Happy Holidays to all, as we end another calendar year. I am proud to say that the CU Neurosurgery Department has continued to grow, hitting all time highs in clinical case load (over 5,000 operative cases for this past year), as well as in research funding. I would like to thank all of our faculty and staff for their incredibly hard work and their dedication to advancing the neurosciences. CU Neuroscience is making a name for itself nationally and internationally.
As we enter the New Year, we are excited with what lies ahead and the many opportunities that we will encounter. In this issue of “HEADlines” we have taken the opportunity to highlight the many accomplishments that have taken place this past year, particularly in the past several months, in each of our Neurosurgery Programs of Excellence. In addition, we introduce the new staff and faculty members that help to make all this happen. We also give tribute to faculty who will be leaving us. In particular, we will miss our Director of Neurosurgical Spine, Dr. Peter Witt, who will be retiring from academic medicine. Dr. Witt has done an amazing job in building this service, recruiting excellent colleagues, and promoting our reputation across the region. We will miss him.
In this issue, we will also present some of our newest programs, including Dr. Cava’s “Latin American Outreach in Neurosurgical Critical Care,” the newly designated “Pituitary Tumor Center of Excellence,” and the continued growth of the spinal CSF leak program.
Happy Holidays to all, and I thank you for your support of the CU Department of Neurosurgery.
Sincerely,
Kevin O. Lillehei, MD Chair, Department of Neurosurgery
Ogsbury-Kindt Professor of Neurosurgery
University of Colorado
John
Sampson, MD, PhD, MHSc, MBA
New Dean of the CU School of Medicine
WELCOME TO OUR NEW DEAN AND A NEW FACULTY MEMBER TO THE DEPARTMENT!
The Department of Neurosurgery is proud and pleased to welcome John Sampson, MD, PhD, MHSc, MBA to his new role! Congratulations, Dr. Sampson, on your new role as Dean of the University of Colorado School of Medicine and Vice Chancellor for Health Affairs for CU Anschutz. In addition, Dr. Sampson is a Neurosurgeon, and therefore, his “home department” is with us! Formerly the Senior Vice President of Duke University Health System and the Duke Health Integrated Practice, Dr. Sampson is a prolific researcher and has authored nearly 300 peer reviewed publications. He has also held the distinction of being the highest National Institutes of Health (NIH) funded investigator in his field for several consecutive years.
NEURO
CU ANSCHUTZ
PITUITARY PROGRAM BECOMES A “PITUITARY TUMOR CENTER OF EXCELLENCE.”
Congratulations to our entire Pituitary Team for becoming a national Center of Excellence, as recognized by the International Pituitary Society, the NIH and the Pituitary Networking Association! The program initially began back in 1987 with Dr. Kevin Lillehei (neurosurgery), Dr. Betty K DeMasters (pathology) and Dr. E Chester Ridgway (endocrinology). Since then, the large multi-disciplinary team has performed over 3,000 pituitary tumor surgeries, published over 100 peer reviewed articles, as well as numerous book chapters and even a text book written by Dr. Margaret Weirman with input from the entire team.
To meet the standards of a Pituitary Tumor Center of Excellence (PTCOE), the center needs to satisfy several guidelines that include some of the following:
• Managing a monthly Multidiscipilinary Pituitary Tumor Board.
• Evaluating and treating these patients in a shared, multi-disciplinary clinic.
• Working with supporting specialties, such as neuroradiology and neuropathology.
• Tracking outcomes and providing courses, publications and lectures to colleagues, administrators and scientific bodies.
• Provide updated information, new treatments, and outcomes for patients on our website.
The CU Pituitary Team meets and exceeds all of these guidelines, and many more. We are considered the regional expert in these life altering pituitary disorders.
THE MULTI-DISCIPLINARY TEAM MEMBERS:
Kevin O. Lillehei, MD, FAANS is the Chairman of the CU Department of Neurosurgery and co-Director of the Pituitary Program at the Anschutz Health Sciences Campus. He has performed over 2500 surgeries for pituitary diseases, a number starkly in contrast with the “average” of less than 50 cases per career performed by the majority of neurosurgeons in North America. He receives numerous patient referrals from throughout the Western part of the United States due to his strong reputation.
Margaret E. Wierman MD, is a Professor of Medicine, Integrative Physiology and OBGYN at the University of Colorado School of Medicine. Dr. Wierman is a translational physician scientist whose research interest has been in the molecular mechanisms of pituitary tumors and disorders. She directs the Pituitary Tumor Program at the University of Colorado with Dr. Lillehei. Dr Wierman has published over 140 manuscripts and her pituitary studies have examined the differences in the responses of different subtypes of growth hormone tumors to surgery and medical therapy. She is a member of the Pituitary Society, a former Vice President of the Endocrine Society and the immediate past President of the International Society of Endocrinology.
Samy Youssef, MD, PhD, MSc, FAANS, is Professor of Clinical Otolaryngology, Director of Complex Cranial and Skull Base Surgery, Program Director of Skull Base Surgery Fellowship and Vice Chair of Education in the Department of Neurosurgery. He is a member of the Congress of Neurological Surgeons (CNS), American Association of Neurological Surgeons (AANS), North American Skull Base Society (NASBS), and Mayfield Society. His research interested include Microsurgical anatomy and techniques, Endoscopic minimally invasive surgery and brain tumors. Clinically, Dr. Youssef treats Complex Brain Tumors, Skull Base Tumors, Minimally Invasive Endoscopic Cranial Procedures, Meningiomas, Acoustic Neuromas, Trigeminal Neuralgia, Chiari Malformation and, of course, Pituitary Tumors.
BK Kleinschmidt-DeMasters, MD, is a tenured Professor of Pathology, Neurology, and Neurosurgery at the University of Colorado School of Medicine where she has been Director of Neuropathology for over 30 years. Her international recognition stems from her co-authorship on pituitary tumors for the Central Nervous System and Endocrine World Health Organization fascicles, the gold standards used throughout the world for classifying pituitary tumors. She is past president of the American Association of Neuropathologists, the recipient of the Meritorious Service Award from the AANP, and the University of Colorado Florence Sabin Award and numerous teaching awards.
