Emad Eskandar, MD
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Harvard CV
PART 1: General Information
Date Prepared:
August 1, 2002
Name:
Emad N. Eskandar, MD
Office Address:
Massachusetts General Hospital
15 Parkman St. ACC-021
Boston, MA 02114
617-724-6590
Home Address:
Email:
eeskandar@partners.org
Fax:
617-724-0339
Education
1987
1993
B.A.
M.D.
University of Nebraska Lincoln
University of Southern California
Postdoctoral Training
1991
1994
1998
1999
Predoctoral Fellow
Internship
Postdoctoral Fellow
Resident & Chief Resident
Neuroscience
Surgery
Neuroscience
Neurosurgery
HHMI - National Institute of Mental Health
Massachusetts General Hospital
Harvard Medical School
Massachusetts General Hospital
Licensure and Certification
1999
Massachusetts Board of Medicine
Academic Appointments
1999
1999
Instructor in Surgery
Instructor in Neurobiology
Harvard Medical School
Harvard Medical School
Hospital Appointments
1999
Assistant in Neurosurgery
Massachusetts General Hospital
Emad Eskandar, MD
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Harvard CV
Other Professional Positions and Major Visiting Appointments
NA
Hospital and Health Care Organization Service Responsibilities
1999
Attending Neurosurgeon
Massachusetts General Hospital
Major Administrative Responsibilities
N/A
Major Committee Assignments
N/A
Professional Societies
American Association for Stereotactic and Functional Neurosurgery
Congress of Neurologic Surgeons
Community Service Related to Professional Work
N/A
Editorial Boards
Ad Hoc Reviewer Journal of Neuroscience
Awards and Honors
1987
1988
1989
1990
1992
1993
1996
1997
1998
2000
Phi Beta Kappa - University of Nebraska at Lincoln
Medical Student Research Fellowship, University Southern California
Research Scholar, Howard Hughes Medical Institute, N.I.H.
Medical Student Fellowship, Howard Hughes Medical Institute
Alpha Omega Alpha – University of Southern California
Lange Medical Award – Top Student University of Southern California
National Research Service Award, National Eye Institute
R. S. Morrison Fellowship, Grass Foundation
Resident Research Award - American Association Neurologic Surgeons
Rappaport Fellowship - Massachusetts General Hospital
PART II: Research, Teaching, and Clinical Contributions
A. Narrative Report
The goal of my work is to understand the functional circuitry involved in motor control in order
to provide better treatments for movement disorders such as Parkinson’s Disease (PD). My research
involves single and multi-neuron recordings in awake behaving primates and in humans undergoing
surgery. The focus of my clinical work is functional neurosurgery which involves placing deep brain
Emad Eskandar, MD
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Harvard CV
stimulating (DBS) electrodes to treat PD, tremor, and other disorders. In addition to research and clinical
work, I teach students at Harvard Medical School and residents at the Massachusetts General Hospital.
Over the previous 5 years, I have focused on the role of the posterior parietal cortex (PPC) in
visually guided movements. We discovered that different areas within PPC are functionally segregated
and that one area of PPC appears to convey unique, predictive information. Area MST conveys primarily
visual information, area MIP conveys sensorimotor information, and area LIP appears to convey a
predictive signal about moving or ambiguous stimuli. This work has been published in Nature
neuroscience and Journal of Neurophysiology.
My current research is aimed at understanding the interaction of two important pathways in the
basal ganglia (direct and indirect) which are important in motor control. This work has been funded by a
K08 (Mentored Clinical Scientist Development Award) and more recently a grant from the Harvard
Center for Neurodegeneration and Repair. Preliminary data suggests that the two pathways function in a
center-surround organization similar to that seen in the visual system. A better understanding of the
interaction between the pathways will hopefully lead to better treatments for PD.
I am currently in the process of setting up my own laboratory at MGH. The lab will include two
rigs for awake monkey recordings and one rig for anesthetized preparations. The lab will be part of a
larger group , including Jeff Mackliss and Dick Masland. One of the goals of this group will be to
explore restorative therapies such as the use of deep brain stimulation and transplantation to treat
neurologic disorders due to trauma, stroke, and degenerative disease.
Clinically, I have been involved in creating an active program in deep brain stimulation at MGH.
In addition, I have an approved protocol to study the physiologic properties of basal ganglia neurons in
patients undergoing surgery and have built an intra-operative rig which allows for neuronal recordings
while patients are performing reproducible visually guided movements. High quality data of this sort has
never been obtained in humans and preliminary data already suggest several novel observations regarding
the function of the basal ganglia in patients with PD. Some of this work has been published in JAMA and
the Journal of Neurosurgery.
I have been teaching the basal ganglia and spinal cord lectures in the HST neurobiology course
since 1997. More recently, I have initiated a multi-media lecture that utilizes videotape of patients with
movement disorders, surgical therapies of PD, and a computerized demonstration of intraoperative
recordings to consolidate the basal ganglia information. In addition I have an active role in teaching
neurosurgical residents during cases and in 2-4 formal lectures per year.
