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Article ; Online: Letter to the Editor. Integrating approaches in motor speech mapping.

Silverstein, Justin W / Shah, Harshal A / D'Amico, Randy S

2024 , Page(s) 1–2

Language	English
Publishing date	2024-04-12
Publishing country	United States
Document type	Journal Article ; Letter
ZDB-ID	3089-2
ISSN	1933-0693 ; 0022-3085
ISSN (online)	1933-0693
ISSN	0022-3085
DOI	10.3171/2024.1.JNS24165
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Article ; Online: In Reply: I Asked a ChatGPT to Write an Editorial About How We Can Incorporate Chatbots Into Neurosurgical Research and Patient Care….

D'Amico, Randy S / Shah, Harshal A / Langer, David J

Neurosurgery

2023 Volume 93, Issue 4, Page(s) e109

MeSH term(s)	Humans ; Patient Care ; Writing
Language	English
Publishing date	2023-07-20
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/neu.0000000000002620
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Zs.A 1424: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Sonodynamic Therapy and Sonosensitizers for Glioma Treatment: A Systematic Qualitative Review.

Mehta, Neel H / Shah, Harshal A / D'Amico, Randy S

World neurosurgery

2023 Volume 178, Page(s) 60–68

Abstract: Sonodynamic therapy (SDT) has emerged as an encouraging noninvasive technique that uses ultrasound to activate targeted agents to induce antitumor effects for the treatment of glioma. With extensive variation in the types of sonosensitizers, protocols ... ...

Abstract	Sonodynamic therapy (SDT) has emerged as an encouraging noninvasive technique that uses ultrasound to activate targeted agents to induce antitumor effects for the treatment of glioma. With extensive variation in the types of sonosensitizers, protocols for sonication, and model systems, a comprehensive overview of existing preclinical data on the efficacy of SDT in glioma treatment is warranted. Here, we conduct a systematic review of preclinical and early clinical literature on implementing SDT to treat in vitro and in vivo models of glioma. Our findings suggest that coupling sonosensitizers such as 5-aminolevulinic acid, hematoporphyrin monomethyl ether, and sinoporphyrin sodium with focused ultrasound induces robust cytotoxic activity in tumor cells (in vitro and in vivo). These effects are likely mediated by the oxidative stress induced by reactive oxygen species production, apoptotic signaling cascades, and intracellular calcium overload. Future research is needed to better understand the biochemical and mechanistic properties of SDT, and ongoing trials may help elucidate the clinical feasibility of glioma treatment with optimized sonically activated treatments.
MeSH term(s)	Humans ; Ultrasonic Therapy/methods ; Glioma/therapy ; Glioma/drug therapy ; Aminolevulinic Acid/pharmacology ; Apoptosis ; Reactive Oxygen Species ; Antineoplastic Agents/therapeutic use ; Antineoplastic Agents/pharmacology ; Cell Line, Tumor
Chemical Substances	Aminolevulinic Acid (88755TAZ87) ; Reactive Oxygen Species ; Antineoplastic Agents
Language	English
Publishing date	2023-07-15
Publishing country	United States
Document type	Systematic Review ; Journal Article ; Review
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2023.07.030
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Article ; Online: Why are clinical trials of deep brain stimulation terminated? An analysis of clinicaltrials.gov.

Mishra, Akash / Begley, Sabrina L / Shah, Harshal A / Santhumayor, Brandon A / Ramdhani, Ritesh A / Fenoy, Albert J / Schulder, Michael

World neurosurgery: X

2024 Volume 23, Page(s) 100378

Abstract: Background: Although deep brain stimulation (DBS) has established uses for patients with movement disorders and epilepsy, it is under consideration for a wide range of neurologic and neuropsychiatric conditions.: Objective: To review successful and ... ...