Christie Turin More, MD is an assistant professor in the Division of Endocrinology, Metabolism and Diabetes at the University of Colorado. She is an active member of the Pituitary Society, a moderator for the annual Fellows Course, and an appointed member to the Clinical Surveys Committee. She has received awards in recognition of her outstanding qualities in patient care, research and most recently, she was elected fellow of the American College of Physicians. Her national recognition stems from her service as the co-investigator of a clinical trial in acromegaly and the principal investigator of a Phase 4 study involving patients with growth hormone deficiency. She has published over 25 manuscripts and has presented multiple posters and oral presentations in national and international meetings.
Dr. Kiseljak-Vassiliades is an associate professor in the Division of Endocrinology. Her research interests are in endocrine neoplasia. She has published over 45 manuscripts and led a project to understand the differences in growth hormone pituitary tumors, specifically in their aggressiveness, recurrence rates and variable response to medical therapies. Dr Kiseljak-Vassiliades has been a co-investigator on several clinical trials in pituitary disease, including acromegaly, Cushing’s disease and growth hormone deficiency. On the national level, she is a member of the Pituitary Society and has been involved in the education committee promoting training of early society members. Dr Kiseljak-Vassiliades has also been a long time member of Endocrine Society and has chaired Trainee and Development committee dedicated to promoting career of early physicians and scientists.
Dr. Timothy Waxweiler is a radiation oncologist from Emory University School of Medicine. He attended the University of Michigan for his undergraduate degree, interned at the Presbyterian-St.Luke’s Medical Center, and did his residency with us at CU Anschutz. His research focuses on radiation oncology, pediatric and adult cancers, including testicular, salivary gland, melanoma, prostate and brainstem tumors.
Timothy Ung, MD is the newest recruit to the pituitary tumor team. He joined the Department of Neurosurgery in 2023 as an Assistant Professor. His research interests include surgical outcomes in large vestibular schwannomas, metastatic lesions of the brain and spine, and stereotactic radiosurgery for trigeminal neuralgia secondary to tumor (among many other interests).
Thomas Borges, MD has been a Neuro-radiologist at CU since 2010. His primary research interest is Pituitary tumors, specifically arterial spin labeling (ASL) imaging for tumor progression vs treatment change. He also has an interest in stroke imaging, pituitary and skull base tumors, primary brain tumors and infections. In 2022, Dr. Borges received the John C Stears Faculty teaching award in neuro radiology.
Brian Kavanaugh, MD, MPH is the Department Chair and a professor in Radiation Oncology. He has received the “Top Doctor” award in 5280 magazine, and is a graduate of Tulane University. He completed his residency in radiation oncology at Duke University Hospital. He has more than 200 pier reviewed publications which span many topics, including Stereotactic Body Radiation Therapy, Cancer’s Basal Apoptotic Rate, High Grade Glioma Radiation Necrosis, Image Guidance for Thoracic TumorRadiotherapy, and Radiotherapy for Liver and Lung Metastases.
“Angela is the glue that holds all this together,” says Dr. Kevin Lillehei. As the pituitary program coordinator, Angela Grant acts as a patient advocate and educator, connects patients with the proper clinics and procedures, enters and maintains data and much more. She started with the Pituitary Program in 2012 and has enjoyed working with this wonderful team. She loves helping patients and families navigate their healthcare journey. She is a Colorado native who spends her spare time baking, camping, and being with her family.
DR. RYAN ORMOND SPEAKS ABOUT GLIOBLASTOMA AND OPTUNE TECHNOLOGY
Recently, Dr. Ryan Ormond was interviewed in conjunction with the death of NBA Star Dikembe Mutombo. He answered multiple questions about this devastating disease, including symptoms. These include seizures, behavioral changes, weakness, speech difficulties, memory lapses and frequent headaches. Although the sooner a glioblastoma is diagnosed, the better- but the average life expectancy is 15 months. In Dikembe Mutombo’s case, he lived two years.
When asked what kinds of new treatments are available, Dr. Ormond spoke about Optune. The Optune device works by producing alternating electrical fields that penetrate into the brain and affect cancer cells, causing them to die before they can replicate. Cancer cells can only replicate when conditions are optimal. When a cell is basically polarized, the electrical environment is disrupted, making it difficult for cells to grow or duplicate. The cells can’t line up and are pulled to the side, causing apoptosis (cell death).
Used in conjunction with chemotherapy, Optune is approved for patients who already have had surgery to remove most of their tumor. It is typically worn for an average of 18 hours a day over a 30-day period, but the more patients wear it, the better it works. It can be worn during sleep and physical activity, just not when showering or bathing. There is no pain, but it can be uncomfortable. In a time when very few clinical trials have shown significant positive outcome, Optune is one option that could prolong life.
DONATIONS CONTINUE TO MAKE A DIFFERENCE!
For more information on
A recent paper has been submitted for publication, naming many of our brain tumor surgeons, along with our brain tumor donor, Barbara Hopper, and the special fund she has set up to study glioblastomas. The title of the paper is “Differential Effects of Extracellular Vesicles form Two Different Glioblastomas on Normal Human Brain Cells.” Funds from this donor help pay for our Nervous System Biorepository, one of several brain banks on campus. Neural tissue is a vital resource for researchers. The Nervous System Biorepository is a collection of all nervous system tissues collected during surgery. Our bank houses hundreds of tissues including tumors, brain tissue, dura, and various diseased specimens. We also collect matched blood samples, serum, urine, and have successfully established several cell lines. Please contact Dr. Michael Graner Michael.graner@cuanschutz.edu for inquiries about donating funds to this very important resource.
For the complete article on Dikembe Mutombo’s case scan here
Optune scan here
BRAIN
TUMOR RESEARCHER, DR. MICHAEL GRANER, MAKES THE ROUNDS!
Dr. Graner has been busy. This past summer he spoke for the CU Anschutz CREU/UCCC Summer Fellows on the topic of “Brain Tumors, and How We Treat Them.” In between speaking engagements, he served on an NIH Study Section. This fall, he hosted Dr Gabriela Chiosis from Memorial Sloan Kettering Cancer Center, as a Dean’s Distinguished Seminar Speaker, served on the program committee and chaired several sessions at the American Society for Intercellular Communication (ASIC) annual meeting in Washington, DC, and chaired two SelectBIO conferences in Portland, Oregon and Laguna Beach, California.
