Neurosurgical Engineering (2006)

Science Times Editorial There is much in common between basic science and engineering approaches to research. The two seek empiric testing of hypotheses, both are grounded in quantitative measurements, and both require rigor, objectivity and bias control. The two approaches use the concepts of fundamental science (chemistry, physics, biology), both employ empiric tools (microscopy, chemical characterization, spectroscopic signatures), and both frame results using computational techniques and statistics. In the broad sense, both ultimately seek the truth. Yet there is a distinct philosophy between basic science and engineering approaches. They have different identity, method and purpose, and we all know it. Basic science seeks new knowledge for the sake of knowledge, with applications left as a footnote in the background and potential significance. The usefulness of basic science discoveries is typically left to further hypothesis testing in future studies. Engineering research is problem driven, aiming to overcome a specific challenge, to circumvent a limitation, or to model a phenomenon—all with practical applications conceived up front. It has been observed that neurosurgeons function more like engineers than basic scientists. They face practical problems and they seek scientific approaches to solve them. Yet neurosurgeons' research training, as with many biomedical sciences, has largely been driven by basic science models and mentors. And as basic science has become more complex, neurosurgeons have become more disconnected, and less literate. In two decades, at more than five academic institutions, we have documented a similar disconnection, and this has undoubtedly contributed to the alienation of many innovative neurosurgical minds from the academic enterprise. Many simply do not identify with the basic science culture, yet they see themselves as “tinkerers” problem solvers. Few mentors and incubation models have directed this neurosurgical talent into rigorous bioengineering research. In our opinion, neurosurgery has suffered, by losing talent from the limited academic pool, and by missing out on neurosurgical innovations and solutions that these minds could have contributed. Engineering has suffered as well by missing out on cogent neurosurgical applications of its tools and concepts. Engineering has embraced the tools of modern biology and engineers from all disciplines are more sophisticated in their approach to life sciences than they were a generation ago. The National Institutes of Health have recognized the bioengineering approach by establishing the National Institute of Biomedical Imaging and Bioengineering as an orthodox venue of scientific research (http://www.nibib.nih.gov). It is perhaps the one federal research institute that is most braced toward translational application of basic science knowledge, and interdisciplinary integration of concepts and tools for the solutions of specific medical problems. Many institutions have acknowledged their lag in this area, and recognized herein a unique opportunity. At Northwestern University, the McCormick School of Engineering is closer physically to one of our teaching hospitals in Evanston, but not to the Feinberg School of Medicine campus in downtown Chicago. The two schools had not generally been well integrated programmatically. Our neurosurgical department has worked to overcome these cultural and geographical gaps, in close collaboration with the faculty and leadership of the School of Engineering. Close working groups including faculty from both schools were established in the areas of imaging, robotics and nanotechnology, polymers and material science, and computational biology and modeling. We hosted joint retreats with poster presentations (Figure) and with focus group discussions. We have pooled resources to incentivize collaborations at the junior faculty level, by competitive funding of postdoctoral fellows under joint mentoring of paired faculty from engineering and neurosurgery. This Neurosurgical Bioengineering Initiative (http://www.medschool.northwestern.edu/neurosurgery/research/collaboration/Bioengineering%20collaboration.pdf) resulted in supporting three new working groups engaging junior neurosurgery faculty in projects related to bioadhesives, optical diffraction imaging of tumors, and advanced modeling of Parkinson's Disease circuits in deep brain stimulation. These are all braced to generate pilot data for extramural funding. More senior faculty groups have continued to formalize collaborations in ongoing research on gait analysis after spinal fusion, applied mathematical modeling of cerebral aneurysm growth dynamics, and molecular imaging of cerebrovascular disease. In less than a year, a whole new dynamic of research has emerged in our department. New collaborations, laboratories and infrastructure have presented themselves, motivating faculty and trainees at all levels, and opening new venues for mentoring, incubation and application of talent.Figure: Poster session in Neurosurgery Engineering Retreat motivating focused working groups of engineering and neurosurgery faculty and trainees.Neurosurgical engineering should not and will not replace basic neuroscience and applied clinical research venues shaping much of neurosurgical investigations. Yet they open a fantastic new venue and create a whole new dimension for motivating neurosurgical and engineering innovations, and they establish a novel front for training and funding. In some ways, neurosurgeons have always been engineers, and these strategies allow us to rediscover ourselves. ISSAM AWAD, M.D. ASSOCIATE EDITOR H. HUNT BATJER, M.D. Chairman of the Department of Neurological Surgery at the Feinberg School of Medicine, Northwestern University MATTHEW R. GLUCKSBERG, PH.D. PROFESSOR AND CHAIRMAN OF THE DEPARTMENT OF BIOENGINEERING AT THE MCCORMICK SCHOOL OF ENGINEERING, NORTHWESTERN UNIVERSITY