Chengyuan Wu MD MSBmE FAANS

09/24/2025

When electrodes deviate from their planned path, the error isn’t random. It’s a consistent, reproducible systematic error — which means it can be corrected once recognized.

Our new paper in Operative Neurosurgery (e-pub ahead of print) shows that both cannula and non-cannula approaches are subject to the same deviations. The real driver appears to be brain tissue mechanics, not the surgical tools.

Although correction is possible, the real challenge ahead is moving from reactive fixes to proactive strategies that prevent bending before it occurs. That’s not easy — but it’s where the field needs to go.

Full article here:
🔗 https://journals.lww.com/onsonline/fulltext/9900/surgical_technique_for_repositioning_deep_brain.1744.aspx

Thomas Jefferson University
Jefferson Health
Vickie and Jack Farber Institute for Neuroscience Jefferson Health
Villanova University
University of Delaware
American Society for Stereotactic and Functional Neurosurgery
Congress of Neurological Surgeons (CNS)

09/16/2025

Even with the best surgical techniques, electrodes sometimes bend or seemingly drift off target—often enough to require repositioning or even revision surgery.

On the new Congress of Neurological Surgeons (CNS) Journal Club Podcast, Dr. Kim Burchiel interviewed me about our group's research showing how the brain’s own tissue properties can influence electrode deviation.

It’s an important reminder that the brain isn’t just a target—it’s a living environment that shapes outcomes.

🎧 Listen here: https://www.cns.org/publications/journal-club-podcasts/podcast-detail/october-2025-journal-club-podcast-deep-brain-stimu

🎧 or on Apple Podcasts: https://podcasts.apple.com/us/podcast/deep-brain-stimulation-electrode-deviations-are-associated/id1279506968?i=1000726912064

American Society for Stereotactic and Functional Neurosurgery
Thomas Jefferson University
Jefferson Health
Vickie and Jack Farber Institute for Neuroscience Jefferson Health
Villanova University
University of Delaware

09/05/2025

Stroke recovery shouldn’t stop before you’re ready!

The RESTORE study — led nationally by Dr. André Machado and Cleveland Clinic — is testing whether brain stimulation ( ) can help survivors regain use of their arm and hand.

We are honored to bring this groundbreaking research to patients here in the Delaware Valley, with Thomas Jefferson University and Jefferson Health serving as one of the national study sites.

CNN recently featured this important work: https://amp.cnn.com/cnn/2023/08/14/health/deep-brain-stimulation-stroke

If you or a loved one in our region is living with arm weakness after a stroke, you may qualify. Learn more: http://restorestrokestudy.com/jefferson

RESTORE Stroke Study

09/05/2025

Where do you draw the line in epilepsy surgery? 🧠✏️

Anterior temporal lobectomy can transform lives. But techniques differ from surgeon to surgeon — and those differences could impact seizure and functional outcomes.

We’re asking epilepsy surgeons to take 10 minutes to mark resection lines on standardized brain images. This anonymous, voluntary survey will help us capture how temporal lobectomy is practiced today — and ultimately inform teaching and standards.

👉 Complete on desktop: https://redcap.uhhospitals.org/redcap/surveys/?s=AR3LJJHCJTJ4JCEN

This is a collaborative effort between Case Western Reserve University, Cleveland Clinic, and Thomas Jefferson University. Please share widely so as many voices as possible are included.

ILAE - International League Against Epilepsy
American Society for Stereotactic and Functional Neurosurgery
American Association of Neurological Surgeons
Congress of Neurological Surgeons (CNS)
World Society for Stereotactic and Functional Neurosurgery

08/12/2025

07/30/2025

🎯 500 Stereotactic Robotic Cases at Jefferson Health!

Today, we hit a major milestone: our 500th robotic-assisted stereotactic neurosurgery case!

As relatively early adopters of this technology, we’ve seen it evolve from a focused tool for stereoelectroencephalography ( ) into a robust platform now used for deep brain stimulation ( ), responsive neurostimulation ( ), laser ablation ( ), stereotactic biopsy, and intracerebral drug infusion trials.

Across these procedures, we’ve planned and executed nearly 3,000 individual trajectories — and counting.

We’re proud to be the most experienced program in North America using this robotic system — the result of over a decade of consistent clinical use and thoughtful integration into practice. During that time, we’ve stayed focused on meaningful innovation: integrating new tools in ways that improve accuracy, safety, and clinical workflow.

I’m so proud of our team here at Jefferson. This is an achievement for our entire Stereotactic and Functional Neurosurgery team; and a reflection of the dedication of our nurses, advanced practice providers, scrub technicians, imaging specialists, industry partners, and everyone behind the scenes.

And yes — case #501 was completed right after. 😏



📍 Jefferson Health
🔬 Thomas Jefferson University
Renishaw USA

05/21/2025

Another Week, Another Imaging Conference

Just wrapped up the ASNR2025 Scientific Meeting here in — and once again, really glad I made the time for an imaging-focused meeting.

Honored to have our work selected as the Outstanding Functional Project. Always grateful for the opportunity to share our work and even more so when it resonates with a broader audience.

Proud to see a strong Thomas Jefferson University showing throughout the meeting with others from presenting and a number of Radiology faculty involved.

