Why can a rhythmic tune halt the tremors and walking struggles in people with Parkinson’s disease, allowing them to dance with fluidity and box with precision? And why do some teenagers storm sobbing out of clinic doors when their providers broach the subject of weight control?
Those were two of 62 questions University of Colorado Anschutz Medical Campus students tackled as part of the 32nd Annual Student Research Forum. Posters stretched across the north and south towers of the Education 2 building, as the students presented their projects to about 400 of their instructors and peers.
“We’ve been told that the half-life of medical information is approximately seven years, so something that we are taught at the beginning of our first year of medical school may or may not be relevant at the end of our residency,” said David Nguyen, a third-year medical student, explaining the importance of the event. “Especially if we want to go into academic medicine, research is our bread and butter, and we need to stay informed.”
While learning research skills, students also benefit from networking, connecting with mentors, honing presentation skills, boosting resumes and delving into something new by taking part in research forums, said Will Dewispelaere, a second-year medical student. “We all have this inherent scientific desire to find out new things,” he said.
Probing the Parkinson’s brain
Dewispelaere, whose undergraduate degree is in neuroscience, has had a long interest in disorders such as Parkinson’s disease (PD), a progressive neurodegenerative disease that leads to severe tremors, limb rigidity, slowness of movement and gait and balance problems.
“I’ve been involved with Parkinson’s research since my junior year in college,” he said. “For some time, we have known that if you ask some people with PD to walk, they’ll have trouble getting started. But if you ask them to snap their fingers or listen to music and then walk to the beat, they tend to have fewer problems.”
Research has linked the sound of rhythm to improvement of gait, velocity and postural stability, Dewispelaere said. “Preliminary findings showed music therapy could ease these common Parkinson’s symptoms, including depression and anxiety,” he said, noting the popularity of dancing and boxing classes for PD patients. “But no one really knew why.”
In his study, researchers compared the brains of 23 PD patients with 21 age-matched, healthy patients (HC), using a special imaging technique (magnetoencephalography). The participants tapped a button with their right fingers to rhythmic cues played in their left ears.
While both groups had similar activation in some areas of the brain, the PD group had increased activation in two right areas, one responsible for sound recognition and processing (superior temporal gyri), and the other important to the integration of sensory information, including hearing and self-motion (supramarginal).
“Our conclusion was that increased activity in these two regions of the brain allows for those with Parkinson’s disease to bypass some of their abnormal neural circuitry to generate regular movements,” Dewispelaere said.
Closing a provider-teenager gap
Four-year medical student Paola Casillas and second-year medical student Nemanja Vukovic focused their project on improving provider and teenage patient communication regarding a top health issue of today: obesity.
“It started about six years ago with a medical student here who saw a lot of these conversations go downhill really quickly, with the teens leaving feeling very discouraged or crying or worse,” Vukovic said. “Feeling like these conversations were super counterproductive, she wanted to know what was turning these kids off,” he said.
With the help of a teenage advisory board, the students devised questions and formed focus groups, using 47 volunteers from Denver-area high schools. The most consistent finding revolved around providers’ use of the Body Mass Index (BMI) chart when initiating conversations about patients’ weight.
Most focus-group members said they disliked the tactic, Casillas said. “They said: ‘I’m not a dot on a screen. This isn’t getting to know me and finding out what I struggle with,” Casillas recounted.
Cultural and gender differences surrounding what family and peers considered appropriate weight also placed pressure on some teens. “The biggest thing we ultimately learned was that they really want the provider to get to know who they are, what their family is like, and their goals and motivations for wanting to lose weight,” Vukovic said.
The project also involved sending surveys to local providers who served teens. Nearly 70 percent of the providers reported almost always starting weight conversations with a BMI chart, with the majority also indicating that their weight-control counseling with teens was not very effective.
The good news: Both providers and teens want to see change. “I was surprised by how much they cared,” Casillas said of the high-school students. “They want to have these conversations with their providers, and they understand the importance of the issue.”
With most providers indicating interest in learning the results of the project and incorporating the findings into their practices, the student researchers aim to expand the study and develop a provider plan for tailoring weight conversations to individual patients, Vukovic said. “We found some areas of disconnect, and we are hoping to bridge those gaps.”