Abstract	Background: Although deep brain stimulation (DBS) has established uses for patients with movement disorders and epilepsy, it is under consideration for a wide range of neurologic and neuropsychiatric conditions. Objective: To review successful and unsuccessful DBS clinical trials and identify factors associated with early trial termination. Methods: The ClinicalTrials.gov database was screened for all studies related to DBS. Information regarding condition of interest, study aim, trial design, trial success, and, if applicable, reason for failure was collected. Trials were compared and logistic regression was utilized to identify independent factors associated with trial termination. Results: Of 325 identified trials, 79.7% were successful and 20.3% unsuccessful. Patient recruitment, sponsor decision, and device issues were the most cited reasons for termination. 242 trials (74.5%) were interventional with 78.1% successful. There was a statistically significant difference between successful and unsuccessful trials in number of funding sources ( Conclusion: One in five clinical trials for DBS were found to be unsuccessful, most commonly due to patient recruitment difficulties. The source of funding was the only factor associated with trial success. As DBS research continues to grow, understanding the current state of clinical trials will help design successful future studies, thereby minimizing futile expenditures of time, cost, and patient engagement.
Language	English
Publishing date	2024-04-03
Publishing country	United States
Document type	Journal Article
ISSN	2590-1397
ISSN (online)	2590-1397
DOI	10.1016/j.wnsx.2024.100378
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Article: Neuromonitoring Guided Vessel Identification in Iatrogenic Arterial Injury During Meningioma Resection.

Silverstein, Justin W / Shah, Harshal A / Ellis, Jason A / D'Amico, Randy S

The Neurodiagnostic journal

2023 Volume 63, Issue 1, Page(s) 47–57

Abstract: Neuromonitoring is commonly used in neurosurgery and allows intraoperative assessment of functional pathways in the brain during surgery. Monitoring alerts can guide surgical decision making in real-time allowing surgeons to mitigate or avoid potential ... ...

Abstract	Neuromonitoring is commonly used in neurosurgery and allows intraoperative assessment of functional pathways in the brain during surgery. Monitoring alerts can guide surgical decision making in real-time allowing surgeons to mitigate or avoid potential iatrogenic injury and subsequent postoperative neurologic sequelae that may result from cerebral ischemia or malperfusion. Here we present a case of a patient undergoing a right pterional craniotomy for the resection of a tumor which crosses midline with multimodal intraoperative neuromonitoring including somatosensory evoked potentials, transcranial motor evoked potentials, and visual evoked potentials. During the final portion of tumor resection, arterial bleeding was noted of unknown origin shortly followed by loss of right lower extremity motor evoked potential recordings. Motor evoked potential recordings in the right upper, and left upper and lower extremities were stable, as well as all somatosensory evoked potentials and visual evoked potentials. This distinct pattern of right lower extremity motor-evoked potential loss suggested compromise of the contralateral anterior cerebral artery and guided the surgeons to a rapid intervention. The patient awoke from surgery with moderate postoperative weakness in the affected limb that resolved to preoperative status by postoperative day 2, and back to normal strength prior to three-month follow-up. In this case the neuromonitoring data suggested compromise to the contralateral anterior cerebral artery which guided the surgeons to investigate and identify the site of vascular injury. The present case reinforces the utility of neuromonitoring in emergent surgical situations to guide surgical decision making.
MeSH term(s)	Humans ; Vascular System Injuries ; Meningioma/surgery ; Evoked Potentials, Visual ; Monitoring, Intraoperative ; Evoked Potentials, Motor/physiology ; Meningeal Neoplasms/surgery ; Iatrogenic Disease/prevention & control ; Retrospective Studies
Language	English
Publishing date	2023-03-20
Publishing country	United States
Document type	Case Reports ; Journal Article
ZDB-ID	2663639-6
ISSN	2375-8627 ; 2164-6821
ISSN (online)	2375-8627
ISSN	2164-6821
DOI	10.1080/21646821.2023.2168971
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Article ; Online: I Asked a ChatGPT to Write an Editorial About How We Can Incorporate Chatbots Into Neurosurgical Research and Patient Care….

D'Amico, Randy S / White, Timothy G / Shah, Harshal A / Langer, David J

Neurosurgery

2023 Volume 92, Issue 4, Page(s) 663–664

MeSH term(s)	Humans ; Patient Care ; Writing
Language	English
Publishing date	2023-02-09
Publishing country	United States
Document type	Editorial
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/neu.0000000000002414
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Zs.A 1424: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 539: Show issues

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Article ; Online: In Reply: I Asked a ChatGPT to Write an Editorial About How We Can Incorporate Chatbots Into Neurosurgical Research and Patient Care….

