Paul S. Larson MD

Paul Larson MD

Professor and Vice Chair of Clinical Neurological Surgery

Chief, Neurosurgery Service, Veterans Affairs Medical Center

Principal Investigator, Movement Disorders Research

Dr. Larson specializes in stereotactic and functional neurosurgery, particularly deep brain stimulation for movement disorders such as Parkinson’s disease and tremor. Dr. Larson and his colleagues at UCSF were the originators of MRI-guided DBS, a surgical technique that allows DBS electrodes to be placed with the patient asleep inside a MRI scanner using real-time imaging. He has extensive experience in MRI-guided surgery for a variety of neurosurgical applications including drug delivery and laser ablation, and is an internationally recognized innovator in this field. Dr. Larson is also a leader in gene transfer for Parkinson’s disease, an investigational treatment that can alter the brain’s function at a molecular level. He has one of the largest surgical experiences in the world in gene transfer clinical trials.

Dr. Larson's research interests are focused in three primary areas; neuromodulation of the basal ganglia for treatment refractory tinnitus, gene transfer for Parkinson’s disease (as well as other neurodegenerative disorders), and interventional MRI-guided stereotactic surgery. He has been involved in 12 major clinical trials to date, and has held a leadership or major role in 9 of them. His basic science work includes studies in the neurobiology of phantom auditory disorders, MR physics related to imaging devices and fluid infusion dynamics in the brain, and the development of new technologies to perform functional neurosurgery using real-time MR imaging.

Read about Dr. Larson's current research ►

Education, Training, and Previous Positions

1990: BS, Arizona State University
1995: MD, University of Arizona
1995-1996: Surgical Internship, University of Louisville
1996-2001: Neurosurgical Residency, University of Louisville

Selected Professional Memberships and Appointments

American Association of Neurological Surgeons
Congress of Neurological Surgeons
AANS-CNS Joint Section on Stereotactic and Functional Neurosurgery
American Society of Stereotactic and Functional Neurosurgery
World Society of Stereotactic and Functional Neurosurgery
The Movement Disorder Society
Society of Neurological Surgeons

Selected Honors and Awards

1991-93: NIH Medical Student Research Fellowships, University of Arizona Barrow Neurological Institute
1995: Excellence in Medical Student Research, University of Arizona
2000: Excellence in Clinical Education Award , University of Louisville School of Medicine
2004: Harold Rosegay Teaching Award, Neurological Surgery, UCSF
2007: Diane D. Ralston Teaching Award, Department of Neurological Surgery, UCSF
2013: Harold Rosegay Teaching Award, Neurological Surgery, UCSF
2014: Alumni Achievement Award, Arizona State University
2015: Moving Day Honoree, National Parkinson Foundation 

Selected Recent Publications

Chabardes S, Isnard S, Castrioto A, Oddoux M, Fraix V, Carlucci L, Payen JF, Krainik A, Krack P, Larson P, Le Bas JF. Surgical implantation of STN-DBS leads using intraoperative MRI guidance: technique, accuracy, and clinical benefit at 1-year follow-up. Acta Neurochir (Wien). 2015 Apr;157(4):729-37. doi: 10.1007/s00701-015-2361-4. Epub 2015 Feb 18. PubMed PMID: 25788414.

Katz M, Luciano MS, Carlson K, Luo P, Marks WJ Jr, Larson PS, Starr PA, Follett KA, Weaver FM, Stern MB, Reda DJ, Ostrem JL; CSP 468 study group. Differential effects of deep brain stimulation target on motor subtypes in Parkinson's disease. Ann Neurol. 2015 Apr;77(4):710-9. doi: 10.1002/ana.24374. PubMed PMID: 25627340.

Rowland NC, Starr PA, Larson PS, Ostrem JL, Marks WJ Jr, Lim DA. Combining cell transplants or gene therapy with deep brain stimulation for Parkinson's disease. Mov Disord. 2015 Feb;30(2):190-5. doi: 10.1002/mds.26083. Epub 2014 Dec 17. PubMed PMID: 25521796.

Yoon JH, Larson P, Grandelis A, La C, Cui E, Carter CS, Minzenberg MJ. Delay Period Activity of the Substantia Nigra during Proactive Control of Response Selection as Determined by a Novel fMRI Localization Method. J Cogn Neurosci. 2015 Jun;27(6):1238-48. doi: 10.1162/jocn_a_00775. Epub 2014 Dec 16. PubMed PMID: 25514657.

