Neurosurgical Reboots: Restoring Function in the Brain with Innovative Cellular Therapies

Schuck Schmidtke^*
*Correspondence: Schuck Schmidtke, Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, 20-954 Lublin, Poland, Email:

Introduction

The brain, one of the most complex and vital organs in the human body, is responsible for our thoughts, emotions, movements and all forms of cognition. When the brain suffers damage due to injury, disease, or degeneration, the effects can be catastrophic and profoundly impact a person's quality of life. Whether through trauma, stroke, or neurodegenerative diseases such as Alzheimer's or Parkinson's, the human brain has a limited ability to repair itself. Traditional neurosurgical methods focus on alleviating symptoms, managing the progression of diseases and sometimes restoring function through mechanical interventions like deep brain stimulation or tumor resections. However, these treatments often fall short of completely restoring lost brain functions. In recent years, a new frontier in neurosurgery has emerged: the use of cellular therapies to "reboot" the brain’s damaged systems. These innovative therapies involve leveraging the regenerative potential of cells— ranging from stem cells to other types of regenerative treatments-to repair damaged brain tissue, stimulate regeneration and restore lost cognitive and motor functions. The focus of this article is to explore the transformative role of cellular therapies in neurosurgery, how they can "reboot" brain function and the promising future of these treatments [1].

Description

The concept of cellular therapy is not entirely new. For decades, researchers and clinicians have studied how cells can be used to regenerate damaged tissues in various parts of the body. In neurosurgery, this focus has intensified as the brain's regenerative capacity is more limited compared to other organs. The idea behind cellular therapies is to replace or repair the damaged cells or tissues in the brain using cells that can differentiate into neurons, glial cells, or other necessary brain structures. These therapies aim to promote recovery from a variety of neurological conditions, including brain injury, stroke and neurodegenerative diseases. The cellular therapies used in the context of neurosurgery are diverse, ranging from stem cell therapies to gene editing techniques and even extracellular vesicle therapies. Below are some of the most prominent approaches being used and developed: Stem cells are undifferentiated cells that have the potential to develop into many different types of cells. The concept of using stem cells to treat neurological conditions has attracted considerable attention in recent years. These cells can either come from the patient’s own body (autologous) or be derived from donors (allogeneic). Embryonic stem cells are pluripotent, meaning they can differentiate into any cell type in the body, including neurons. However, ethical and safety concerns have limited their use in clinical applications. Induced Pluripotent Stem Cells (iPSCs) are adult cells reprogrammed back into a pluripotent state. They offer a promising alternative to ESCs, as they do not carry the same ethical concerns and can be derived from the patient's own cells, potentially minimizing the risk of immune rejection [2]. Stem cells have shown promise in preclinical and early clinical studies for conditions such as Traumatic Brain Injury (TBI), stroke and Parkinson’s disease. For example, in stroke patients, stem cell therapy can potentially aid in tissue regeneration, improving functional recovery in the brain by replacing lost or damaged neurons. Gene therapy, the process of introducing or altering genetic material within a patient’s cells, is another frontier in cellular therapies for the brain. While stem cells can regenerate tissue, gene therapies can enhance the function of existing brain cells or make cells in the brain more resilient to disease. One of the most commonly used methods of delivering genes to brain cells is through viral vectors, which can introduce new genes into a patient’s neurons. These genes may encode proteins that promote neuronal growth, reduce inflammation, or protect neurons from further damage. Gene-editing technology enables precise changes to DNA within living cells. In neurosurgery, CRISPR has the potential to correct genetic defects that contribute to neurological disorders. For example, it could be used to edit genes responsible for diseases like Huntington's disease, a neurodegenerative condition caused by a mutation in a single gene. Gene therapies are particularly valuable in treating inherited neurodegenerative disorders. They can potentially slow or halt the progression of diseases like amyotrophic lateral sclerosis (ALS) and Duchenne muscular dystrophy [3]. Neurosurgery plays a crucial role in facilitating the application of cellular therapies to the brain. Surgical procedures are often necessary to implant stem cells or gene therapy vectors into targeted areas of the brain, or to create the optimal environment for cell-based therapies to take effect. Many of the cellular therapies discussed here require the use of advanced neurosurgical techniques to ensure precise delivery of cells or genes to the brain. Minimally invasive techniques, such as stereotactic surgery or endoscopic surgery, are increasingly used to inject stem cells or gene therapy agents directly into the brain with minimal disruption to surrounding healthy tissue. In some cases, surgeons may also need to implant biodegradable scaffolds that provide structural support to the newly introduced cells or tissue-engineered constructs. These scaffolds help guide the growth of cells and promote proper tissue regeneration. Advanced imaging techniques, such as functional MRI (fMRI) and Positron Emission Tomography (PET), are used to track the progress of cellular therapies in real-time. Neurosurgeons rely on these tools to ensure the success of the procedure and to monitor the functional outcomes. Cellular therapies in neurosurgery have made significant strides in recent years, with several promising applications already underway in clinical settings [4]. Traumatic brain injury is one of the leading causes of disability worldwide. While current treatments are primarily focused on symptom management and preventing secondary brain damage, cellular therapies offer hope for actual regeneration of brain tissue. Clinical trials involving stem cells for TBI have demonstrated the potential for improving functional outcomes. For instance, research on the transplantation of neural stem cells into injured brain regions has shown promise in regenerating neurons and improving cognitive and motor functions. Stroke causes the death of brain cells due to a lack of oxygen. In recent years, cellular therapies, particularly stem cells, have been tested in stroke patients. Early clinical trials have shown that stem cells can promote tissue repair and even enhance neuroplasticity, helping the brain reorganize and recover function. Additionally, gene therapies that encourage the growth of new blood vessels and neurons are being studied in stroke recovery. These treatments aim to improve the brain's ability to compensate for the lost functions following a stroke. Parkinson's disease is a neurodegenerative disorder characterized by the progressive loss of dopamine-producing neurons in the brain. Cellular therapies, particularly the use of dopamine-producing stem cells, have shown promise in animal models and early-phase human trials. By replacing lost neurons and restoring dopamine production, these therapies could potentially reduce symptoms and slow the progression of Parkinson's disease [5].

Conclusion

The future of neurosurgery is being redefined by the exciting developments in cellular therapies. Stem cells, gene therapies, exosome treatments and tissue engineering are opening new possibilities for restoring brain function, offering hope to patients with conditions that were once thought to be untreatable. While many of these therapies are still in early stages of development, the results so far are promising, suggesting that the day may soon come when neurosurgical reboots-using cells and innovative technologies to regenerate and repair the brain-become mainstream treatments. However, there are still many challenges to overcome, including refining the methods of delivery, ensuring the safety and efficacy of these therapies and addressing ethical concerns surrounding the use of certain types of stem cells. As research continues and technology advances, it is likely that the ability to restore lost brain function will become more effective and accessible. With the potential to revolutionize the treatment of neurological disorders, cellular therapies could pave the way for a new era in neurosurgery, where the brain is not just treated, but truly healed and rejuvenated. The promise of a brain reboot is on the horizon and the future of neurological care has never been more exciting.

Acknowledgment

None

Conflict of Interest

None

References

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