SUMMER STUDENTS MAKE AN IMPACT
Chordoma is a rare, slow-growing, malignant tumor that can occur anywhere along the spine (usually the sacrum,) or at the base of the skull. Symptoms depend on the location of the tumor, but can include pain, weakness, numbness, headaches, double vision or difficulty swallowing. Chordomas are caused by leftover cells from the notochord (the embryonic tissue that forms the spine).
Through the Cancer Center’s CREU (Cancer Research Experience for Undergraduates), we were fortunate to have two undergraduate students studying chordomas in one of our labs this past summer. Zoe Zizzo, from Colorado College, and Ada Bozikov, from Mary Baldwin University, wrote papers on their findings and one of these papers was submitted to the International Journal of Molecular Sciences.
CURRENT RESEARCH IN NEURO ONCOLOGY
Jose Contreras-Zarate M, Alvarez-Eraso K, Goodspeed A, Costello J, Jaramillo-Gomez J, Koliavas S, Fox M, Ormond R, Kabos P, Karam S, Cittelly D. TRSC-07 Combination of Endocrine Therapy with Radiation Decreases Brain Metastases Through Reactivation of Effector Immune-Cell Recruitment to the Brain. NeuroOncology Advances, Volume 6, Issue Supplement_1, August 2024, Page i41, https://doi.org/10.1093/noajnl/ vdae090.135
Bauman MMJ, Jusue-Torres I, White JJ, Bouchal SM, Hsu AR, Ha Y, Pumford AD, Hong S, Riviere-Cazaux C, Wang K, Brown DA, Helal A, Parney IF. Presentation, surgical outcome, and supplementary motor area syndrome risk of posterior superior frontal gyrus tumors. J Neurosurg. 2024 Aug 30:1-12. doi: 10.3171/2024.5.JNS231850. Epub ahead of print. PMID: 39213666.
Kleinschmidt-DeMasters BK, Turin CG. Reassessment of Plurihormonal Pituitary Adenomas/PitNETs. Am J Surg Pathol. 2024 Sep 5. doi: 10.1097/PAS.0000000000002306. Epub ahead of print. PMID: 39233337. Lee JC, Koo SC, Furtado LV, Breuer A, Eldomery MK, Bag AK, Stow P, Rose G, Larkin T, Sances R, KleinschmidtDeMasters BK, Bodmer JL, Willard N, Gokden M, Dahiya S, Roberts K, Bertrand KC, Moreira DC, Robinson GW, Mo JQ, Ellison DW, Orr BA. Concurrent ependymal and ganglionic differentiation in a subset of supratentorial neuroepithelial tumors with EWSR1-PLAGL1 rearrangement. Acta Neuropathol Commun. 2024 Sep 3;12(1):143. doi: 10.1186/s40478-024-01809-9. PMID: 39228008; PMCID: PMC11370057.
Aloy NM, Coughlan C, Graner MW, Witt SN. Possible regulation of the immune modulator tetraspanin CD81 by alpha-synuclein in melanoma. Biochem Biophys Res Commun. 2024 Aug 30;734:150631. doi: 10.1016/j.bbrc.2024.150631. Epub ahead of print. PMID: 39222576.
NEUROSURGICAL SPINE PROGRAM NEWS
CU DEPARTMENT OF NEUROSURGERY BIDS FAREWELL TO DR. PETER WITT
Our department is saddened to announce the retirement of Dr. Jens Peter Witt, the Director of our Neurosurgical Spine Program. Dr. Witt has been one of our neurosurgical faculty since 2002, where he began as an Assistant Professor. Prior to this he attended Hannover Medical School in Hannover, Germany, studied topographical engineering in Bundeswehr, Germany and attended high school in Salzgitter, Germany. He did an internship in trauma/ orthopedics in Germany before interning in General Surgery at the CU School of Medicine, and then entering the University of Colorado neurosurgical residency. He has studied comprehensive spinal surgery instrumentation techniques, and completed a clinical fellowship in spine surgery in Karlsruhe, Germany.
Dr. Witt has won numerous awards over the years, including “Best Doctor for Executives” (Denver Business Journal), the popular “5280 Top Doc” award (5280 Magazine), Appreciation Awards for teaching, several scholarships and scholarly awards, and he is a member of MENSA, scoring in the top 2% of the entire population in standardized intelligence tests.
We all know Dr. Witt is very smart, but he is also a beloved instructor, fellowship director, faculty member, contributing editor of numerous peer reviewed journals, and serves on international committees across the globe. Dr. Witt is married to Carla, a family practice provider at Kaiser. They have four “mostly grown” children (two of whom are in medical school or premed), and they are all avid cyclists, snow skiiers, hikers and water skiiers.
Dr. Witt is treasured by his patients. “He literally saved my life,” says a former patient who now lives in Park City, Utah. “I have never had such an incredible surgeon.” Another patient states, “of the many doctors I’d seen, seeking a solution to my many years of chronic knee/back pain, Dr. Witt was the only Neurosurgeon who took the time to study my case, identify my spine problems, and subsequently successfully treat me.” Yet another patient says, “Dr. Witt has performed 3 surgeries on my back, as I have disc issues and have required several fusions. I trust him completely and feel like he and his staff listen to me and problem solve ways to help me.”
Dr. Witt, we all will miss you and we wish you well!
SECOND ANNUAL CEREBRAL SPINAL FLUID CONFERENCE A HUGE SUCCESS
“Bridging the Gap” is an annual conference, held in early November at the University of Colorado Anschutz Medical Campus. This event aims to share collective insights via a diverse cohort of clinicians, researchers and patients, and is aimed at any person interested in spinal CSF leak, be they physicians, patients, caregivers, or the general population. The goal of this conference is to foster a nuanced, patient-centered understanding of the diagnosis and treatment of spinal CSF leak. This event is presented by Dr. Andrew Callen and the University of Colorado Anschutz Medical Campus in partnership with the Spinal CSF Leak Foundation.
With more than 700 total registrants from 31 different countries, including over 100 in-person registrants, this annual conference is exponentially growing. The speakers were from 6 different countries and included the top names in CSF leak research from around the world, including our own Peter Lennarson from the Department of Neurosurgery.
The conference included topics such as atypical symptoms of spinal CSF, overlapping syndromes, photon counting, patching basics, mental health and the emotional toll of CSF leaks, and many patient stories and perspectives. Congratulations to the entire CSF Leak Team!!