Kanal E, Froelich J, Barkovich AJ, Borgstede J, Bradley W Jr, Gimbel JR, Gosbee J, Greenberg T, Jackson E, Larson P, Lester J Jr, Sebek E, Shellock FG, Weinreb J, Wilkoff BL, Hernandez D; American College of Radiology Subcommittee on MR Safety. Standardized MR terminology and reporting of implants and devices as recommended by the American College of Radiology Subcommittee on MR Safety. Radiology. 2015 Mar;274(3):866-70. doi: 10.1148/radiol.14141645. Epub 2014 Oct 20. PubMed PMID: 25329683.

Silvestrini MT, Yin D, Martin AJ, Coppes VG, Mann P, Larson PS, Starr PA, Zeng X, Gupta N, Panter SS, Desai TA, Lim DA. Interventional magnetic resonance imaging-guided cell transplantation into the brain with radially branched deployment. Mol Ther. 2015 Jan;23(1):119-29. doi: 10.1038/mt.2014.155. Epub 2014 Aug 20. PubMed PMID: 25138755.

Larson PS. Deep brain stimulation for movement disorders. Neurotherapeutics. 2014 Jul;11(3):465-74. doi: 10.1007/s13311-014-0274-1. Review. PubMed PMID: 24833244; PubMed Central PMCID: PMC4121453.

Ivan ME, Yarlagadda J, Saxena AP, Martin AJ, Starr PA, Sootsman WK, Larson PS. Brain shift during bur hole-based procedures using interventional MRI. J Neurosurg. 2014 Jul;121(1):149-60. doi: 10.3171/2014.3.JNS121312. Epub 2014 May 2. PubMed PMID: 24785326.

Starr PA, Markun LC, Larson PS, Volz MM, Martin AJ, Ostrem JL. Interventional MRI-guided deep brain stimulation in pediatric dystonia: first experience with the ClearPoint system. J Neurosurg Pediatr. 2014 Oct;14(4):400-8. doi: 10.3171/2014.6.PEDS13605. Epub 2014 Aug 1. PubMed PMID: 25084088.

Vega RA, Holloway KL, Larson PS. Image-guided deep brain stimulation. Neurosurg Clin N Am. 2014 Jan;25(1):159-72. doi: 10.1016/ Epub 2013 Oct 11. Review. PubMed PMID: 24262907.

Silvestrini MT, Yin D, Coppes VG, Mann P, Martin AJ, Larson PS, Starr PA, Gupta N, Panter SS, Desai TA, Lim DA. Radially branched deployment for more efficient cell transplantation at the scale of the human brain. Stereotact Funct Neurosurg. 2013;91(2):92-103. doi: 10.1159/000343213. Epub 2013 Jan 22. PubMed PMID: 23343609; PubMed Central PMCID: PMC3739996.

Larson PS, Cheung SW. A stroke of silence: tinnitus suppression following placement of a deep brain stimulation electrode with infarction in area LC. J Neurosurg. 2013 Jan;118(1):192-4. doi: 10.3171/2012.9.JNS12594. Epub 2012 Oct 19. PubMed PMID: 23082889.

Ostrem JL, Galifianakis NB, Markun LC, Grace JK, Martin AJ, Starr PA, Larson PS. Clinical outcomes of PD patients having bilateral STN DBS using high-field interventional MR-imaging for lead placement. Clin Neurol Neurosurg. 2013 Jun;115(6):708-12. doi: 10.1016/j.clineuro.2012.08.019. Epub 2012 Sep 1. PubMed PMID: 22944465; PubMed Central PMCID: PMC3578021.

Potts MB, Larson PS. Securing dual ipsilateral leads through a single burr hole in deep brain stimulation surgery: technical note. Stereotact Funct Neurosurg. 2012;90(6):361-4. doi: 10.1159/000339634. Epub 2012 Aug 23. PubMed PMID: 22922401.

Air EL, Ryapolova-Webb E, de Hemptinne C, Ostrem JL, Galifianakis NB, Larson PS, Chang EF, Starr PA. Acute effects of thalamic deep brain stimulation and thalamotomy on sensorimotor cortex local field potentials in essential tremor. Clin Neurophysiol. 2012 Nov;123(11):2232-8. doi: 10.1016/j.clinph.2012.04.020. Epub 2012 May 26. PubMed PMID: 22633916; PubMed Central PMCID: PMC3577937.

Mittermeyer G, Christine CW, Rosenbluth KH, Baker SL, Starr P, Larson P, Kaplan PL, Forsayeth J, Aminoff MJ, Bankiewicz KS. Long-term evaluation of a phase 1 study of AADC gene therapy for Parkinson's disease. Hum Gene Ther. 2012 Apr;23(4):377-81. doi: 10.1089/hum.2011.220. Epub 2012 Apr 10. PubMed PMID: 22424171.

