Engineering transforms the operating room

Until he entered an operating room for the first time, Aaron Batista believed he understood the brain. As a neural engineer who had spent decades studying brain-computer interfaces at the University of Pittsburgh’s Swanson School of Engineering, he was familiar with neural circuits, electrical activity and the algorithms researchers use to interpret brain signals. But watching neurosurgeons work with living human tissue changed his perspective. The experience, he said, was like spending a lifetime snorkeling before suddenly learning to scuba dive: the familiar surface gave way to a far deeper and more complicated reality.

That realization has become the driving force behind a new postdoctoral training program designed to bring engineers and neurosurgeons into the same research environment. The program, called Neural Engineering in Neurosurgery: Bridging Engineering to Clinical Practice, is supported by a new National Institutes of Health T32 training award, 1T32NS147937-01. It will connect postdoctoral researchers in bioengineering with residents in neurological surgery and a network of 32 affiliated faculty members and clinicians. Their shared goal is to develop technologies and procedures that address urgent problems in neurosurgical care, while giving each discipline a more accurate understanding of how the other works.

The need for such collaboration is rooted in a persistent divide between laboratory research and clinical practice. Engineers often approach the brain as a biological computing system, analyzing how electrical circuits produce movement, language, memory or emotion. Surgeons, by contrast, must make immediate decisions involving individual patients, often while navigating tissue that cannot be replaced and functions that may be impossible to recover once damaged. Although Pittsburgh’s engineering laboratories and neurosurgical operating rooms are separated by only a short walk, the intellectual distance between them has historically been much greater. The new program is intended to turn that physical proximity into a durable scientific partnership.

Batista will co-direct the initiative with Jorge González-Martínez, a professor and vice-chair of neurological surgery at the University of Pittsburgh School of Medicine. Together, they will oversee eight trainees: four postdoctoral associates from bioengineering and four neurological surgery residents. Rather than working in parallel on unrelated projects, the participants will be paired and assigned to collaborative research clusters organized around areas where clinical needs and engineering expertise already intersect. These areas include epilepsy, stroke, speech and language mapping, sensory restoration, pain, traumatic brain injury, movement disorders and brain tumors.

The structure of the program is designed to expose trainees to the realities of both sides of translational research. Postdoctoral engineers will shadow neurosurgeons in the operating room, observing how physicians identify anatomical structures, interpret electrical recordings and balance treatment benefits against the risk of permanent neurological injury. Residents, meanwhile, will spend extended time in engineering laboratories, learning how experiments are designed, how neural signals are recorded and processed, and how prototypes such as implanted sensors or stimulation systems are tested. Each trainee pair will develop a project under joint supervision, with the expectation that the research will be shaped by an actual clinical challenge rather than by technology alone.

One of the central scientific opportunities involves understanding how neural signals relate to behavior. Neurosurgeons increasingly use microelectrode recordings, in which tiny electrodes capture electrical activity from individual neurons or small populations of cells. These measurements can reveal patterns associated with seizures, movement, speech or sensory processing, but interpreting them requires knowledge of both physiology and human behavior. In epilepsy surgery, for example, clinicians may need to identify the networks generating seizures while preserving regions responsible for language or motor control. Engineering methods can help analyze these complex signals, but only clinical expertise can determine what the patterns mean for a particular patient.

González-Martínez is especially interested in applying this combined approach to epilepsy and disorders involving language and movement. The program will build on existing collaborations at Pittsburgh, including work involving González-Martínez and Elvira Pirondini of the School of Medicine. Their research uses stimulation of the thalamus, a deep brain structure that helps coordinate communication with the cerebral cortex, to investigate ways of restoring speech and motor function after stroke. The thalamus acts as a major relay and integrative hub, linking distributed cortical networks involved in movement and communication. Understanding how targeted stimulation alters those networks could lead to therapies that do more than activate or suppress a single region; they could help reorganize communication across damaged circuits.

Other projects will focus on some of the most difficult decisions in neurosurgery. During tumor removal, surgeons must eliminate as much abnormal tissue as possible without damaging healthy regions that control speech, movement or other essential functions. Engineering tools capable of mapping brain activity in real time could help make that boundary more visible. The program will also support research into spinal cord stimulation for chronic pain, next-generation implantable sensors and closed-loop neuromodulation systems. In a closed-loop system, implanted electrodes continuously monitor neural activity and automatically adjust stimulation in response, creating a feedback cycle that could provide more precise treatment for movement disorders, emotional disorders and other conditions than fixed stimulation settings.

The trainees will also complete a yearlong course, BIOENG 2805: Translational Neural Engineering, focused on the scientific, technical and practical challenges of moving discoveries from laboratories into hospitals. Neural devices must function reliably in a noisy biological environment, remain safe over long periods and communicate with external systems without damaging tissue. Researchers must also determine how to interpret signals that vary from one person to another and change over time. Beyond engineering, clinical translation requires regulatory approval, ethical oversight, careful patient selection and outcome measures that demonstrate meaningful improvements in daily life. By studying these issues together, engineers and physicians may be able to identify obstacles earlier and design technologies that are more likely to reach patients.

University officials describe the initiative as an example of how interprofessional teams can drive innovation in clinical care. Paul Wallach, vice chancellor for health sciences education and executive vice dean for academic affairs at the School of Medicine, said that the program reflects Pittsburgh’s strength across professional disciplines. For Batista and González-Martínez, however, the broader ambition extends beyond training eight researchers. They hope the program will establish a formal, lasting bridge between bioengineering and neurosurgery, creating a culture in which engineers routinely enter the operating room and surgeons routinely help shape laboratory investigations. If that bridge succeeds, the next generation of neural technologies may be designed not only to decode the brain’s signals, but also to solve the urgent problems faced by the people whose brains those signals come from.

Web References: https://reporter.nih.gov/search/RHhEBDVwt0mo4xpJ54-40w/project-details/11334537 ; https://www.neurosurgery.pitt.edu/centers/clinical-neurophysiology/micro-electrode-recording

References: University of Pittsburgh Swanson School of Engineering; University of Pittsburgh School of Medicine; National Institutes of Health T32 Award 1T32NS147937-01