unversity of california san francisco curriculum … · deep brain stimulation, gene therapy,...

UNVERSITY OF CALIFORNIA SAN FRANCISCO CURRICULUM VITAE July 1, 2010 Name Paul S. Larson, MD Positions Associate Clinical Professor, Step 1 Department of Neurological Surgery School of Medicine Chief, Neurosurgery Founder and Director, CanOp (Center for Advanced Neurosurgical Operative Procedures) San Francisco VA Medical Center Address University of California, San Francisco 505 Parnassus Avenue, Box 0112 San Francisco, CA 94143-0112 Voice (415) 353-3489 Fax (415) 353-3459 Email [email protected] URL www.neurosurgery.ucsf.edu

EDUCATION Arizona State University BS 1984-1990 Department of Zoology The University of Arizona MD 1990-1995 College of Medicine and Graduate Program in Neuroscience University of Louisville Intern 1995-1996 General Surgery University of Louisville Resident 1996-2000 Neurological Surgery University of Louisville Chief Resident 2000-2001 Neurological Surgery

LICENSURE AND CERTIFICATIONS California Medical License Lic # available by request 2001-present American Board of Neurological Surgery Board Certification #27101 2007-present CA Fluoroscopy Supervisor & Operator Permit # RHC 166629 2008-present

PRINCIPAL POSITIONS HELD Department of Neurological Surgery Assistant Professor in Residence 2001-2004 University of California, San Francisco

Paul Larson, MD

Department of Neurological Surgery Assistant Clinical Professor 2004-2009 University of California, San Francisco Department of Neurological Surgery Associate Clinical Professor 2009-present University of California, San Francisco Veterans Affairs Medical Center Chief, Neurosurgical Service 2008-present San Francisco, CA Veterans Affairs Medical Center Director, Center for Advanced 2009-present San Francisco, CA Neurosurgical Operative Procedures

OTHER POSITIONS HELD CONCURRENTLY Veterans Affairs Medical Center Attending Neurosurgeon 2001-present San Francisco, CA San Francisco General Hospital Attending Neurosurgeon 2001-present San Francisco, CA

HONORS AND AWARDS Medical Student Research Awards 1991, 1992 The University of Arizona and Barrow Neurological Institute

Excellence in Medical Student Research 1995 The University of Arizona First Place, Resident Paper Competition 1999 Louisville Surgical Society First Place, Biotechnology Research Category 1999 Research!Louisville 1999 Excellence in Clinical Education Award 2000 University of Louisville School of Medicine Harold Rosegay Teaching Award 2004 Department of Neurological Surgery University of California, San Francisco Who's Who in Medical Sciences Education 2005 Diane D. Ralston Teaching Award 2007 Department of Neurological Surgery University of California, San Francisco

KEY WORDS/AREAS OF INTEREST Deep brain stimulation, gene therapy, interventional MRI, movement disorders, Parkinson’s disease, essential tremor, tinnitus, auditory physiology, psychiatric disorders, Tourette’s syndrome, major depressive disorder, obsessive compulsive disorder, high field MRI imaging

Paul Larson, MD

PROFESSIONAL ACTIVITIES

CLINICAL Attending, Inpatient Neurosurgical Service, San Francisco VA Medical Center I have attended this service 3 days a week since 2001, supervising residents, fellows, medical students, nurse practitioners and physician assistants in the ICU, wards and operating room. Attending, Parkinson’s Disease Research, Education and Clinical Center (PADRECC) I have attended this service since its creation in 2002. This includes supervising neurology and neurosurgery residents, fellows and medical students in the outpatient, inpatient and surgical settings. Attending, Outpatient Neurosurgery Clinic, San Francisco VA Medical Center I have attended this clinic 1 day a week since 2001, supervising residents, medical students, nurse practitioners and physician assistants. Attending, Inpatient Functional Neurosurgery Service, University of California San Francisco I have attended this service an average of two days a week since 2001, supervising residents, fellows, medical students and nurse practitioners in the ICU, wards and operating room. Attending, Multidisciplinary Movement Disorders Clinic, University of California San Francisco I have attended this clinic one half day a week since 2001, supervising neurosurgery and neurology movement disorders fellows and a nurse practitioner. Attending, Adult Hydrocephalus Clinic, University of California San Francisco I have attended this clinic two months a year since 2005. Attending, Inpatient Neurosurgery Service, San Francisco General Hospital I have attended this service on call during the weekends approximately 8 to 9 times a year since 2002, supervising residents, medical students and nurse practitioners in the ICU, wards and operating room. Attending, Intensive Care Unit Team, San Francisco VA Medical Center I have attended this service for 1-2 weeks per year since 2005, supervising residents, fellows, medical students and nurse practitioners in critical care management of all patients in the ICU (includes general medicine, medical subspecialty, general surgery and surgical subspecialty services). Consultant Neurosurgeon, Specialty Clinics, Ioannis A. Lougaris VA Medical Center I traveled to Reno, Nevada to attend this clinic 6 times a year from 2001 to 2005, and currently act as a consultant for the medical center. VTEL Attending, Neurosurgical Service, San Francisco VA Medical Center I attend periodic remote video-teleconference clinics with remote VA sites an average of 2 times a month. These include both movement disorders and general neurosurgical patients at VA sites throughout the western continental United States, the Hawaiian islands and Guam.

SUMMARY OF CLINICAL ACTIVITIES The majority of my time is spent attending the neurosurgical service at the San Francisco VA Medical Center, the highest volume VA neurosurgical service in the country. This includes supervising a wide variety of neurosurgical cases including deep brain stimulation (DBS), craniotomy for neoplastic, vascular, and functional disorders, skull base surgery, neuroendoscopy, complex spine surgery and peripheral nerve surgery. I have created new interdisciplinary team efforts with the ENT service for the surgical treatment of acoustic neuromas, with the cardiothoracic service for thoracoscopic procedures to treat spinal and diaphragmatic disorders, and with the general surgery service to create the first lumbar disc replacement service in the VA system. I have formed a formal epilepsy service in conjunction with neurology for formal inpatient evaluation and surgical management of veterans with seizure disorders. In 2009, I founded the

Paul Larson, MD

San Francisco VA CanOp (Center for Advanced Neurosurgical Operative Procedures). This is the first center of its kind within the VA system, and allows our neurosurgical staff to offer veterans the latest surgical technologies including minimally invasive spinal surgery techniques, lumbar and cervical disc prostheses, keyhole and endoscopic cranial approaches, and interventional MRI-guided procedures. Our Movement Disorders Program at UCSF has one of the largest volumes of DBS patients in the country. In addition to my regular DBS practice, I am currently involved in several clinical trials related to the surgical treatment of movement disorders. These include gene therapy trials for Parkinson’s disease, a trial using real-time high field interventional MRI for implantation of DBS electrodes, and a pre-FDA clinical trial for a new DBS system. I am also in the process of starting a new program for the surgical treatment of psychiatric disorders. Please refer to the “Current Research Interests/Program” section for further information.

