Peter C. Gerszten, MD

Dr. Gerszten has a research interest in spinal neuromodulation. His work explores the role of spinal cord electrical stimulation for a variety of clinical indications. Dr. Gerszten collaborates with members of the University of Pittsburgh Rehabilitation Neural Engineering Laboratory (RNEL) and the Neurosciences Institute of Carnegie Mellon University to conduct the first ever clinical trial to implant cervical spinal cord stimulators in patients with post-stroke upper limb paralysis in order to regain arm function. Epidural electrical stimulation is currently used to treat pain caused by damage or injury to the cervical spinal nerves. The implantation of electrodes over the cervical dorsal root ganglia allows for the selective engagement of hand and arm muscles by providing the surviving neural circuits with appropriate electrical signals. By adjusting the location of the cervical leads as well as modifying the electrical stimulation of the spinal cord stimulator, patients have regained the ability to use paralyzed limbs. The team has also begun clinical trials to evaluate the effect of spinal cord stimulation in patients with spinal cord injury and spinal muscular atrophy (SMA). 

Dr. Gerszten also collaborates with members of RNEL on a variety of non-human primate investigations. The team has developed a technique for robot assisted neurosurgery for high-accuracy minimally-invasive deep brain electrophysiology in monkeys. This research focuses on better defining the neuronal pathways of motor and sensory transmission within the spinal cord. The work has led to a novel deep brain neuromodulation modality for post-stroke patients. These experiments also determined that proprioceptive pulses consistently produced neural trajectories in the network that were disrupted by concurrent cutaneous branch stimulation. This disruption propagated to the somatosensory cortex, suggesting that peripheral electrical stimulation can disrupt natural information processing across the neural axis.

Dr. Gerszten’s clinical research focuses on the adoption of minimally invasive surgical treatments for disorders of the spine. Such minimally invasive techniques allow for decreased morbidity while improving outcomes in neurosurgical patients. Such techniques include the use radiosurgery and expanded radiofrequency ablative techniques for patients with spinal tumors. Dr. Gerszten was a co-principal investigator of the NRG Oncology/RTOG 0631 Clinical Trial comparing stereotactic radiosurgery versus conventional radiotherapy for localized vertebral metastases of the spine which was published this year in JAMA Oncology. Dr. Gerszten continues to expand and systematically analyze the clinical outcomes and safety profiles associated with the use of new spinal implant devices. Dr. Gerszten has a particular interest in documenting the safety and efficacy of minimally invasive sacroiliac joint fusions using titanium screw implants for sacroiliac joint dysfunction.