Neurosurgery in Minnesota

Research

Novel techniques, protocols and technical advances in neurosurgery are attributable, at some point, to our research and development in this area. Our investigation includes both bench science research and clinical research through the care and interaction with patients. Many of our laboratory discoveries have been translated into technologic and therapeutic advances and integrated into clinical trials and patient care.

Neuroscience in the Department of Neurosurgery focuses on brain disease and injury, with the goals of preventing and repairing damage caused by stroke, cancer, trauma and neurodegenerative diseases. Strong collaborations between basic scientists and scientist-clinicians are making this our most productive and promising era of basic research.

Particular strengths of the Department of Neurosurgery have included research in traumatic brain injury; awake brain surgery; sterotactic and functional neurosurgery; neuro-oncology; cerebrovascular and skull base neurosurgery; pain; brachial plexus and peripheral nerve disorders; and spine and spinal disorders.

Our neurosurgeons have authored or co-authored thousands of clinical articles and research papers on neuroscience and neurosurgical conditions and treatments, a testimony to the department's long-standing commitment to medical inquiry.

There continues to be a great need for continued research efforts, particularly to elucidate the mechanisms of neurological disease and treatment. Operative advances will continue to improve the care and treatment of patients with neurosurgical disease.

Ongoing research efforts include laboratory studies of the mechanics of neurological disease, as well as clinical and epidemiological research, drawing from more than 100 years of Mayo Clinic patient records.

Although research themes vary across the labs, all efforts are focused on the causes and cures of brain disease and
injury — with clear implications for practice in the clinic and operating room.

Neurosurgical Oncology Laboratory

Here, researchers focus on the cellular and immunological characteristics of malignant brain tumors. Particular areas of interest include immunotherapy, brain tumor stem cells, and mouse models of malignant gliomas.

This laboratory has demonstrated that an interrelated cellular network mediates immunosuppression in malignant glioma patients including glioma cells (differentiated and stem cell phenotypes), tumor-infiltrating monocytes/microglia, circulating myeloid-derived suppressor cells, and regulatory T cells. Multiple molecular mechanisms contribute to these cells' effects, but evidence from our lab has implicated a central role for the immunosuppressive T cell costimulatory molecule homologue B7-H1. Much of our work is aimed at disrupting this network to facilitate immunotherapies and develop appropriate murine models of glioma-mediated immunosuppression to allow pre-clinical testing.

A major aim of our work is to translate discoveries to the clinic through glioma vaccine clinical trials, an effort that is facilitated by the presence of a GMP ("Good Manufacturing Practices") laboratory for generating clinical grade cellular therapy reagents. We also work closely with other members of the Mayo Clinic Brain SPORE (Specialized Program of Research Excellence). Only three "Brain" SPOREs have been awarded nationwide, underscoring the Mayo Clinic's exceptional capacity to perform translational research in neuro-oncology.

Also see Neuro-oncology research program

Neurosurgery Regenerative Laboratory

This group engages in advanced research in regenerative neuroscience from the molecular to cell biological and integrative levels. Specific topics under investigation include:

• Molecular analysis of receptors and signal transduction mechanisms
• Axon guidance, target recognition and regeneration
• Formation and plasticity of synapses
• Control of neural cell fate
• Development of neural networks
• Regulation of glioma cell motility
• Mechanisms controlling vascular development and regeneration.

The lab offers an integrated approach to training in modern neurobiology, utilizing molecular, biochemical and cell biological techniques, as well as advanced optical imaging. Members of this lab have the opportunity to work closely with the Mayo's Spinal Cord Injury Research team.

Also see Developmental and regenerative neurobiology

Deep Brain Stimulation Laboratory

High-frequency deep brain stimulation (DBS) is an effective treatment for Parkinson's disease, tremor, epilepsy, dystonia, and depression. However, the precise mechanisms of action for the therapeutic effects of DBS are unknown.

Because both DBS and lesionectomy target similar brain regions, many researchers believe that electrical stimulation works through neuronal inhibition. However, this lab has found that DBS results in excitation of neuronal and glial elements, suggesting that electrically excited neurotransmitter release may be the mechanism of action of DBS. Accordingly, our lab is studying how DBS effects changes in neuronal action potential firing and modifies neural network activities. To study the mechanism of action of DBS, we perform fluorescent microscopy along with intra-cellular and extra-cellular electrophysiologic recordings.

In addition, our lab also utilizes electrochemical techniques of constant potential amperometry to measure neurotransmitter levels both in the in vivo and in vitro settings. Through this research, our lab hopes to combine sophisticated electrophysiological recordings with miniaturized analytical elements (micropressors) to augment and repair disrupted brain functions. Thus, we are actively involved with biomedical engineers to develop the next generation of deep brain stimulation devices.

Multidisciplinary Neural Regeneration Laboratory

Research are developing synthetic polymeric scaffolds and controlled delivery methods of bioactive molecules for peripheral nerve and spinal cord repair and regeneration. This NIH-funded research endeavor combines strong collaborative efforts of neurosurgeons, neuroscientists, orthopedists, tissue engineers and cellular neurobiologists, and polymer chemists.

The goal is to commercialize biodegradable conduits for clinical use.