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Harvard CV
B. Funding Information
Years Covered Funding
1996-1998
2000-2003
2002-2004
PI/Co-PI
NRSA - NEI Eskandar
K08- NINDS Eskandar
HCNR – HMS Eskandar
Grant Title
Extraretinal Signal in Parietal Cortex
Neostriatal Visual Processing in Movement Initiation
Basal Ganglia in Movement Control
C. Report of Current Research Activities
Project
Role
Neostriatal visual processing in movement initiation
Basal ganglia in movement control
Basal ganglia function in human PD patients
Transplantation of embryonic cells in MPTP treated monkeys
Clinical outcome of DBS in patients with PD
Principal Investigator
Principal Investigator
Principal Investigator
Collaborator with Ole Isacson
Collaborator with Neurology Group
D. Report of Teaching
1. Local Contributions
a. Medical School Courses Taught
Section
Class
Role
1996-1998
HST II Neurobiology
Neuroanatomy
Teaching Asst. 8 HST Students
30 hours/Year
1997-2001
HST II Neurobiology
Basal Ganglia
Lecturer
60 HST Students
10 hours /Year
1999-2001
HST II Neurobiology
Movement Disorders
Lecturer
60 HST Students
10 hours /Year
1997-2001
HST II Neurobiology
Spinal Cord
Lecturer
60 HST Students
10 hours /Year
Lecturer
120 HMS Students
20 hours/Year
2000 - 2002
HMS II Neurobiology Basal Ganglia
b. Graduate Medical Courses
# Students
Contact Hours
1999-2002
Attending Neurosurgeon
Neurosurgery
1999-2002
Lecturer
Basal Ganglia Residents and 4th year students 20 hrs / year
Residents and 4th year students 8 hrs / week
c. Local Invited Presentations for CME Credit
2000
Neurology Grand Rounds, MGH
Management of Closed Head Injury Staff and Residents
Emad Eskandar, MD
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2000
2000
2001
2001
2002
Surgical Treatment of PD
Parietal Cortex in Guidance
The STN in the treatment of PD
Surgical Treatment of PD
Surgical Treatment of PD
Neurology Grand Rounds, MGH
Neurosurgery Grand Rounds, BWH
Neurosurgery Grand Rounds, MGH
Neurology Grand Rounds, Beverly
Medicine Grand Rounds, South Shore
Harvard CV
Staff and Residents
Staff and Residents
Staff and Residents
Staff
Staff
d. CME Courses
2001
Neuromodulation Symposium
Cleveland Clinic
Surgery for Psychiatric Disorders
e. Advisory and Supervisory Positions
1999-2002
Attending Neurosurgeon
Supervision of Neurosurgical Residents
2001-2002
Lab Preceptor
2 Residents on Research Rotations
6 Weeks / year
6 months / year
f. Teaching leadership role
N/A
g. Names of Advisees or trainees
Duration
Name
6 months
Ziv Williams, MD
6 months
Ekkehardt, Kaspar, MD
Position
Neurosurgical Resident
Neurosurgical Resident
2. Regional, National, or International Contributions
1999 Neurosurgery Grand Rounds
2000 Neurobiology Seminar
2000 Neurology Grand Rounds
2000 CVS Symposium
3. Description of teaching awards
UCSF
U. Chicago
Cleveland Clin
U. Rochester
Role of Parietal Cortex in Visual Guidance
Role of Parietal Cortex in Visual Guidance
Surgical Treatment of Parkinson’s Disease
Role of Parietal Cortex in Visual Guidance
N/A
4. Description of major curriculum offerings
I have been involved, in conjunction with John Assad, with developing the motor systems portion
of the HST II neurobiology course. We have been jointly giving this course since 1997. In addition to
giving the spinal cord and basal ganglia lectures, I have developed a lecture about movement disorders
and their surgical therapy. This lecture involves videotape presentations of different types of movement
disorders, operative procedures, and more recently demonstrations of intra-operative physiology, all of
which help bring the material to life and are generally quite well received by the students.
E. Report of Clinical Activities
1.
My clinical practice is in functional neurosurgery and is aimed at treating patients with
Parkinson’s disease, tremor, intractable pain, and epilepsy among others. I also have interest in the
treatment of brain tumors, trigeminal neuralgia, and some spinal disorders. My sole practice is in the
Department of Neurosurgery at the Massachusetts General Hospital.
2.
I see about 20 patients per week on my office day and I operate one day per week. The
complexity of the cases varies but includes highly complex deep brain stimulation cases and complex
spine cases with multi-level instrumentation. The remainder of my time is generally spent in the
laboratory.
Emad Eskandar, MD
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Harvard CV
3.
My major contribution has been to bring the promising new technology of deep brain stimulation
and high quality intra-operative microelectrode recordings to MGH. We have now performed about 30
operations with excellent results and the practice is growing. These operations involve stereotactic
localization of the target area, intra-operative multi-electrode recordings, and implantation of the
electrodes. An important aspect of these cases is that they provide the unique opportunity to record
neuronal activity in the context of a controlled experimental paradigm. These data will yield important
insights into the underlying pathophysiology. More recently, I have begun collaborations with the MGH
psychiatry service to place DBS electrodes in the cingulate gyrus for the treatment of intractable
obsessive compulsive disorder and with the MGH Anesthesia service to place thalamic stimulators for the
treatment of intractable pain. In both cases we will have protocols to explore the underlying physiology.
