- Assistant Professor, Neurosurgery
- Assistant Professor, Neurology
- MPH Health Policy and Administration
- Yale University, New Haven, Connecticut, United States
- M.D. Medicine
- Albert Einstein College of Medicine of Yeshiva University, Bronx, New York, United States
- (With Distinction in Research in Epilepsy)
- B.A. Biology
- Harvard University, Cambridge, Massachusetts, United States
- Division of Neurosurgery, University of Arizona Department of Surgery (2014 - Ongoing)
- Department of Neurosurgery, Emory University School of Medicine (2012 - 2013)
- Young Investigator Award
- American Epilepsy Society, Fall 2011
- Einstein Research Fellowship
- Albert Einstein College of Medicine, Summer 2002
Licensure & Certification
- Diplomate, American Board of Neurological Surgery (2017)
- Licensed Physician, US Centers for Medicare & Medicaid Services (2008)
- Licensed Physician, Illinois Department of Financial and Professional Regulation (2013)
- Licensed Physician, Arizona Medical Board (2014)
- Licensed Physician, Georgia Composite Medical Board (2012)
- Licensed Physician, US Drug Enforcement Agency (2012)
Epilepsy surgery, movement disorders surgery, pain surgery, psychosurgery
Neurosurgery, neuromodulation, deep brain stimulation (DBS), epilepsy surgery, functional neurosurgery
NeurosurgerySURG 848C (Fall 2016)
Neurosurgery (Surgery Subspec)SURG 837C (Fall 2016)
- Kasoff, W., & Gross, R. E. (2016). Deep brain stimulation: introduction and technical aspects. In Neuromodulation in Psychiatry. John Wiley & Sons.
- Bina, R. W., Palsma, R., Weinand, M. E., & Kasoff, W. (2020). Peripheral Nerve Stimulation for Refractory Trigeminal Pain: Recent Single-Institution Case Series with Long-Term Follow-Up. Neuromodulation.
- Darrow, J. J., Robertson, C. T., & Kasoff, W. S. (2020). Evidence Supporting the Value of Surgical Procedures: Can We Do Better?. The American surgeon, 3134820979792.More infoThere is an acknowledged need for higher-quality evidence to quantify the benefit of surgical procedures, yet not enough has been done to improve the evidence base. This lack of evidence can prevent fully informed decision-making, lead to unnecessary or even harmful treatment, and contribute to wasteful expenditures of scare health care resources. Barriers to evidence generation include not only the long-recognized technical difficulties and ethical challenges of conducting randomized surgical trials, but also legal challenges that limit incentives to conduct surgical research as well as market-based challenges that make it difficult for those funding surgical research to recoup investment costs. These legal and market dynamics differ substantially from those surrounding new drug or device development. Nevertheless, obstacles could be overcome and overall expenditures could be reduced if a share of federal health care agency budgets were reallocated to generating randomized trial data, standardizing outcome measures, and conducting observational studies analogous to those that have been facilitated for drugs via the Food and Drug Administration's Sentinel Initiative. Until better quality evidence is available, ethical principles require adequate disclosure of the limited evidence base supporting current surgical procedures.
- Gravbrot, N., Burket, A., Saranathan, M., & Kasoff, W. S. (2020). Asleep Deep Brain Stimulation of the Nucleus Ventralis Intermedius for Essential Tremor Using Indirect Targeting and Interventional Magnetic Resonance Imaging: Single-Institution Case Series. Movement disorders clinical practice, 7(5), 521-530.More infoLiterature on asleep deep brain stimulation (DBS) of the ventralis intermedius (Vim) nucleus in essential tremor is relatively sparse. Furthermore, controversy exists as to whether indirect ("consensus" or "atlas-based") targeting of the Vim requires physiologic adjustment for effective clinical outcomes in DBS surgery.
