David Darrow, MD

New trigeminal neuralgia guideline episode: @vishadsukul and I speak with neuroradiologist Ajay Malhotra about MRI protocols, neurovascular compression, secondary causes, recurrence, and imaging standardization. @painsection youtu.be/TyFj0hpSTv0 #TrigeminalNeuralgia #MRI

New paper out in Journal of Neural Engineering. We tested effective connectivity metrics against simulated brain networks with known ground truth. Takeaway: if brain communication has time delays, zero-lag methods can fail. Metric choice matters. doi.org/10.1088/1741-2…

Amazing fireside chat between Dr. Park and #dbs pioneer Dr. Benebid at #aans2026 @umnneurosurgery

A groundbreaking custom brain implant has successfully lifted a man’s 30-year battle with severe depression, placing his condition into full remission. For the first time in decades, the patient experienced genuine feelings of joy after receiving a highly personalized brain “pacemaker.” Developed by researchers at the University of Minnesota, the experimental treatment,called Personalized Adaptive Cortical Electro-stimulation (PACE), uses the patient’s own brain mapping to deliver targeted electrical stimulation. Using functional MRI scans, scientists identified the unique neural pathways associated with his depression. Electrodes were then precisely implanted to stimulate those specific regions. Unlike standard “one-size-fits-all” approaches, this device adapts in real time, delivering tailored pulses that restored emotional access and well-being. The results were dramatic: suicidal thoughts disappeared within seven weeks, and the patient achieved full remission after nine months. This success highlights a promising shift toward precision medicine in psychiatry, offering new hope for the millions of people with treatment-resistant depression who have not responded to antidepressants or other conventional therapies. The case demonstrates how deeply individualized brain stimulation could become a powerful new tool for treating some of the most challenging mental health conditions.

@StaudtMD @painsection group effort!

An important milestone for the @painsection guidelines. Another phenomenal effort by @daviddarrow!

Good paper on radiosurgery for refractory cluster headache. Meaningful relief, but recurrence over time raises a mechanistic question: are normal pain/autonomic circuits adapting, or is the radiation effect recovering? doi.org/10.1227/neu.00…

First stakeholder conversation for the AANS/CNS Section on Pain trigeminal neuralgia guideline effort is live. @StaudtMD and I spoke with Dr. Gary Klasser about orofacial pain, TN vs neuropathy, imaging, dental misdiagnosis, and patient-centered care. youtu.be/reYNipKY3WM

New in Neurosurgery: 23-year MVD series (n=523) for Type 1 TN ~70% pain-free at 15 yrs — highly durable • Worse outcomes in women → phenotype/diagnostic mixing? • Vein sacrifice: small risk, more complete decompression journals.lww.com/neurosurgery/f… @NeurosurgeryCNS

Perhaps the most provocative implication: Some patients classified as “TN with continuous pain” or TN2 may actually represent temporomandibular disorders rather than primary trigeminal neuralgia. We have known for a while but now the discourse begins! journals.lww.com/neurosurgery/f…

Daryl Fields, @yiluspine , and Joe Neimat put on a fantastic course Modulating the spinal cord for #spinalcordinjury amongst many other disorders is just the beginning for a true partnership of @spinesection @painsection and @ASSFNeurosurg for the greater good!

While it was certainly different to attend a spine conference #spinesummit as a pain and functional neurosurgeon, I was honored to contribute to the stellar momentum for the future of functional in spine surgery

targeting the gasserian ganglion is challenging from an anchoring perspective and these leads are tricky to get just right. Despite this there is real potential for such an isolating pain disorder @facialpainassoc

This raises a novel idea: Can we modulate central targets (e.g., thalamus) through the remaining afferent fibers? Instead of only targeting the brain directly like we have found beneficial through cortical stim #Neuromodulation

Our case report on percutaneous trigeminal ganglion stimulation for refractory anesthesia dolorosa is now live. #Neurosurgery #PainMedicine all inspired by Nick Boulis journals.lww.com/neurosurgpraco…

Thank you @U2FP_CureSCI for inviting me to talk about the future of #neuromodulation for #spinalcordinjury. It is always a different view from the stage! This year really galvanized a cohesive direction for the future

I have been at a loss for words. Sanjeet was not only a colleague & my main collaborator, but also one of my best friends. His enthusiasm to push the boundaries of science were unmatched. So little of our work would have been possible if it weren’t for his openness and bravery to do something new, but also his patience with us as we worked through MANY challenges! Sanjeet was a true advocate and pioneer for what we do in imaging, particularly our functional and 7T fields. He always sought even the tiniest advantage he could have to ensuring his patients have the best outcome. It is hard to express the impact his loss will have on his family, friends, colleagues, and medicine.

A truly tragic loss. Sanjeet was such an amazing person, physician, neurosurgeon, and friend amongst many. It was a privilege to know and work alongside him. My heart goes out to his family and everyone touched by his kindness and expertise during this incredibly difficult time.

We are excited to be a part of this community to further efforts to understand and treat #bipolardisorder where we hope to bring biological insight back to psychiatry @UMNews @umnneurosurgery with @ZiadNahas7 @DrDamienFair @TNetoff @AlexHermanMDPhD @HermanDarrowLab

@ELHELOUA @HermanDarrowLab @umnneurosurgery Thank you Antonios!

@daviddarrow @HermanDarrowLab @umnneurosurgery Fantastic Job David!!

This is the future. The reality of biological #psychiatry. We listen to the patient, create a personalized map of their brain, use algorithms to disrupt stuck networks, and adapt the stimulation over time while continuing our quest to understand those networks. @umnneurosurgery