Research Opportunities for Neurosurgical Residents
The training program offers multiple opportunities for clinical and basic research. These include projects in neurooncology, neurotrauma/critical care, neuroimaging, neurodegenerative disorders, neuroimmunology, pain, spinal biomechanics, intractable epilepsy, cerebrovascular surgery, and pediatric neurosurgery. Residents are expected to submit at least one paper per year for publication, except in the PGY 1 and PGY 7 years. The research years (PGY 4 and 5) will provide an opportunity to focus on a particular area of interest and to produce several manuscripts reflecting original, analytic research.
The Feinstein Institute for Medical Research (FIMR) has 2 full-time labs that study aspects of brain tumor biology. One group, led by Dr. Marc Symons, focuses on mechanisms of glioma invasion. The other is led by Dr. Rosemaria Ruggieri. This group studies the cellular and molecular effects of radiation therapy on brain tumors. A tumor tissue bank program collects specimens from patients undergoing tumor resection.
Clinical research may be pursued with Dr. Michael Schulder for neurosurgery. Ongoing projects include assessment of patient outcomes with intraoperative MRI (iMRI); comparing different methods of image guidance; and examining the correlation of different fMRI analysis methods used for surgical planning. The Brain Tumor Center also participates in several multicenter clinical trials, medical and surgical, for patients with various tumor types. Research is facilitated by a full-time research coordinator and the maintenance of a brain tumor registry.
Dr. Raj Narayan and Dr. Chunyan Li are leading an effort to develop a sensor that can monitor multiple parameters in the brain (ICP, pO2, pCO2, temperature, multiple metabolic factors) on a single, small, implantable catheter. This project will include basic science as well as clinical research components. Clinical research in the NSCU may be pursued under the aegis of Dr. David LeDoux.
Facilities at NSUH include a 3 Tesla MRI on which most functional imaging is acquired. Two PhD physicists are in charge of the functional imaging program, including Dr. Aziz Ulug, who has particular expertise in DTI. The FIMR houses a PET scan used for clinical imaging but also for research. There are ongoing projects examining the fMRI and PET findings in Parkinson’s disease and other degenerative disorders.
A group headed by David Eidelberg, MD conducts ongoing research into the imaging of Parkinson’s disease. They are also leaders in new therapeutic approaches to Parkinsons’ disease and other movement disorders. The group supports the movement disorders surgery program and provides opportunities for clinical research in this area. Dr. Peter Davies runs the Alzheimer’s disease research program, and interested residents may pursue projects of neurosurgical interest related to that illness.
Dr. Kevin Tracey, a neurosurgeon and CEO of the FIMR, leads a basic science research effort into the control of immune reactions by the nervous system. Residents may elect to pursue projects aimed at studying the possible use of neuromodulation to regulate the immune response.
There is a large ongoing clinical experience in treating patients with intractable pain, especially with peripheral nerve or motor cortex stimulation.
Spinal Biology and Biomechanics
Dr. Nadeen Chahine and Mitchell Levine, MD , Director of Spinal Neurosurgery, have established a lab within the Department of Neurosurgery that studies the potential role of stem cells in spinal fusion techniques. Clinical research on outcomes of spinal surgery may also be pursued using a specially maintained patient database. This lab also investigates the molecular biology of spinal disc degeneration.
The residency program in epilepsy specializes in the treatment of patients with intractable epilepsy and is headed by Dr. Sean T. Hwang of the Department of Neurology. The Center includes a 2-bed inpatient unit for video monitoring. Research is led by Ashesh Mehta, MD, PhD from the Department of of Neurosurgery focuses on the application of functional imaging in the evaluation and surgical treatment of seizure patients, and basic science research in the mechanisms of neuronal excitability in epileptogenesis.
There is extensive clinical experience in open and endovascular treatment of patients with aneurysms and AVMs. Interested residents may pursue research assessing comparative outcomes of different therapeutic approaches to these patients. Dr. David Langer, Chief of Neurosurgery, Lenox Hill Hospital, has also established a medical infomatics project connecting the ORs, Neurosurgical ICU, and other clinical venues.
The Division of Pediatric Neurosurgery has set up a laboratory effort, together with Dr. Symons in the FIMR, to investigate the mechanisms of medulloblastoma growth and invasion. The resources of the Steven and Alexandra Cohen Children's Medical Center of New York and the Division of Pediatric Neurology provide an excellent platform for pursuing clinical research.
Residents at all levels are encouraged to submit original research for presentation at national and international meetings. They will be expected to attend such meetings where they will present as first author. In addition, residents may attend selected educational courses as long as there is no interruption to their core educational program. Periodically, cadaver dissection courses are held in the Bioskills Education Center, a short walk from LIJ.