- Gravbrot, N., Saranathan, M., Nagae, L. M., Becker, J., & Kasoff, W. S. (2020). Safety Profile of Infinity Deep Brain Stimulation Electrode Placement in a 1.5T Interventional MRI Suite: Consecutive Single-Institution Case Series. AJNR. American journal of neuroradiology, 41(12), 2257-2262.More info"Asleep" deep brain stimulation using general anesthesia and intraoperative MR imaging guidance is considered "off-label" use by current FDA guidelines but is widely used in neurosurgical practice, and excellent safety has been demonstrated using first-generation, omnidirectional electrodes. Safety data for second-generation, directional electrodes in the interventional MR imaging environment have not yet been published. Herein, we report 34 cases of asleep deep brain stimulation using second-generation, directional electrodes in an interventional MR imaging suite at a single institution. Procedural complications and imaging data are described. All patients underwent postoperative MR imaging with fully implanted ("internalized") electrodes after scalp closure; 4 patients also underwent MR imaging with "externalized" electrodes before scalp closure. No MR imaging-related complications were observed, and procedural complication rates were comparable to prior series. This suggests that the use of second-generation, directional electrodes in the interventional MR imaging environment appears to be safe when following manufacturer-published imaging guidelines.
- Kasoff, W. S., & Bina, R. W. (2020). Placement and Anchoring of Trigeminal Neurostimulation Electrodes: Technical Report. Stereotactic and functional neurosurgery, 1-8.More infoPeripheral neurostimulation (PNS) for medically refractory trigeminal and craniofacial pain is an emerging alternative to traditional surgical approaches. Technical problems with craniofacial PNS have included electrode migration and erosion, limiting the utility and cost-effectiveness of this procedure.
- Kasoff, W., Bina, R., Weinand, M., & Palsma, R. (2020). Peripheral nerve stimulation for refractory trigeminal pain: recent single-institution case series with long-term follow-up.. Neuromodulation.
- Kasoff, W., Saranathan, M., & Gravbrot, N. (2020). Advanced imaging and direct targeting of the motor thalamus and dentato-rubro-thalamic tract for tremor: a systematic review. Stereotactic and Functional Neurosurgery.
- Palsma, R., Gravbrot, N., Bina, R., Agastya, M., & Kasoff, W. S. (2020). Deep Brain Stimulation Surgery for Essential Tremor in a Patient with Type A Hemophilia. World neurosurgery, 139, 158-162.More infoHemophilia is generally considered a contraindication to deep brain stimulation (DBS) and other elective intracranial surgery because of the elevated risk of perioperative hemorrhage. Two prior case reports have suggested, however, that DBS may be safe in patients with hemophilia who undergo appropriate factor replacement. Here, we describe a third case of DBS surgery for medically refractory essential tremor (ET) in a patient with hemophilia A.
- Preston, C., Alvarez, A., Barragan, A., Becker, J., Kasoff, W., & Witte, R. (2020). High resolution transcranial acoustoelectric imaging of current densities from a directional deep brain stimulator. Journal of neural engineering.More infoNew innovations in deep brain stimulation (DBS) enable directional current steering - allowing more precise electrical stimulation of the targeted brain structures for Parkinson's disease, essential tremor and other neurological disorders. While intra-operative navigation through MRI or CT approaches millimeter accuracy for placing the DBS leads, no existing modality provides feedback of the currents as they spread from the contacts through the brain tissue. In this study, we investigate transcranial acoustoelectric imaging (tAEI) as a new modality to non-invasively image and characterize current produced from a directional DBS lead. tAEI uses ultrasound (US) to modulate tissue resistivity to generate detectable voltage signals proportional to the local currents.
- Texakalidis, P., Tora, M. S., Anthony, C. L., Greven, A., McMahon, J. T., Nagarajan, P., Kasoff, W. S., AuYong, N., & Boulis, N. M. (2020). Peripheral trigeminal branch stimulation for refractory facial pain: A single-center experience. Clinical neurology and neurosurgery, 194, 105819.More infoFacial pain refractory to medical treatments may benefit from neurosurgical interventions. Only a few studies have reported on the efficacy of peripheral trigeminal stimulation and more specifically supraorbital nerve (SON) and infraorbital nerve (ION) stimulation for the treatment of facial pain.
- Krase, J. M., Kasoff, W. S., & DuPont, J. P. (2019). Mohs Micrographic Surgery of the Scalp in a Patient With a Deep Brain Stimulator. Dermatologic surgery : official publication for American Society for Dermatologic Surgery [et al.].
