Adam Glaser

PGY4 Neurosurgery Resident @BWHNeurosurgery @HarvardMed @BostonChildrens | @GeiselMed ‘22 | All-American @Middlebury '17 ⚽ | DC Native @GDSHoppers '13

[Michael Okun @MichaelOkun]

Can you 'zap' the brain with focused ultrasound if you have a DBS lead in place? A new possible twist for cases w/ both tremor and Parkinson's. For the first time, at least that I have read, focused ultrasound (FUS) thalamotomy was successfully used in a person who already had deep brain stimulation (DBS) leads implanted. Glaser, Cosgrove and colleagues open a potential path for tremor-dominant Parkinson��s disease w/ tremor recurrence despite GPi DBS. Their paper just published in the journal Stereotactic and Functional Neurosurgery.
Key Points:
- First human case I can find in a publication of MRI-guided FUS (MRgFUS) thalamotomy performed safely w/ indwelling GPi DBS leads still in place.
- They share a case of bilateral GPi DBS who developed progressive unilateral tremor unresponsive to DBS adjustments.
- The authors used 'no-pass zones' around the DBS hardware during targeting.
- The method employed the 'MRI-compatibility mode.'
- A single right-sided VIM thalamotomy via MRgFUS led to tremor improvement at 6 months following the procedure.
- The authors felt the side effects were mild and manageable (imbalance, fatigue, minor speech issues).
- They noted no hardware damage or thermal issues.
My take: If a person has a DBS lead or leads, we have, for safety reasons, not been performing focused ultrasound. If the leads are in GPi (a more lateral in the brain), the authors demonstrate it may be possible to add a focused ultrasound lesion. Here are 5 points in this work that resonated w/ me. 1- This is the first time I have read about a group combining DBS and focused ultrasound sequentially. Hopefully more groups will share experiences. 2- Tremor that returns after DBS doesn’t always mean failure. You can revise the DBS lead, add a DBS target or possibly use focused ultrasound if the lead is in the GPi target and far enough away from the FUS target. 3- Focused ultrasound, once off-limits to people with DBS, may in select cases be possible w/ careful planning. 4- Technology like this reminds us that Parkinson’s is not one size fits all disease and that there may be many innovative solutions for treatment(s). 5- Though more cases are needed, this opens a door. One important point for folks interested is the author's comment that, "FUS is not be possible with VIM or STN electrodes due to electrode overlap at the target zone." BRAVO to this team for pulling this off.
https://t.co/VXLpN2ord4 @DBSThinkTank @ParkinsonDotOrg @FixelInstitute @essentialtremor #parkinson #tremor #DBS

[Brigham and Women's Neurosurgery @BWHNeurosurgery]

Today, we warmly welcome our new residents to BWH Neurosurgery! We're excited to see all the incredible things you'll accomplish during your time with us! #NeurosurgeryResidents #BWH #HMS 🧠 🤓 🥼

[Gabrielle Luiselli, MD @galuiselli]

Welcome to the family!! Superstar class ⭐️

[Gabrielle Luiselli, MD @galuiselli]

#GratefulFor my amazing co-residents @dvddliu and @acglaser9. Impressed every single day by these two. Very lucky to call them teammates and more importantly, best friends 🧠❤️@BWHNeurosurgery @wenyalindabi @harvardmed

[Brigham and Women's Neurosurgery @BWHNeurosurgery]

Morning debrief with chief resident Neil Klinger #residency #neurosurgery #leadership #teamwork

[Brigham and Women's Neurosurgery @BWHNeurosurgery]

An incredible end to an incredible first day of our symposium. Dr. Sultan leads a fireside chat with Dr. Heros, Dr. Laws, and Dr. Moret spanning lessons learned over the arc of their careers.

#HarvardCVSB #DivingforPearls #Neurosurgery #Cerebrovascular #SkullBase

[Brigham and Women's Neurosurgery @BWHNeurosurgery]

Today we welcome our PGY-1 residents! @ChalifEric , MD, @RonGadot , MD, and @Chi_bu_eze, MD, welcome to our residency program! #Match2023 #BWH #Neurosurgery #Residency #HMS

[Wenya Linda Bi @wenyalindabi]

Privileged to learn from Professor Paulo Kadri @BWHNeurosurgery White Matter Dissection course. Thank you @arikappelmd for organizing such an enriching #neuroanatomy #microneurosurgery course!

[David Liu @dvddliu]

This has also optimized my educational experience as the current neuro ICU intern — very lucky to have this! @BWHNeurosurgery @BrighamWomens

[Adam Glaser @acglaser9]

Thank you @CNS_Update - grateful to win best poster in neurocritical care / trauma section and thank you as always to @jh_kanterMD, Dr. Boone and such a supportive program @BWHNeurosurgery @lola_chambless

[Brigham and Women's Neurosurgery @BWHNeurosurgery]

Recently, a few members of @BWHNeurosurgery attended the 2022 CNS Annual Meeting in San Francisco, California.

Here are some highlights from the conference!

@CNS_Update #2022CNS #CNS2022 #neurosurgery #nsgy

[Dr. Glaucomflecken @DGlaucomflecken]

Big news in academic publishing!

[Neurocritical Care @NeurocritCareJ]

Kanter et al: The Effect of Antiseizure Medication Administration on Mortality and Early Posttraumatic Seizures in Critically Ill Older Adults with Traumatic Brain Injury

Link: https://t.co/2gBdnJU6WS

@neurocritical #NeuroCritCare

[Adam Glaser @acglaser9]

Proud of this work, and grateful to my mentors that made it possible

[John Kanter @jh_kanterMD]

Anti-seizure medication for “patients over
65 years of age within 24 hours of admission to an #ICU after #TBI is associated with a significant
reduction of mortality…” Read more: https://t.co/EwWhYPeTp1…
Published in @NeurocritCareJ
#research #neuroscience #Neurosurgery

[Adam Glaser @acglaser9]

@galuiselli @dvddliu @BWHNeurosurgery Can’t wait!

[The xG Philosophy @xGPhilosophy]

Liverpool scored 0 goals from 6.12(xG) in cup finals this season.

[Aaron Boes @boeslab]

The individual with this precuneus lesion experienced a dramatic change in how he perceived the passage of time after surgery of a glioma.

Minutes felt like hours… each time he would check his watch he’d be surprised how little time had passed. 👇

[David Fischer, MD @dbfisch]

1/
I wanted to share a formative rabbit hole I went down prior to joining #NeuroTwitter. It was a project with one goal: to use neuroimaging to understand human consciousness. What ensued was fascinating. A 🧵, and you can read it in @GreenJournal here: https://t.co/AVfd6YpEuL

[FOX Soccer @FOXSoccer]

WE’RE BACK 😤

The @USMNT has qualified for the 2022 FIFA World Cup! 🇺🇸🙌