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Neurosurgical Research

Celebrating 75 Years of NINDS: The Legacy and Impact of the Surgical Neurology Branch

By Medical Innovation, Medical ResearchNo Comments

This year marks the 75th anniversary of the National Institute of Neurological Disorders and Stroke (NINDS), a monumental milestone that offers an opportunity to reflect on its remarkable contributions to neurology and human neuroscience. Among the many significant components of NINDS, the Surgical Neurology Branch (SNB) stands out for its pioneering advancements and transformative impact on the treatment of neurological disorders. Established with the vision of integrating surgical techniques with neurological research, the SNB has played an instrumental role in shaping modern neurosurgery and advancing human neuroscience.

The SNB was established to address the growing need for specialized surgical interventions in the treatment of neurological disorders. Over the years, the SNB has become synonymous with innovation, spearheading groundbreaking research and developing novel surgical techniques that have revolutionized patient care. This translational approach, integral to the SNB, has led to significant advancements in the understanding and treatment of a wide range of neurological conditions. Many dedicated SNB clinician-investigators and basic scientists, including Maitland Baldwin, Igor Klatzo, John M. Van Buren, Ayub K. Ommaya, Richard J. Youle, Edward H. Oldfield, and Russell R. Lonser, have made significant advancements in understanding and treating various neuropathological conditions, including brain tumors, epilepsy, spinal cord injuries, and movement disorders. Their work has provided fundamental insights for delineating differences between cytotoxic and vasogenic edema, advancing treatments for Cushing disease, studying the effects of vascular endothelial growth factor, developing new methods for central nervous system drug delivery, and understanding the underlying pathophysiology and biology of familial tumor syndromes and malignant gliomas.

By fostering an innovative environment that bridges the gap between laboratory research and clinical practice, the SNB has been at the forefront of medical breakthroughs that have improved the lives of countless patients. This commitment to patient-centered care is central to the SNB’s mission. It is reflected in its focus on conducting cutting-edge research and clinical trials aimed at developing new treatments for neurological disorders, as well as translating basic scientific discoveries to the bedside. The branch is dedicated to providing compassionate, individualized treatment plans that address the unique needs of each patient evaluated and treated at the NIH Clinical Center, the world’s largest hospital dedicated solely to clinical research. This approach involves close collaboration between neurosurgeons, neurologists, radiologists, and other healthcare professionals to ensure that patients receive comprehensive, multidisciplinary care. The SNB also places a strong emphasis on patient education and empowerment. By providing patients and their families with detailed information about their condition and treatment options, the SNB helps them make informed decisions about their care. This patient-centered approach not only improves clinical outcomes but also enhances the overall patient experience.

An equally critical component of the SNB’s mission is to train and mentor the next generation of neurosurgeons. Over its history, dozens of former fellows and staff have gone on to become leaders of academic neurosurgery and chairs of neurosurgical departments. In 2010, the SNB further solidified its commitment to education by developing a residency-training program in neurological surgery. This program is designed to provide comprehensive training that encompasses clinical excellence, research acumen, and innovative thinking. By integrating rigorous clinical training with robust research opportunities, the SNB residency program aims to produce neurosurgeons who are well-equipped to tackle the complexities of neurological disorders and contribute to the advancement of neurosurgery. The SNB’s commitment to education also extends beyond its training program, with faculty members regularly participating in national and international conferences, workshops, and symposia. These efforts ensure that the latest advancements in neurosurgery are disseminated widely, fostering a global community of practitioners who are equipped with the knowledge and skills to provide the highest standard of care.

As NINDS celebrates its 75th anniversary, the SNB remains committed to advancing the fields of neurosurgery and human neuroscience through innovative research, education, and patient care. The future holds exciting possibilities, with ongoing research into new surgical techniques, neurotechnologies, and therapeutic approaches that have the potential to further transform the treatment of neurological disorders. The SNB’s legacy of excellence and innovation serves as a testament to the vision and dedication of its founders as well as the many talented individuals who have contributed to its success over the years. As we look ahead to the next 75 years, the SNB will continue to play a central role in shaping modern neurosurgery and advancing human neuroscience, paving the way for discoveries and treatments that will improve the lives of patients around the world.

