What is functional neurosurgery?

Functional neurosurgery is devoted to treating patients with chronic neurological disorders that disrupt a patient’s quality of life. Our Functional neurosurgery - UNC Department of Neurosurgery functional neurosurgery team treats patients with a wide variety of diagnoses:

Movement disorders such as essential tremor, Parkinson’s disease, dystonia
Chronic pain such as chronic back pain, complex regional pain syndrome, trigeminal neuralgia, trigeminal neuropathic pain, diabetic neuropathy, cancer-associated pain
Spasticity disorders such as cerebral palsy, spinal cord or nerve injury
Psychiatric disorders such as obsessive-compulsive disorder and treatment-resistant depression

What is neuromodulation?

Neuromodulation technology allows us to adjust the nerve activity by delivering electrical stimulation or medications directly to a target area in the brain, spinal cord, or nerves. It is one of the fastest-growing medical specialties. Neuromodulation is now a standard-of-care treatment for selected patients with movement disorders, chronic pain, spasticity, epilepsy, and psychiatric disorders.

Neuromodulation is delivered through less-invasive treatments like deep brain stimulation, spinal cord stimulation, nerve stimulation, and intrathecal pumps. More recently, focused ultrasound treatment offers an incision-less alternative for patients who are not a candidate or unwilling to pursue less-invasive treatments.

Why choose UNC Health for movement disorders and neuromodulation?

Our team is passionate about excellence in patient care. We value a personal touch with patients to guide their journey of healing and recovery. UNC’s functional neurosurgery team is the region’s most experienced team with expertise in cutting-edge treatments. We incorporate the latest technology to personalize each patient’s treatment plans. In addition, we are engaged in research to optimize the treatment technique and maximize our patients’ improvement.

Dr. Eldad Hadar serves as the director of the epilepsy surgery and the functional neurosurgery programs at UNC Health. In addition, he is a member of the multidisciplinary team at the UNC Epilepsy Center. His surgical expertise includes deep brain stimulation and epilepsy surgery.
Dr. Vibhor Krishna is an expert in functional neurosurgery and neuromodulation. He is an early adopter of focused ultrasound technology and is considered a thought leader in the field. His research aims to enhance neuromodulation’s effectiveness through personalized medicine, developing and optimizing less-invasive neurosurgery, and testing emerging surgical treatments in clinical trials.

What is deep brain stimulation?

The majority of patients with movement disorders can be effectively treated with medications. However, some patients either don’t Dr. Eldad Hadar, member of the deep brain stimulation team respond to medication or initially respond to medication that eventually becomes ineffective. For these patients, deep brain stimulation surgery can be a life-changing option.

In deep brain stimulation procedures, precise electrodes are implanted into specific targets in the brain. Then, a pacemaker installed below the collarbone delivers continuous electrical stimulation to the affected brain target. An overwhelming majority of patients experience a remarkable improvement in symptoms and quality of life after deep brain stimulation surgery.

A successful deep brain stimulation program requires the partnership of several medical specialties, including neurosurgery, neurology, neuropsychology, radiology, and anesthesiology. The UNC deep brain stimulation program incorporates these specialties into a multidisciplinary team approach. We discuss and treat every patient individually to meet our patients’ specific needs and maximize their clinical improvement.

What is focused ultrasound ablation?

Focused ultrasound (FUS) is an incision-less treatment for patients with movement disorders. Like DBS, FUS can be an excellent option for some patients who either don’t respond to medication or initially respond to medication that eventually becomes ineffective.

Guided by real-time MR imaging, FUS can achieve precise and targeted ablation in the brain. Patients are awake and participate in testing during FUS treatment. A functional neurosurgeon first delivers ultrasound at low power to test whether ablation of the targeted area is safe. Once the safety is established, the target area is ablated for sustained improvement in patient symptoms.

What is spinal cord or nerve stimulation?

Spinal cord or nerve stimulation uses a surgically implanted device that sends pulses through the body to stop pain messages from reaching the brain. This treatment option is considered when medications and other pain interventions cannot relieve pain.

Patients undergo a multidisciplinary assessment by experts in interventional pain, neuropsychology, and neurosurgery. A trial of the spinal cord or nerve stimulation is then performed. Patients who experience substantial pain improvement then receive permanent stimulator implants to reduce pain long-term.

If you would like to make an appointment, please call 984-974-4175.

Research

Dr. Vibhor Krishna is a surgeon-scientist with expertise in functional neurosurgery and neuromodulation. Learn about cutting-edge translational research for patients with movement disorders on the Krishna Lab website.