Joseph Madsen

Joseph Madsen, MD

Director, Epilepsy Surgery; Associate in Neurosurgery

Associate Professor, Harvard Medical School

"I believe in taking my time to talk to patients and charting an individual direction in medicine."

Medical Services

Specialties

  • Brain Tumors
  • Congenital Anomalies
  • Chiari Malformations
  • Fetal Anomalies
  • Neurosurgery
  • Hemispherectomy
  • Hydrocephalus
  • Invasive Phase II Monitoring for Epilepsy
  • Minimally Invasive Laser Surgery
  • Surgical Treatment of Epilepsy
  • Vagal Nerve Stimulator

Departments

  • Neurosurgery

Languages

  • English

Programs

  • Advanced Fetal Care Center
  • Epilepsy Center
  • Hydrocephalus Program
  • Neuromotor Therapy Program
  • Neurosurgical Service
  • Tuberous Sclerosis Program
To schedule an appointment: Call 617-355-6008 or Request an Appointment
Joseph Madsen

I grew up in Salt Lake City, Utah, educated by my father, an engineer, and my mother, a nurse. 

The wide-open vistas of my youth -- with mountains and canyons outside my doorstep -- and the pioneer spirit of the western settlers have had profound influences on my approach to care and research. I believe in taking my time to talk to patients and charting an individual direction in medicine.

I bring a strong interest in engineering, computer programming and mathematics to my practice. An early influence in these areas came during a summer of high school, when I was an intern in the lab of Ed Catmull, then a graduate student at the University of Utah who subsequently founded Pixar, the technology company that changed art, animation and entertainment forever. Thinking about how to approach animation as a computational problem (we were trying to digitize pictures to create a 3D representation of a moving person), I had a chance to think about how cutting-edge computational techniques might dramatically change a field -- and that is something I have tried to bring to neurosurgery.

That interest carries through to today. I hold nine U.S. patents and am interested in creating devices to help my patients. I study epilepsy from a mathematical perspective, using equations to predict specific places in the brain where seizures originate and designing surgeries that can cure them. I teach residents how to bring math, engineering and science to bear on a clinical problem, and stress that thinking this way will lead to better work on every case they undertake.

Experience and Education

Education

Undergraduate Degree

University of Utah, 1976

Salt Lake City, Utah

Medical Degree

Harvard Medical School, 1981

Boston, Massachusetts

Internship

Beth Israel Deaconess Medical Center, 1981-1982

Boston, Massachusetts

Research Fellowship

Beth Israel Deaconess Medical Center, 1982-1983

Boston, Massachusetts

Residency & Fellowship

Massachusetts General Hospital, 1983-1989

Boston, Massachusetts

Certifications

  • ABNS - American Board of Neurological Surgery

  • ABPNS - American Board of Pediatric Neurological Surgery

  • Neurological Surgery, Pediatric Neurological Surgery

Research

I lead a multidisciplinary group of researchers in the use of engineering and quantitative principles to better understand and treat children's brains. Through my Neurodynamics Laboratory, I study the biophysics and biology underlying epilepsy and hydrocephalus as well as the use of advanced imaging and radiological tools, mathematical analyses and robotics.

Our lab applies these progressive tools to hydrocephalus and epilepsy research, specifically integrating strides in biology, imaging, mathematics and engineering to provide a much needed framework to these important fields. Recent efforts in our engineering approach have generated new concepts in the fundamental understanding of these conditions, and development of devices to improve care.

In epilepsy, our work has correlated the frequency and phase of specifically recorded intracranial signals with cognitive events, particularly memory and perception. Our current efforts focus on utilizing these methods to improve surgical patient selection and operative resection planning, as well as to understand the mechanisms of nonresective surgical strategies such as vagal nerve stimulation.

In patients evaluated for resective surgery, we assume that there may actually exist an optimal neurosurgical intervention tailored to the individual patient. Techniques of applied mathematics, such as Granger causality calculations on large datasets of intracranial EEG, might allow the most objective practical determination of this intervention.

In hydrocephalus, we have proposed that failure of a mechanism to absorb the kinetic energy of cardiac pulsations may underlie headache and clinical symptoms of hydrocephalus. We have recently published the world’s largest experience with noninvasive thermal measurement of shunt flow, and we now correlate these findings with an MRI-based technique to quantify shunt flow.

Building on a project initiated with Dr. Judah Folkman, we are investigating the levels of VEGF in cerebrospinal fluid, and pursuing a pharmacological strategy resulting from the interplay of these investigations. The impact on diagnosis of shunt problems has led to improved therapy in individual patients and we anticipate therapeutic advances with measurable impact on outcomes for the large population of children with hydrocephalus.

My research has resulted in publications that have advanced the field and provided new options to patients, including:

Sederberg PB, Schulze-Bonhage A, Madsen JR, Bromfield EB, Litt B, Brandt A, Kahana MJ. Gamma oscillations distinguish true from false memories. Psychol Sci. 2007;18:927-932.

Zou R, Park EH, Kelly EM, Egnor M, Wagshul ME, Madsen JR. Intracranial pressure waves: characterization of a pulsation absorber with notch filter properties using systems analysis: laboratory investigation. J Neurosurg Pediatrics. 2008; 2: 83-94.

Liu H, Buckner RL, Talukdar T, Tanaka N, Madsen JR, Stufflebeam SM. Task-free presurgical mapping using functional magnetic resonance imaging intrinsic activity. J Neurosurg. 2009; 111: 746-754.

