{"id":223518,"date":"2025-02-05T07:30:15","date_gmt":"2025-02-05T12:30:15","guid":{"rendered":"https:\/\/today.uconn.edu\/?p=223518"},"modified":"2025-02-06T14:26:07","modified_gmt":"2025-02-06T19:26:07","slug":"pentagon-funds-study-of-cranial-regeneration","status":"publish","type":"post","link":"https:\/\/today.uconn.edu\/2025\/02\/pentagon-funds-study-of-cranial-regeneration\/","title":{"rendered":"Department of Defense Program Funds Study of Cranial Regeneration"},"content":{"rendered":"

Biomedical engineering researchers at UConn Health believe there might be a way to use ultrasound to compel the body to regrow cranial tissue.<\/p>\n

Yusuf Khan<\/a>, an associate professor of orthopedic surgery, and Dr. David Hersh, associate professor of neurosurgery, have been studying whether some principles of bone development in children could apply to bone healing in adults who\u2019ve had part of their skull removed and replaced.<\/p>\n

\"comparative
A decompressive craniectomy (left) is performed to accommodate intracranial swelling by removing a large portion of the skull. When the swelling resolves, a cranioplasty (right) is performed to replace the missing bone, often with the original bone flap that had been removed during the first surgery. (Images provided by David Hersh)<\/figcaption><\/figure>\n

They recently were awarded a two-year grant totaling $435,000 through the Congressionally Directed Medical Research Program\u2019s Peer Reviewed Medical Research Program, part of the Department of Defense.<\/p>\n

A decompressive craniectomy, or the removal of a portion of the skull, is a potentially life-saving intervention for when a patient suffers from brain edema, or severe swelling, such as when there has been a traumatic brain injury. The procedure gives the swelling brain more space, relieving pressure and lowering the risk of herniation, which can be fatal.<\/p>\n

Hersh, a pediatric neurosurgeon at Connecticut Children\u2019s who performs craniectomies on select patients with certain conditions, notes that after the follow-up cranioplasty, which is when the portion of skull that had been removed is then reattached, that piece of bone can have problems reintegrating with the remainder of the skull. In some cases, the bone gets resorbed, meaning it instead starts to shrink and get absorbed by the body.<\/p>\n

\u201cYou end up being left with big gaps in the bone, which can leave the underlying brain at risk,\u201d Hersh says. \u201cAnd then the patient needs even more surgeries to provide appropriate coverage, which might involve a synthetic replacement.\u201d<\/p>\n

\"two
Dr. David Hersh (left), UConn School of Medicine associate professor of neurosurgery and pediatric neurosurgeon at Connecticut Children\u2019s, speaks with Yusuf Khan, associate program director of the UConn School of Medicine\u2019s Skeletal Biology and Regeneration Graduate Program, in Khan’s lab at UConn Health. (Tina Encarnacion\/UConn Health photo)<\/figcaption><\/figure>\n

Original bone has many biological and other advantages over synthetic materials, such as metals or hard plastics, and trying to eliminate or reduce the need for synthetics is one of the tenets of regenerative engineering.<\/p>\n

In 2019, Hersh started collaborating with Khan, who had been studying therapeutic ultrasound and how it facilitates fracture repair. Hersh had prior experience using therapeutic ultrasound for neurosurgical applications such as for blood brain barrier opening.<\/p>\n

\u201cDavid came to me with a very specific pediatric problem that he wanted to try to solve,\u201d Khan says. \u201cThis grant really grew from the original pediatric application, but, through us working together over the years, we realized the potential for adults, too. And the Congressionally Directed Medical Research Program is an ideal funder for a project like this because of the type of battlefield injuries that soldiers unfortunately experience.\u201d<\/p>\n

The focus is on the dura, the thin layer of tissue that encloses the brain, and whether low-intensity ultrasound can provide a physical force that the cells can sense, possibly stimulating cranial bone regeneration.<\/p>\n

\u201cWe think that there\u2019s something unique about those dural cells in that they respond to physical forces, just like bone cells do,\u201d Khan says. \u201cWe\u2019ve seen interesting responses by dural cells from young animals that are exposed to ultrasound, and we\u2019re now going to explore whether skeletally mature cells act the same way. We plan to add stem cells to the defect site to study how they communicate with dural cells and whether this can stimulate new bone formation.\u201d<\/p>\n

\"researcher
Hannah Anderson is a 2025 Ph.D. candidate in The Cato T. Laurencin Institute for Regenerative Engineering. Yusuf Khan is her mentor. (Photo by Chris DeFrancesco)<\/figcaption><\/figure>\n