Englot DJ, Glastonbury CM, Larson PS. Abnormal T2-weighted MRI signal surrounding leads in a subset of deep brain stimulation patients. Stereotact Funct Neurosurg. 2011;89(5):311-7. doi: 10.1159/000329365. Epub 2011 Aug 31. PubMed PMID: 21894061.

Larson PS, Cheung SW. Deep brain stimulation in area LC controllably triggers auditory phantom percepts. Neurosurgery. 2012 Feb;70(2):398-405; discussion 405-6. doi: 10.1227/NEU.0b013e3182320ab5. PubMed PMID: 21849922.

Larson PS, Starr PA, Bates G, Tansey L, Richardson RM, Martin AJ. An optimized system for interventional magnetic resonance imaging-guided stereotactic surgery: preliminary evaluation of targeting accuracy. Neurosurgery. 2012 Mar;70(1 Suppl Operative):95-103; discussion 103. doi: 10.1227/NEU.0b013e31822f4a91. PubMed PMID: 21796000; PubMed Central PMCID: PMC3249469.

Richardson RM, Kells AP, Martin AJ, Larson PS, Starr PA, Piferi PG, Bates G, Tansey L, Rosenbluth KH, Bringas JR, Berger MS, Bankiewicz KS. Novel platform for MRI-guided convection-enhanced delivery of therapeutics: preclinical validation in nonhuman primate brain. Stereotact Funct Neurosurg. 2011;89(3):141-51. doi: 10.1159/000323544. Epub 2011 Apr 14. PubMed PMID: 21494065; PubMed Central PMCID: PMC3085040.

Richardson RM, Kells AP, Rosenbluth KH, Salegio EA, Fiandaca MS, Larson PS, Starr PA, Martin AJ, Lonser RR, Federoff HJ, Forsayeth JR, Bankiewicz KS. Interventional MRI-guided putaminal delivery of AAV2-GDNF for a planned clinical trial in Parkinson's disease. Mol Ther. 2011 Jun;19(6):1048-57. doi: 10.1038/mt.2011.11. Epub 2011 Feb 22. PubMed PMID: 21343917; PubMed Central PMCID: PMC3129792.

Chang EF, Cheng JS, Richardson RM, Lee C, Starr PA, Larson PS. Incidence and management of venous air embolisms during awake deep brain stimulation surgery in a large clinical series. Stereotact Funct Neurosurg. 2011;89(2):76-82. doi: 10.1159/000323335. Epub 2011 Feb 2. PubMed PMID: 21293166.

Shahlaie K, Larson PS, Starr PA. Intraoperative computed tomography for deep brain stimulation surgery: technique and accuracy assessment. Neurosurgery. 2011 Mar;68(1 Suppl Operative):114-24; discussion 124. doi: 10.1227/NEU.0b013e31820781bc. PubMed PMID: 21206322.

Fiandaca MS, Salegio EA, Yin D, Richardson RM, Valles FE, Larson PS, Starr PA, Lonser RR, Bankiewicz KS. Human/nonhuman primate AC-PC ratio--considerations for translational brain measurements. J Neurosci Methods. 2011 Mar 15;196(1):124-30. doi: 10.1016/j.jneumeth.2010.12.023. Epub 2010 Dec 24. PubMed PMID: 21185868; PubMed Central PMCID: PMC3042049.

Marks WJ Jr, Bartus RT, Siffert J, Davis CS, Lozano A, Boulis N, Vitek J, Stacy M, Turner D, Verhagen L, Bakay R, Watts R, Guthrie B, Jankovic J, Simpson R, Tagliati M, Alterman R, Stern M, Baltuch G, Starr PA, Larson PS, Ostrem JL, Nutt J, Kieburtz K, Kordower JH, Olanow CW. Gene delivery of AAV2-neurturin for Parkinson's disease: a double-blind, randomised, controlled trial. Lancet Neurol. 2010 Dec;9(12):1164-72. doi: 10.1016/S1474-4422(10)70254-4. Epub 2010 Oct 20. PubMed PMID: 20970382.

Larson PS. Minimally invasive surgery for movement disorders. Neurosurg Clin N Am. 2010 Oct;21(4):691-8, vii. doi: 10.1016/ Review. PubMed PMID: 20947036.

Valles F, Fiandaca MS, Eberling JL, Starr PA, Larson PS, Christine CW, Forsayeth J, Richardson RM, Su X, Aminoff MJ, Bankiewicz KS. Qualitative imaging of adeno-associated virus serotype 2-human aromatic L-amino acid decarboxylase gene therapy in a phase I study for the treatment of Parkinson disease. Neurosurgery. 2010 Nov;67(5):1377-85. doi: 10.1227/NEU.0b013e3181f53a5c. PubMed PMID: 20871425.