Q&A with Dr Yaara Erez

Running out of the NEC in Birmingham on the 26th and 27th March, the European Neuro Convention will be the only trade show for brain and spine experts in Europe in 2019. We caught up with speaker Dr Yaara Erez, who is currently working as a cognitive neuroscientist at the University of Cambridge currently trying to map the brain systems that control executive function in health and disease. With such an interesting and expansive topic, we wanted to reach out and find out more about how Dr Yaara Erez came to her current position and also find out more about the research she is currently conducting.

Tell us a little bit more about your professional background...

My background is Computer Science and Psychology, but I came across neuroscience as a student in high school and found it fascinating. Following several years as a software developer, I since decided to follow my dream and pursue a PhD in neuroscience! During my PhD, I studied the effects of deep brain stimulation on neuronal activity in Parkinsonism. Following on from my PhD, I came to Cambridge several years ago to work with Prof John Duncan as a post-doc to study cognitive processes in the brain, and particularly attention. I now have my own independent research programme as a Royal Society Dorothy Hodgkin Research Fellow.

What are you currently working on?

My research combines both basic neuroscience and clinical research.

In my clinical branch of research, I develop new techniques for functional brain mapping for patients with brain tumours, with a particular focus on cognitive and executive function. Executive function refers to a wide range of cognitive functions, including problem-solving, keeping focus, switching focus, planning, all the essentials to normal healthy life. I proposed that recordings of brain activity, or ‘listening’ to the brain, can be used to assist awake neurosurgery for patients with low grade gliomas, to further optimise the balance between tumour research and quality of life post-surgery, and improve healthcare and treatment for patients.

More generally, I am interested in the brain systems that support executive function, and how we use these systems to represent the world around us and act in it. The brain is an adaptive and flexible machine, when we see something, it is always in the context of what we are trying to do at that moment. We process the information that is around us in an active way - we pay attention to what is relevant to us and filter out what we don’t need. We do that all the time, effortlessly and efficiently, and it is part of everyone’s daily life. But from a computational perspective this is a very complicated problem, and we only have hints about how this is done in the brain. I am interested in the neural mechanisms that allow us to behave flexibly and select only the information that we need.

What impact does this have on brain surgery?

The current approach for intraoperative cognitive mapping is to use brief pulses of electrical stimulation on the patient’s brain while the patient is doing a cognitive task such as counting or naming pictures. If a stimulation on a certain location leads to change in behaviour, e.g. the patient stops talking for a second or so, then it means that this area of the brain is related and essential to the tested function, speech in this case. Mapping of motor functions and language is widely used during awake brain surgery. However, while many patients suffer from deficits in executive function after surgery, it is rarely used for mapping during surgery, and in fact quite hard to do with stimulation, because of the complexity of these cognitive processes. Moreover, because using the stimulation approach takes time, the current technique only allows for limited cognitive testing during surgery. Based on knowledge and evidence from basic neuroscience, I propose a new approach to awake functional mapping – using brain activity to determine whether a certain area is related to executive function or not. Furthermore, the same approach can be used to test for many other cognitive functions, such as language and memory, and is time- and cost-efficient. This will widen the range of functions that can be tested intraoperatively. It Important to note that this will not replace the use of stimulation, which will still remain essential to brain surgery, but will rather complement it and provide a further support for a more efficient and comprehensive procedure.

What does the future for this new technology look like?
In the future, neurosurgeons will be able to tailor the surgical treatment for each patient depending on their lifestyle and personal preferences as to the cognitive functions that are most important to each individual. Patients will be more involved in the decision will be able to have more information about the potential cognitive risks of surgery for their individual case. Additionally, in combination with pre-operative advanced neuroimaging data, we will be able to get a comprehensive picture of each patient’s brain and how the different brain regions are connected to each other and communicate with each other. This will be used to further guide surgery and enable us to have a better understanding of the disease and its impact on the brain and function.

What are your thoughts about speaking at the European Neuro Convention?
I am looking forward to presenting my research at the coming European Neuro Convention! It will exciting to interact with people from diverse and complementing perspectives.

For more information about Dr Yaara Erez, you can find her full profile on the European Neuro Convention website, where you will also find the full speaker line up and features available for visitors at the free to attend event next March 26th & 27th.

 

The European Neuro Convention will take place on March 26th and 27th at the NEC Birmingham, running alongside the European Oncology Convention and the Medical Imaging Convention. Tickets are free and available here.