PROFESSIONAL ORGANIZATIONS

MEMBERSHIPS Congress of Neurological Surgeons 2001-present

AANS-CNS Joint Section on Stereotactic and Functional Neurosurgery 2001-present

American Society for Stereotactic and Functional Neurosurgery 2001-present

World Society of Stereotactic and Functional Neurosurgery 2001-present

The Movement Disorder Society 2004-present

American Association of Neurological Surgeons 2008-present

Intraoperative Imaging Society 2008-present

Society of Lateral Access Surgery 2009-present

SERVICE TO PROFESSIONAL ORGANIZATIONS Congress of Neurological Surgeons Sergeant at Arms 1999 Council of State Neurosurgical Societies Resident Delegate, Southeast Quadrant 2000-2001 The Movement Disorders Society Neurosurgery Task Force 2004-present American Society for Stereotactic and Abstract Selection Committee 2006 Functional Neurosurgery American Society for Stereotactic and Executive Council 2006-2010 Functional Neurosurgery American Society for Stereotactic and Webmaster 2006-2010 Functional Neurosurgery American Society for Stereotactic and Moderator 2008 Functional Neurosurgery Congress of Neurological Surgeons IML Technology Moderator 2008 Congress of Neurological Surgeons Abstract Selection Committee 2009 American Association of Neurological Abstract Selection Committee 2009 Surgeons

Paul Larson, MD

AANS/CNS Joint AANS/CNS Guideline Committee 2009-present American Society for Stereotactic and Moderator 2010 Functional Neurosurgery

SERVICE TO PROFESSIONAL PUBLICATIONS Ad Hoc Reviewer 2007 Neurotherapeutics Invited Reviewer 2008 Neuropsychiatric Disease and Treatment Invited Reviewer 2008 Parkinsonism and Related Disorders Ad Hoc Reviewer 2009-present Journal of Neurosurgical Anesthesiology Ad Hoc Reviewer 2009-present The International Journal of Neuroscience Associate Editor for Psychiatry and Movement Disorders 2009-present Neurosurgery Editorial Board 2010-present NeuroMapping & Therapeutics

INVITED PRESENTATIONS

INTERNATIONAL GE Clinical Investigators Steering Committee Meeting (platform speaker) May 2, 1999 Leipzig, Germany St. Andrews Hospital (visiting professor) September 3-4, 2009 Brisbane, Queensland, Australia 6th Annual Australia/New Zealand DBS Users Meeting (honored guest) September 5-6, 2009 Sydney, New South Wales, Australia Polish Society of Stereotactic and Functional Neurosurgery (honored guest) March 4-5, 2010 Ustron, Poland NATIONAL Intraoperative MRI Practical Course (invited talk) October 30, 1999 Congress of Neurological Surgeons, Boston, MA Department of Neurological Surgery Grand Rounds (invited talk) January 11, 2001 UCSF, San Francisco, CA American College of Surgeons Annual Congress (invited panelist) October 3, 2002 San Francisco, CA

Paul Larson, MD

Deep Brain Stimulation Practical Course (invited faculty) April 26, 2003 American Assoc of Neurological Surgeons, San Diego, CA Am Soc for Stereotactic and Functional Neurosurgery (platform) May 20, 2003 New York, NY Deep Brain Stimulation Practical Course (invited faculty) October 18, 2003 Congress of Neurological Surgeons, Denver, CO Focus on Activa Deep Brain Stimulation Therapy (invited faculty) February 7-8, 2004 San Francisco, CA Focus on Activa Deep Brain Stimulation Therapy (invited faculty) March 6-7, 2004 Scottsdale, AZ

General Electric Whitney Symposium (invited speaker) March 9, 2004 Niskayuna, NY Focus on Activa Deep Brain Stimulation Therapy (invited faculty) August 21-22, 2004 Oklahoma City, OK Am Soc for Stereotactic and Functional Neurosurgery (plenary session) October 1, 2004 Cleveland, OH Focus on Activa Deep Brain Stimulation Therapy (invited faculty) October 9-10, 2004 Memphis, TN Image Guided Neurologics (invited speaker) October 19, 2004 Congress of Neurological Surgeons, San Francisco, CA Deep Brain Stimulation Practical Course (invited faculty) October 19, 2004 Congress of Neurological Surgeons, San Francisco, CA Focus on Activa Deep Brain Stimulation Therapy (invited faculty) December 11-12, 2004 Minneapolis, MN Focus on Activa Deep Brain Stimulation Therapy (invited faculty) January 15-16, 2005 Salt Lake City, UT GKF National Gamma Knife User's Meeting (invited faculty) February 26, 2005 San Francisco, CA Focus on Activa Deep Brain Stimulation Therapy (invited faculty) August 11-12, 2005 San Francisco, CA Medtronic Foundations DBS Course (invited faculty) August 25, 2005 Minneapolis, MN Medtronic Foundations DBS Course (invited faculty) November 2, 2005 Minneapolis, MN Medtronic Foundations DBS Course (invited faculty) February 28, 2006 Minneapolis, MN

Paul Larson, MD

Frameless DBS Course (invited faculty) April 1, 2006 San Francisco, CA American Association of Neurological Surgeons (invited panelist) April 25, 2006 San Francisco, CA Western Regional DBS Roundtable (invited moderator) August 26, 2006 Newport Beach, CA American Association of Neurological Surgeons (invited panelist) April 16, 2007 Washington, DC International Essential Tremor Foundation (invited speaker) July 14, 2007 San Rafael, CA Neurosurgery Update in the Wine Country (faculty) August 3, 2007 Napa, CA Midwest Regional DBS Roundtable (invited moderator) January 12, 2008 New Orleans, LA Intraoperative Imaging Society (invited faculty) February 22, 2008 Lake Tahoe, NV American Association of Neurological Surgeons (invited panelist) April 28, 2008 Chicago, IL American Society of Artificial Internal Organs (platform) June 21, 2008 San Francisco, CA Second Annual Neuroscience Symposium (invited speaker) June 21, 2008 Taylor McAdam Bell Neuroscience Institute, Freemont, CA The Movement Disorder Clinic of Oklahoma (visiting professor) June 26-27, 2008 Tulsa, OK Society of University Neurosurgeons (invited speaker) June 30, 2008 San Francisco, CA Neurosurgery Update in the Wine Country (faculty) July 24, 2008 Napa, CA American Association of Neurological Surgeons (invited panelist) May 5, 2009 San Diego, CA SurgiVision, Inc. (keynote speaker) May 5, 2009 American Association of Neurological Surgeons, San Diego, CA Neurosurgery Update in the Wine Country (faculty) July 31, 2009 Napa, CA SurgiVision, Inc. (keynote speaker) October 27, 2009 Congress of Neurological Surgeons, New Orleans, LA VA PADRECC Parkinson’s Disease Seminar (invited faculty) November 13, 2009 San Francisco, CA + video feed to 14 other national sites

Paul Larson, MD

American Association of Neurological Surgeons (moderator and panelist) May 5, 2010 Philadelphia, PA

REGIONAL AND OTHER INVITED PRESENTATIONS 11th Annual Summer Workshop (invited faculty) July 20, 1998 University of Louisville, Louisville, KY 7th Annual International Medical Conference (invited speaker) May 17, 1999 University of Louisville and Norton Healthcare, Louisville, KY Quarterly Meeting of the Norton Women’s Board (invited speaker) November 15, 1999 Louisville, KY Kentucky-Indiana Society of Radiology Technologists (invited speaker) March 6, 2000 Louisville, KY Department of Anesthesia Grand Rounds (invited speaker) March 14, 2000 University of Louisville, Louisville, KY Inaugural Patient Focused Grand Rounds (invited speaker) April 12, 2000 University of Louisville, Louisville, KY Medical Student Luncheon Seminar Series (invited speaker) February 13, 2001 University of Louisville, Louisville, KY Association of Surgical Technologists (invited speaker) March 3, 2001 Louisville, KY Department of Anesthesia Lecture Series (invited speaker) June 4, 2001 University of Louisville, Louisville, KY Department of Neurological Surgery Grand Rounds (invited speaker) February 20, 2003 University of California, San Francisco Daly City Parkinson’s Support Group (invited speaker) March 4, 2003 Daly City, CA Santa Rosa Parkinson’s Disease Support Group (invited speaker) April 5, 2003 Santa Rosa, CA Magnolia Peninsula Support Group (invited speaker) April 10, 2003 Millbrae, CA San Francisco Parkinson’s Disease Support Group (invited speaker) June 17, 2003 San Francisco, CA North Bay Neurology Dinner Program (invited speaker) November 20, 2003 Santa Rosa, CA Department of Neurological Surgery Grand Rounds (invited speaker) August 12, 2004 University of California, San Francisco Movement Disorders Interest Group (invited speaker) November 10, 2004 University of California, San Francisco