- Sprissler, R., Bina, R., Kasoff, W., Witte, M. H., Bernas, M. J., Walter, C. M., Labiner, D. M., Lau, B., Hammer, M., & Weinand, M. E. (2019). Leukocyte expression profiles reveal gene sets with prognostic value for seizure-free outcome following stereotactic laser amygdalohippocampotomy. Nature Scientific Reports.
- Su, J. H., Thomas, F. T., Kasoff, W. S., Tourdias, T., Choi, E. Y., Rutt, B. K., & Saranathan, M. (2019). Thalamus Optimized Multi Atlas Segmentation (THOMAS): fast, fully automated segmentation of thalamic nuclei from structural MRI. NeuroImage, 194, 272-282.More infoThe thalamus and its nuclei are largely indistinguishable on standard T1 or T2 weighted MRI. While diffusion tensor imaging based methods have been proposed to segment the thalamic nuclei based on the angular orientation of the principal diffusion tensor, these are based on echo planar imaging which is inherently limited in spatial resolution and suffers from distortion. We present a multi-atlas segmentation technique based on white-matter-nulled MP-RAGE imaging that segments the thalamus into 12 nuclei with computation times on the order of 10 min on a desktop PC; we call this method THOMAS (THalamus Optimized Multi Atlas Segmentation). THOMAS was rigorously evaluated on 7T MRI data acquired from healthy volunteers and patients with multiple sclerosis by comparing against manual segmentations delineated by a neuroradiologist, guided by the Morel atlas. Segmentation accuracy was very high, with uniformly high Dice indices: at least 0.85 for large nuclei like the pulvinar and mediodorsal nuclei and at least 0.7 even for small structures such as the habenular, centromedian, and lateral and medial geniculate nuclei. Volume similarity indices ranged from 0.82 for the smaller nuclei to 0.97 for the larger nuclei. Volumetry revealed that the volumes of the right anteroventral, right ventral posterior lateral, and both right and left pulvinar nuclei were significantly lower in MS patients compared to controls, after adjusting for age, sex and intracranial volume. Lastly, we evaluated the potential of this method for targeting the Vim nucleus for deep brain surgery and focused ultrasound thalamotomy by overlaying the Vim nucleus segmented from pre-operative data on post-operative data. The locations of the ablated region and active DBS contact corresponded well with the segmented Vim nucleus. Our fast, direct structural MRI based segmentation method opens the door for MRI guided intra-operative procedures like thalamotomy and asleep DBS electrode placement as well as for accurate quantification of thalamic nuclear volumes to follow progression of neurological disorders.
- Zaninovich, O., Ramey, W., Eldersveld, J., & Kasoff, W. S. (2019). Malignant Melanotic Schwannian Tumor Presenting with Spinal Cord Infarction Due to Occlusion of the Artery of Adamkiewicz: Case Report and Review of the Literature. World neurosurgery, 128, 422-425.More infoMalignant melanotic schwannian tumors (MMSTs) are rare peripheral nerve sheath tumors that typically exhibit benign clinical presentation and histopathology but malignant long-term behavior.
- Chen, N. K., Chou, Y. H., Sundman, M., Hickey, P., Kasoff, W. S., Bernstein, A., Trouard, T. P., Lin, T., Rapcsak, S. Z., Sherman, S. J., & Weingarten, C. P. (2018). Alteration of Diffusion-Tensor Magnetic Resonance Imaging Measures in Brain Regions Involved in Early Stages of Parkinson's Disease. Brain connectivity, 8(6), 343-349.More infoMany nonmotor symptoms (e.g., hyposmia) appear years before the cardinal motor features of Parkinson's disease (PD). It is thus desirable to be able to use noninvasive brain imaging methods, such as magnetic resonance imaging (MRI), to detect brain abnormalities in early PD stages. Among the MRI modalities, diffusion-tensor imaging (DTI) is suitable for detecting changes in brain tissue structure due to neurological diseases. The main purpose of this study was to investigate whether DTI signals measured from brain regions involved in early stages of PD differ from those of healthy controls. To answer this question, we analyzed whole-brain DTI data of 30 early-stage PD patients and 30 controls using improved region of interest-based analysis methods. Results showed that (i) the fractional anisotropy (FA) values in the olfactory tract (connected with the olfactory bulb: one of the first structures affected by PD) are lower in PD patients than healthy controls; (ii) FA values are higher in PD patients than healthy controls in the following brain regions: corticospinal tract, cingulum (near hippocampus), and superior longitudinal fasciculus (temporal part). Experimental results suggest that the tissue property, measured by FA, in olfactory regions is structurally modulated by PD with a mechanism that is different from other brain regions.