Also appreciated the chance to connect with new colleagues outside of neurosurgery — and to catch up with old friends I haven’t seen in a while. The energy at these meetings is very different, and in a good way.

Jefferson Health
Vickie and Jack Farber Institute for Neuroscience Jefferson Health

05/15/2025

Just wrapped up my first ISMRM meeting—an incredible few days of learning, connecting, and presenting.

I had the chance to share our team’s research on how magnetic resonance elastography (MRE) can help explain electrode bending in deep brain stimulation (DBS). This work came together through close collaboration between Thomas Jefferson University, Villanova University, and University of Delaware—exactly the kind of cross-disciplinary partnership that moves things forward.

It was a change of pace from my usual neurosurgery conferences. The focus on imaging research brought out a different kind of conversation—new perspectives, thoughtful questions, and a broader view of the science behind what we do.

Also: really enjoyed meeting new colleagues and catching up with old ones. And yes, having this all happen in Honolulu didn’t hurt.

Looking forward to coming back!

ISMRM
Vickie and Jack Farber Institute for Neuroscience
Jefferson Health

05/02/2025

Today I performed my first focused thalamotomy for refractory , made possible only through the growing collaboration between Jefferson Health and Lehigh Valley Health Network.

I admittedly have been a late adopter of focused ultrasound, but it certainly has value as part of the broader surgical treatment spectrum for movement disorders. For carefully selected patients, the benefit can be immediate and meaningful.

This case was made possible by the new partnership between Jefferson and Lehigh Valley. The patient was evaluated in one of the Jefferson satellite clinics I’ve staffed for years, which now serves as a bridge to the outstanding team at Lehigh Valley Hospital Cedarcrest. The coordination — from outpatient evaluation to imaging and procedural support — was remarkably seamless.

We were also able to leverage patient-specific diffusion imaging to identify the tremor network and avoid primary motor and sensory pathways. This allowed me to refine the surgical target preoperatively, which ultimately led to excellent tremor control without any side effects in this case.

I’m grateful we were able to offer this patient and his family real, immediate improvement in daily function. This is exactly the kind of patient-centered care that becomes possible when institutional collaboration meets clinical innovation.

Thomas Jefferson University
Vickie and Jack Farber Institute for Neuroscience Jefferson Health
INSIGHTEC
International Essential Tremor Foundation
International Parkinson and Movement Disorder Society

https://www.lvhn.org/treatments/focused-ultrasound-essential-tremor

03/10/2025

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Learn from the experts to refine your 🧠 targeting skills. Get the scoop on advanced tools, imaging techniques, research methodologies. 💡

📍 Register now: bit.ly/DBSTargetingAdv

03/10/2025

🧠 New Insights from the AES Temporal Lobe Club from the Annual Scientific Meeting this past December 2024!

Balancing seizure freedom with cognitive preservation remains key in Temporal Lobe Epilepsy surgery. Highlights include:
✅ Resection (ATL): Highest seizure freedom, but more cognitive risk.
✅ Laser Ablation (LITT): Less invasive, quicker recovery, moderate seizure control.
✅ Neuromodulation (VNS, DBS, RNS): Good cognitive outcomes, modest seizure reduction—ideal when resection isn’t possible.
Personalizing treatment based on individual goals and careful patient selection is critical for success.

📖 Dive into the full review here: https://pmc.ncbi.nlm.nih.gov/articles/PMC11869217/

02/26/2025

🚨 Check out our new publication in Operative Neurosurgery!

Accurate electrode placement is critical for optimal deep brain stimulation (DBS) outcomes, yet electrode deviation remains a persistent issue—one that is often underrecognized and poorly understood. Our latest study, just published in Operative Neurosurgery, reveals that brain stiffness interfaces, specifically at the internal capsule (IC), contribute to electrode bending and target deviation.

Using magnetic resonance elastography (MRE), we found that the angle of approach relative to the IC stiffness interface strongly correlates with electrode deviation. This suggests that DBS accuracy is not just about precise trajectory planning but also about how the electrode interacts with the brain’s mechanical properties.

➡ Key findings:
🔹 Electrode deviation is not random—it correlates with the angle of approach to brain stiffness interfaces.
🔹 Greater angles of approach lead to more significant deviations, emphasizing the role of tissue mechanics in stereotactic accuracy.
🔹 MRE may help predict and mitigate deviations preoperatively, potentially reducing revision rates and improving clinical outcomes.

This study challenges the assumption that electrode bending is inevitable and calls for a more critical evaluation of where and how deviations occur. If we want to improve DBS accuracy, we need to rethink how we plan trajectories, incorporating biomechanical insights rather than relying solely on traditional stereotactic principles.

🔗 Read the full paper here: https://journals.lww.com/onsonline/abstract/9900/deep_brain_stimulation_electrode_deviations_are.1480.aspx

Neurosurgery Publications
Thomas Jefferson University
Villanova University
University of Delaware

tion, an estimated 3% to 8% of patients still require revision surgery to address suboptimal electrode placement. DBS electrode deviation may occur at mechanical tissue interfaces, with denser internal capsule (IC) fibers being the most likely factor. Based on basic principles of physics, we hypothe...