Liu H, Agam Y, Madsen JR, Kreiman G. Timing, timing, timing: fast decoding of object information from intracranial field potentials in human visual cortex. Neuron. 2009;62:281-290.

Grinberg L, Anor T, Cheever E, Madsen JR, Karniadakis GE. Simulation of the human intracranial arterial tree. Philos Transact A Math Phys Eng Sci. 2009; 367: 2371-2386.

Cash SS, Halgren E, Dehghani N, Rossetti AO, Thesen T, Wang C, Devinsky O, Kuzniecky R, Doyle W, Madsen JR, Bromfield E, Eross L, Halász P, Karmos G, Csercsa R, Wittner L, Ulbert I. The human K-complex represents an isolated cortical down-state. Science. 2009; 324: 1084-1087.

Eide PK, Rapoport BI, Gormley WB, Madsen JR. A dynamic nonlinear relationship between the static and pulsatile components of intracranial pressure in patients with subarachnoid hemorrhage. J Neurosurg. 2010; 112: 616-625.

Park EH, Dombrowski S, Luciano M, Zurakowski D, Madsen JR. Alterations of pulsation absorber characteristics in experimental hydrocephalus. J Neurosurg Pediatr. 2010; 6:159-170.

Stufflebeam SM, Liu H, Sepulcre J, Tanaka N, Buckner RL, Madsen JR. Localization of focal epileptic discharges using functional connectivity magnetic resonance imaging. J Neurosurg. 2011; 114: 1693-1697.

Truccolo W, Donoghue JA, Hochberg LR, Eskandar EN, Madsen JR, Anderson WS, Brown EN, Halgren E, Cash SS. Single-neuron dynamics in human focal epilepsy. Nat Neurosci. 2011; 14: 635-641.

Poh MZ, Loddenkemper T, Reinsberger C, Swenson NC, Goyal S, Madsen JR, Picard RW. Autonomic changes with seizures correlate with postictal EEG suppression. Neurology. 2012; 78:1868-1876.

Park EH, Eide PK, Zurakowski D, Madsen JR. Impaired pulsation absorber mechanism in idiopathic normal pressure hydrocephalus. J Neurosurg. 2012; 117:1189-1196.

Jha RM, Liu X, Chrenek R, Madsen JR, Cardozo DL. The postnatal human filum terminale is a source of autologous multipotent neurospheres capable of generating motor neurons. Neurosurgery. 2013; 72: 118-129.

Duffy FH, Eksioglu YZ, Rotenberg A, Madsen JR, Shankardass A, Als H. The frequency modulated auditory evoked response (FMAER), a technical advance for study of childhood language disorders: cortical source localization and selected case studies. BMC Neurology. 2013; 13: 12.

Tanaka N, Peters JM, Prohl AK, Takaya S, Madsen JR, Bourgeois BF, Dworetzky BA, Hämäläinen MS, Stufflebeam SM. Clinical value of magnetoencephalographic spike propagation represented by spatiotemporal source analysis: correlation with surgical outcome. Epilepsy Res. 2014; 108: 280-288.

Shim JW, Sandlund J, Han CH, Hameed MQ, Connors S, Klagsbrun M, Madsen JR, Irwin N. VEGF, which is elevated in the CSF of patients with hydrocephalus, causes ventriculomegaly and ependymal changes in rats. Exp Neurol. 2013; 247:703-709.

Singer JM, Madsen JR, Anderson WS, Kreiman G. Sensitivity to timing and order in human visual cortex. J Neurophysiol. 2015; 113: 1656-1669.

Professional History

I am a pediatric neurosurgeon with a strong interest in innovative approaches to the dynamic brain maladies of children, especially epilepsy and hydrocephalus. My clinical efforts are closely tied to my research program, the Neurodynamics Laboratory.

I received my medical degree in 1981 from a joint program poised uniquely at the intersection between engineering and medicine, the Harvard-MIT Program in Health, Science and Technology. I hold the Webster Family Chair in Neurosurgery and Neuroengineering at Boston Children's Hospital, direct the hospital's Epilepsy Surgery Program and am an associate professor at Harvard Medical School. My work is multidisciplinary and focused on applying engineering and mathematical approaches to my practice.

I have brought several innovations to clinical practice. These include a new technique to monitor shunt flow in patients with hydrocephalus, including the use of cardiac-gated MRI scans, thermal detection of shunt flow, and a valve massager technology. I have also developed a new technique to predict seizure focus using intracranial data gathered from implanted electrodes, which will one day allow surgeons like myself to better plan epilepsy surgeries. My practice has grown in part because of successful patient approaches developed during planning of such research programs.

I also have a strong interest in improving pediatric neurosurgery and epilepsy surgery abroad, specifically in China. In that context, I have been an adjunct professor in functional neurosurgery at Xuanwu Hospital, affiliated with Capitol Medical University, Bejing Institute of Functional Neurosurgery. I have been specifically working on a mechanism to review surgical cases in real time with colleagues at Beijing's Children's Hospital.

To schedule an appointment: Call 617-355-6008 or Request an Appointment

Locations

The future of pediatrics will be forged by thinking differently, breaking paradigms and joining together in a shared vision of tackling the toughest challenges before us.”
- Sandra L. Fenwick, President and CEO

Boston Children's Hospital 300 Longwood Avenue, Boston, MA 02115 617-355-6000 | 800-355-7944

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