- Preston, C., Kasoff, W. S., & Witte, R. S. (2018). Selective Mapping of Deep Brain Stimulation Lead Currents Using Acoustoelectric Imaging. Ultrasound in medicine & biology, 44(11), 2345-2357.More infoWe describe a new application of acoustoelectric imaging for non-invasive mapping of the location, magnitude and polarity of current generated by a clinical deep brain stimulation (DBS) device. Ultrasound at 1MHz was focused near the DBS device as short current pulses were injected across different DBS leads. A recording electrode detected the high-frequency acoustoelectric interaction signal. Linear scans of the US beam produced time-varying images of the magnitude and polarity of the induced current, enabling precise localization of the DBS leads within 0.70mm, a detection threshold of 1.75mA at 1 MPa and a sensitivity of 0.52 ± 0.07 μV/(mA*MPa). Monopole and dipole configurations in saline were repeated through a human skullcap. Despite 13.8-dB ultrasound attenuation through bone, acoustoelectric imaging was still >10dB above background with a sensitivity of 0.56 ± 0.10 μV/(mA*MPa). This proof-of-concept study indicates that selective mapping of lead currents through a DBS device may be possible using non-invasive acoustoelectric imaging.
- Laxpati, N. G., Kasoff, W. S., & Gross, R. E. (2014). Deep brain stimulation for the treatment of epilepsy: circuits, targets, and trials. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 11(3), 508-26.More infoDeep brain stimulation (DBS) has proven remarkably safe and effective in the treatment of movement disorders. As a result, it is being increasingly applied to a range of neurologic and psychiatric disorders, including medically refractory epilepsy. This review will examine the use of DBS in epilepsy, including known targets, mechanisms of neuromodulation and seizure control, published clinical evidence, and novel technologies. Cortical and deep neuromodulation for epilepsy has a long experimental history, but only recently have better understanding of epileptogenic networks, precise stereotactic techniques, and rigorous trial design combined to improve the quality of available evidence and make DBS a viable treatment option. Nonetheless, underlying mechanisms, anatomical targets, and stimulation parameters remain areas of active investigation.
- Cavus, I., Kasoff, W. S., Cassaday, M. P., Jacob, R., Gueorguieva, R., Sherwin, R. S., Krystal, J. H., Spencer, D. D., & Abi-Saab, W. M. (2005). Extracellular metabolites in the cortex and hippocampus of epileptic patients. Annals of neurology, 57(2), 226-35.More infoInterictal brain energy metabolism and glutamate-glutamine cycling are impaired in epilepsy and may contribute to seizure generation. We used the zero-flow microdialysis method to measure the extracellular levels of glutamate, glutamine, and the major energy substrates glucose and lactate in the epileptogenic and the nonepileptogenic cortex and hippocampus of 38 awake epileptic patients during the interictal period. Depth electrodes attached to microdialysis probes were used to identify the epileptogenic and the nonepileptogenic sites. The epileptogenic hippocampus had surprisingly high basal glutamate levels, low glutamine/glutamate ratio, high lactate levels, and indication for poor glucose utilization. The epileptogenic cortex had only marginally increased glutamate levels. We propose that interictal energetic deficiency in the epileptogenic hippocampus could contribute to impaired glutamate reuptake and glutamate-glutamine cycling, resulting in persistently increased extracellular glutamate, glial and neuronal toxicity, increased lactate production together with poor lactate and glucose utilization, and ultimately worsening energy metabolism. Our data suggest that a different neurometabolic process underlies the neocortical epilepsies.
- Lehmann, L. S., Kasoff, W. S., Koch, P., & Federman, D. D. (2004). A survey of medical ethics education at U.S. and Canadian medical schools. Academic medicine : journal of the Association of American Medical Colleges, 79(7), 682-9.More infoTo assess the format, content, method, and placement of medical ethics education in medical schools; the faculty and curricular resources and institutional structure and support of medical ethics; and the perceptions of ethics education among deans of medical education and medical ethics course directors at U.S. and Canadian medical schools.