Paul Larson, MD

Medtronic Deep Brain Stimulation Patient Symposium (invited speaker) November 20, 2004 Petaluma, CA Mill Valley Parkinson’s Support Group (invited speaker) November 23, 2004 Mill Valley, CA Intensive Care Unit Conference (invited speaker) December 20, 2004 San Francisco VA Medical Center Neuroradiology Conference (invited speaker) January 18, 2005 University of California, San Francisco Movement Disorders Interest Group (invited speaker) April 6, 2005 University of California, San Francisco San Francisco Parkinson's Support Group (invited speaker) April 21, 2005 San Francisco, CA Intensive Care Unit Conference (invited speaker) June 21, 2005 San Francisco VA Medical Center Sonoma Valley Parkinson’s Support Group (invited speaker) August 6, 2005 Santa Rosa, CA Santa Rosa Memorial Hospital Grand Rounds (invited speaker) October 28, 2005 Santa Rosa, CA Marin General Hospital Grand Rounds (invited speaker) December 6, 2005 Greenbrae, CA UCSF Neurosurgical Nurses Team Dinner (invited speaker) January 26, 2006 San Francisco, CA Good Samaritan Hospital Grand Rounds (invited speaker) January 3, 2007 San Jose, CA Department of Neurological Surgery Grand Rounds (invited speaker) August 30, 2007 University of California, San Francisco Medtronic DBS Patient Education Seminar (invited speaker) October 11, 2007 Berkeley, CA Parkinson Association of Northern California (invited speaker) October 19, 2007 Sacramento, CA San Francisco Neurological Society (invited speaker) March 15, 2008 Monterey, CA Parkinson Association of Northern California (invited speaker) September 13, 2008 Sacramento, CA Department of Psychiatry Grand Rounds (invited speaker) September 15, 2008 University of California, San Francisco

Paul Larson, MD

National Alliance on Mental Illness (invited speaker) February 18, 2009 San Francisco, CA Parkinson Association of Northern California (invited speaker) July 30, 2009 Napa, CA

Medtronic DBS for OCD Physician Dinner (invited speaker) August 13, 2009 San Francisco, CA

UCSF Conference on Parkinson Disease (invited speaker) November 14, 2009 San Francisco, CA

International Essential Tremor Foundation (invited speaker) March 20, 2010 Walnut Creek, CA

UCSF Neurosurgical Nurses Team Dinner (invited speaker) April 22, 2010 San Francisco, CA

Medtronic DBS for OCD Physician Dinner (invited speaker) June 7, 2010 Oakland, CA

Paul Larson, MD

CME COURSES ATTENDED (PAST 5 YEARS) The Movement Disorders Society March, 2005 New Orleans, LA Congress of Neurological Surgeons October, 2005 Boston, MA American Association of Neurological Surgeons April, 2006 San Francisco, CA American Society for Stereotactic and Functional Neurosurgery June, 2006 Boston, MA The Movement Disorders Society October, 2006 Kyoto, Japan American Association of Neurological Surgeons April, 2007 Washington, DC Intraoperative Imaging Society February, 2008 Lake Tahoe, NV American Association of Neurological Surgeons April, 2008 Chicago, IL American Society for Stereotactic and Functional Neurosurgery June, 2008 Vancouver, BC Congress of Neurological Surgeons September, 2008 Orlando, FL American Association of Neurological Surgeons May, 2009 San Diego, CA The Movement Disorders Society June, 2009 Paris, France Congress of Neurological Surgeons October, 2009 New Orleans, LA American Association of Neurological Surgeons May, 2010 Philadelphia, PA American Society for Stereotactic and Functional Neurosurgery June, 2010 New York, NY

OTHER COURSES ATTENDED (PAST 5 YEARS) Charite Artificial Lumbar Disc Course October, 2005 DePuy Spine, Cincinnati, OH Neuroendoscopy Course January, 2007 Aesculap, Phoenix, AZ

Paul Larson, MD

XLIF Course December, 2007 NuVasive, La Jolla, CA Prestige Artificial Cervical Disc and DLIF Training October, 2008 Medtronic, San Francisco, CA Mastery XLIF Course August, 2009 NuVasive, La Jolla, CA MAST/O-arm Training August, 2009 Medtronic, Sunnyvale, CA DBS for Obsessive Compulsive Disorder Team Training September, 2009 Medtronic, Minneapolis, MN

GOVERNMENT AND OTHER PROFESSIONAL SERVICE Intraoperative MRI Clinical Investigators Program Steering Committee 1999 General Electric Medical Systems Steering Committee, 2nd International Workshop on 3D Imaging and Virtual Endoscopy 2000-2001 University of Essen, Essen, Germany and University of Parma, Parma, Italy Invited Reviewer 2008 Volkswagen Stiftung (Germany) Invited Reviewer 2008 The Michael J. Fox Foundation Invited Reviewer 2008 Fondation pour la Recherche Medicale (France)

UNIVERSITY AND PUBLIC SERVICE

UNIVERSITY/VA CAMPUS-WIDE Restraint Reduction Task Force 2002-2003 San Francisco Veterans Affairs Medical Center Root Cause Analysis Team 2004 San Francisco Veterans Affairs Medical Center Care of the Patient Functional Team 2003-2006 San Francisco Veterans Affairs Medical Center

Operating Room New Item Committee 2003-present San Francisco Veterans Affairs Medical Center Chair, Operating Room New Item Committee 2007-present San Francisco Veterans Affairs Medical Center

OR Committee 2008-present San Francisco Veterans Affairs Medical Center

Paul Larson, MD

Surgery Representative, Equipment Committee 2008-present San Francisco Veterans Affairs Medical Center

SCHOOL OF MEDICINE Critical Care Performance Improvement Team 1997-1999 University of Louisville Hospital Graduate Medical Education Committee 2000-2001 University of Louisville School of Medicine Representative, House Staff Council 2000-2001 University of Louisville School of Medicine

Credentials Committee 2005-2009 School of Medicine University of California, San Francisco

Evaluator, Intern Surgical Skills Laboratory 2009 School of Medicine, Department of Surgery University of California, San Francisco

Faculty Search Committee 2009 Department of Radiology University of California, San Francisco Faculty Search Committee 2009 Department of Neurological Surgery University of California, San Francisco

DEPARTMENTAL SERVICE Internal Residency Review Committee 1998 Department of Neurological Surgery University of Louisville School of Medicine Internal Residency Review Committee 1999 Department of Neurology University of Louisville School of Medicine

Co-Director, Resident Neuroscience Course 2005-present Department of Neurological Surgery University of California, San Francisco Resident Education Committee 2005-present Department of Neurological Surgery University of California, San Francisco

Chair, Resident Education Committee 2007-present Department of Neurological Surgery University of California, San Francisco

Neurosurgery Resident Site Director 2008-present San Francisco VA Medical Center

Paul Larson, MD

PUBLIC SERVICE Kentucky Organ Donor Affiliates Steering Committee 1998-2000 Louisville, KY Westwind Architectural Committee 2005-present Sonoma County, CA

SUMMARY OF SERVICE ACTIVITIES At the VA Medical Center, my service activities are largely related to the ongoing operations of the Surgical Service, particularly with regards to functioning of the operating room. As Chief of the neurosurgical service and member of the OR committee, I participate in everything from development of policy to evaluation of daily block time utilization. As the chair of the OR New Item Committee and member of the campus-wide equipment committee, I oversee the evaluation and purchase of surgical equipment and instrumentation requested by all of the surgical subspecialties. As Director of the CanOp, I acquire capital equipment to support the program and oversee the clinical activities of the center. At UCSF, most of my service activities are focused on resident education within the Department of Neurological Surgery. I am co-director for the three-hour long weekly Resident’s Neuroscience Course; I set the curriculum and arrange speakers for 6 months of the course (52 lectures) per year. I am also Chair of the Resident Education Committee, which presides over all resident education issues including but not limited to resident rotations and curriculum, performance and disciplinary measures, policy matters and administrative management of fellowships within the department.

