The Hunterian Neurosurgical Laboratory
Located at the main campus of The Johns Hopkins Hospital, the 5,275 square foot Hunterian Neurosurgical Laboratory houses research groups representing multiple specialties and interests within the neurosurgical community, each led by a world-renowned expert in that field.
The facility includes a fully equipped microsurgical laboratory, cell culture and microscopy facilities, quantitative image analysis, certified operating rooms and radiologic equipment.
Established in 1895, the Hunterian has a rich history of significant discoveries in neurosurgery, from surgical procedures to modern methods of administering chemotherapy for brain cancer. Read more:
- The Johns Hopkins Hunterian Laboratory Philosophy: Mentoring Students in a Scientific Neurosurgical Research Laboratory
- The Hunterian Neurosurgical Laboratory: the first 100 years of neurosurgical research
History of the Hunterian Neurosurgical Laboratory
The nation’s first experimental surgery laboratory, the Hunterian initially was established in 1895 by Hopkins Medicine’s first dean, pathologist William Welch, and founding surgeon-in-chief William Halsted to conduct scientific research for improving techniques in surgery and pathology. (It is named for 17th century Scottish physician John Hunter, the father of scientific surgery.)
In 1904, Halstead appointed Harvey Cushing, who had come to Hopkins as a surgical resident in 1896 and joined the faculty in 1901, to head the laboratory. Cushing, whose surgical and scientific interests had begun centering on disorders of the nervous system — and who became the first to declare neurosurgery a separate specialty — refocused the Hunterian’s mission on neurosurgical research and techniques.
Under Cushing and his successors, Walter Dandy, D. Earl Walker and Donlin Long, researchers in the Hunterian made significant discoveries and devised important innovations that had substantial impact on patients requiring either brain surgery or other operative procedures. In 1991, Henry Brem, then an assistant professor of neurosurgery, re-established the Hunterian Neurosurgical Laboratory’s focus on novel treatments for brain tumors. The strong tradition of performing basic research with clinical relevance has continued to this day.
The original building housing the Hunterian Neurosurgical Laboratory
A 1907 portrait of Harvey Cushing, M.D., appointed to lead the Hunterian in 1904
Henry Brem, M.D., who revived the Hunterian in 1991
Students working in the Hunterian Laboratory, circa 1905
At the brain tumor laboratory, Henry Brem, M.D. and Betty Tyler, along with more than 350 trainees, have conducted scientific research, contributed to scientific literature, amended clinical practice, and illuminated new pathways for improving clinical outcomes.
The laboratory has advanced the understanding of gene therapy, angiogenesis, intracranial implantation of biodegradable polymers to treat malignant glioma, tumor genetics and proteomics, microchip drug delivery and drug resistance studies. Dr. Brem and his colleagues have designed and led many multi-institutional clinical trials to improve and expand the range of therapeutic options for patients with brain tumors.
Chetan Bettegowda, M.D., explores the genetic underpinnings that drive the pathogenesis of a variety of primary central nervous system neoplasms. He is interested in exploiting genetic changes for both diagnostic and therapeutic purposes. He is currently working on understanding the extreme responders and extreme clinical phenotypes of brain and spinal cord tumors to identify factors that may modulate responses to therapy.
The laboratory is focused on a range of immunotherapeutic approaches to treating brain tumors.
In addition to focusing on checkpoint inhibitor therapy, the lab is also investigating innovative approaches to stimulating the immune system to target cancer cells. The lab seeks to both identify novel treatment methods and also characterize the underlying changes in the immune system that make for effective cancer treatment.
The lab is involved in multiple clinical trials meant to translate their basic science and translational research to the clinic to help curb the growth of brain tumors and improve patients’ quality of life. Several immunotherapy clinical trials have come from the scientific work of this laboratory.
Directed by Alan R. Cohen, M.D., Carson-Spiro Professor of Neurosurgery, Oncology and Pediatrics, the laboratory is focused on developing novel instruments and approaches to enhance the safety and efficacy of neurosurgical procedures. Current investigations include work in microsurgery, endoscopy, image guidance and robotic surgery. A cadaveric Skills Lab offers training in neurosurgical techniques.
The team headed by Shenandoah “Dody” Robinson, M.D., professor of neurosurgery, neurology and pediatrics, studies perinatal brain injury and repair. Employing developmentally age-appropriate models, the lab investigates neurological consequences of extremely preterm birth, including cerebral palsy, chronic pain, cognitive and behavioral impairment, epilepsy and posthemorrhagic hydrocephalus of prematurity.