Khan likens it to how certain fractures actually benefit from weight-bearing during the healing process.<\/p>\n

Hersh says the body already provides an encouraging clue.<\/p>\n

\u201cOur hypothesis is based on what people have learned about normal development \u2013the skull grows in response to the underlying dura releasing signals that then stimulate bone formation,\u201d Hersh says. \u201cWe think that happens as a result of the brain itself growing when we\u2019re young and applying mechanical strain to the dura, which then signals to the bone above it. So, our aim is to recreate that natural process to facilitate bone healing in a way that’s similar to the original bone development.\u201d<\/p>\n

While studying this issue may have utility for wounded warriors, its potential applications may extend far beyond that. Examples include patients undergoing a decompressive craniectomy and subsequent cranioplasty for reasons unrelated to combat, including in the setting of civilian traumatic brain injury and certain severe types of stroke.<\/p>\n

\u201cThis collaboration on regenerating cranial bone is so important for the future of our wounded warriors,\u201d says Dr. Cato T. Laurencin<\/a>, the founder and director of the Cato T. Laurencin Institute for Regenerative Engineering<\/a>. \u201cIt is also beneficial to any mature patient with a traumatic brain injury. Congratulations to Dr. Khan and Dr. Hersh for securing funding to continue their life-altering research.\u201d<\/p>\n

\"portrait
The UConn School of Medicine\u2019s Dr. David Hersh (left) and Yusuf Khan are studying how ultrasound may help the body regrow skull bone, funded through a grant from the Congressionally Directed Medical Research Programs. (Tina Encarnacion\/UConn Health photo)<\/figcaption><\/figure>\n

Khan is the associate program director of the UConn School of Medicine\u2019s Skeletal Biology and Regeneration Graduate Program<\/a>\u00a0and a member of the Laurencin Institute.<\/p>\n

\u201cThis is a great example of the power of academic interdisciplinary medicine, where a talented surgeon brought a clinical problem to an engaged and creative scientist-engineer to work towards the betterment of patient care,\u201d says Dr. Isaac Moss<\/a>, chair of UConn Health\u2019s Department of Orthopaedic Surgery<\/a>. \u201cWhen I connected Drs. Hersh and Khan five years ago, it was clear that these two faculty members would form a great partnership and it\u2019s great to see fruits from this collaboration.\u201d<\/p>\n

Dr. Ketan Bulsara<\/a>, chair of UConn Health\u2019s Department of Neurosurgery<\/a>, agrees.<\/p>\n

\u201cThe interdepartmental collaboration between Dr. Hersh from neurosurgery and Dr. Khan from orthopedic surgery is just another example of our symbiotic clinical and research excellence that has the potential to transform patient care through our tripartite mission,\u201d Bulsara says. \u201cI congratulate them both on receiving this prestigious grant, and congratulate Dr. Jonathan Martin also for leading our exemplary pediatric neurosurgery team at Connecticut Children\u2019s.\u201d<\/p>\n

Martin, a professor of surgery and pediatrics, directs Connecticut Children\u2019s Division of Neurosurgery and holds its Paul M. Kanev Chair of Pediatric Neurosurgery.<\/p>\n

\u201cWe have been privileged to partner with the UConn Health Department of Neurosurgery through the neurosurgery residency program, which has also expanded our access to new clinical and research partners,\u201d Martin says. \u201cThe collaboration between Connecticut Children\u2019s and UConn Health has accelerated the ability of exceptional faculty like Dr. Hersh to pursue answers to difficult questions that will benefit patients well beyond Connecticut and Western New England.\u201d<\/p>\n

The grant starts Feb. 1. While the research is in its very early stages, Khan says when the time comes, the work in the lab will be easily translatable.<\/p>\n

\u201cTo me, this represents the best version of a clinician-research collaboration, where there is a clinical need looking for a solution, and there is a research solution looking for the ideal clinical application,\u201d he says. \u201cThis demonstrates the power of and the need for clinician-scientist collaborations.\u201d<\/p>\n

The work was supported by the Assistant Secretary of Defense for Health Affairs endorsed by the Department of Defense, in the amount of $435,465.00, through the Peer Reviewed Medical Research Program under Award No. HT9425-25-1-0053. Opinions, interpretations, conclusions and recommendations are those of the author and are not necessarily endorsed by the Assistant Secretary of Defense for Health Affairs or the Department of Defense.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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