Nicholas Boulis, Neurosurgery
Faculty Distinction Fund Recipient

 


As a Yale undergraduate double majoring in philosophy and biology, Nicholas Boulis contemplated what it means to be human. As a member of the National Guard during the first Gulf war, he spent time at Walter Reed Hospital doing neurosurgery rotations. Those experiences, combined with his travels to Nicaragua during the Contra War, helped shape his decision to become a surgeon. "I wanted to be doing, as well as thinking," Boulis says.

Recruited from the Cleveland Clinic to Emory's Department of Neurological Surgery in the School of Medicine, Boulis brings impressive credentials. While in graduate school at Harvard, he received a Howard Hughes Fellowship. As a resident in neurological surgery at the University of Michigan, he won both the university's Young Investigator Award and a Resident Award from the Michigan Association of Neurological Surgeons. In 2007 he received an Early Career Award from the Howard Hughes Medical Institute, which promises $375,000 over a five-year period in support of his research. Boulis intends to make Emory a leader in new gene therapies for neurodegenerative diseases.

Boulis uses surgical techniques to promote neuroprotection and regeneration - the manipulation of the nervous system's genetic pattern in ways that protect healthy cells and regenerate sick ones. "I am interested in how the nervous system underlies experience and behavior, or how an organ, the human brain, can create what we understand as human existence," he says. His surgical interventions promise to improve the quality of life for patients with ALS (Amyotrophic Lateral Sclerosis, also known as Lou Gehrig's Disease), Parkinson's, spasticity, and other neurodegenerative movement disorders.

His current research involves two related components. First, he is using genetic therapies to protect and regenerate motor neurons affected by ALS. "We're trying to address the machinery that keeps cells alive and makes them healthier," Boulis says. In clinical trials, he and his colleagues have used surgical interventions to deliver new genes to damaged portions of the nervous system, an effort to slow or even halt the progression of neurodegenerative disease in patients. Genetic therapies of this kind have the potential to stop the massive apoptosis (or cell death) that leads to neuromuscular failure for so many ALS sufferers.

A second component of Boulis' research involves manipulating the genes that affect neural activity. "Here we're trying to look at the proteins that alter the way neurons talk to each other," he says. This is "wireless" deep brain stimulation (DBS). Instead of implanting wires and batteries in patients who need electrodes to regulate nervous system activity, Boulis and his peers are working to deliver genes that can "teach" neurons to regulate their own activity without external help. This kind of intervention holds promise not only for Parkinson's and spasticity - Boulis's specializations - but also for psychiatric disorders, including depression and obsessive compulsive disorder. Boulis is intrigued by the broader possibilities in this area. "I've seen patients who hadn't left their house in decades come away from DBS surgery saying they want to go to the museum," he says. "Gene delivery can play a similar role, altering the function of the nervous system to compensate for a disorder of the brain." And while many people still associate 'psychosurgery' with the lobotomies performed during the mid-twentieth century, surgical technologies have come a long way since then. What's more, Boulis says, the potential benefits of surgical therapies for psychiatric illness remain compelling. "As long as it [the surgical treatment] is fundamentally reversible, it isn't that different from giving someone a drug. What's more, it needn't have a drug's side effects."

Boulis says he is glad to be at Emory because the university takes seriously its investment in physician scientists - those who remain fully active in both lab and clinic. He has already lined up a number of new collaborators, including a partnership with scientists at the University of North Carolina and at Asklêpios BioPharmaceutical Inc. to initiate a gene therapy trial for the treatment of epilepsy. And Boulis regularly gets on a plane to Guatemala to work on one of his favorite projects - a non-profit organization he founded in 1997 called Project Shunt, an effort to treat hydrocephalus and spina bifida in underserved Latin American children. Boulis hopes his Emory medical students will be intrigued by this project in particular. "At bottom, most medical students are idealistic," he says. "They want to believe that medicine is still about helping those who need it most."

Though he now spends more time in the operating room and in the laboratory than he does in the library, Boulis's early passion for the humanities is never far removed from his current endeavors. Kierkegaard's Fear and Trembling rests on his office shelf, adjacent to neurological textbooks and diagnostic manuals. For Boulis, this isn't a contradiction. It's the natural outgrowth of a lifelong commitment to critical thinking.