Bio


Emergency medicine resident with research interests in medical education, emergency airway management, and critical care

Professional Education


  • MD, Northwestern University, Feinberg School of Medicine (2019)
  • BA, University of Wisconsin, Neurobiology (2015)

All Publications


  • Direct Evidence of Plasticity within Human Primary Motor and Somatosensory Cortices of Patients with Glioblastoma NEURAL PLASTICITY Gibb, W. R., Kong, N. W., Tate, M. C. 2020; 2020: 8893708

    Abstract

    Glioblastoma multiforme (GBM) is a devastating disease without cure. It is also the most common primary brain tumor in adults. Although aggressive surgical resection is standard of care, these operations are limited by tumor infiltration of critical cortical and subcortical regions. A better understanding of how the brain can recover and reorganize function in response to GBM would provide valuable clinical data. This ability, termed neuroplasticity, is not well understood in the adult human brain. A better understanding of neuroplasticity in GBM could allow for improved extent of resection, even in areas classically thought to have critical, static function. The best evidence to date has demonstrated neuroplasticity only in slower growing tumors or through indirect measures such as functional MRI or transcranial magnetic stimulation. In this novel study, we utilize a unique experimental paradigm to show direct evidence of plasticity via serial direct electrocortical stimulation (DES) within primary motor (M1) and somatosensory (S1) cortices in GBM patients. Six patients with glioblastoma multiforme in or near the primary motor or somatosensory cortex were included in this retrospective observational study. These patients had two awake craniotomies with DES to map cortical motor and sensory sites in M1 and S1. Five of six patients exhibited at least one site of neuroplasticity within M1 or S1. Out of the 51 total sites stimulated, 32 (62.7%) demonstrated plasticity. Of these sites, 14 (43.7%) were in M1 and 18 (56.3%) were in S1. These data suggest that even in patients with GBM in or near primary brain regions, significant functional reorganization is possible. This is a new finding which may lead to a better understanding of the fundamental factors promoting or inhibiting plasticity. Further exploration may aid in treatment of patients with brain tumors and other neurologic disorders.

    View details for DOI 10.1155/2020/8893708

    View details for Web of Science ID 000578380700002

    View details for PubMedID 33029127

    View details for PubMedCentralID PMC7527884

  • Plasticity of the Primary Motor Cortex in Patients with Primary Brain Tumors. Neural plasticity Kong, N. W., Gibb, W. R., Badhe, S., Liu, B. P., Tate, M. C. 2020; 2020: 3648517

    Abstract

    There are two neuron-level mechanisms proposed to underlie neural plasticity: recruiting neurons nearby to support the lost function (ipsilesional plasticity) and uncovering latent pathways that can assume the function that was lost (contralesional plasticity). While both patterns have been demonstrated in patient groups following injury, the specific mechanisms underlying each mode of plasticity are poorly understood. In a retrospective case series of 13 patients, we utilize a novel paradigm that analyzes serial fMRI scans in patients harboring intrinsic brain tumors that vary in location and growth kinetics to better understand the mechanisms underlying these two modes of plasticity in the human primary motor cortex. Twelve patients in our series had some degree of primary motor cortex plasticity, an area previously thought to have limited plasticity. Patients harboring smaller lesions with slower growth kinetics and increasing distance from the primary motor region demonstrated recruitment of ipsilateral motor regions. Conversely, larger, faster-growing lesions in close proximity to the primary motor region were associated with activation of the contralesional primary motor cortex, along with increased activation of the supplementary motor area. These data increase our understanding of the adaptive abilities of the brain and may lead to improved treatment strategies for those suffering from motor loss secondary to brain injuries.

    View details for DOI 10.1155/2020/3648517

    View details for PubMedID 32714384

  • Characteristics of Emergency Department Patients With COVID-19 at a Single Site in Northern California: Clinical Observations and Public Health Implications. Academic emergency medicine : official journal of the Society for Academic Emergency Medicine Duanmu, Y. n., Brown, I. P., Gibb, W. R., Singh, J. n., Matheson, L. W., Blomkalns, A. L., Govindarajan, P. n. 2020

    Abstract

    In December 2019, a novel coronavirus disease (COVID-19) emerged in Wuhan, China and spread globally, resulting in the first World Health Organization (WHO) classified pandemic in over a decade.1 As of April 2020, the United States (US) has the most confirmed COVID-19 cases worldwide, but public health interventions and testing availability have varied across the country. 2.

    View details for DOI 10.1111/acem.14003

    View details for PubMedID 32344458

  • Neuroplasticity: Insights from Patients Harboring Gliomas NEURAL PLASTICITY Kong, N. W., Gibb, W. R., Tate, M. C. 2016; 2016: 2365063

    Abstract

    Neuroplasticity is the ability of the brain to reorganize itself during normal development and in response to illness. Recent advances in neuroimaging and direct cortical stimulation in human subjects have given neuroscientists a window into the timing and functional anatomy of brain networks underlying this dynamic process. This review will discuss the current knowledge about the mechanisms underlying neuroplasticity, with a particular emphasis on reorganization following CNS pathology. First, traditional mechanisms of neuroplasticity, most relevant to learning and memory, will be addressed, followed by a review of adaptive mechanisms in response to pathology, particularly the recruitment of perilesional cortical regions and unmasking of latent connections. Next, we discuss the utility and limitations of various investigative techniques, such as direct electrocortical stimulation (DES), functional magnetic resonance imaging (fMRI), corticocortical evoked potential (CCEP), and diffusion tensor imaging (DTI). Finally, the clinical utility of these results will be highlighted as well as possible future studies aimed at better understanding of the plastic potential of the brain with the ultimate goal of improving quality of life for patients with neurologic injury.

    View details for DOI 10.1155/2016/2365063

    View details for Web of Science ID 000379869900001

    View details for PubMedID 27478645

    View details for PubMedCentralID PMC4949342