- Cavus, I., Kasoff, W., Sherwin, R. S., Krystal, J., & Spencer, D. D. (2003). Interictal neurometabolite levels in the anterior versus posterior hippocampus in temporal lobe epilepsy: a microdialysis study. Epilepsia, 44 Suppl. 9:175..
- Kasoff, W. (2019, Fall). Trigeminal neuralgia: Part 1. Neurosurgery Didactic Conference. Tucson, AZ: The University of Arizona.
- Kasoff, W. (2019, Winter). Deep Brain Stimulation for Epilepsy. University of Arizona Neuroscience Grand Rounds. Tucson, AZ: University of Arizona.More infoDecember 6, 2019. Webcast archived at https://streaming.biocom.arizona.edu/event/?id=29125
- Kasoff, W. (2019, Winter). Neuromodulation for Trigeminal Pain. University of Arizona Neuroscience Grand Rounds. Tucson, AZ: The University of Arizona.More infoNovember 1, 2019. Webcast archived at https://streaming.biocom.arizona.edu/event/?id=29052
- Kasoff, W. (2015, December). Neurosurgical interventions for cancer pain. University of Arizona Neuroscience Grand Rounds, Tucson AZ, December 18, 2015..
- Kasoff, W. (2017, July 19). Traumatic brain injury. Perioperative staff education. Tucson, AZ: BUMCT.
- Kasoff, W. (2017, July 26). Neurosurgical options for cancer pain. Department of Surgery Grand Rounds. Tucson, AZ: BUMCT.
- Kasoff, W. (2017, March 27). Deep brain stimulation: pre-anesthesia perspective. In-service to Pre-Anesthesia staff. BUMCT.
- Kasoff, W. (2017, May 25). Interventional MRI-guided brain biopsy. University of Arizona Neuro-Oncology Tumor Board. Tucson, AZ.
- Kasoff, W. (2015, December). History and principles of stereotaxis. Neuroscience Grand Rounds. Tucson: University of Arizona.
- Kasoff, W. (2015, December). Neurosurgical interventions for cancer pain. Neuroscience Grand Rounds. Tucson, AZ: University of Arizona.
- Kasoff, W. (2015, February). iMRI and the future of neurosurgery. Neuroscience Grand Rounds. Tucson: University of Arizona.
- Kasoff, W. (2015, January). Spinal cord stimulation part1: mechanisms of action. University of Arizona Multidisciplinary Spine Conference. Tucson.
- Kasoff, W. (2014, August). Craniofacial neuromodulation. Univeristy of Arizona Neuro-Oncology Tumor Board.
- Kasoff, W. (2014, August). Trigeminal neuralgia: part 2. Neurosurgery Didactic Conference.
- Kasoff, W. (2014, July). The state of the art in DBS and movement disorders surgery. University of Arizona Neuroscience Grand Rounds.
- Kasoff, W. (2014, June). Trigeminal neuralgia: part 1. Neurosurgery Didactic Conference.
- Kasoff, W. (2014, October). Deep brain stimulation for psychiatric disease. University of Arizona Psychiatry Grand Rounds.
- Kasoff, W. (2014, October). Trigeminal neuralgia: part 3. Neurosurgery Didactic Conference.
- Kasoff, W. (2020, August). Imaging of current density distribution in deep brain stimulation (DBS). International Society for Magnetic Resonance in Medicine 2020.
- Bina, R., & Kasoff, W. (2018, June). Peripheral nerve stimulation for complex craniofacial pain: recent single-institution experience. Oral presentation at ASSFN Biennial Meeting. Denver, CO.
- Kasoff, W., & Bina, R. (2018, June). Placement and anchoring of craniofacial neurostimulation electrodes: technical note. ASSFN Biennial Meeting. Denver, CO.
- Preston, C., Kasoff, W., & Witte, R. S. (2018, April). Non-invasively mapping deep brain stimulation currents in 4D using acoustoelectric imaging. Minnesota Neuromodulation Symposium. Minneapolis, MN.
- Thomas, F., Saranathan, M., Kasoff, W., Kasoff, W., Thomas, F., & Saranathan, M. (2018, Spring). A novel strategy for automated near-real-time segmentation of the ventral intermediate (Vim) nucleus for deep brain stimulation (DBS) surgery. ISMRM.