NEUROSURGICAL SPINE SURGEONS ON
A MISSION!
Dr. Peter Lennarson and Dr. Daniel Craig just returned from Honduras with ONE WORLD SURGERY.
This organization is a nonprofit confronting the global health crisis by partnering with communities, healthcare providers, and leaders in healthcare to deliver surgical services. Their vision is a world with safe, timely, and accessible surgical and primary care.
Our neurosurgeons operated and saw patients in the clinic, Monday through Friday. They saw a total of 112 spine patients and did 23 surgeries. They also provided about 20 spine injections and set up another 23 surgeries for a future visit. The Department of Neurosurgery has always been supportive of physicians volunteering their time for important causes and missions, like this. Congratulations to Dr. Lennarson and Dr. Craig for a successful and productive mission trip!
Nevzati E, Kemp OAG, Rhoads C, Witt JP, Finn M, Moser M, Spiessberger A. Biomechanical analysis of stabilization for thoracolumbar anterior spinal failure caused by osteolytic lesions, a finite element comparison of direct lateral corpectomy and posterior long segment instrumentation. Spine J. 2024 Jul 27:S15299430(24)00892-1. doi: 10.1016/j.spinee.2024.06.570. Epub ahead of print. PMID: 39074736.
Lennarson PJ, Callen A. Cerebrospinal Fluid Leaks: Diagnosis, Management, and Outcomes. Elsevier. Sep 2024. Doi: 10/1016/j.nec.2024.08.003.
Callen AL, Han L, Pisani Petrucci SL, Andonov N, Lennarson P, Birlea M, O’Brien C, Wilhour D, Anderson A, Bennett JL, Carroll IR. Patterns of clinical and imaging presentations in patients with spontaneous intracranial hypotension due to spinal cerebrospinal fluid venous fistula: A single-center retrospective cross-sectional study. Headache. 2024 Sep;64(8):939-949. doi: 10.1111/head.14805. Epub 2024 Aug 11. PMID: 39129307.
PEDIATRIC NEUROSURGICAL PROGRAM NEWS
PEDIATRIC NEUROSURGERY NEWS
SPASTICITY: OPTIONS & UPDATES FROM DR. CORBETT WILKINSON, PEDIATRIC NEUROSURGEON
Spasticity in children is usually caused by damage to the brain or spinal cord that controls muscle movement. An imbalance of the signals that are sent from the central nervous system to the muscles in the body may cause muscles to become stiff or tight, and can impact a child’s ability to walk, speak, or perform other daily activities. Treatments may include exercise, physical therapy, medication or other treatments. A common medication used since 1960 is Baclofen. Initially designed to address epilepsy, it was reintroduced in 1971 for its efficacy in treating muscle spasticity. In the late 1980’s, researchers began experimenting with a pump device which would deliver the medication directly into the spinal canal for more severe cases of spasticity which were not managed by other means. The pump is a battery-powered device that’s surgically implanted under the skin, usually near the pelvis. It continually delivers the drug via catheter into the spinal canal and is programmed by a doctor. It can improve functions, such as ambulation, ability to control a wheelchair, or ability to dress oneself or feed oneself. It can also reduce pain, make diaper changing easier and can prevent the need for bracing, casting, or the need for orthopedic procedures. By reviewing charts, back to 2006, Dr. Wilkinson and other researchers at Children’s Hospital Colorado have been studying the risks and advantages of the Baclofen Pump. Their initial findings found that
Dr. Corbett Wilkinson
Caption: Image Courtesy of Royal Children’s Hospital Melbourne, Dept of Developmental Medicine
78.2% of patients had some type of complications, such as infections, mechanical issues with the pump, catheter issues, or pseudomeningocele, a rare condition where cerebrospinal fluid (CSF) leaks from the spinal canal into the surrounding tissue. Some of their major findings include the following:
• Initial medical management with enteric baclofen and pump rate adjustments can benefit some patients
• Complete catheter replacements may be more effective than partial revisions
• Fixing leak at pump-catheter connection may be effective without replacing entire catheter
Further research is needed to optimize treatment strategies and outcomes for patients with these complications. Another technique used for spasticity (usually after a testing period with the pump), is Selective Dorsal Rhyzotomy (SDR). A neurosurgeon opens the lower spine to expose the spinal cord and cuts the nerve roots that are causing spasticity. After surgery, patients need intensive physical therapy and exercise to regain strength and improve function. This can continue for up to two years. Children who are cognitively able to follow directions and participate in therapy are good candidates for SDR. The ideal age for surgery is between 3-10 years old, but there is no age limit. SDR improves mobility, reduces pain, and relieves spasticity in many patients. SDR is considered a safe and effective operation, but it’s only offered at a few pediatric hospitals. We are fortunate to have surgeons, such as Dr. Wilkinson, offering this option at the Children’s Hospital Colorado.
CURRENT RESEARCH IN PEDIATRIC NEUROSURGERY
Freeman L, Bothwell S, Pazniokas J, Mecum A, Ngyen K, Park T, Samples DC. The pediatric brain injury guidelines (pBIG): A retrospective clinical validation study. Journal of Neurosurgery: Pediatrics. 2024
Ryan MV, Freeman LM, Blasco S, Sawyer K, Graber S, Tong S, Oleszek J, Wilkinson C. Complications of intrathecal baclofen therapy in children and young adults. J Neurosurg Pediatr. 2024 Sep 20:1-12. doi: 10.3171/2024.6.PEDS23360. Epub ahead of print. PMID: 39303297.
Alshareef M, Bsat S, Hankinson TC. Operative Adjuncts in Pediatric Brain Tumor Surgery with a Focus on Suprasellar Tumors. Adv Tech Stand Neurosurg. 2024;53:13-25. doi: 10.1007/978-3-031-67077-0_2. PMID: 39287800.
Apps JR, Gonzalez-Meljem JM, Guiho R, Pickles JC, Prince E, Schwalbe E, Joshi N, Stone TJ, Ogunbiyi O, Chalker J, Bassey A, Otto G, Davies R, Hughes D, Brandner S, Tan E, Lee V, Hayhurst C, Kline C, Castellano S, Hankinson T, Deutschbein T, Jacques TS, Martinez-Barbera JP. Recurrent adamantinomatous craniopharyngiomas show MAPK pathway activation, clonal evolution and rare TP53-loss-mediated malignant progression. Acta Neuropathol Commun. 2024 Aug 10;12(1):127. doi: 10.1186/s40478-024-01838-4. PMID: 39127699; PMCID: PMC11316312.
