UAB Neurosurgery is at the forefront of brain cancer research. As part of the UAB Comprehensive Cancer Center's Neuro Oncology Program, our team conducts multiple lines of multi-disciplinary research to improve the understanding brain tumors and create new treatment options for our patients. These diverse yet interconnected research areas include:

• Immune system and cancer: Dr. Jianmei Leavenworth’s research seeks to understand how the immune system responds in the fight against brain cancer, and how to help those responses succeed. A patient’s antitumor immune status can help us determine if they will respond to some treatments, but we do not yet understand why some treatments work better than others. Dr. Leavenworth focuses on studying subsets of T cells, NK cells, and other immune cells, then boosting their natural antitumor responses in order to develop effective strategies for brain cancer immunotherapy.
• Tumor models: Dr. Yancey Gillespie has developed a large tumor repository with more than 14,000 tumor samples and patient-derived xenolines--all available for other scientists to request and use in their studies. These resources are critically important for cancer research because they allow scientists to further their understanding of multiple types of cancer and test the effectiveness of new potential treatment options.
• Comparative Oncology and Genomics of Brain Tumors: Dr. M. R. Chambers, a veterinarian and neurosurgeon, brings a unique perspective to brain tumor research. She is a strong proponent of the One Health Initiative, an effort to improve animal and public health worldwide and strengthen medicine by working together. Her NIH-funded research includes “CANINE,” a network of regional colleges of veterinary medicine to treat their canine patients who develop naturally occurring brain tumors. Veterinarians at those institutions are using combination therapies under guidelines established by Dr. Chambers at UAB, which serves as the coordinating center for the study. Comparative genomics are used to identify genetic targets for the development of novel treatments in the future. In terms of "translational medicine," or moving research from bench to bedside, this program is a revolution in the approach, translating research findings from human to animal and back to human, to the benefit of both.
• Using viruses to fight cancer: Recently, viruses have been successfully used as specific treatments for brain cancer. Dr. James Markert has been at the forefront of developing oncolytic Herpes Simplex Virus (oHSV) as a novel tool to fight brain cancer. Based on what was known about the immune system and glioma, Dr. Markert has engineered a new virus strain that stimulates the immune system as well as kills tumor cells. This work is in conjunction with Dr. Leavenworth and aims to understand the how the immune system helps destroy the brain cancer and to pair that with their virus to cure the disease. Additionally, working with Dr. James Johnston and Dr. Gregory Friedman at Children's Hospital of Alabama, the team has expanded this approach to include investigations of pediatric brain tumors as well.
• Pediatric brain tumors and social needs: Dr. Brandon Rocque is conducting research to better understand the psychological and social needs of children who are newly diagnosed with brain tumors and their families. Finding out that your child, who has been previously healthy, has a brain tumor can be an incredible source of distress for a family. Most children’s hospitals have resources to help deal with that stress, but there are no established protocols. Dr. Rocque’s research, funded by the UAB CCTS KL2, will help understand the stressors that families face, and how the pediatric neurosurgery team can best help them cope. This has the potential to improve long-term brain tumor outcomes, by providing a stronger support system for the sick child.

• Cerebrovascular clinical research: Dr. Mark Harrigan’s research centers on the prevention and management of stroke. Dr. Harrigan is the UAB site Principal Investigator of several National Institutes of Health-sponsored multicenter cerebrovascular studies. These studies include an international randomized trial to compare aggressive medical management to surgery and stenting for the management of asymptomatic carotid stenosis (CREST 2), a study of the mechanism of recurrent stroke in patients with symptomatic intracranial stenosis (MyRIAD), and a trial comparing minimally invasive surgery to medical management for patients with brain hemorrhage (MISTIE III). He is also the site Principal Investigator of a study of stem cell-treatment of stroke patients, and treatment of patients with aneurysmal subarchnoid hemorrhage with intraventricular injection of nimodipine. Dr. Harrigan is also conducting research into the management of patients with blunt traumatic cerebrovascular injury, which is present in about 1% of all blunt trauma admissions and is a significant cause of stroke in young people. His research has provided insight into the evolution, risk of stroke, and optimal management of patients with injury to the extracranial carotid and vertebral arteries. He is collaborating with the NIH StrokeNet Prevention Working group to design and organize a multicenter study of this disorder.

