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2024.5.27

Message from Alumnus: 6th generation NGP graduate (March 2024)

Graduate School of Medicine
Kazuo Kakinuma

"I would like to study the human brain at this university," I answered in my admission interview at Tohoku University. Over a decade later, I have fulfilled my initial goal and am about to take it even further. The Neuro Global Program (NGP) has given me many opportunities. Here is a brief review of what I have gained during this doctoral program.

After graduating from medical school, I spent two years working at a city hospital as an initial resident and then three years as a resident at Tohoku University Hospital before entering a doctoral program in April 2020. Continuing on from my work as a resident, I entered the Department of Behavioral Neurology and Cognitive Neuroscience [1] as a doctoral student. I decided on my own research theme, which encouraged me to enter a doctoral program. The graduate school program for medical doctors is a four-year doctoral program without a master's program. I read the NGP brochure [2] and found the curriculum fascinating, so I applied for the NGP in my first year of graduate school and officially enrolled in the program as an NGP student starting my second year.

My research theme is to establish a unique brain function assessment method, called the "super-selective Wada test," as a standardized test procedure. And the broader goal is to achieve effective preoperative brain evaluation for epilepsy patients by combining a wide variety of examinations. The super-selective Wada test directly simulates cognitive dysfunction that would be caused by resection or damage to a targeted brain region by using anesthetic administration to a localized brain region. This test has been conducted for patients with epilepsy or brain tumors since 2019 at Tohoku University Hospital, where it was established and is almost the only institution that successfully implements this test in clinical evaluations. This test is a multidisciplinary clinical practice that must be performed in collaboration with many departments. However, the information that this test provides is well worth it. My goal in the doctoral program was to demonstrate the usefulness of the "super-selective Wada test" for clinical medicine and to present the interesting findings from this test for the global academic community. Furthermore, I hoped to advance preoperative brain function assessment in epilepsy patients.

There are three main points that attracted me to the NGP curriculum. They were (1) interdisciplinary courses and interactions, (2) training curriculum for global outreach, and (3) study abroad. Looking back after completing the NGP, I still feel that these three points were excellence of the NGP. I address these points in more detail below.

(1) Interdisciplinary courses and interactions

NGP students are enrolled from the Graduate School of Life Sciences and Graduate School of Medicine, and their expertise is wide-ranging; from molecular and cellular research, to genetic and animal experiments, to clinical research on humans such as myself, with a single overlap in "brain." While I learned a lot from other graduate students on topics such as molecules and genes, I also had knowledge to offer from my own experience on the realities of some neurological diseases. Without participating in the NGP, I would not have had the opportunity for such close interdisciplinary research interactions. I also appreciate the experience of introducing my research to people in other fields or asking questions about their research, which I feel was an indispensable experience for me as I embark on my future research career. This bird's-eye view of my position in the research world enhances my research activities.

(2) Training curriculum for global outreach

There are many international students at the NGP, where English is the "common language." For this reason, including the academic interactions mentioned earlier, the NGP provides ample opportunities to present one's research in English and to conduct Q&A sessions in English. To be honest, I had felt inferior in my English communication and presentation skills. I had spent my early life at a local public school, and I was not exposed to English until I was 13 years old. The more I got to know people with richer international experiences than my own, the more I recognized the need to work harder. Thus, I tried to be active in seizing domestic opportunities to go out into the world. While some may find the many programs conducted in English bothersome, I instead appreciated the numerous opportunities to practice English in Japan. These experiences kept me optimistic when presenting at international conferences and submitting academic papers. I had no special talents, but thanks to my ample training experience and the help of many people, I was able to thoroughly enjoy my study abroad experience.

Additionally, the Academic English course provided a valuable experience for me to learn the basics of academic paper writing. In Japan, there are very few educational programs that provide the basic knowledge for writing academic papers.

(3) Study abroad

I detailed my study abroad report earlier, so please read it as well [3]. Since 2020, when I entered the doctoral program, many international events and study abroad programs had been canceled or postponed due to the COVID-19 pandemic. However, I had the opportunity to study abroad in 2023, when the situation had calmed down. I studied under Professor Peter Janssen at KU Leuven in Belgium [4]. KU Leuven is a university that has been ranked first on the list of the most innovative universities in Europe [5]. KU Leuven has a long history, dating back to 1425, but its university hospital (UZ Leuven) dates back even further, to 1080 [6]. While Tohoku University Hospital is one of the largest university hospitals in Japan, UZ Leuven is two to three times larger and has a significantly larger number of medical researchers. In Professor Janssen's lab, we were analyzing brain activity in epilepsy patients using special electrodes that detect firing signals of individual neurons along with the conventional electrocorticography. It was a great experience to deepen my understanding of neurons and epilepsy through the struggle with novel data analysis. In addition to research, I gained extensive experience in clinical medicine and cultural exchange during this study abroad program. Although it was only for three months, it was a great experience not only to deepen my professional knowledge and skills in neurophysiology, but also to get used to engaging in academic discussions with people from different cultural backgrounds.

After four years of struggling in this way, I completed my PhD and NGP curriculum in March 2024. Based on two papers published in journals [7, 8], I wrote and submitted a doctoral thesis outlining the availability of the super-selective Wada test. Although my Ph.D. program was severely affected by the pandemic, I have nevertheless committed myself to my research. For the past four years, I have spent every day thinking about the brain. Last week, I tallied my research outputs during my PhD program; I authored 5 academic papers, co-authored 9, and gave 9 academic presentations (as well as 19 others as a co-presenter) at academic conferences. These are, of course, not the result of my own abilities. I owe all of my academic achievements to my supervisors, colleagues, and collaborators. I would like to express my gratitude to Professor Kyoko Suzuki of the Department of Behavioral Neurology and Cognitive Neuroscience, who has supervised my research and made great efforts; to the researchers of the Department of Behavioral Neurology and Cognitive Neuroscience, Department of Neurosurgery, and Department of Epileptology, who have given me guidance and encouragement as my collaborators; and to the NGP, whose support and activities have helped make my doctoral course so valuable. I would also like to express my great appreciation to all the other NGP students who interacted with me and wish them all the best in their future endeavors.

At last, I have accepted a position as Assistant Professor at Tohoku University in April 2024, and will continue to be involved in clinical research on cognitive function in the Department of Behavioral Neurology and Cognitive Neuroscience. Beyond the doctoral thesis, I consider it my mission to demonstrate the utility of the super-selective Wada test and to establish better evaluation of brain function in epilepsy patients. I hope to use the knowledge and skills that I have developed during this program to impact the world through research conducted in Japan. Additionally, if there are any students who are unsure of their future career path or are interested in clinical brain research, please do not hesitate to contact me. If you want to ask me anything, you can reach me via our office [1].

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