Paul Larson, MD

TEACHING AND MENTORING FORMAL SCHEDULED CLASSES FOR UCSF STUDENTS (PAST 5 YEARS)

Academic Year Course No. & Title Teaching Contribution Class Size

2005-2006 Neuro 110 – Core Clerkship in Neurology and Neurosurgery

Neurosurgery teaching rounds (10 one-hour didactic sessions); Lecturer (3 lectures)

Didactic sessions, 6; lectures, 25










2008-2009 OR Assist – Surgical Elective for first year medical students

One-on-one teaching in the OR on surgical and sterile technique

3 Individual sessions




2009-2010 OR Assist – Surgical Elective for first year medical students



2010-present Neuro 110 – Core Clerkship in Neurology and Neurosurgery



2010-present OR Assist – Surgical Elective for first year medical students



POSTGRADUATE AND OTHER COURSES (PAST 5 YEARS)

Academic Year Course No. & Title Teaching Contribution Class Size

2005-2006 Dept of Neurological Surgery Resident Neuroscience Course

Course Director (52 lectures), Lecturer (6 lectures)

15

2005-2006 Dept of Neurology Resident’s Course

Lecturer (1 lecture) 20

2006-2007

Dept of Neurological Surgery Resident Neuroscience Course


15





15





15





15

Paul Larson, MD



2010-present Dept of Neurological Surgery Resident Neuroscience Course


15

2010-present Dept of Neurology Resident’s Course


PREDOCTORAL STUDENTS SUPERVISED OR MENTORED

Dates Name Program or School Role Current Position

2002-2003

Gabriel Zada, MS III

Longitudinal Clinical Experience, UCSF School of Medicine

Clinical Instructor and Mentor

Neurosurgery Resident, USC

2003-2004

Matt Potts, MS III



Neurosurgery Resident, UCSF

2003-2004

Brian Baker, MS III Longitudinal Clinical Experience, UCSF School of Medicine


Emergency Medicine Resident, NYU

2004-2005

Jonathan Rosenson, MS III



Emergency Medicine Resident, UC

2004-2005

Jason Chang, MS III Longitudinal Clinical Experience, UCSF School of Medicine



2005 Michael Ivan, MS I Summer Research Volunteer Univ of Medicine and Dentistry of New Jersey

Research Supervisor and Mentor


2005-2006

Maria Carolina-Court, MS III



(Lost contact)

2005-2006

Catherine Chan, MS III



Neursurgery Resident, UC Irvine

2006-2007

Chris Potter, MS III Longitudinal Clinical Experience, UCSF School of Medicine


Radiology Resident, UCSF

2006-2007

Malcolm Anthony, MS III



Surgical Resident, UT Houston

2007-2008

Jonathan Chong, MS III

VALOR Mentoring Program, UCSF/VA Medical Center


Plastic surgical Resident

2008 Mike Tseng, MSI OR Assist Elective, UCSF School of Medicine

Clinical Instructor MSIV

2008-2009

Ari Kane, MSIII Longitudinal Clinical Experience, UCSF School of Medicine


Howard Hughes Research Fellow

2009 Laurent Menut, MSI OR Assist Elective, UCSF School of Medicine

Clinical Instructor MSIIi

2009-2010

Derek Southwell, MSIII



MSIV

2010 Lusine Danakian, MSI OR Assist Elective, UCSF School of Medicine

Clinical Instructor MSII

Paul Larson, MD

POSTDOCTORAL FELLOWS AND RESIDENTS DIRECTLY SUPERVISED OR MENTORED

Dates Name Position Faculty Role Current Position

2001 Steven Ojemann, MD

Neurosurgical Resident

Clinical Training Asst Professor, Univ of Colorado

2001-2002

Philip Theodosopoulos, MD


Clinical Training Asst Professor, Univ of Cincinnati

2001-2003

Anthony Mosley, MD, MS

Movement Disorders Neurology Fellow

Clinical Training Medical Director, Parkinson’s Ctr, Evergreen, WA

2002 Matthew Smyth, MD Neurosurgical Resident

Clinical Training Asst Professor, Washington U

2002 Jay Chun, MD, PhD


Clinical Training Private Practice, New Jersey

2003 Edward Vates, MD, PhD


Clinical Training Asst Professor, Univ of Rochester

2002-2003

Efstathios Papavassiliou, MD

Movement Disorders Surgery Fellow

Clinical Training, Research Supervision

Asst Professor, Beth Israel Deconess Med Ctr, Boston

2003 Rose Du, MD, PhD Neurosurgical Resident

Clinical Training Asst Professor, Brigham and Women’s Hosp

2003 Kurtis Auguste, MD Neurosurgical Resident

Clinical Training Asst Professor, UCSF

2004 Justin Smith, MD, PhD


Clinical Training Asst Professor, UVA

2004 Marcus Ware, MD, PhD


Clinical Training Asst Professor, Tulane Univ

2004

John Chi, MD, MPH Neurosurgical Resident

Clinical Training Asst Professor, Brigham and Women’s Hosp

2005 Devin Binder, MD, PhD

Neurosurgical Resident Clinical Training Asst Professor, UC Irvine

2005 Alfredo Quinones, MD

Neurosurgical Resident Clinical Training Asst Professor, Johns Hopkins

2004-2005

Paul House, MD Movement Disorders Surgery Fellow


Asst Professor, Univ of Utah

2004-2006

Suketu Khandhar, MD


Clinical Training Asst Professor, UC Davis

2005 Dan Lim, MD, PhD Neurosurgical Resident Clinical Training Asst Professor, UCSF

2005-2006

Rene Sanchez, MD

Neurosurgical Resident Clinical Training Fellow, Mass General

2006- Frank Acosta, MD Neurosurgical Resident Clinical Training Fellow, Rush Univ

2006-2007

Karl Sillay, MD Movement Disorders Surgery Fellow

Clinical training, Research

Asst Professor, Univ of

Paul Larson, MD

Supervision Wisconsin

2006-2007

Stacey Daniels, MD Movement Disorders Neurology Fellow

Clinical Training Private Practice, San Diego, CA

2006 James Waldron, MD Neurosurgical Resident Clinical Training Fellow, Stanford Univ

2006-2007

Dan Lu, MD, PhD Neurosurgical Resident Clinical Training Fellow, Univ of Tennessee

2007 Nader Sanai, MD Neurosurgical Resident Clinical Training Fellow, BNI

2007-2008

Sephr Sani, MD Movement Disorders Surgery Fellow


Asst Professor, Rush Univ

2007-present

Lauren Shrock, MD Movement Disorders Neurology Fellow

Clinical Training Asst Professor, Univ of Utah

2007 Edward Chang, MD Neurosurgical Resident Clinical Training Chief Resident

2007-2008

Vincent Wang, MD, PhD

Neurosurgical Resident Clinical Training Chief Resident

2008 Isaac Yang, MD Neurosurgical Resident Clinical Training Chief Resident

2008 Seok-Ho Hong, MD, PhD

Visiting Assistant Professor, Neurosurgery, Univ of Ulsan, Seoul, Korea

Clinical Training Asst Professor, Unv of Ulsan

2008-2009

Michael Sughrue, MD Neurosurgical Resident Clinical Training Resident

2008-present

Rima Ash, MD Movement Disorders Neurology Fellow

Clinical Training

2008-2009

Nick Galifianakis, MD Movement Disorders Neurology Fellow

Clinical Training Asst Professor, UCSF

2008-2009

R. Mark Richardson, MD, PhD

Neurosurgical Resident Clinical Training Chief Resident

2009-2010

Kia Shahlaie, MD Movement Disorders Surgery Fellow

Clinical Training Asst Professor, UC Davis

2009-present

Aldofo Ramirez-Zamora, MD


Clinical Training

2009-present

Jennifer Landes, MD Movement Disorders Neurology Fellow

Clinical Training

2009 Matthew Tate, MD Neurosurgical Resident Clinical Training Resident

2009 Yi Guo, MD Visiting Neurosurgeon, Peking Union Medical College, China

Observership Attending Neurosurgeon

2009-2010

Orin Bloch, MD Neurosurgical Resident Clinical Training Resident

2010-present

Brian Jian, MD Neurosurgical Resident Clinical Training

INFORMAL TEACHING

2001-ongoing

Attending Rounds, Neurosurgery Service, VA Medical Center (3 days per week with one resident, 1-2 fellows, 3 nurse practitioners and occasional students)

