TGH Functional Neurosurgery Program

The TGH Functional Neurosurgery Program in Tampa General Hospital’s Neuroscience Institute is one of the busiest programs of its kind in the nation. Our neurosurgeons use state-of-the-art technologies to ensure precise, targeted care for patients experiencing certain neurological movement disorders and diseases.

About Functional Neurosurgery

Broadly, functional neurosurgery involves procedures that modify or restore the functioning of the nervous system, which includes the brain and spinal cord (central nervous system) and nerves in the arms and legs (peripheral nervous system). Oftentimes, nervous system dysfunction leads to movement and other neurological disorders such as Parkinson’s disease, essential tremor, dystonia, obsessive-compulsive disorder, epilepsy, spasticity, and certain types of chronic pain.

Functional neurosurgery aims to alter abnormal brain or nerve activity to improve the quality of life for patients living with these conditions. Using advanced surgical techniques, neurosurgeons target the nervous system with procedures such as deep brain stimulation and focused ultrasound—using advanced intraoperative CT imaging and intraoperative MRI techniques—to alleviate symptoms and achieve optimal results.

Why Choose TGH

The functional neurosurgery team at Tampa General handles a high volume of unique, complex neurological cases, and our multidisciplinary approach to care means patients receive comprehensive treatment, no matter their condition. This ensures that patients receive the right therapy for them, at the right time. We have a dedicated clinical coordinator to ensure every patient’s journey is as smooth as possible.

Tampa General Hospital is a forerunner in the world of academic medicine and in conjunction with USF Health Morsani College of Medicine, was one of the first hospitals in North America to offer deep brain stimulation therapy. We consistently perform a high number of these procedures to ensure the best possible outcomes for our patients.

We were also the first on the west coast of Florida to perform and offer focused ultrasound, which involves a state-of-the-art intraoperative MRI that delivers high-resolution images of the brain during and after procedures. This allows us to offer targeted treatments and excellent outcomes.

Due to our high volume and extensive experience with these procedures, TGH is consistently sought out as a partner for research studies to better understand these conditions, improve patient outcomes, and identify new medications, technologies and procedures to better for our patients. We are currently involved in both large multicenter trials and smaller exploratory studies in which patients and their families can be involved if they so chose.

For these and many other reasons, Tampa General Hospital has been recognized as a hospital in the Top 10% in the Nation for Neurology & Neurosurgery by U.S. News & World Report in 2024-25.

Conditions Treated

Expert neurosurgeons involved with the TGH Functional Neurosurgery program treat a variety of movement and other neurological disorders, including:

• Parkinson’s disease
• Essential tremor
• Dystonia
• Obsessive-compulsive disorder
• Epilepsy
• Spasticity
• Chronic pain

Testing & Diagnostics

Testing for and diagnosing movement disorders that may benefit from functional neurosurgery typically begins with a thorough physical exam and neurological assessment. Additional tests will be ordered to confirm or rule out a diagnosis. Tests may include:

• Blood tests to check hormone levels and look for mitochondrial DNA damage, infections, clotting disorders and other issues that may cause neurological dysfunction
• Comparison of symptoms on medications compared to off medications
• Neuropsychological assessments to assess cognitive status
• A lumbar puncture to assess cerebrospinal fluid
• A full range of standard and functional imaging tests, such as a CT scan, PET scan and MRI scan, to detect visible abnormalities in the brain
• An electroencephalogram (EEG) to measure the electrical activity in the brain
• An electromyography (EMG) to measure electrical impulses along nerves in muscles

Treatment Options

Treatment options for patients with movement disorders often involve medications, injections, and some form of adaptive devices, such as weighted items. But when these therapies aren’t enough or are causing unwanted side effects, functional neurosurgery options may be recommended. These can include:

• Focused ultrasound (FUS) – Also known as high-intensity focused ultrasound (HIFU), focused ultrasound is a non-invasive treatment that uses MRI-guided ultrasound waves to safely target and destroy specific regions in the brain that are causing the tremors without the need for incisions. Patients can return home the same day.

To find out if you’re a candidate for FUS treatment, fill out this questionnaire and a member of our team will contact you.

• Deep brain stimulation (DBS)– Deep brain stimulation is an established procedure that implants a brain pacemaker in specific brain areas through small incisions to deliver mild electrical pulses, disrupting the abnormal signals causing uncontrollable muscle movements. While not a cure for movement disorders, DBS can significantly reduce symptoms and improve quality of life.

Deep brain stimulation procedures may involve intraoperative microelectrode recording and intraoperative CT imaging, and / or intraoperative MRI. Intraoperative microelectrode recording identifies cellular activity within the brain and charts the effects of stimulation in patients who are partially awake during surgery. This allows neurosurgeons to observe symptom improvements in real-time within the operating room. Intraoperative CT is then used to identify the precise location of the leads.

Intraoperative MRI visualizes specific brain regions directly to ensure precise placement of the leads in those specific brain regions while patients are asleep. With directional leads, brain-signal-sensing generators and advanced software that maps the electricity delivery to those targeted areas, our functional neurosurgeons can customize treatments for the patient with greater precision.

Support Services

Our team of board-certified neurosurgeons works closely with internationally renowned movement disorder neurologists, neuropsychologists, neuroradiologists, psychiatrists, epilepsy specialists, and physiatrists and are available 24/7 to diagnose and treat even the most complex conditions. Additional support services are provided by a skilled staff of expert nurses, technicians, physical therapists, speech-language pathologists, social workers, nutrition counselors, health psychologists, financial support counselors and support groups. As a cohesive team, we are all committed to guiding patients through their recovery, regardless of the severity of their condition.

Research & Clinical Trials

The TGH Functional Neurosurgery team actively participates in clinical trials to better understand movement and other neurological disorders, improve patient outcomes, and identify new medications, technologies and procedures to better for our patients. In fact, we are involved in several multicenter clinical trials focused on broadening the application of deep brain stimulation, including a Phase III trial for DBS in Treatment Resistant Depression.