CONGRATULATIONS TO DR. DANIEL KRAMER AND HIS TEAM!
Dr. Kramer and associates have recently received an NIH R61 grant for $3.3 million to study Neuropixels in humans. CU will be the first in the country to receive this Investigational Device Exemption (IDE).
Advancing our understanding of the neural basis of human cognition is limited due to the rarity of intracranial recordings in humans, and the inherent inadequacy of animal models. Additionally, studying something as complex and flexible as executive function will likely require recording from hundreds of neurons simultaneously, a scenario not currently possible in humans with the existing recording technology. With this funding, a Neuropixels probe with 960 possible recording electrodes on a single shank, will allow us to study human executive function. Placing these Neuropixels probes in the dorsolateral prefrontal cortex during awake deep brain stimulation recordings, Dr. Kramer and his team will assess the neural population activity during an executive function task that employs feature selection, conflict processing, and decision making. With the use of the unique recording structure of the probe, having electrodes placed regularly along the shank, they can evaluate the local topography, expecting cortical layers to stratify neural responses to task-conditions. They will also evaluate the neural population response to task conditions, hypothesizing that the neural dimensions and geometry exhibit features that explain the flexibility so crucial to executive function. This study will establish the neural underpinnings of human executive function.
CONGRATULATIONS, DR. STEVE OJEMANN!
The 11th Annual Stereotactic and Functional Neurosurgery Course was another huge success, and was held at CU Anschutz October 24-26, 2024. Once again, faculty from across the globe attended, as residents and fellows learned the newest and most optimal surgical procedures. Stereotactic and Functional Neurosurgery is the single and most rapidly advancing subspecialty within neurosurgery. The term “stereotactic” refers to the use of a three-dimensional coordinate system combined with an imaging technique, such as computed tomography scanning (CT) or magnetic resonance imaging (MRI), to precisely locate targets deep within the brain.
Conditions which can be treated include: movement disorders (such as Parkinson’s disease, essential tremor, and dystonia), pain, epilepsy, psychiatric disorders, spasticity disorders and even brain tumors.
CURRENT RESEARCH IN STEREOTACTIC & FUNCTIONAL NEUROSURGERY
Domen CH, Sillau S, Liu Y, Leehey MA. Reply to: Cognitive Safety of Cannabis Products in Parkinson’s Disease: Need for Solid Scientific Evidence to Guide Clinicians and Patients Currently on Shaky Grounds. Mov Disord. 2024 Jan;39(1):222-223. doi: 10.1002/mds.29667. PMID: 38294047.
Sakai JT, Tanabe J, Battula S, Zipperly M, Mikulich-Gilbertson SK, Kern DS, Thompson JA, Raymond K, Gerecht PD, Foster K, Abosch A. Deep brain stimulation for the treatment of substance use disorders: a promising approach requiring caution. Front Psychiatry. 2024 Jul 12;15:1435109. doi: 10.3389/ fpsyt.2024.1435109. PMID: 39071229; PMCID: PMC11272460
Ryan MV, Satzer D, Ojemann SG, Kramer DR, Thompson JA. Neurophysiologic Characteristics of the Anterior Nucleus of the Thalamus during Deep Brain Stimulation Surgery for Epilepsy. Stereotact Funct Neurosurg. 2024 Jul 15:1. doi: 10.1159/000539398. Epub ahead of print. PMID: 39008968.
Baker S. Radcliffe E, Kramer D, Ojemann S, Case M, Zarns C, Holt-Becker A, Raike R, Baumgartner A, Kern D, Thompson J. Towards an Objective Beta Frequency Peak Detection Algorithm to Inform DBS Programming in Parkinson’s Disease. Neuromodulation: Technology at the Neural Interface. 2024 Oct. doi.org/10.1016/j. neurom.2024.06.364.
Baker SK, Radcliffe EM, Kramer DR, Ojemann S, Case M, Zarns C, Holt-Becker A, Raike RS, Baumgartner AJ, Kern DS, Thompson JA. Comparison of beta peak detection algorithms for data-driven deep brain stimulation programming strategies in Parkinson’s disease. NPJ Parkinsons Dis. 2024 Aug 9;10(1):150. doi: 10.1038/s41531-024-00762-7. PMID: 39122725; PMCID: PMC11315991.
SKULL BASE NEUROSURGERY NEWS
9TH ANNUAL INTERNATIONAL SKULL BASE CONFERENCE, A SUCCESS!
Congratulations to Dr. Samy Youssef, MD, PhD, MSc, FAANS, for hosting the 9th Annual Skull Base Course in November. Faculty from across the globe participated in this prestigious event, held in the Bioscience 3 building at Anschutz. The University of Colorado Hospital Skull Base Program provides advanced, comprehensive care in the Rocky Mountain region for patients with complex skull base tumors, cerebral aneurysms, meningiomas, acoustic neuromas, pituitary tumors, trigeminal neuralgia, and head and neck cancer. The care for such challenging lesions is founded on close multidisciplinary care.
The skull base team consists of collaborative, multidisciplinary providers including neurosurgeons, otolaryngologists, head and neck surgeons, oculoplastic surgeons, oncologists, radiation oncologists, neuropsychologists, and neuropathologists.
Dr. Youssef, who speaks English, Arabic and French is Vice Chairman for Education and Professor of Clinical Neurosurgery and Otolaryngology at CU. He is Program Director of the Skull Base Surgery fellowship at CU, and the Director of Skull Base Surgery. In addition to his many appointments, Dr. Youssef is an Instructor of Microsurgical Anatomy and serves on the Congress of Neurological Surgeons (CNS), and the World Federation of Neurosurgery, Skull Base Committee. For years, he has hosted and lead Annual Masters Courses in Skull Base Surgery at several universities.
DR. YOUSSEF MAKES THE ROUNDS!