2001-ongoing

Operating Room Teaching and Supervision, VA Medical Center (2-3 days per week with one resident, 1-2 fellows and occasional students)

Paul Larson, MD

2001-ongoing

General Neurosurgery and Movement Disorders Clinics, VA Medical Center (one day per week with one resident, 1-2 fellows and 1-2 students)

2001-ongoing

Neuroradiology Conference, VA Medical Center (weekly with one neurosurgery resident, 2-3 neurology residents and 4-8 students)

2001-ongoing

On-call Attending Rounds, San Francisco General Hospital (8-9 weekends per year with one resident, 2 surgical interns and occasional students)

2001-ongoing

On-call Operating Room Teaching and Supervision (8-9 weekends per year with one resident, one surgical intern and occasional students)

2001-ongoing

Movement Disorders Conference, UCSF Medical Center (monthly with 2-3 residents, 2 fellows, 2-5 graduate students and occasional students)

2001-ongoing

Neurosurgery Journal Club, UCSF Medical Center (once yearly with 15 residents)

2002-ongoing

Attending Rounds, Movement Disorders Service, UCSF Medical Center (1-2 days per week with one resident, one fellow and occasional students)

2002-ongoing

Operating Room Teaching and Supervision, UCSF Medical Center (one day per week with one resident, 1-2 fellows and occasional students)

2004-ongoing

Movement Disorders Interest Group, UCSF Medical Center (bi-weekly with 2 fellows and occasional students)

TEACHING AWARDS AND NOMINATIONS

2000 Excellence in Clinical Education Award University of Louisville School of Medicine

2004 Harold Rosegay Teaching Award Department of Neurological Surgery, UCSF

2007 Diane D. Ralston Teaching Award Department of Neurological Surgery, UCSF

SUMMARY OF TEACHING HOURS (PAST YEAR, CURRENT AND ANTICIPATED)

2008-2009

Total teaching hours: Formal class or course teaching hours: Informal teaching hours: Mentoring hours:

1,718 hours 16 hours 1,426 hours 276 hours

2009-2010

Total teaching hours: Formal class or course teaching hours: Informal teaching hours: Mentoring hours:

1,718 hours 16 hours 1,426 hours 276 hours

2010-2011

Total anticipated hours of teaching 1,718 hours

TEACHING NARRATIVE The majority of my teaching activities occur on the inpatient and outpatient neurosurgical services at the San Francisco VA Medical Center. I directly teach and supervise neurosurgical residents who are assigned to the service for 4 to 6 month periods on a daily basis. I also directly supervise and teach neurology residents, neuroradiology fellows, neurology movement disorders fellows, neurosurgical movement disorders fellows, physician assistants, nurse practitioners, nursing students and medical students weekly. Most of this activity occurs during formal conferences, teaching rounds on the wards and ICU, in the neurosurgery clinic and the Parkinson’s Center clinics, and in the operating room. Regular meetings with the third year medical students are carried out as part of the Neuro 110 clerkship, and I supervise and teach two students weekly in the clinic as part of the UCSF Longitudinal Clinical Experience program as well as the VA VALOR medical student program.

Paul Larson, MD

At UCSF, I attend the multidisciplinary Movement Disorders Clinic every Wednesday and directly teach the neurology and neurosurgery movement disorders fellows. I also supervise the neurosurgery movement disorders fellow and neurosurgical residents during deep brain stimulation procedures performed at UCSF. Formal didactic sessions are also carried out at UCSF as part of the Neuro 110 clerkship. I present cases to the neurosurgical residents during our weekly UCSF teaching conference approximately 5 to 6 times per year. I also give 6 annual lectures to the residents as part of their weekly Resident Neurosciences Course, and serve as Co-Director of the course; in this capacity, I set the curriculum and oversee 52 lectures during the year.

Paul Larson, MD

RESEARCH AWARDS AND GRANTS

CURRENT Sponsor: Surgi-Vision, Inc. 2007-2010 Title: “Interventional MRI Deep Brain Stimulator Implantation" Role: Co-PI Description: This project involves both the development of hardware and software technologies to perform DBS implantation using interventional MRI and a clinical trial studying outcomes in Parkinson’s subjects undergoing this novel procedure. Sponsor: Advanced Neuromodulation Systems, Inc./St. Jude Medical, Inc. 2005-2010 Title: “A Clinical Evaluation of the ANS Totally Implantable Deep Brain Stimulation System for the Suppression of Tremor in the Upper Extremities of Patients With Essential Tremor” Role: Co-PI Description: This clinical trial investigates the use of a new DBS system in human subjects with essential tremor. Sponsor: NIH/NIBIB (R21) 2009-2011 Title: “MR Guided DBS Implantation for Parkinson’s Disease” Role: Consultant Description: This project aims to improve STN visualization and surgical target selection in interventional MRI using using diffusion tensor imaging, high field strength MRI and internal micro-MR coils.

PENDING Sponsor: NIH/Transformative R01 2010-2015 Title: “Deep Brain Stimulation in Tinnitus” Role: PI Description: This would be a phase I/II clinical trial examining the safety, tolerability and preliminary efficacy of deep brain stimulation to treat patients with medically refractory, severe tinnitus.

PAST Sponsor: Ceregene, Inc./The Michael J. Fox Foundation 2006-2008 Title: “A Phase II Clinical Trial of Intrastriatal Injection of AAV-Neurturin for Advanced Parkinson’s Disease” Role: Co-Investigator Description: This was a phase II, double blind, sham controlled clinical trial examining the efficacy of bilateral intraputaminal infusion of AAV-Neurturin in subjects with Parkinson’s disease performed at eight centers. UCSF enrolled 11 of the 56 patients in the trial. Sponsor: Genzyme, Inc. (formerly Avigen, Inc.) 2005-2008 Title: “A Phase I Clinical Trial of Intrastriatal Injection of AAV-AADC for Motor Fluctuations in Parkinson’s Disease” Role: Co-Investigator Description: This was a phase I clinical trial examining the safety and tolerability of bilateral intraputaminal infusion of AAV-AACD in subjects with Parkinson’s disease. UCSF was the only clinical site and enrolled all 10 patients in the trial. Sponsor: VA Health Administration 2001-2007 Title: “A Randomized Trial of Deep Brain Stimulation of the Globus Pallidus or Subthalamic Nucleus Versus Best Medical Therapy for Parkinson’s Disease” Role: Co-Investigator Description: This was a six center clinical trial studying best medical therapy vs DBS and subsequently GPi vs STN DBS in the treatment of Parkinson’s disease. UCSF and the SFVA enrolled 80 of the 316 patients in the trial.

