Expanding the Boundaries of Neurosurgical Care: Recent Advances Give Patients New Hope

Robert E. Gross, MD, PhD

(Credit: RWJBarnabas Health)

Several exciting neurosurgical advances enable surgeons to more precisely and effectively treat neurological conditions such as brain tumors, epilepsy, and Parkinson Disease, giving patients new hope and a chance for more successful outcomes. According to Robert Gross, MD, PhD, senior vice president of neurological services at RWJBarnabas Health, there has been a wide range of innovations in the areas of imaging and mapping, the use of robotic assistants and extended reality (the combination of real and virtual environments using computer technology).

Among the future advances Gross, who also serves as the chair of the Department of Neurosurgery at Rutgers Robert Wood Johnson Medical School and Rutgers New Jersey Medical School, is looking forward to is the integration of functional brain networks developed by the National Institutes of Health Human Connectome Project. The goal of the project is to map the neural pathways that underly human brain function and acquire and share data about the structural and functional connectivity of the human brain.

"This information helps us maximize the balance between treating a tumor and maintaining function, or onco-functional balance, for our brain tumor patients,” Gross said to NeurologyLive^®. "Connectomics has widespread applications in brain tumor, epilepsy, Parkinson, depression, OCD, addiction and other disorders."

RWJBarnabas Health has also deployed 2 new, minimally invasive technologies to aid neurosurgeons in treating patients with epilepsy, movement disorders, and other neurological conditions. The ClearPoint Navigation System and ROSA ONE Brain system are designed to enhance the precision and efficacy of neurosurgery. The technologies are currently being used at RWJUH in New Brunswick. "Adding robotic assistants (such as ROSA) to our collection of frame-based and frameless stereotactic instruments increases the effectiveness and accuracy of stereotactic brain biopsy, device implantation, and treatment delivery," Gross noted.

Intraoperative and extraoperative electrical stimulation for functional brain mapping also shows great promise. “One that we are developing involves ‘temporal interference’ that can deliver brain stimulation anywhere in the brain non-invasively,” Gross explained. Extended reality is another imaging innovation that allows patients, family members, and treating physicians to share the 3-D view of the brain to better visualize brain tumors and brain pathways impacted by them. Artificial Intelligence (AI) has significantly impacted many disciplines, including neurosurgery and stroke treatment.

“Using AI predictive models, we can expand the treatment window for stroke and successfully treat more patients based on perfusion changes in the brain, which the AI system recognizes,” Gross explained. “We are essentially treating two to three times the number of stroke patients now with the help of AI compared to what we were doing 10 years ago.”

AI is being integrated into neuroendovascular surgery for better decision-making in areas such as stroke triage, improving diagnostic accuracy with imaging, and optimizing procedural planning for aneurysm and AVM treatment. “These advances significantly reduce the need for open surgeries, decrease recovery times, and improve patient outcomes,” Gross said.

Robert E. Gross, MD, PhD, a renowned neurosurgeon who has led collaborative teams of clinician-scientists in the pursuit of improving the quality of life for patients with neurological and psychiatric disorders, currently serves as senior vice president of neurological services at RWJBarnabas Health and chair of the Department of Neurosurgery at Rutgers Robert Wood Johnson Medical School and Rutgers New Jersey Medical School. Gross is an expert in neuromodulation and employing innovative techniques that use electrical impulses to target nerves within the brain, lessening life-altering symptoms of severe disorders, including epilepsy, Parkinson disease, depression, and others.