In the 19th century, there was little differentiation between psychiatric and neurological conditions. Often, patients presenting with schizophrenia, depression and other mental illnesses were cared for alongside patients with cerebral palsy, epilepsy and other neurological disorders. However, the following century saw a significant change in how the medical community addressed conditions categorized as brain disorders.
In 1920, the University of Michigan’s Department of Nervous and Mental Diseases was split into two departments – Psychiatry and Neurology. That same year, Neurosurgery was recognized as a section in the Department of Surgery. Neurosurgery became a department of its own in 2001.
Over the past century, the evolution of neuroscience has been remarkable. We’ve gone from only being able to examine a brain post-mortem to minimally invasive surgery and technology that lets us see how the living brain works on molecular and cellular levels. And the best is yet to come, thanks to advances in medical technology and broader research collaboration across disciplines. In many ways we are just on the cusp of understanding brain function and disease.
If you have heard a presentation of the UMHS Strategic Plan (SP) or spent time on the SP internal website, you might know that the SP identified significant opportunity for us to build on our strengths and expertise in highly complex clinical neuroscience, specifically in the following areas:
- Cerebrovascular care, which includes treatment for aneurysms and strokes
- Complex spinal procedures, including those that are the result of malformations or trauma
- Epilepsy, with a focus on surgery for those remaining uncontrolled with medical management
- Neuro-oncology, which includes benign and malignant tumors of the brain and spinal cord
- Cranial-base, which includes tumors of the base of the skull and pituitary gland and acoustic neuromas (benign tumors of the nerve that connects the ear to the brain)
These five areas were named strategic priorities because analysis indicated growing demand for these services now and in the future and because we have untapped potential, given our clinical expertise and research portfolio in these areas.
One action plan under way in support of UMHS becoming the MI leader in caring for patients with highly complex neurological conditions is re-purposing the previous C.S. Mott Children’s Hospital to be the home of a U-M Neuroscience Hospital. This new space will offer important benefits, such as:
- Increased acute care and ICU bed, OR and imaging capacity. This is especially important because current capacity constraints – especially in the OR – have been limiting our ability to see patients, recruit new faculty and generate revenue.
- Improved throughput and coordination of care in support of creating the Ideal Patient Care Experience
- Expedited personalized treatment plans through improved research collaboration and integration of research into clinical work
- Improved ability to collect new data and discover pathways for translational research
- An opportunity to bring together and connect disciplines like never before
From planning to the day we open and beyond, this project has been and will continue to be all about teamwork. Because care delivered in this facility will represent a full-spectrum of services provided by multidisciplinary teams, we want to take this opportunity to move away from the “department silo effect” and toward a model of cohesive collaboration that best meets patients’ and the Health System’s needs. As such, throughout the process, we will continue to seek input from all key stakeholders, including representatives from Neurosurgery, Neurology, Orthopedics, Otolaryngology, Radiology, PM&R, OR, Anesthesiology, Nursing, Finance, Marketing, Facilities and Administration of UH, C&W and Ambulatory Care.
This is a very exciting time for UMHS, and I believe we will ascend to statewide and national leadership in complex neuroscience because we will be building from a foundation of impressive strengths like these:
- The University of Michigan is home to the decades-old interdisciplinary U-M Molecular & Behavioral Neuroscience Institute (MBNI), which brings together neuroscientists from the Medical School and LS&A. (Fun fact – MBNI is where the term “neuroscience” was coined by Dr. Ralph Waldo Gerard 50 years ago.)
- We have a history of innovation, including creating the nation’s first neurointerventional suite, where diagnosis and therapy/intervention happen in the same room, saving valuable time.
- Neurosurgery ranks 7th nationally in NIH funding of peer departments and Neurology faculty receives more than $14M annually in federally-funded research grants.
- Our Neurosurgery and Neurology residency programs are highly competitive and allow us to recruit the best and brightest in the world. Last year, Neurosurgery received 250 applications for three slots; Neurology received nearly 500 applications for six slots.
- We are home to scientists who are conducting groundbreaking research that will drive the next evolution of neuroscience, including:
- Dr. Eva Feldman’s work as principal investigator of the first FDA-approved human clinical trial of a stem cell treatment for ALS (also known as Lou Gehrig’s disease);
- Dr. Jack Parent’s use of stem cells from patients with Dravet Syndrome – an inherited form of epilepsy – to study the genetic cause of the disease and, ultimately, discover novel treatments ;
- Dr. Parag Patil’s work with Deep Brain Stimulation, which was featured on the Emmy Award-winning show The Doctors (watch video);
- Dr. George Mashour’s work combining neuroscience, network science and anesthesiology to probe mechanisms of human consciousness and develop more sophisticated brain monitors ; and
- Drs. Maria Castro’s and Pedro Lowenstein’s work as principal investigators of the first FDA-approved human clinical trial using a combination of adenoviral vectors for gene therapy of deadly malignant brain tumors.
Finally, we are well-positioned for success because we have outstanding leaders in Dr. Karin Muraszko, who is one of my heroes (read why here), and Dr. David Fink, whose cutting-edge research with Dr. Marina Mata could revolutionize the way we treat pain and diseases of peripheral nerves (learn more here and here). Drs. Fink and Muraszko, along with their administrative partner, Shon Dwyer, are excited to take Neuroscience at UMHS to the next level, and I am equally excited to see where they take us.
As we build on our strengths and take advantage of new opportunities to forge a new frontier of Neuroscience at UMHS, I know that we will continue to move the needle in creating the future of health care through discovery.