Dr. Samy Youssef has been traveling the country the past few months. He was Dissection Faculty and Lecturer, for the Carle Illinois Course: Surgical Exposure of the Cavernous Sinus, July 2024.This was part of the Carle Illinois College of Medicine, University of Illinois, UrbanaChampagne, Illinois. He conducted a lecture at the CNS-SANS Challenge in Houston, Texas in September. He then lectured in September in Houston again: MASSIN: Combined Endoscopic Endonasal and Transcranial Approaches: Useful or Overzealous? And, he was lecturer and dissection faculty at the Emory Skull Base Course in Atlanta, Georgia: Tuberculum Sella Meningiomas, Oct 2024
CURRENT RESEARCH IN SKULL BASE
Gattozzi DA, Hosokawa PW, Martinez-Perez R, Youssef AS. Comparative Anatomy of the Contralateral Transmaxillary Approach Alone and With Ipsilateral Transpterygoid Extension: Quantitative Insights on Surgical Exposure and Maneuverability in the Petroclival Region. Oper Neurosurg (Hagerstown). 2024 Jul 5. doi: 10.1227/ons.0000000000001234. Epub ahead of print. PMID: 38967437.
Olson, MG, Park, TD, Alvarez, R, Hogan EA, Khanna O, Youssef AS. The effect of SARS-CoV-2 on the incidence of post-operative venous sinus thrombosis following skull base procedures. Acta Neurochir 166, 302 (2024). https://doi.org/10.1007/s00701-024-06197-6
Kalmanson O, Olson M, Ovard O, Freeman L, Ung TH, Hogan E, Cass S, Youssef AS, Gubbels S. Factors Affecting Speech Discrimination After Vestibular Schwannoma Resection. Otol Neurotol. 2024 Jul 16. doi: 10.1097/MAO.0000000000004252. Epub ahead of print. PMID: 39010263.
Alvarez R, Khanna O, Youssef AS. How I do it: safe resection of a complex type 3 foramen magnum meningioma with dorsal displacement of the neurovascular bundle. Acta Neurochir (Wien). 2024 Sep 23;166(1):376. doi: 10.1007/s00701-024-06268-8. PMID: 39312005.
Martinez-Perez R, Casanova-Martinez D, Thompson JA, Hirt L, Kortz M, Labib MAM, Razmara A, Youssef AS. Circumferential exposure of the cavernous sinus and parasellar region through a combined open and endoscopic endonasal transcavernous approach, a morphometric study. Acta Neurochir (Wien). 2024 Oct 9;166(1):399. doi: 10.1007/s00701-024-06259-9. PMID: 39382802.
Congratulations to Dr. Robert G. Kowalski, MD, PhD for completing his PhD in the Clinical Science PhD Program (CCTSI) at Anschutz, August 15, 2024
CEREBROVASCULAR CLINICAL FACULTY AT CU ANSCHUTZ
Neurosurgery Inpatient Medical Director
Cerebrovascular Neurosurgeons are often testing new devices and technologies. Currently, there are many being studied.Here are two of the many!
The Pipeline Flex Embolization Device (PED) with Shield Technology (PED-Shield) is a flow diverter stent that’s used to treat intracranial aneurysms: The PED-Shield is a third-generation flow diverter stent that’s designed to reduce platelet adhesion and thrombogenicity. It has a surface modification that’s made by covalently binding phosphorylcholine to the metal struts.
CerebroFlo® EVD Catheter by Integra Health systems is currently being studied for safety and efficacy. The external ventricular drainage (EVD) system uses a catheter (a thin, plastic tube), which is placed in the ventricle of the brain. This is connected to a drainage system outside the body. The drainage system works by using gravity. The EVD systems are commonly used when there is raised intracranial pressure associated with head injuries, subarachnoid hemorrhages, acute hydrocephalus, posterior fossa tumors and meningitis.
RESEARCH IN CEREBROVASCULAR
Morel B, Lester J, Seinfeld J, Roark C, Folzenlogen Z, Case D. Treatment of Bilateral Barrow Type B CarotidCavernous Fistulas with Pipeline Flow-Diverting Stents: A Case Study. J NeuroIntervent Surg 2024;16(Supple 1): A1-A289. Study. Doi: 10.1136/jnis-2024-SNIS.247.
Joshua Seinfeld, MD Professor, Neurosurgery
David Case, MD Associate Professor, Neurosurgery
Christopher Roark, MD Associate Professor,
NEUROSURGICAL CRITICAL CARE NEWS
Congratulations to Dr. Luis Cava. He began a new project this fall entitled “Latin America Outreach in Neurosurgical Critical Care.” Their first session (via zoom) included 100 providers from six different countries. Sessions are to be held twice a month and the neuro critical care team is very excited about the impact they can make!
Arden Bring, long time hockey player, suffers a stroke at age 29. His symptoms included a piercing headache, slurred words, double vision and problems with balance. The number of strokes in people ages 18 to 45 has been growing at a faster rate nationally, than any other age group. Arden returned to hockey less than three months after his stroke.
For the complete article scan here
NEURO CRITICAL CARE INVESTIGATES BIOMARKERS IN MODERATE TO SEVERE TRAUMATIC BRAIN INJURY
Biomarkers are measurements that can indicate the state of a person’s health or response to treatment. They can be used to diagnose or predict the outcome of a condition. In the case of traumatic brain injury (TBI), biomarkers can help clinicians and researchers predict patient outcomes and improve the standard of care. With the help of Jen Maitlen and Terra Ornelas, our clinical research administrators, we have enrolled 161 patients in our new TBI Biomarker study. This includes 72 mild, 27 moderate and 70 severe TBI’s. The study is under the supervision of Aurelie Ledreux, PhD.
Welcome to William Sutton, our newest Advanced Practice Provider (APP) on our Neuro Critical Care Unit. Will moved here from Gainesville, Florida this past summer with his girlfriend, Jenn, and their two dogs. Previously he worked with the burn and surgical ICU at University of Florida, where he completed his PA training. He enjoys rock climbing, live music and watching sports.
Aurelie Ledreux, PhD
Terra Ornelas, RN
Jennifer Maitlen, RN
WELCOME
Aimi Nelson-Sheese,
Associate Professor
Dr. Nelson-Sheese completed her bachelors degree at University of Central Oklahoma and her masters and PhD in clinical psychology at the University of Tulsa. She has been at the University of Nebraska Medical Center for over a decade, serving as Neuropsychology Division Chief, Clinic Director and Fellowship Training Director. Her husband owns three coffee shops and a roastery in Omaha (Archetype Coffee), and last year, he won the National Barista Championship and received 4th place in the World Barista Championship. They are both thrilled to be in Colorado, where they love to hike and be in nature.
