The studies of the Functional Neurosurgery Lab currently test whether neural activity related to the experimental vigilance and conditioned expectation toward pain can be described by interrelated networks in the brain. These two psychological dimensions play an important role in chronic pain syndromes, but their neuroscience is poorly understood. Our studies of spike trains and LFPs utilize an anatomically focused platform with high temporal resolution, which complements fMRI studies surveying the whole brain at lower resolution. This platform to analyze the oscillatory power of structures in the brain, and functional connections (interactions and synchrony and causal interactions) between these structures based upon signals recorded directly from the waking human brain during surgery for epilepsy and movement disorders, e.g. tremor. Our studies have demonstrated that behaviors related to vigilance and expectation are related to electrical signals from the cortex and subcortical structures. These projects are based upon the combined expertise of Dr. Nathan Crone in recordings and clinical management of the patients studied; Dr. Anna Korzeniewska in the analyses of signals recorded from the brain; Drs. Claudia Campbell, Luana Colloca and Rick Gracely in the clinical psychology and cognitive neurology of the expectation of pain and chronic pain; Dr. Joel Greenspan in quantitative sensory testing; and Dr. Martin Lindquist in the statistical techniques. Dr. Lenz has conducted studies of this type for more than thirty years with continuous NIH funding.

The research goals of the Functional Neurosurgery Laboratory include the development of computational models to understand how brain function is affected by neurological conditions and how this abnormal function might be corrected or minimized by neuromodulation through electrical stimulation. The lab uses data collected from patients during epilepsy monitoring or in the operating room during DBS procedures to construct and calibrate the computational models. The models can be manipulated to explore functional changes and treatment possibilities. The other primary goal of the laboratory is the development of a neuromodulation system that applies stimulation pulses at specific phases of brain oscillatory activity. This technique is being explored in the context of Parkinson's disease as well as memory function, and may lead to less invasive therapeutic treatment system with more effective stimulation.

Directed by Alan R. Cohen MD, Carson-Spiro Professor of Neurosurgery, Oncology and Pediatrics, the laboratory is focused on developing novel instruments and approaches to enhance the safety and efficacy of neurosurgical procedures. Current investigations include work in microsurgery, endoscopy, image guidance and robotic surgery. A cadaveric Skills Lab offers training in neurosurgical techniques.

Directed by Alan R. Cohen, M.D., Carson-Spiro Professor of Neurosurgery, Oncology and Pediatrics, the laboratory is focused on developing novel instruments and approaches to enhance the safety and efficacy of neurosurgical procedures. Current investigations include work in microsurgery, endoscopy, image guidance and robotic surgery. A cadaveric skills lab offers training in neurosurgical techniques.

Research in the Athir Morad Lab primarily focuses on perioperative pain management for neurosurgery patients. Our team has conducted two randomized controlled trials to assess the efficacy of patient-controlled analgesia (PCA) following craniotomy. Our current research includes studies on the safety of opioid administration following craniotomy through the use of end-tidal CO2 detection, as well as research into the use of transcortical magnetic stimulation (TMS) for managing pain after spine surgery.

Directed by Debraj “Raj” Mukherjee, MD, MPH, the laboratory focuses on improving access to care, reducing disparities, maximizing surgical outcomes, and optimizing quality of life for patients with brain and skull base tumors.

The laboratory achieves these aims by creating and analyzing institutional and national databases, developing and validating novel patient-centered quality of life instruments, leveraging machine learning and artificial intelligence platforms to risk-stratify vulnerable patient populations, and designing novel surgical trials to push the boundaries of neurosurgical innovation.

Our research also investigates novel approaches to improve neurosurgical medical education including studying the utility of video-based surgical coaching and the design of new operative instrumentation.

Led by Drs. Nicholas Theodore and Amir Manbachi, the HEPIUS team unites neurosurgeons, biomedical engineers, scientists, radiologists and other physicians to treat and diagnose spinal cord injuries

Vascular research led by Rafael Tamargo, M.D., the Walter E. Dandy Professor of Neurosurgery, explores treatment of aneurysms, arteriovenous malformations, cavernous malformations, and arteriovenous fistulas of the brain and spinal cord. Basic science research has focused on endothelial cell-leukocyte interactions (inflammation) after subarachnoid hemorrhage and identifying drugs that might inhibit this inflammatory response as well as the narrowing of blood vessels.

We investigate the brain networks and neurotransmitters involved in symptoms of movement disorders, such as Parkinson's disease, and the mechanisms by which modulating these networks through electrical stimulation affects these symptoms. We are particularly interested in the mechanisms through which neuromodulation therapies like deep brain stimulation affect non-motor brain functions, such as cognitive function and mood. We use imaging of specific neurotransmitters, such as acetylcholine and dopamine, to understand the changes in brain chemistry associated with the clinical effects of deep brain stimulation and to predict which patients are likely to have changes in non-motor symptoms following DBS. Through collaborations with our neurosurgery colleagues, we explore brain function by making recordings during DBS surgery during motor and non-motor tasks. Dr. Mills collaborates with researchers in the Department of Neurosurgery, the Division of Geriatric and Neuropsychiatry in the Department of Psychiatry and Behavioral Sciences and in the Division of Nuclear Medicine within the Department of Radiology to translate neuroimaging and neurophysiology findings into clinical applications.

Epilepsy affects 1-3% of the population and can have a profound impact on general health, employment and quality of life. Medial temporal lobe epilepsy (MTLE) develops in some patients following head injury or repeated febrile seizures. Those affected may first suffer spontaneous seizures many years after the initial insult, indicating that the neural circuit undergoes a slow pathologic remodeling over the interim. There are currently no methods of preventing the development of MTLE. It is our goal to better understand the process in order to slow, halt, and ultimately reverse it. Our laboratory draws on electrophysiology, molecular biology, and morphology to study the contribution of dysregulated neurogenesis and newborn neuron connectivity to the development of MTLE. We build on basic research in stem cell biology, hippocampal development, and synaptic plasticity. We work closely with colleagues in the Institute for Cell Engineering, Neurology, Neurosurgery, Biomedical Engineering, and Radiology. As physician neuropathologists our grounding is in tissue alterations underlying human neurologic disease; using human iPSC-derived neurons and surgical specimens we focus on the pathophysiological processes as they occur in patients. By understanding changes in cell populations and morphologies that affect the circuit, and identifying pathologic alterations in gene expression that lead to the cell-level abnormalities, we hope to find treatment targets that can prevent the remodeling and break the feedback loop of abnormal activity > circuit change > abnormal activity.