Paul Larson, MD

Sponsor: Image Guided Neurologics, Inc./Medtronic, Inc. 2004-2007 Title: “Implantation of Deep Brain Stimulators Using Interventional MRI " Role: Co-PI Description: This project involved the development of hardware, software and a methodology for DBS implantation using interventional MRI as well as clinical trial studying application accuracy and preliminary outcomes in Parkinson’s subjects undergoing this novel procedure. Sponsor: Ceregene, Inc./The Michael J. Fox Foundation 2005-2006 Title: “A Phase I Clinical Trial of Intrastriatal Injection of AAV-Neurturin for Advanced Parkinson’s Disease” Role: Co-Investigator Description: This was a phase I clinical trial examining the safety and tolerability of bilateral intraputaminal infusion of AAV-Neurturin in subjects with Parkinson’s disease. UCSF was the lead clinical site and enrolled 8 of the 12 patients in the trial. Sponsor: UCSF School of Medicine, Office of the Dean, REAC Program 2002-2003 Title: “Stimulation of Neurotransplants in a Rodent Model of Parkinson’s Disease” Role: PI Description: This project involved the development of an animal model to study the effects of physiologic stimulation of fetal cell grafts in 6-OHDA rats. Sponsor: University of California Academic Senate 2003-2004 Title: “Stimulation of Cell Transplants in Parkinson’s Disease” Role: PI Description: This project involved the development of an animal model to study the effects of physiologic stimulation of fetal cell grafts in 6-OHDA rats. Sponsor: Pfizer Inc. 1998-2000 Title: “A double-blind, placebo controlled, multicenter study to evaluate the efficacy and safety of a single intravenous dose of CP-101,606 in subjects with severe head injury” Role: Co-Investigator Description: This study investigated the use of an investigational drug in patients presenting with severe traumatic brain injury.

PEER REVIEWED PUBLICATIONS

1. Bloedel JR, Bracha V, Larson PS: Real time operations of the cerebellar cortex. Can J Neurol Sci 20(3):7-18, 1993.

2. Timmann D, Shimanski Y, Larson PS, Wunderlich DA, Stelmach GE, Bloedel JR: Visuomotor

learning in cerebellar patients. Behav Brain Res 81:99-113, 1996.

3. Larson PS, Shields CB, Moriarty TM: Intraoperative MRI and image guided neurosurgery: present and future. Innervision (Japan) 14(9):46-49, 1999.

4. Larson PS, Christiano JA Jr, Raque GH, Shields CB: Emergency magnetic resonance imaging of

cervical spinal cord injuries: clinical correlation and prognosis. Neurosurgery 45(4):956-7, 1999.

5. Larson PS, Reisner A, Morassutti DJ, Abdulhadi B, Harpring JE: Traumatic intracranial aneurysms. Neurosurgical Focus 8(1), January 2000.

6. Moriarty TM, Quinones-Hinojosa A, Larson PS, Alexander E III, Gleason PL, Schwartz RB, Jolesz

FA, Black PM: Frameless stereotactic neurosurgery using intraoperative magnetic resonance imaging: stereotactic brain biopsy. Neurosurgery 47(5):1138-1145, 2000.

Paul Larson, MD

7. Papavassiliou E, Rau G, Heath S, Abosch A, Barbaro NM, Larson PS, Lamborn K, Starr PA: Thalamic deep brain stimulation for essential tremor: relation of lead location to outcome. Neurosurgery 54(5):1120-1129, 2004.

8. Martin AJ, Larson PS, Ostrem JL, Sootsman WK, Talke P, Weber OM, Levesque N, Meyers J, Starr

PA: Placement of deep brain stimulator electrodes using real-time high-field interventional magnetic resonance imaging. Magn Reson Med 54(5):1107-14, 2005.

9. Larson PS, Richardson RM, Starr PA, Martin AJ: MR imaging of implanted deep brain stimulators:

Experience in a large series . Stereotact Funct Neurosurg 86(2):92-100, 2007.

10. Larson PS: Deep brain stimulation for psychiatric disorders. Neurotherapeutics 5(1):50-58, 2008.

11. Martin AJ, Hall WA, Roark C, Starr PA, Larson PS, Truwit CL: Minimally invasive precision brain access using prospective stereotaxy and a trajectory guide. J Magn Reson Imaging 27(4):737-43, 2008.

12. Sillay K, Larson PS, Starr PA: Deep brain stimulator hardware infections: incidence and

management in a large series. Neurosurgery 62(2):360-6, 2008. 13. Marks WJ, Ostrem JL, Verhagen L, Starr PA, Larson PS, Bakay RA, Taylor R, Cahn-Weiner D,

Stoessl AJ, Olanow CW, Bartus RT: Safety and tolerability of intraputaminal delivery of CERE-120 (adeno-associated virus serotype 2-neurturin) to patients with idiopathic Parkinson’s disease: an open-label, phase I trial. Lancet Neurol 7(5):400-8, 2008.

14. Papavassiliou E, Rau G, Heath S, Abosch A, Barbaro NM, Larson PS, Lamborn K, Starr PA.

Thalamic deep brain stimulation for essential tremor: relation of lead location to outcome. Neurosurgery 62(Suppl 2):884-94, 2008.

15. Eberling JL, Jagust WJ, Christine CW, Starr PA, Larson PS, Bankiewicz KS, Aminoff MJ: Results

from a phase I clinical trial of hAADC gene therapy for Parkinson’s disease. Neurology 70(21):1980-3, 2008.

16. Richardson RM, Larson PS, Bankiewicz KS. Gene and cell delivery to the degenerated striatum:

status of preclinical efforts in primate models. Neurosurgery 63(4):629-442, 2008. 17. Martin AJ, Larson PS, Ostrem JL, Starr PA. Interventional magnetic resonance guidance of deep

brain stimulator implantation for Parkinson disease. Top Magn Reson Imaging 19(4):213-221, 2008. 18. Weaver F, Follett K, Stern M, et al; for the CSP 468 Study Group. Bilateral deep brain stimulation

vs best medical therapy for patients with advanced Parkinson disease: a randomized controlled trial. JAMA 301(1):63-73, 2009.

19. Glass GA, Ku S, Ostrem JL, Heath S, Larson PS. Fluoroscopic EMG-guided injection of botulinum

toxin into the longus colli for the treatment of anterocollis. Parkinsonism Relat Disord 15(8):610-3, 2009.

20. Christine CW, Starr PA, Larson PS, Eberling JL, Jagust WJ, Hawkins R, VanBrocklin H, Wright JF,

Bankiewicz K, Aminoff MJ. Safety and tolerability of putaminal AADC gene therapy for Parkinson’s disease. Neurology 73(20):1662-9, 2009.

21. Shimamoto SA, Larson PS, Ostrem JL, Glass GA, Turner RS, Starr PA. Physiological identification

of the human pedunculopontine nucleus. J Neurol Neurosurg Psychiatry 81(1):80-6, 2010.

Paul Larson, MD

22. Starr PA, Martin AJ, Ostrem JL, Talke P, Levesque N, Larson PS. Subthalamic nucleus deep brain stimulator placement using high field interventional MRI and a skull-mounted aiming device: technique and application accuracy. J Neurosurg 112(3):479-90, 2010.

23. Follett KA, Weaver FM, Stern M, et al; for the CSP 468 Study Group. Pallidal versus subthalamic

deep-brain stimulation for Parkinson’s disease. N Engl J Med 362(22):2077-91, 2010.

24. Cheung SW, Larson PS. Tinnitus modulation by deep brain stimulation in locus of caudate neurons (area LC). Neuroscience: June 10, 2010 (Epub ahead of print).

25. Valles F, Fiandaca MS, Eberling JL, Starr PA, Larson PS, Christine CW, Forsayeth J, Aminoff MJ,

Bankiewicz KS. Qualitative imaging of AAV2-hAADC gene therapy in a phase I study for the treatment of Parkinson’s disease. Neurosurgery (in press).