PROVIDERS!
Kaitlyn Schodt, Fellow in Neuropsychology
Dr. Schodt Kaitlyn is an Albuquerque native, where she earned her Ph.D. in Clinical Psychology from the University of New Mexico. She then completed a predoctoral internship at Rush University Medical Center. Her research interests broadly include examining the impact of anxiety disorders and PTSD on cognitive functioning; emotion regulation in anxiety disorders; and the role of interpersonal relationships in each of these areas. She is a hiker, baker, traveler and spending time with friends and her cat.
NEUROPSYCHOLOGISTS PRESENT AT ANNUAL AMERICAN ACADEMY OF CLINICAL NEUROPSYCHOLOGY CONFERENCE IN SCOTTSDALE, ARIZONA
K. Brown (Neuropsychology Fellow) –Brown, K.D., Domen, C.H., & Greher, M.R. (2024, June). Expanding the use of the D-KEFS Color Word Interference Test as an Embedded Measure of Performance Validity with Neurologic Patient Populations. Poster presented at the 22nd Annual American Academy of Clinical Neuropsychology Conference, Scottsdale, AZ
STRESS AND YOUR PET!
For the complete article scan here
RESEARCH IN NEUROPSYCHOLOGY
Farrar JE, Stefanos SS, Cava L, Kiser TH, Mueller SW, Neumann R, Reynolds PM, Sherman DS, MacLaren R. Correlation Between Serum and CSF Concentrations of Midazolam and 1-Hydroxy-Midazolam in Critically Ill Neurosurgical Patients. Ann Pharmacother. 2024 Aug 20:10600280241271130. doi: 10.1177/10600280241271130. Epub ahead of print. PMID: 39164827.
CONGRATULATIONS TO THESE RESEARCHERS WHO RECEIVED FUNDING THIS PAST FALL
Lotta E. GranholmBentley, PhD
Robert G. Kowalski, MD PhD
“The INCLUDE Project Down Syndrome Biorepository (DS-Biorepository)”
NIH
Role: Co-Investigator
Grant Dates: 2024-2029
Total Direct Costs: $17,621,616
“Phase I Cell Therapy for Maintaining Cholinergic Circuits in the Spectrum of Alzheimer’s Disease”
Role: Co-investigator with Greg Gerhardt, University of Kentucky
Grant dates: 2024-2029
Total: $2.5 Million
NINDS LRP Grant “Ultraearly cellular, molecular and neuroinflammatory biomarkers in acute ischemic stroke.”
NIH
Role: Principal Investigator
Grant Dates: 2024-2025
Total Direct Costs: $69,500
“Hydrocephalus Association Innovator Award Foundation/NonProfit”
Role: Principal Investigator
Grant Dates: 2025-2026
Total Direct Costs: $50,000
NEUROSURGERY RESEARCHERS BUSY WITH STUDIES ON ALZHEIMERS DISEASE AND ITS OVERLAP WITH DOWN SYNDROME
Ledreux A, Borras C. Editorial: women in molecular mechanisms of aging. Front Aging. Aug 2024. https://doi. org/10.3389/fragi.2024.1471233
Saternos H, Hamlett ED, Guzman S, Head E, Granholm AC, Ledreux A. Unique Pathology in the Locus Coeruleus of Individuals with Down Syndrome. J Alzheimers Dis. 2024;101(2):541-561. doi: 10.3233/JAD240043. PMID: 39213062.
Granholm AC, Larsson L, Öhman F, Zetterberg H, Hansson O, Eriksdotter M, Kern S, Nordberg A. Nya forskningsrön om Alzheimers sjukdom vid Downs syndrom [Dementia in Down syndrome]. Lakartidningen. 2024 Sep 30;121:23083. Swedish. PMID: 39354735.
Aldecoa I, Barroeta I, Carroll SL, Fortea J, Gilmore A, Ginsberg SD, Guzman SJ, Hamlett ED, Head E, Perez SE, Potter H, Molina-Porcel L, Raha-Chowdhury R, Wisniewski T, Yong WH, Zaman S, Ghosh S, Mufson EJ, Granholm AC. Down Syndrome Biobank Consortium: A perspective. Alzheimers Dement. 2024 Mar;20(3):2262-2272. doi: 10.1002/alz.13692. Epub 2024 Jan 25. PMID: 38270275; PMCID: PMC10984425. Impact factor: 13.
Granholm AC, Englund E, Gilmore A, Head E, Yong WH, Perez SE, Guzman SJ, Hamlett ED, Mufson EJ. Neuropathological findings in Down syndrome, Alzheimer’s disease and control patients with and without SARS-COV-2: preliminary findings. Acta Neuropathol. 2024 May 27;147(1):92. doi: 10.1007/s00401-02402743-9. PMID: 38801558; PMCID: PMC11130011. Impact factor: 16.6.
Mohammed Alshareef, MD
Granholm AC, Hamlett ED. The Role of Tau Pathology in Alzheimer’s Disease and Down Syndrome. J Clin Med. 2024 Feb 27;13(5):1338. doi: 10.3390/jcm13051338. PMID: 38592182; PMCID: PMC10932364.
Granholm AC, Larsson L, Öhman F, Zetterberg H, Hansson O, Eriksdotter M, Kern S, Nordberg A. Nya forskningsrön om Alzheimers sjukdom vid Downs syndrom [Dementia in Down syndrome]. Lakartidningen. 2024 Sep 30;121:23083. Swedish. PMID: 39354735.
Saternos H, Hamlett ED, Guzman S, Head E, Granholm AC, Ledreux A. Unique Pathology in the Locus Coeruleus of Individuals with Down Syndrome. J Alzheimers Dis. 2024;101(2):541-561. doi: 10.3233/JAD240043. PMID: 39213062.
Wohlfert AJ, Phares J, Granholm AC. The mTOR Pathway: A Common Link Between Alzheimer’s Disease and Down Syndrome. J Clin Med. 2024 Oct 17;13(20):6183. doi: 10.3390/jcm13206183. PMID: 39458132; PMCID: PMC11508835.
