Functional neurosurgery program places emphasis on 'function'

Gamma Knife
Advanced technology, such as the Gamma Knife (pictured), allows UTSW physicians to use minimally invasive techniques to lessen the symptoms of many brain and spinal-cord tumors.

Combining advanced technology, leading-edge surgical techniques, and an extraordinarily multidisciplinarian approach, the team of experts in UT Southwestern’s Functional and Stereotactic Neurosurgery Program routinely performs medical feats that not long ago would have been relegated to the realm of science fiction.

Patients referred to the Program, whether for movement disorders, chronic pain, depression, epilepsy, or other neurological and psychiatric conditions, typically have been through all that medical therapy offers yet still suffer the symptoms of their disease.

Now, though, using minimally invasive techniques, UTSW physicians often are able to lessen the symptoms of many brain and spinal-cord disorders, bringing relief and hope to those previously considered untreatable with surgery.

“Unlike traditional neurosurgery, which is aimed at repairing damaged structures or removing tumors or foreign bodies, functional neurosurgery focuses on restoring the function of the nervous system,” says Tony Whitworth, M.D., the Program’s Director.

Pathway to recovery

“What sets our program apart from those at other medical centers is found in the depth of our expertise and in how very, very extensive our planning and testing are for any procedure,” says Shilpa Chitnis, M.D., Ph.D., Associate Professor of Neurology and Neurotherapeutics and one of four fellowship-trained movement disorder neurologists who are part of a multidisciplinary team its members call the “Neuromodulation Network.”

Other members include a fellowship-trained functional neurosurgeon, two psychologists, a psychiatrist, speech-language and ear/nose/throat doctors, physical management and rehabilitation doctors, speech therapists, physical therapists, and nurse specialists.

“Ours is a well-established and formal program,” Dr. Chitnis says. “For example, when a patient with Parkinson’s disease, essential tremor, or dystonia is referred for potential deep-brain stimulation, we enter that patient into what we call the neuromodulation pathway. What that generally entails is our comprehensive network of specialists doing very detailed neuropsychological testing to see whether there’s any cognitive dysfunction and whether the patient is, in general, a good candidate.”

The neuromodulation pathway for epilepsy patients—another part of the Functional Neurosurgery Program—is similar.

“About a third of epilepsy patients will never be controlled with medicine. For those patients, we need to work with these alternative therapies, such as surgery or device implants,” says Paul Van Ness, M.D., Director of UTSW’s Epilepsy Program. “Outcomes depend on location, resection of a lesion, and the pathology.”

Primary testing site

Physicians in UTSW’s Functional and Stereotactic Neurosurgery Program are continually involved in groundbreaking clinical trials and research. Among those, UTSW will soon be a primary testing site for studies in targeted plasticity, a new procedure that uses vagus nerve stimulation of the brain as a therapeutic alternative to invasive brain surgery for a wide range of disorders, including tinnitus, chronic pain, stroke, and Alzheimer’s disease.