The Department of Neurological Surgery at Indiana University School of Medicine recently welcomed two new functional neurosurgeons to expand the growing specialty.
Jason Schwalb, MD, Betsey Barton Professor of Neurological Surgery, and David Purger, MD, PhD, assistant professor of neurological surgery, joined department faculty in September 2024.
Schwalb has spent the past 15 years as a clinician in the Henry Ford Health System in Detroit, Michigan; he also held professorships at Michigan State University and Wayne State University School of Medicine. Purger comes to IU School of Medicine following the completion of his neurosurgery training at the Stanford University School of Medicine in spring 2024.
Functional neurosurgeons specialize in restoring neurological function to a person’s nervous system by using leading-edge techniques to treat patients with movement disorders, epilepsy, pain. They frequently collaborate with neurologists, psychiatrists and neuroradiologists. At IU School of Medicine, these specialists provide specific expertise in deep brain stimulation and focused ultrasound to treat movement disorders with minimally- and non-invasive techniques.
We spoke with Schwalb and Purger about their backgrounds in neurosurgery and what drew them to the Department of Neurological Surgery at IU School of Medicine.
Jason Schwalb, MD
Why did you choose the field of neurosurgery? When I started medical school, I thought I would go into internal medicine or pediatrics. However, my exposure to neuroscience was life changing. I had long been interested in linguistics and how language function influences creativity and thought. Neuroscience was the way to better understand how function follows form and the quintessence of what we are as human beings. The circuitry of the brain was awe inspiring. When I was exposed to neurosurgery as a third-year medical student, I saw a way to maintain that sense of wonder with life-long learning, use all my skills as a scientist and humanist, and make a profound difference in people’s lives.
What is your specialty? I specialize in functional and complex peripheral nerve surgery. Functional neurosurgery involves an approach to the nervous system that involves modulating or changing the circuitry of the nervous system to improve the lives of patients. This has traditionally been used for pain, epilepsy and movement disorders like Parkinson’s disease, essential tremor and dystonia. However, we can use this approach and technological toolkit for other conditions as we learn more about the circuitry of the brain. Emerging indications include addiction, depression and obsessive-compulsive disorder. There are several functional neurosurgeons who also perform complex peripheral nerve surgery due to the overlap in approach in rewiring the peripheral nervous system to improve function.
What drew you to IU School of Medicine? IU School of Medicine has a great history of excellence in functional neurosurgery, having been involved in pivotal trials in the surgical treatment of epilepsy. There is a huge opportunity to make the program even greater with our excellent partners in the Departments of Neurology, Physical Medicine and Rehabilitation, Psychiatry and Radiology and Imaging Sciences. As someone interested in quality improvement, health care delivery and disparities, I was also drawn by the opportunities for partnership with the Regenstrief Institute to rationalize and improve care by getting the right patient to the right provider at the right time.
What are your research and clinical focuses? Functional neurosurgery, advanced imaging, Parkinson's disease, medical education, health policy, quality improvement, complex peripheral nerve surgery, adult hydrocephalus, pain (including facial pain and cancer pain), essential tremor, epilepsy, dystonia, health equity, registry science and neurofibromatosis.
Do you have any goals in your new role at IU School of Medicine? Many! My goals are to make IU School of Medicine and IU Health a nationally recognized center for functional and complex peripheral nerve surgery as a model for high volume clinical care, innovation and education. This will involve development of infrastructure for critically looking at the outcomes that are important to our patients with continuous feedback and improvement. This will also allow us to continue to be an attractive site for industry and National Institutes of Health-sponsored research. It is also extremely important to me and the department that I mentor junior faculty, fellows, residents and medical students to carry the message and advance our field.
David Purger, MD, PhD
Why did you choose the field of neurosurgery? I chose neurosurgery for the incredible privilege of helping patients and families suffering from conditions of the nervous system that impact their movements, thoughts, emotions, behaviors, and personalities — the very things that make us human. I was drawn to the deeply rewarding relationships that develop as a result of the enormous trust between neurosurgeons and their patients. At the same time, the unique access neurosurgeons have to the central and peripheral nervous systems provides a tantalizing opportunity to use the latest technology to shed light on some of the most important questions in neuroscience while simultaneously helping patients recover function and restore well-being.
What is your specialty? I specialize in stereotactic, functional and epilepsy surgery, with a specific interest in treating refractory psychiatric disorders with brain stimulation. I also focus on peripheral nerve neurosurgery.
What drew you to IU School of Medicine? There is a unique energy palpable at the IU School of Medicine that draws together students, residents, faculty and staff to work together to advance the institution’s goals of making discoveries to improve lives all over the world while turning Indiana into one of America’s healthiest states. The IU School of Medicine confidently supports pioneering, high-risk/high-reward research while simultaneously focusing on our local communities and those who need our help the most. Finally, rarely have I encountered such an accomplished group of clinicians and scientists who are both among the best and brightest in their field and are also some of the kindest and most collaborative people around.
What are your research and clinical focuses? Clinical: deep brain stimulation (DBS) and focused ultrasound (FUS) for movement disorders; open and minimally-invasive craniotomies, DBS, responsive neurostimulation (RNS), robot-assisted stereoelectroencephalography (sEEG), and vagus nerve stimulation (VNS) for epilepsy; microvascular decompression (MVD) surgery for trigeminal neuralgia, hemifacial spasm, glossopharyngeal neuralgia, and geniculate neuralgia; percutaneous rhizotomy for trigeminal neuralgia; spinal cord stimulation (SCS) for failed back syndrome; decompressions, nerve repairs, and nerve transfers for a variety of peripheral nerve disorders throughout the body; and general neurosurgical procedures for brain and spine tumors, spinal disorders, and hydrocephalus. Research: patient-specific neuromodulation strategies for psychiatric disorders, basic network mechanisms of consciousness, psychedelic science and mechanisms of psychedelic-assisted therapy.
Do you have any goals in your new role at IU? My goal is to provide the highest level of personalized, compassionate, and comprehensive care to my patients, while advancing basic and translational neuroscience using the latest technology both inside and outside of the operating room. Within functional and restorative neurosurgery, I see our clinical and research goals as being two arms of the same mission, where we can learn a great deal from all our patients as well as apply lessons from our discoveries back to every patient’s care. Together with my colleagues, I will work toward IU School of Medicine and IU Health becoming a regional, national and international destination for world-class neurosurgical care and research in consciousness, psychiatric neuromodulation and psychedelic science.