D'Amico, Randy S / White, Timothy G / Shah, Harshal A / Langer, David J

Neurosurgery

2023 Volume 93, Issue 3, Page(s) e78

MeSH term(s)	Humans ; Patient Care ; Writing
Language	English
Publishing date	2023-06-28
Publishing country	United States
Document type	Journal Article ; Comment
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/neu.0000000000002589
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Zs.A 1424: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Influence of Preoperative Motor Score and Patient Comorbidities on Transcranial Motor-Evoked Potential Acquisition in Intracranial Surgery: A Retrospective Cohort Study.

Chen, Adrian C / Shah, Harshal A / Vilaysom, Sabena / Ryan, Casey / Kruse, Aaron / D'Amico, Randy S / Silverstein, Justin W

Neurosurgery

2024

Abstract: Background and objectives: Intraoperative neurophysiological monitoring plays a pivotal role in modern neurosurgery, aiding in real-time assessment of eloquent neural structures to mitigate iatrogenic neural injury. This study represents the largest ... ...

Abstract	Background and objectives: Intraoperative neurophysiological monitoring plays a pivotal role in modern neurosurgery, aiding in real-time assessment of eloquent neural structures to mitigate iatrogenic neural injury. This study represents the largest retrospective series to date in monitoring corticospinal tract integrity during intracranial surgery with transcranial motor-evoked potentials (TCMEPs), focusing on the influence of demographic factors, comorbidities, and preoperative motor deficits on the reliability of intraoperative neurophysiological monitoring. While the impact of patient-specific factors affecting TCMEP monitoring in spine surgery is well-documented, similar insights for intracranial surgery are lacking. Methods: A total of 420 craniotomy patients were retrospectively analyzed from electronic medical records from December 2017 to February 2023, excluding patients without preoperative Medical Research Council scores or medical histories. Using intrinsic hand muscles as a robust data set, 840 hand TCMEPs acquired during intracranial surgery were assessed. Demographic and clinical factors, including preoperative motor scores, were analyzed to identify associations with TCMEP acquisition and amplitude. Nonparametric statistics and multivariate regression analysis were employed. Results: TCMEPs were successfully acquired in 734 (87.7%) patient hands, even in the presence of preoperative motor deficits in 13.9% of total patient hands. Preoperative motor scores did not predict the ability to acquire baseline TCMEPs (P = .6). Notably, older age (P < .001) and hypertension (P = .01) were independent predictors of lower TCMEP acquisition rates. Preoperative motor scores significantly influenced TCMEP amplitudes, with higher scores correlating with higher amplitudes (1771 [SD = 1550] eve vs 882 [SD = 856] μV, P < .0001). Older age (P < .001) and chronic kidney disease (P = .04) were also associated with reduced TCMEP amplitudes. Conclusion: Our investigation into TCMEPs during intracranial surgery demonstrated a notably high acquisition rate in hand muscles, irrespective of preoperative motor deficits. Preoperative motor scores reliably correlated with TCMEP amplitudes in a linear fashion while advanced age and renal disease emerged as independent predictors of lower TCMEP amplitudes.
Language	English
Publishing date	2024-04-19
Publishing country	United States
Document type	Journal Article
ZDB-ID	135446-2
ISSN	1524-4040 ; 0148-396X
ISSN (online)	1524-4040
ISSN	0148-396X
DOI	10.1227/neu.0000000000002943
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Zs.A 1424: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
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Article ; Online: Ethical Incorporation of Artificial Intelligence into Neurosurgery: A Generative Pre-Trained Transformer Chatbot-Based, Human-Modified Approach.

Shlobin, Nathan A / Ward, Max / Shah, Harshal A / Brown, Ethan D L / Sciubba, Daniel M / Langer, David / D'Amico, Randy S

World neurosurgery

2024

Abstract: Introduction: Artificial intelligence (AI) has become increasingly used in neurosurgery. Generative pre-trained transformers (GPTs) have been of particular interest. However, ethical concerns regarding the incorporation of AI into the field remain ... ...

