Daniel Yoshor, MD - US grants

? DESCRIPTION (provided by applicant): Baylor Research Education Program in Neurosurgery Abstract The Baylor Neurosurgery Residency has been in place for over fifty years, and has long been one of the nation's largest and most well respected neurosurgical training programs. The program has always had a strong academic tradition, and graduates have served as faculty at many leading medical schools. Beginning in 2006, the program was retooled to substantially enhance its ability to train the next generation of academic neurosurgeons. In addition to developing a culture that emphasizes evidence-based practice, clinical and basic research, and didactic training in basic neuroscience underlying neurosurgical practice, the program was expanded by a full year in order to provide residents with a deeper and more meaningful academic experience. Subsets of trainees in the Baylor Neurosurgery Residency have the potential to develop into academicians who can effectively combine clinical neurosurgery practice with research that advances the field. The Baylor Research Education Program in Neurosurgery will select outstanding individual neurosurgery residents who have the background, talent, and motivation to become successful physician-scientists, and then carefully integrate additional specialized research education into their residency training. The program will mentor these residents through the entire research process, from project conception to experimental design, data analysis and interpretation, to publication of results, and finally to th development of an effective plan for beginning a career as a physician-scientist. The hallmark of this program will be a twelve-month research block during the fourth year of the residency, during which the trainee will engage in a mentored research project on a near full time basis. This hands-on approach is the most effective way to prepare young clinician scientists for a productive research career by allowing them to conduct research independently, but with enough support to avoid the common pitfalls experienced by young researchers. To maximize research productivity, residents will also have a four-month part time research block in the preceding year to plan a project and write a research proposal with guidance from an experienced scientific mentor, as well as an additional four-month part time research block during the year that follows the dedicated research year in order to wrap up their projects, complete remaining data analysis, and write up manuscripts for publication. In addition to carrying out a research project, residents selected for the research education program will be trained in experimental design, scientific writing, oral presentation, and in the responsible conduct of research. Furthermore, they will receive considerable oversight and career counseling from a team of experts mentors with the intent of paving their way to success in obtaining a mentored career development award and becoming a productive physician-scientist.

Project Summary/Abstract Blindness disables millions of people across the world. In most cases, incurable blindness is caused by damage or dysfunction of the eye, retina, or optic nerve, but the visual cortex is undamaged and potentially functional. Electrical stimulation of visual cortex, even in blind patients, produces a percept of a distinct spots of light known as phosphenes. There has long been interest in developing a prosthetic device that employs direct activation of the intact visual cortex to restore vision to the blind. It has been speculated that phosphenes could serve as the building blocks for visual restoration in the blind; but unlike pixels in a video display, multiple phosphenes are not readily combined into a percept of a coherent form. We propose a novel stimulation paradigm, termed dynamic current steering, that can dramatically enhance the ability of visual cortical prosthetics (VCPs) to produce useful percepts of visual forms. Because there are imminent plans for clinical trials of several VCPs within the next few years, now is a currently particularly important time to develop improved methods for stimulation of visual cortex. To assess and refine dynamic current steering as a methodology for a VCP, we will measure percepts produced with this novel paradigm in pre-clinical testing in human epilepsy patients with implanted intracranial electrodes. In Aim 1, we will test dynamic current steering as a novel method for producing percepts of visual forms. In Aim 2, we will optimize the components of dynamic current steering to promote perception of coherent forms. Together, these aims will result in a novel paradigm for producing useful percepts of coherent visual forms by stimulation visual cortex that will be immediately translatable in forthcoming clinical trials of the next generation of VCPs.