NON-PEER REVIEWED PUBLICATIONS BOOKS AND CHAPTERS

1. Starr PA, Martin AJ, Talke P, Ostrem J, Sootsman WK, Levesque N, Meyers J, & Larson PS (2007). Placement of subthalamic DBS electrodes in a radiology suite using interventional MRI. In Proceedings of the Medtronic forum for neuroscience and neuro-technology 2005. Berlin: Springer.

2. Larson PS (2008). Technical alternatives in performing DBS implantation. In D Tarsy , JL Vitek,

PA Starr, & MS Okun (Eds.), Deep brain stimulation in neurological and psychiatric disorders. New Jersey: The Humana Press.

3. Starr PA, Barbaro N, & Larson PS (Eds.). (2008). Functional Neurosurgery, 2/E. New York:

Thieme Medical Publishers.

4. Lim D, & Larson PS (Guest Eds.). (2009). Intraoperative MRI in Functional Neurosurgery. Neurosurgical Clinics of North America. New York: Elsevier.

5. Starr PA, Martin AJ, Larson PS. Implantation of deep brain stimulator electrodes using

interventional MRI. Neurosurg Clin N Am 20(2):193-203, 2009.

6. Martin AJ, Starr PA, Larson PS. Software requirements for interventional MR in restorative and functional neurosurgery. Neurosurg.Clin N Am 20(2):179-86, 2009.

ABSTRACTS (PAST 5 YEARS)

1. Martin A, Larson P, Ostrem J, Sootsman WK, Talke P, Lindsey N, Myers J, Starr P. MR Guided Deep Brain Stimulator Implantation: Clinical Practice and Outcome Assessment. 6th Annual Interventional MRI Symposium, Leipzig, Germany, 2006.

2. Martin AJ, Starr PA, Larson PS, Sootsman WK: Development of an image guided approach for the

delivery of deep brain stimulator electrodes. 5th Interventional MRI Symposium, Boston, MA, October, 2004.

3. House P, Larson P, Starr P: Optimization of indirect subthalamic nucleus targeting. The Movement

Disorders Society’s Ninth International Congress of Parkinson’s Disease and Movement Disorders, New Orleans, LA, March, 2005.

Paul Larson, MD

4. Rothlind JC, Cockshott RW, Walker JA, Starr PA, Marks WJ, Larson PS: Surgical microtrauma as a predictor of neuropsychological change following unilateral pallidal DBS. The Movement Disorders Society’s Ninth International Congress of Parkinson’s Disease and Movement Disorders, New Orleans, LA, March, 2005.

5. House PA, Starr PA, Larson PS: Locations of movement related and cutaneous sensory cells in the

human ventral thalamus. 13th World Congress of Neurological Surgery, Marrakesh, Morocco, June, 2005.

6. Christine CW, Starr PA, Larson P, Mah R, Eberling J, Jagust W, McGuire D, Aminoff MJ: Aromatic

L-amino acid decarboxylase gene transfer therapy for Parkinson’s disease: initial results of an open label dose escalation, safety and tolerability study. Annual Meeting of the American Academy of Neurology, San Diego, CA, April, 2006.

7. Marks WJ, Verhagen Metman LA, Starr PA, Larson PS, Bakay RA, Taylor R, Cahn-Weiner D,

Bartus RT, Ostrem JL: Phase I study of putaminal gene transfer with adeno-associated virus serotype 2 [AAV2]-Neurturin [NNT] (CERE-120) for Parkinson’s disease: preliminary observations. Annual Meeting of the American Academy of Neurology, San Diego, CA, April, 2006.

8. Ivan ME, Martin AJ, Starr PA, Sootsman K, Larson PS: Brain shift analysis during burr hole based

procedures using interentional MRI. Annual Meeting of the American Association of Neurological Surgeons, San Francisco, CA, April, 2006.

9. Larson PS, Richardson M, Starr PA, Martin AJ: MR imaging of implanted deep brain stimulators:

the UCSF experience. Biennial Meeting of the American Society for Stereotactic and Functional Neurosurgery, Boston, MA, June, 2006.

10. Christine CW, Starr PA, Larson PS, Mah R, Eberling J, Jagust W, Aminoff MJ. Aromatic L-Amino

Acid Decarboxylase Gene Transfer therapy for Parkinson’s disease: initial results of an open-label, dose escalation, safety and tolerability study. Movement Disorders 21(supplement 15):S399, 2006.

11. Christine CW, Starr PA, Larson PS, Mah R, Eberling J, Jagust W, McGuire D, Aminoff MJ. Aromatic

L-Amino Acid Decarboxylase Gene Transfer therapy for Parkinson’s disease: initial results of an open-label, dose escalation, safety and tolerability study. Neurology 66 (supplement 2):A185, 2006.

12. Larson PS, Martin AJ, Ostrem JL, Talke P, Sootsman WK, Levesque N, Meyers J, Starr PA:

Placement of subthalamic DBS electrodes using 1.5T interventional MRI: preliminary clinical outcomes and targeting accuracy. Annual Meeting of the American Association of Neurological Surgery, Washington, DC, April, 2007.

13. Starr PA, Verhagen LM, Larson PS, Bakay RA, Taylor R, Cahn-Weiner D, Bartus RT, Ostrem JL,

Marks WJ: Intrastriatal gene transfer with AAV-neurturin for Parkinson’s disease: results of a phase I trial. Annual Meeting of the American Association of Neurological Surgery, Washington, DC, April, 2007.

14. Sillay K, Larson PS, Starr PA. Deep brain stimulator hardware infections: incidence and

management in a large series. Annual Meeting of the American Association of Neurological Surgery, Washington, DC, April, 2007.

15. Marks WJ, Ostrem JL, Verhagen LM, Starr PA, Larson PS, Bakay RA, Bartus RT. CERE-120

(AAV2-Neurturin) for Parkinson’s disease: 24-month follow up of the phase I clinical trial. The Movement Disorders Society’s International Congress of Parkinson’s Disease and Movement Disorders, Istanbul, Turkey, June, 2008.

Paul Larson, MD

16. Ostrem JL, Christine C, Volz M, Glass GA, Larson PS, Schrock LE, Starr PA. Pedunculopontine nucleus deep brain stimulation in primary progressive freezing of gait. The Movement Disorders Society’s International Congress of Parkinson’s Disease and Movement Disorders, Istanbul, Turkey, June, 2008.

17. Shimamoto S, Larson PS, Sani SB, Ostrem JL, Glass GA, Turner RS, Starr PA. Single unit

discharge in the human pedunculopontine nucleus. Biennial Meeting of the American Society for Stereotactic and Functional Neurosurgery, Vancouver, BC, June, 2008.

18. Bankiewicz KS, Valles F, Starr PA, Larson PS, Christine CW, Fiandaca MS, Jagust WJ, Hawkins

RA, Forsayeth J, Aminoff MJ, Eberling JL. Imaging of AAV2-hAADC infusion in a phase I study of AAV2-hAADC gene therapy for Parkinsonʼs disease. The Movement Disorders Society’s International Congress of Parkinson’s Disease and Movement Disorders, Paris, France, June, 2009.

19. Aminoff MJ, Christine CW, Starr PA, Larson PS, Eberling JL, Jagust WJ, Hawkins RA, VanBrocklin

HF, Bankiewicz KS. Intraputaminal AADC gene therapy for Parkinsonʼs disease: results of a phase 1 study. The Movement Disorders Society’s International Congress of Parkinson’s Disease and Movement Disorders, Paris, France, June, 2009.

20. Bankiewicz KS, Valles F, Starr PA, Larson PS, Christine CW, Fiandaca MS, Jagust WJ, Hawkins

RA, Forsayeth J, Aminoff MJ, Eberling JL. Imaging of AAV2-hAADC infusion in a phase I study of AAV2-hAADC gene therapy for Parkinsonʼs disease. The Movement Disorders Society’s International Congress of Parkinson’s Disease and Movement Disorders, Paris, France, June, 2009.

