-five hemiparetic perinatal stroke subjects aged 6-19 years c...

Background: Perinatal stroke causes lifelong motor disability, affecting independence and quality of life. Non-invasive neuromodulation interventions such as transcranial direct current stimulation (tDCS) combined with intensive therapy may improve motor function in adult stroke hemiparesis but is under-explored in children. Measuring cortical meta...

Background: Recent changes in surgical training environments may have limited opportunities for trainees to gain proficiency in skill. Complex skills such as neurosurgery required extended periods of training. Methods to enhance surgical training are required to overcome duty-hour restrictions, to ensure skill proficiency is met. Transcranial dire...

Background: Development of motor pathways is modulated by activity in these pathways, when they are maturing (i.e., critical period). Perinatal stroke injures motor pathways including the corticospinal tracts (CST), reducing their activity, and impairing motor function. Current intervention for the lower limb emphasizes passive approaches (stretchi...

Transcallosal fibers facilitate interhemispheric networks involved in motor tasks. Despite their clinical relevance, interhemispheric motor control systems have not been completely defined in the developing brain. The objective of this study was to examine the developmental profile of transcallosal inhibition in healthy children and adolescents. Ni...

Introduction Non-invasive brain stimulation can interrogate neurophysiology and therapeutically modulate brain function. Transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS) are the primary modalities. Despite such potential, experience in the developing brain has been limited. Objective Assess safety and tole...

Introduction Perinatal stroke (PS) causes most hemiparetic cerebral palsy. Motor recovery is highly dependent on developmental plasticity in bilateral motor cortex. The fundamental neurophysiology of the lesioned motor cortex (M1) is poorly understood. Objective To characterize lesioned corticomotor neurophysiological properties in hemiparetic chi...

Question Interhemispheric inhibition (IHI) is a crossed, transcallosal inhibitory relationship between the left and right motor cortex (M1). This can be assessed in vivo using transcranial magnetic stimulation (TMS). Interhemispheric interactions may be altered in disease such as stroke where IHI imbalance is a potential target for therapeutic neur...

Introduction Transcranial direct-current stimulation (tDCS) enhances motor learning in adults. We recently demonstrated robust effects in children. Unique tDCS effects may occur in the developing brain, confounding trial design in disabled children. We investigated the neurophysiology underlying tDCS-induced enhancement of motor learning. Methods...

Transcranial direct-current stimulation (tDCS) is an emerging form of non-invasive brain stimulation that shifts cortical excitability to a state of excitation of inhibition. Neuroimaging, pharmacological, and neurophysiology studies have elucidated the basic mechanisms of tDCS, although these studies are limited to adult populations. Computational...

Objective: To determine whether the addition of transcranial direct current stimulation (tDCS) to intensive therapy increases motor function in children with perinatal stroke and hemiparetic cerebral palsy. Methods: This was a randomized, controlled, double-blind clinical trial. Participants were recruited from a population-based cohort with MRI...

Background: Perinatal stroke causes most hemiparetic cerebral palsy. Ipsilateral connections from nonlesioned hemisphere to affected hand are common. The nonlesioned primary motor cortex (M1) determines function and is a potential therapeutic target but its neurophysiology is poorly understood. Objective: We aimed to characterize the neurophysio...

Introduction: Mild traumatic brain injury (mTBI) outcomes are variable, and 10-15% may suffer from prolonged symptoms beyond 3 months that impair the child's return to normal activities. Neurophysiological mechanisms of mTBI are incompletely understood, particularly in children, but alterations in cortical excitability have been proposed to underl...

This study aims to determine the effects of transcranial direct-current stimulation (tDCS) on motor learning in healthy school-aged children. Safety, tolerability, and translation of effects to untrained tasks were also explored. We recruited 24 right-handed children for a randomized, sham-controlled, double-blinded trial to receive: right primary...

Background: Perinatal stroke causes hemiparetic cerebral palsy. Brain stimulation may enhance motor function in adult stroke. We demonstrated that rTMS enhances motor learning therapy in children with perinatal stroke. Transcranial direct current stimulation (tDCS) may have similar capacity but is unstudied. Hypothesis: tDCS increases motor functio...

The Role of RVLM and PACAP in Sympathetic Response and Breathing Stability - Volume 42 Issue S3 - F. Derakhshan, E. Mosca, P. Ciechanski, A. Roy, R. Wilson

Objectives: Mild traumatic brain injury (mTBI) is common in children but neurophysiological mechanisms are poorly understood. We aimed to characterize changes in cortical excitability using transcranial magnetic stimulation (TMS) in children with and without persistent post-concussive symptoms after mTBI. Methods: A case-controlled study was perfor...

Methylxanthines like caffeine and theophylline have long been used to treat apnea of prematurity. Despite their success in stimulating neonatal breathing, their mechanism of action remains poorly understood. Methylxanthines can act as both non-specific adenosine receptor antagonists and inhibitors of cAMP-dependent phosphodiesterases, sarcoplasmic/...

Pituitary adenylate cyclase-activating peptide (PACAP) is an important mediator of the stress response and is crucial in maintaining breathing in neonates. Here we investigate the role of exogenously applied PACAP in neonatal breathing using the neonatal rat in situ working heart-brainstem preparation. A 1-minute bolus of 250nM PACAP-38 caused an i...