GENERAL NEUROSURGERY NEWS
TRAINEE ACCOMPLISHMENTS
Hannah Saternos (Ledreux Lab) – New Grant: Ciliary involvement in the progression of Alzheimer’s disease in Down syndrome
Selection to give oral presentation at NSUR Glenn Kindt Research Day
Ahmed Helal, MD PGYIV and Reinier Alvarez, MD
PGYIV won the Resident SANS Challenge, Sep 2024, Houston, TX (pics – helal & Alvarez)
Brittany Crowley (Neuropsychology Fellow) – Crowley, B.Z., Molden, J., Riggs, K., Wodushek, T., & Domen, C.H. (2024, February) Utility of the Rey Auditory Verbal Learning Test for Identifying Left and Right Temporal Lobe Epilepsy Using the Mayo Normative Studies Norms. Poster presented at the 52nd Annual Conference of the International Neuropsychological Society, New York, NY.
NEUROSURGERY RESIDENT GIVES OVERVIEW OF EMERGING TECHNOLOGIES AND INNOVATIONS!
Congratulations to Michael Ohene-Adhei, MD – a xxx year resident in our Neurosurgical Residency Program. Recently, he gave an excellent overview of existing and new technologies and innovations in Neurosurgery. He included the history of these technologies:
• Endoscope ~1910 (Alfred Hirschmann)
• Neuro IR technique ~1920s (Egas Moniz)
• Microscope ~1920s (Gunnar Holmgren)
• Radiosurgery ~1950s ( Lars Leksel)
• CT ~1970s (Allan MacLeod &Cormack Hounsfield)
• MRI ~ 1970s (• Paul C. Lauterbur)
• DBS ~ 1980s (Alim-Louis Benabid)
• Surgical Robots 2000s (MAZOR, ROSA)
Dr. Ohene-Adjei’s very well organized topics included Artificial Intelligence (Machine Learning and Deep Learning/Neural Networks), Virtual and Augmented Reality (Preoperative planning, intraoperative, and educational uses), and Brain Interfaces (invasive vs. partially invasive).
In addition to extensive information about the uses and limitations in each of these topic areas, he presented a diagram that (for laypeople) illustrates the differences in these various types of learning.
CU ANSCHUTZ SCIENTISTS ON NEW APPROACHES TO DBS
CU Anschutz scientists recently published a study on the new approaches to DBS in the journal NPJ Parkinson’s Disease. Researchers include: John Thompson, PhD, associate professor in the departments of Neurosurgery and Neurology at the University of Colorado School of Medicine; Sunderland Baker, a Boettcher Scholar and Colorado College alum, now a PhD candidate in Biobehavioral Health at Penn State University; and Drew S. Kern, MD, MS, FAAN, co-director of the deep brain stimulation and advanced therapies in movement disorders programs and associate professor of the Movement Disorders Center in the departments of Neurology and Neurosurgery at the CU School of Medicine. Their study added to research calling for a more general, objective strategy to detect beta peaks more easily. This work could help under-resourced clinics around the world as well as telemedicine by providing an efficient, computerized approach for streamlining DBS. More than 180,000 people worldwide could benefit from these improvements.
Departments
John Thompson, PhD
Associate Professor, Departments of Neurosurgery & Neurology
Drew Kern, MD, MS, FAAN
Associate Professor of Movement Disorders
For the complete article scan here
CONGRATULATIONS TO THESE NEUROSURGERY FACULTY MEMBERS WHO HAVE RECENTLY BEEN PROMOTED!
Robert G. Kowalski, MD PhD
Promoted to Assistant Professor October 16, 2024
Michael Greher, PhD
Promoted to Professor, July 1, 2024
Muhammad Riaz, MD Promoted to Associate Professor, July 1, 2024
Allyson Alexander, MD,PhD
Promoted to Associate Professor, July 1, 2024
Cristin Welle, PhD Promoted to Professor with Tenure, July 1, 2024
Corbett Wilkinson, MD
Promoted to Professor, July 1, 2024
Steven Ojemann, MD Promoted to Professor July 1, 2024
CONGRATULATIONS TO OUR ADVANCED PRACTICE PROVIDERS!
The following nurse practitioners and physician assistants have been promoted to senior instructor! We could not do what we do without these gifted and committed individuals. Congratulations to:
Lawrence Cloutier, PA-C
Jennifer Coffman, DNP, JD, APRN, CPNP-AC
Jodi Sagastume, PA-C
Marisa Marsolek, PA-C
Michelle DeGrave, PA-C
Atsuhiro Saisho, PA-C
WELCOME TO OUR NEW ADMIN STAFF
Erica Scholl is a Florida native who began as an Education Coordinator this past summer. Prior to relocating to Denver (from Flagstaff, AZ) she served as an elementary school teacher where she excelled at juggling multiple tasks, personalities, and raising academic standards. Her stepmother is a neurosurgeon practicing in Ocala, FL, so Erica knows a bit about our culture. She enjoys hiking and camping –and summited her first 14-er in August!
CU NEUROSURGERY MAKES A SPLASH AT THE ANNUAL FALL BLOCK PARTY!
Every year, the various schools on the campus of Anschutz Medical Campus throw a “Block Party” where students, faculty and the general community can learn more about the various programs and departments offered on the campus. Thanks to our excellent admin team, CU Department of Neurosurgery was in the midst of all the action! We handed out stress relieving “squishy brains,” information about enrolling clinical trials, notepads, and general information about our department. Many thanks to all who participated!
A warm welcome to Sarah Williams, who has joined our administrative team in support of our researchers! Sarah has worked at CU in research and grant management for 21 years. She has hit the ground running and has already met almost every neurosurgical researcher! She enjoys horseback riding, hiking, camping, snowboarding and spending time with family. Her current extracurricular goal is to continue hiking another segment of the Colorado Trail with her mom. Their hope to finish the entire trail in the next couple of years.
OTHER CONGRATULATIONS!
We wish a very happy marriage to Keshari Shrestha, MD, Level III Neurosurgery Resident. She was married in September to Garrison Kalvin, a mechanical engineer. She is pictured here, at the wedding, with her fellow residents!
Or donate on the CU Anschutz Advancement Website: https://www.givecampus.com/campaigns/47715/donations/new?a=8404041 Please designate your gift to the CU Neurosurgery Department
If you have trouble navigating the site, or have a specific neurosurgery fund for which you want your donation to be placed, please call or email Tami Lack, Director of Strategic Planning for the department: (303) 907 8977 Tami.Lack@cuanschutz.edu