21. Galifianakis NB, Starr PA, Larson PS, Glass GA, Volz MM, Heath SL, Ostrem JL. Effects of

unilateral pedunculopontine nucleus deep brain stimulation (PPN-DBS) in parkinsonian patients with prominent freezing of gait (FOG). The Movement Disorders Society’s International Congress of Parkinson’s Disease and Movement Disorders, Paris, France, June, 2009.

22. Galifianakis NB, Green AJ, Boxer A, Starr PA, Larson PS, Jafari A, Ostrem JL. Pedunculopontine

nucleus deep brain stimulation (PPN-DBS)-induced oscillopsia: implications for mechanisms of visual fixation. The Movement Disorders Society’s International Congress of Parkinson’s Disease and Movement Disorders, Paris, France, June, 2009.

Paul Larson, MD

RESEARCH PROGRAM FIVE SIGNIFICANT RECENT PUBLICATIONS

Cheung SW, Larson PS. Tinnitus modulation by deep brain stimulation in locus of caudate neurons (area LC). Neuroscience: June 10, 2010 (Epub ahead of print).

This is the first paper ever to describe the use of acute deep brain stimulation in the caudate to modulate tinnitus. The study was performed in movement disorders patients with comorbid tinnitus who were undergoing DBS surgery. It is also the first time that the caudate nucleus has been shown to have a role in auditory perception, which is a completely novel concept in the field of basal ganglia physiology. I was the PI on the IRB protocol, designed the trial with Dr. Cheung, performed all of the surgeries in the study and collected all the physiologic data. As the senior author I participated in preparation of the manuscript with Dr. Cheung.

Starr PA, Martin AJ, Ostrem JL, Talke P, Levesque N, Larson PS. Subthalamic nucleus deep brain stimulator placement using high field interventional MRI and a skull-mounted aiming device: technique and application accuracy. J Neurosurg 112(3):479-90, 2010.

This is the latest publication of our clinical trial using interventional MRI to perform DBS implantations, and the only series of iMRI-implanted DBS patients ever published. I participated in the design of surgical methodology and worked with our sponsors (Image Guided Neurologics and Medtronic) to design and develop the surgical technique and instrumentation. I performed the surgeries for the study and assisted in data analysis. As the senior author I participated in preparation of the manuscript.

Shimamoto SA, Larson PS, Ostrem JL, Glass GA, Turner RS, Starr PA. Physiological identification of the human pedunculopontine nucleus. J Neurol Neurosurg Psychiatry 81(1):80-6, 2010.

This is only the third paper in the literature to describe single cell neuronal recordings in the human PPN in patients undergoing DBS implantation for movement disorders. I performed half of the surgeries described in the series, collected physiologic data and participated in preparation of the manuscript.

Marks WJ, Ostrem JL, Verhagen L, Starr PA, Larson PS, Bakay RA, Taylor R, Cahn-Weiner D, Stoessl AJ, Olanow CW, Bartus RT: Gene transfer of a trophic factor for Parkinson’s disease: initial clinical trial with AAV2-Neurturin (CERE-120). Lancet Neurol 7(5):400-8, 2008.

These are the results of a phase I gene therapy clinical trial using a growth factor to treat Parkinsonʼs disease. I was involved in all phases of this clinical trial, from the earliest development stages to the FDA approval process to performance of the actual surgical procedures. I collaborated with my surgical colleague Dr. Starr and our sponsor (Ceregene) on design of the delivery cannula, targeting methodology, delivery technique and the surgical protocol. I performed the gene transfer surgeries on 50% of the patients enrolled at UCSF, and performed pre-operative and post-operative clinical evaluations of the study participants. I assisted in preparation of the surgical portion of the manuscript.

Eberling JL, Jagust WJ, Christine C, Starr PA, Larson PS, Bankiewicz KS, Aminoff MJ: Early results from a phase I clinical trial of hAADC gene therapy for Parkinson’s disease. Neurology 70(21):1980-3, 2008.

These are the results of another phase I gene therapy clinical trial for Parkinsonʼs disease. I was involved in this trial from the earliest planning stages with our initial sponsor, Avigen, including development of the surgical protocol and design of the targeting cannula and delivery methodology. I performed surgery on 50% of the patients enrolled in the trial, and performed pre-operative and post-operative evaluations of the study participants. I assisted in preparation of the surgical portion of the manuscript.

Paul Larson, MD

CURRENT RESEARCH INTERESTS/PROGRAM My current research program focuses on three primary areas of interest: Tinnitus and the role of the basal ganglia in audition - I am currently collaborating with Dr. Steven Cheung in otolaryngology on a clinical physiology study on of the role of the basal ganglia in audition. We have just published our first paper on this work in Neuroscience, which describes the use of acute deep brain stimulation (DBS) of the caudate in a cohort of patients with comorbid tinnitus undergoing DBS surgery. In it, we describe a specific area of the caudate that modulates tinnitus when stimulated. This is the first time anyone has shown that the caudate appears to play a role in tinnitus and auditory perception, which is a completely novel concept in basal ganglia physiology. We are currently enrolling patients in a second study in which we are performing single-cell neuronal recordings and macrostimulation in the basal ganglia in both tinnitus and normal hearing subjects. We are pursuing funding for a clinical trial to investigate the use of DBS in patients with primary, medically refractory tinnitus. Interventional MRI (iMRI) guided DBS implantation – This is an entirely novel method for implanting DBS electrodes that was developed by our group at UCSF after my arrival in 2001. Traditional surgical methods for DBS implantation require an awake patient and involve extensive physiologic mapping of the brain, which results in multiple penetrations of the brain. This process increases accuracy but results in longer procedures times, increased patient discomfort and increased risk. Because one of the DBS targets implanted in Parkinson’s disease, the subthalamic nucleus, is visible on MRI imaging, our group devised a technique to place DBS electrodes into this target using direct MRI guidance. We developed a delivery methodology and partnered with private industry to develop surgical instruments specifically designed for this procedure. A series of phantom tests were performed to validate the technique, and an IRB approved trial was started in human Parkinson’s subjects in 2004. The entire procedure is performed within the bore of a 1.5T MRI scanner and has several advantages over traditional DBS implantation. No physiologic mapping is required, so implantation may be performed under general anesthesia with a single penetration of the brain. The procedure time is cut in half, and imaging throughout the surgery allows for immediate detection of complications. We have developed a completely new system (ClearPoint) in collaboration with our current funding partner, SurgiVision. The system consists of a skull mounted stereotactic platform and a software environment that allows iMRI DBS to be performed on any 1.5T scanner, and was just approved by the FDA. Our future plans include moving gene therapy infusions (see above) into the iMRI arena; this has already been tested in non-human primates, with a submitted publication on this work pending. Gene therapy for Parkinson’s disease - I have been extensively involved in three gene therapy trials for Parkinson’s disease since 2004. Only four trials of this kind have been performed to date worldwide. Our first trial, using adeno-associated virus to transfer the gene encoding amino acid decaroboxylase (AAV-AADC) to the human putamen, started in December 2004 and was completed in March 2008 with UCSF as the only enrolling site. The second study, using the AAV vector to transfer the gene for neurturin (a growth factor related to GDNF), has completed both phase I and II trials. The phase I trial was completed in March 2006 with UCSF as the primary site, enrolling 8 of 12 patients; the phase II multi-center was completed in October of 2007 with UCSF as the leading site for enrollment. By virtue of our involvement in these three trials, we have become the most experienced center in gene therapy for Parkinson’s disease in the world; as of 2010, one third of the patients in the world who have undergone gene transfer surgery for Parkinson’s disease had their procedures done at UCSF by myself and Dr. Starr. We will be a site for the next AAV-neurturin study, slated to start in the fall of 2010.

unversity of california san francisco curriculum … · deep brain stimulation, gene therapy,...

Documents