Using primarily endogenous neuroreparative cytokines with high translational potential, the researchers focus on how to prevent and mitigate chronic neurological deficits, and the development of serum and imaging biomarkers. The lab also investigates related neurological disorders, such as acquired symptomatic hydrocephalus from hemorrhage, infection and trauma.
Under the guidance and mentorship of Mark Luciano, M.D., director of the Hydrocephalus and Cerebral Fluid Center, the laboratory is developing benchtop models that continuously pass patient-derived cerebrospinal fluid through a variety of flow-diversion technologies as a way to better understand the interaction between cerebrospinal fluid and vascular systems.
Relevant in vivo models developed in the laboratory test new and innovative technologies that can improve the lives of patients at risk of complications related to hydrocephalus. Collaboration between Eric Jackson, M.D. in the laboratory and the Johns Hopkins Applied Physics Laboratory has led to a novel model of a ventriculoperitoneal shunt catheter for the prevention of local astrocyte proliferation and shunt occlusion.
The Spinal Fusion Laboratory, directed by Timothy Witham, M.D., is committed to advancing promising therapies to improve patient outcomes in spinal surgery. One key area of research focuses on the elimination of fusion failure, also known as pseudoarthrosis.
Witham and his colleagues study various strategies for improving spinal fusion outcomes, including delivery of various growth factors and biological agents, stem cell therapies and tissue engineering approaches. The laboratory is also interested in problems concerning overall spine health. In particular, the group is exploring therapies to improve vertebral bone quality in patients with conditions such as osteoporosis and radiation-induced osteonecrosis that may require future spinal fusion procedures.
Chordoma research is led by a comprehensive team including Gary Gallia, M.D., director of the Neurosurgery Skull Base Tumor Center. The laboratory focuses on developing new therapies for brain and skull base tumors, and has established the first primary skull base chordoma xenograft mouse model. The team is also exploring high throughput drug screening using the chordoma model, and the molecular pathways responsible for tumor maintenance and growth.
The Spinal Metastasis Laboratory is developing new therapies and repurposing previously FDA-approved therapies to combat metastases to the spine. This lab is also investigating the molecular pathways that allow primary cancer cells to migrate to and invade the spine. Clinical research in the lab consists of predictive analytics to assess risk factors, complications and prognosis for patients undergoing spine surgery. The lab has developed well-cited patient scoring systems in spinal oncology and spinal deformity surgery.
Nicholas Theodore, M.D., the Donlin M. Long Professor of Neurosurgery, leads a team that focuses on neurotrauma, neuronavigation in spine surgery, robotic-assisted surgery and spinal pathophysiology. Translational research in the lab using large animal models of spinal cord injury assess clinically translatable methods of acute neural decompression following traumatic injury. Theodore co-directs the Carnegie Center for Surgical Innovation, alongside Jeffrey Siewerdsen, Ph.D., working closely with biomedical engineers to design novel diagnostic and therapeutic tools in spinal surgery and spinal cord injury. Clinical research applies recent technological advancements in the field, such as robotic assistance and image guidance, to facilitate safer surgery. Genetic research in the lab is identifying predisposing factors for degenerative spinal conditions and developing targeted treatment for post-operative pain.
Vascular research led by Rafael Tamargo, M.D., the Walter E. Dandy Professor of Neurosurgery, explores treatment of aneurysms, arteriovenous malformations, cavernous malformations, and arteriovenous fistulas of the brain and spinal cord. Basic science research has focused on endothelial cell-leukocyte interactions (inflammation) after subarachnoid hemorrhage and identifying drugs that might inhibit this inflammatory response as well as the narrowing of blood vessels.
In addition to the Hunterian laboratory, the Department of Neurosurgery has several other major research laboratory programs, such as:
- Functional Neurosurgery (Stan Anderson, M.D. and Fred Lenz, M.D.)
- Brain Cancer Biology and Therapy Laboratory (Gregory Riggins, M.D., Ph.D.)
- The Neurosurgery Pain Research Institute (Michael Caterina, M.D., Ph.D. and Allan Belzberg, M.D.)
- The Spinal Column Surgical Outcomes Laboratory (Ali Bydon, M.D.)
- Supendymoma and Ependymoma Research Center (Henry Brem, M.D.)
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