Kareem A. Zaghloul, MD, PhD
National Institute of Neurological Disorders and Stroke, National Institutes of Health
Bethesda, Md.

Career Development in Neurosurgery Research for Medical Students, Residents and Young Neurosurgeons: From Finding Mentorship to Starting and Funding a Lab

By CareerNo Comments

Research has always been integral to the field of neurosurgery. Its purpose is to improve patient treatment paradigms and stimulate innovation. Given these efforts, an emphasis on research quality and productivity has become a minimal requirement to enter and progress in academic neurosurgery. However, the barrier to entry in neurosurgery research remains relatively high for medical students, neurosurgery residents and young neurosurgeons — which may be prohibitive for academic progress. Providing transparency in the research process is a necessary step in reducing the barriers that have been formed.

At all stages of training, the most crucial factor for successful research is mentorship. Identifying the right mentor can open many doors in research and career development. Who is the “right mentor” in research? This person understands the landscape and can provide opportunities that support and guide you to achieve your goals. The right mentor is not given but is sought after. As the emphasis on research continues to increase, so does the average number of publications for matched neurosurgery applicants. Therefore, identifying a mentor where there is a mutual benefit is necessary. Utilizing Pubmed and Google Scholar can provide insight into the type of publications produced through the department of neurosurgery and, more importantly, who is publishing. This can be a resident, attending or research faculty. Once identified, you can reach out with the intention that you will allocate time and effort to completing the projects provided. Not everyone who publishes is a good mentor. However, having a track record of publication is essential and a good start in identifying a potential mentor. Once established, medical student-specific grants such as the American Association of Neurological Surgeons (AANS) Neurosurgery Research & Education Foundation (NREF) Medical Student Summer Research Fellowship can be accessed.

For neurosurgery residents, your stage in training will drive who you seek out for mentorship. Most residents have performed some research before residency to be competitive enough to match. Matching in a program different from where you did medical school can feel like starting over. If undecided on a subspecialty, a similar process can be done using Pubmed and Google Scholar to identify an initial research mentor. If you have decided on a subspecialty, concentrating research efforts with mentors of that subspecialty may be more advantageous. Many programs have created protected research time within the 7-year residency, ensuring a dedicated approach to research can be pursued, especially in translational/basic science laboratories. The process of publishing includes collecting and analyzing data, manuscript writing and submission. It is vital to identify the ways to make this process more efficient. Incorporating medical students and research fellows in the various steps can allow greater productivity and the development of mentoring skills in research. Creating this track record as a resident can open doors with your mentor to apply for research grants. These grants can be funded by:

  • National Institutes of Health, such as R25 (National Institute of Neurological Disorders and Stroke), F32 and T32 training grants;
  • Society grants such as NREF; and
  • Subspecialty society grants.

Establishing your research interests and track record during residency opens doors to these various grant opportunities. As a young attending neurosurgeon, building upon the foundation established during residency can help continue the academic progression with starting your lab. If your residency wasn’t as productive in terms of publications, then utilizing mentors to help create a research laboratory will be key. Advice given to young attending neurosurgeons is to start early and ask questions that you want answered. Once you’ve identified what you want to pursue, then accessing supportive programs to help you is the next step.

Along with society grants mentioned above, other available grants include fellowship grants, early career grants (e.g., AANS Young Clinician Investigator Award), industry-sponsored grants, and foundational grants. One program that has gained interest in early career neurosurgeons is the K12 Neurosurgeon Research Career Development Program, which is intended for junior neurosurgeon faculty to mentor and facilitate advanced research career development. Utilizing institutional resources such as the grants office and collaborators can help jumpstart your academic career in research.

While this is an overview of early career development, everyone’s academic neurosurgery path may differ. All paths have one element in common: finding good mentorship. As you climb the academic ladder, you should also consider giving back to the field by mentoring the next generation.

Editor’s Note: We hope you will share what you learn from our posts in the Making and Maintaining a Neurosurgeon series. We invite you to join the conversation on Twitter by following @Neurosurgery and using the hashtag #Neurosurgery.

Aladine A. Elsamadicy, MD
Yale Department of Neurosurgery
New Haven, Conn.