Abstract	Introduction: Artificial intelligence (AI) has become increasingly used in neurosurgery. Generative pre-trained transformers (GPTs) have been of particular interest. However, ethical concerns regarding the incorporation of AI into the field remain underexplored. We delineate key ethical considerations using a novel GPT-based, human-modified approach, synthesize the most common considerations, and present an ethical framework for the involvement of AI in neurosurgery. Methods: GPT-4, ChatGPT, Bing Chat / Copilot, You, Perplexity.ai, and Google Bard were queried with the prompt "How can artificial intelligence be ethically incorporated into neurosurgery?". Then, a layered GPT-based thematic analysis was performed. The authors synthesized the results into considerations for the ethical incorporation of AI into neurosurgery. Separate Pareto analyses with 20% threshold and 10% threshold were conducted to determine salient themes. The authors refined these salient themes. Results: Twelve key ethical considerations focusing on stakeholders, clinical implementation, and governance were identified. Refinement of the Pareto analysis of the top 20% most salient themes in the aggregated GPT outputs yielded ten key considerations. Additionally, from the top 10% most salient themes, five considerations were retrieved. An ethical framework for the use of AI in neurosurgery was developed. Conclusion: It is critical to address the ethical considerations associated with the use of AI in neurosurgery. The framework described in this manuscript may facilitate the integration of AI into neurosurgery, benefitting both patients and neurosurgeons alike. We urge neurosurgeons to use AI only for validated purposes and caution against automatic adoption of its outputs without neurosurgeon interpretation.
Language	English
Publishing date	2024-05-07
Publishing country	United States
Document type	Journal Article
ZDB-ID	2534351-8
ISSN	1878-8769 ; 1878-8750
ISSN (online)	1878-8769
ISSN	1878-8750
DOI	10.1016/j.wneu.2024.04.165
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Article ; Online: Sonolucent cranioplasty: Is therapeutic FUS the next frontier?

Mehta, Neel H / Shah, Harshal A / Ben-Shalom, Netanel / D'Amico, Randy S

Journal of clinical neuroscience : official journal of the Neurosurgical Society of Australasia

2023 Volume 114, Page(s) 129–130

Abstract: Focused ultrasound (FUS) has emerged as a promising area of research in neuro-oncology. Preclinical and clinical investigation has demonstrated the utility of FUS in therapeutic applications including blood brain barrier disruption for therapeutic ... ...

Abstract	Focused ultrasound (FUS) has emerged as a promising area of research in neuro-oncology. Preclinical and clinical investigation has demonstrated the utility of FUS in therapeutic applications including blood brain barrier disruption for therapeutic delivery, and high intensity FUS for tumor ablation. However, FUS as it exists today is relatively invasive as implantable devices are necessary to achieve adequate intracranial penetration. Sonolucent implants, composed of materials permeable to acoustic waves, have been used for cranioplasty and intracranial imaging with ultrasound. Given the overlap in ultrasound parameters with those used for intracranial imaging, and the demonstrated efficacy of sonolucent cranial implants, we believe that therapeutic FUS through sonolucent implants represents a promising avenue of future research. The potential applications of FUS and sonolucent cranial implants may confer the demonstrated therapeutic benefits of existing FUS applications, without the drawbacks and complications of invasive implantable devices. Here we briefly summarize existing evidence regarding sonolucent implants and describe applications for therapeutic FUS.
MeSH term(s)	Humans ; Skull/diagnostic imaging ; Skull/surgery ; Blood-Brain Barrier/pathology ; Ultrasonography ; Ultrasonic Therapy/methods ; Drug Delivery Systems/methods ; RNA-Binding Protein FUS
Chemical Substances	FUS protein, human ; RNA-Binding Protein FUS
Language	English
Publishing date	2023-06-28
Publishing country	Scotland
Document type	Journal Article
ZDB-ID	1193674-5
ISSN	1532-2653 ; 0967-5868
ISSN (online)	1532-2653
ISSN	0967-5868
DOI	10.1016/j.jocn.2023.06.016
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