Faculty Focus: Brian Dlouhy, MD

What is your hometown?

Tampa, Florida 

How/when did you become interested in science and/or medicine?

I have always been interested in medicine and science. I was exposed to medicine early as a young child watching my mother work as a pharmacist. A career fair in elementary school brought a physician to my school, and I came home convinced of my future profession. Everything else since just reinforced that idea. I participated in local and then state high school science fairs testing various hypotheses of medical questions and problems. By the time I reached college, I couldn’t imagine doing anything but medicine. I studied chemical engineering at the University of Florida in Gainesville, Florida, with my sights set on attending medical school. My engineering background has served me extraordinarily well in both clinical and scientific problem solving as a physician-scientist.

During medical school at New York University, I became fascinated with neuroscience and the complexities of the human brain – so much so, that I spent two years as Howard Hughes Medical Institute Research Scholar at the National Institutes of Health, studying molecular pathways involved in neurological disease.

Why Neurosurgery?

Neurosurgery holds tremendous appeal because, at its very core, the nervous system is unlike any other, and the surgical treatment of neurological disorders presents unique challenges. Because the nervous system lacks the regenerative capacity common to most other tissues in the body, the neurosurgical treatment of disease requires precision, accuracy, excellent judgment and confidence. When I completed my first neurosurgery rotation in medical school, I realized neurosurgery beckoned, captivated and challenged me. Neurosurgical clinical rotations as a third and fourth year medical student convinced me beyond any doubt that neurosurgery was my destiny – as if I had been preparing for it all my life.  

The human brain is unique. Neurons are more than just cells; they are components of an extremely complex electrical circuit. Our understanding of how the human brain functions has relied greatly on neurosurgeons scientifically studying these connections and what circuits and regions of the brain allow us to talk, hear, move, and think. Further understanding of these complex functions and how disease affects them will rely heavily on neurosurgeons continuing these scientific pursuits, something I’m very passionate about.

When did you join the University of Iowa faculty?

2015 

How or why did you choose to join the faculty at the University of Iowa?

I came to the University of Iowa as a neurosurgery resident in 2007 and was fortunate to find incredible mentors and a place that encourages collegiality and camaraderie. I thrive in this kind of environment. I learned a tremendous amount from the neurosurgery faculty and forged my own path in basic science, translational, and clinical research. After residency and then two fellowships – a fellowship in minimally invasive neurosurgery and a fellowship in pediatric neurosurgery – I joined the University of Iowa as a faculty member because it provided me the best environment to hone my skills as a neurosurgeon, becoming technically superb, and foster my growth as a surgeon-scientist. I want to make advancements in the field and make a lasting impact through better surgical treatments, better surgical techniques, understanding mechanisms underlying neurological disease, and curing and preventing neurological disorders. Iowa provided me the best opportunity for me to accomplish my goals.

Is there a teacher or mentor who helped shape your career?

Since beginning my residency at the University of Iowa in 2007, I trained and learned under Arnold Menezes, MD, renowned pediatric and adult neurosurgeon for the treatment of Chiari type I malformation and disorders of the craniovertebral junction (CVJ), the junction between the skull and the spine. He is what many regard as one of the “master neurosurgeons” of the last 50 years. I operated with him routinely during my residency and chief residency at the University of Iowa, learning from his vast experience. Now as a faculty member, we work side by side together both in the clinic and operating room – making decisions together and operating together as a collaborative team to treat complex neurosurgical conditions. His surgical technique has made such an impact on me that I’ve adopted every part of his surgical approach and technique. We work together on clinical research projects to better understand the pathophysiological mechanisms underlying Chiari I malformation and related disorders of the CVJ. His vast knowledge and experience is an unparalleled resource.

My postdoctoral research fellowship during my neurosurgery residency was under the guidance of John Wemmie, MD, PhD, professor in the department of Psychiatry. John has had a significant impact on almost every aspect of my scientific career - hypothesis driven experiments, writing, thinking, and mentoring in science and research. I now work side by side with him running a research lab of my own in the Pappajohn biomedical discovery building in the Iowa Neuroscience Institute.

How do you see your faculty role impacting medicine and/or science?

A major focus in my lab is understanding the mechanisms underlying sudden unexpected death in epilepsy (SUDEP). This research studies adults and children with epilepsy to investigate how seizures cause loss of breathing (apnea) – the inciting event that leads to SUDEP. We recently found that when seizures spread to areas of the brain such as the amygdala, breathing is inhibited. Using deep brain stimulation techniques (electrical stimulation) of the amygdala in humans, we could reproduce the loss of breathing observed with seizures, suggesting the amygdala is a key site involved in SUDEP. We’ve expanded this research program significantly since the start of my faculty position. We’ve also now developed animal models to help us study SUDEP and loss of breathing during seizures. We are rapidly moving toward testing methods to prevent this loss of breathing during seizures and therefore, hopefully prevent SUDEP.

What is the biggest change you've experienced in your field since you were a student?

The technical aspects to neurosurgery have advanced significantly over the last 15 years, it’s incredible. Neurosurgery is the youngest and biggest growth field in all of medicine. There is still an “art” to the surgical treatment of neurosurgical disease. This provides a great opportunity to make an impact with research and providing more science/research to this “art.”

What one piece of advice would you give to today's students?

Find something you love and be determined, persistent and focused to achieve your goals.

In what ways are you engaged in professional activities outside the University (i.e. population based research, mentoring high school students, sharing your leadership/ expertise with organizations or causes, speaking engagement off campus, etc.)?

I give various medical talks within the community - both locally and throughout Iowa. I give talks educating families and patients about neurological conditions that I treat as a surgeon, such as epilepsy, Chiari type I malformation, and complex disorders of the skull and spine. I will give other talks that focus mainly on my research and breakthroughs we’ve made in understanding epilepsy and mechanisms underlying sudden unexpected death in epilepsy (SUDEP) – why patients stop breathing during seizures – and what we are doing to prevent this. Often, my talks will incorporate a little bit of both. High school students have shadowed me in my clinic seeing patients and I routinely work with medical students and others in my growing research endeavors. 

What are some of your outside (personal) interests?

I enjoy working out and running. I enjoy spending time with family and friends and traveling.