As part of our commitment to cutting-edge care for patients with movement disorders, we are actively engaged in research to optimize Deep Brain Stimulation (DBS). The team at UAB has completed more than 1,000 DBS operations, and this extensive experience makes us uniquely qualified to research ways to improve care. DBS is well documented as a successful treatment option for patients with movement disorders who have exhausted medical management options. Despite this widespread adoption, scientists still do not understand exactly why some patients who undergo the procedure fair better than others.

Our multidisciplinary research team, led by Drs. Barton Guthrie and Harrison Walker, focuses on examining outcomes and electrophysiological data to understand what factors cause some patients to fair better than others. Examples of such investigation include mapping the exact brain location of electrodes that tend to produce the best patient results. The program received a large grant to study brain cortical activity in the OR to try to predict which stimulation parameters and will produce the best results after surgery. These and other studies will eventually lead to a better understanding of how neuromodulation works and hopefully enable every patient to receive optimal results.

Clinical Trials

The UAB spinal neurosurgery team is focused on improving care for patients with spinal cord or spinal disorders at UAB and beyond. Our neurosurgeons engage in research and clinical trials that advance the field of neurosurgical care for patients with spinal disorders.

Drs. Mark N. Hadley and Beverly C. Walters have published multiple compilations of medical evidence-based guidelines, which were developed with the support of the Spine and Peripheral Nerves of the American Association of Neurological Surgeons and the Congress of Neurological Surgeons.

• Hadley MN, Shank CD, Rozzelle CJ, Walters BC. Guidelines for the Use of Electrophysiological Monitoring for Surgery of the Human Spinal Column and Spinal Cord. Neurosurgery. 2017 Nov 1;81(5):713-732.
• Hadley MN, Walters, BC, Aarabi B, Dhall SS, Gelb DE, Harrigan MR, Hurlbert RJ, Rozzelle CJ, Ryken TC, Theodore N. Guidelines for the Management of Acute Cervical Spine and Spinal Cord Injuries, 2013 Revision. Neurosurgery 72:3(Supplement), 1-259, 2013.
• Resnick DK, Choudheri TF, Dailey AT, Groff MW, Khoo L, Matz PG, Mummaneni P, Watters WC III, Wang J, Walters BC, Hadley MN. Guidelines for the Performance of Fusion Procedures for Degenerative Disease of the Lumbar Spine. J Neurosurg: Spine 2:636-759, 2005.
• Hadley MN, Walters BC, Grabb, PA, Oyesiku NM, Przybylski, GJ, Resnick DK, Ryken TC. Guidelines for the Management of Acute Cervical Spine and Spinal Cord Injuries. Neurosurg, (Supplement), S1 – S178, 2002.

UAB spinal neurosurgeons are studying the latest treatment strategies for the care of patients with acute spinal cord injuries and have been awarded two Deptartment of Defense Grants.

1. Evaluation of the long-term effects of surgical management of spinal cord perfusion strategies using a porcine spinal cord injury model.
2. A Multicenter, Randomized Controlled Trial of Cerebrospinal Fluid Drainage in Acute Spinal Cord Injury.

Clinical Trials
Our Team

Through research our pediatric neurosurgeons aim to be able to do even more to help children suffering from the neurosurgical diseases. Active areas of current study at present include:

• Brain Tumors: Working collaboratively we enroll large numbers of patients in clinical trials coordinated by the Pediatric Oncology Group (POG) or the Children’s Oncology Group.

• Chiari Malformations: We belong to the Park-Reeves Initiative which is prospectively collecting information on patients with Chiari malformations. Our group has more than 200 publications related to clinical observations about the Chiari malformations.

• Epilepsy: Recent studies have addressed the optimum technique to localize regions of brain that cause seizures and the properties that the brain exhibits in these regions that lead to the initiation of seizures.

• Head Injuries: Externally reviewed and funded collaborative studies are underway that address prevention, diagnosis and treatment of concussions.

• Hydrocephalus: COA/UAB is a charter member of the Hydrocephalus Research Network which conducts clinical trials about the most effective means to treat hydrocephalus.

• Spina Bifida: We have a large Spina Bifida program and are involved in CDC funded programs to prospectively collect a registry of patients affected by SB. We have had both graded and invited presentations at both World Congresses of Spina Bifida sponsored by the Spina Bifida Association of America.