Emad Eskandar, MD
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Harvard CV
PART III. Bibliography
Original Articles
1.
Eskandar, EN, Richmond, BJ, Optican, LM. Role of Inferior Temporal Neurons in Visual
Memory: I. Temporal Encoding of Information about Visual Images, Recalled Images, and Behavioral
Context. J. Neurophysiol 1992; 68(4):1277-95.
2.
Eskandar EN, Optican, LM, Richmond, BJ. Role of Inferior Temporal Neurons in Visual
Memory: II. Multiplying Temporal Waveforms Related to Vision and Memory. J. Neurophysiol., 1992;
68(4):1296-1306.
3.
Hertz, JA, Kjaer, TW, Eskandar, EN, Richmond, BJ. Measuring Natural Neural Processing with
Artificial Neural Networks. International Journal of Neural Systems. 3. Suppl. 1992: 91-103.
4.
Eskandar, EN, Weller, SA, Frim, DA. Hydrocephalus Requiring Urgent External Ventricular
Drainage in a Patient with Diabetic Ketoacidosis and Cerebral Edema. Neurosurgery 1997;40(4):836-8.
5.
Eskandar, EN, Cosgrove GR, Shinobu, LA, Penney JB. The Importance of Accurate Lesion
placement in Pallidotomy. J. Neurosurgery 1998;89(4):630-4,.
6.
Eskandar, EN Assad, JA. Dissociation of Visual, Motor, and Predictive Signals in Parietal Cortex
During Visual Guidance. Nature neuroscience 1999;2(1):88 – 93.
7.
Eskandar EN, Shinobu, LA, Penney JB, Cosgrove GR. Nonmicroelectrode-guided pallidotomy:
Surgical Technique and 2 year results. J. Neurosurgery 2000;92:375-383.
8.
Counihan TJ, Shinobu LA, Eskandar EN, Cosgrove GR, Penney Jr JB Jr. Outcomes following
staged bilateral pallidotomy in advanced Parkinson's disease. Neurology 2001;56(6):799-802.
9.
Eskandar, EN, Borges, LF, Putman, C, Budzik C, Ogilvy, CS. Spinal Dural Arteriovenous
Fistulae: Experience with Endovascular and Microsurgical Therapy. J Neurosurg 2002;96(2):1204-10.
10.
Eskandar, EN, Assad. JA. Representations of direction during visual guidance in the primate
parietal cortex. J Neurophysiology 88: 2002.
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Harvard CV
Proceedings of Meetings
Eskandar EN, Richmond BJ, Hertz, JA, Optican LM, and Kjaer T. Decoding of Neuronal Signals in
Visual Pattern Recognition. Advances in Neural Information Processing Systems IV. San Mateo, CA,
Morgan and Kaufman; 1992. P. 356-363.
Eskandar E, Shinobu LA, Penney JB Jr, Cosgrove GR. Non-microelectrode guided stereotactic
pallidotomy for Parkinson's disease: surgical technique and results. Stereotact Funct Neurosurg.
1999;72(2-4):245.
Reviews, Chapters, and Editorials
Reviews
Eskandar EN, Cosgrove RC, Shinobu, LA. Surgical treatment of Parkinson Disease. JAMA 2001,
286(24):3056-9.
Book Chapters
Cosgrove GR, Eskandar EN. Thalamotomy and Pallidotomy. In: Kaye AH, Black PM, editors.
Operative Neurosurgery; 2000. London: Harcourt Publishers; P. 1431-1445
Eskandar EN, Cosgrove GR. Neurosurgical Treatment of Pain.. In: Ballantyne, J Fishman A, and Abdi
S, editors. The Massachusetts General Hospital Handbook of Pain Management. Philadelphi: Lippincot
Williams and Wilkins; 2002. P. 215-223
Eskandar EN, Cosgrove GR. Intractable Tremor: Thalamotomy or Thalamic Stimulation. In: Eric
Schulder E, editor. Handbook of Functional Neurosurgery; In Press - 2002.
Abstracts of Unpublished Work
Eskandar EN, Shinobu LA, Penney JB, Cosgrove GR. Stereotactic Pallidotomy for Parkinson’s Disease:
Long-term results. Congress of Neurologic Surgeons. 1999.
Williams, Z, Eskandar, E, Elfar J, Assad, J. Neuronal Correlates of Subjective Visual Perception.
Congress of Neurologic Surgeons, 2001.
Eskandar, E, Williams, Z, Shinobu L, Cosgorve, G. Simultaenous mutli-electrode recordings in the
subthalamic nucleus. American Association of Neurologic Surgeons, 2002.
Curry, WT, Hoh, BL, Amin-Hanjani, S, Eskandar EN. Spinal Epidural Abscess: Clinical presentation,
management, and outcome. American Association of Neurologic Surgeons, 2002.