Philip A. Starr MD, PhD


Professor in Residence of Neurological Surgery, Dolores Cakebread Endowed Chair

Co-Director, Functional Neurosurgery Program

Surgical Director, Parkinson's Disease Research, Education and Care Center (PADRECC) at San Francisco Veteran's Affairs Medical Center

Read about Dr. Starr's Current Research ►

Dr. Starr's particular specialty interests lie in the area of movement disorders, including Parkinson's disease, tremor, and dystonia. He has fellowship training in microelectrode-guided surgery of movement disorders, which he completed at Emory University in Atlanta, Georgia. Dr. Starr's research interests include physiology of the basal ganglia, clinical trials of novel surgical therapeutics in movement disorders, and the use of interventional magnetic resonance imaging (iMRI) for functional neurosurgery. His primary focus is on research related to the neurophysiology and therapy of movement disorders.

Working together with William Marks MD and Jill Ostrem MD in Neurology in a joint UCSF-San Francisco Veterans Affairs Hospital Medical Center study, Dr. Starr is an investigator for the largest formal clinical trial of deep brain stimulation (DBS) currently taking place in North America: "A Randomized Trial of Best Medical Therapy versus Deep Brain Stimulation of the Globus Pallidus or Subthalamic Nucleus for Parkinson's Disease." This is a 6-center trial jointly funded by the Department of Veterans Affairs and the National Institutes of Health. The technical approach involves magnetic resonance-based stereotaxy and microelectrode recordings to map the borders of the surgical target area. Dr. Starr is also surgical investigator on several Phase I clinical trials of gene transfer approaches for the treatment of Parkinson's disease.

Dr. Starr is one of the most experienced surgeons in North America in the surgical treatment of dystonia using DBS. He conducts NIH-funded research on pallidal physiology in patients with dystonia.

Watch KTVU's coverage of the new interventional MRI system developed at UCSF to improve surgery for movement disorders

Education, Training, and Previous Positions

1983: BS, Princeton University
1989: MD, Harvard Medical School
1989: PhD, Neuroscience, Harvard Medical School
1989-1990: Internship, General Surgery, Brigham and Women's Hospital
1990-1995: Residency in Neurosurgery, Brigham and Women's and Children's Hospital
1995: Chief Resident (Clinical Elective) C.H.U.V., Prof. N. de Tribolet, Lausanne, Switzerland
1996-1997: Clinical Fellowship in Movement Disorders, Emory University
1997-1998: Instructor, Department of Neurological Surgery, Emory University

Selected Professional Memberships and Appointments

American Association of Neurological Surgeons
Corresponding member, Societe de Neurochirurgie de Langue Francaise
International Society for Movement Disorders
Congress of Neurological Surgeons
AANS/CNS Joint Section for Stereotactic and Functional Neurosurgery

Selected Honors and Awards

1999: Veterans' Administration National Program Initiative Award for a Center of Excellence, Veterans' Administration Medical Center, San Francisco, California
2000-2006: NIH K08 award, "Pallidal physiology in human and primate dystonia"
2001-2005: Parkinson's Disease Research, Education and Clinical Center (PADRECC) award from National VA office for Cooperative Study CSP 468, "A randomized Trial of Best Medical Therapy versus Deep Brain Stimulation of the Globus Pallidus or Subthalamic Nucleus for Parkinson's Disease."
2004: Dystonia "Doctor of Excellence" award, Dystonia Medical Research Foundation
2004: Elected Secretary-Treasurer, American Society For Stereotactic and Functional Neurosurgery
2004: Scientific Program Director, Biennial meeting of the American Society for Stereotactic and Functional Neurosurgery, Cleveland Ohio

Selected Recent Publications

Swann NC, de Hemptinne C, Thompson MC, Miocinovic S, Miller AM, Gilron R, Ostrem JL, Chizeck HJ, Starr PA. Adaptive deep brain stimulation for Parkinson's disease using motor cortex sensing. J Neur Eng. 2018 May 9. [Epub ahead of print]. doi: 10.1088/1741-2552/aabc9b.

Wang DD, de Hemptinne C, Miocinovic S, Ostrem JL, Galifianakis NB, San Luciano M, Starr PA. Pallidal deep brain stimulation disrupts pallidal beta oscillations and coherence with primary motor cortex in Parkinson's disease. J Neurosci. 2018 Apr 16. pii: 0431-18. doi: 10.1523/JNEUROSCI.0431-18.2018. [Epub ahead of print] PubMed PMID: 29661966.

Kundishora AJ, Englot DJ, Starr PA, Martin AJ, Larson PS. Venous Thromboembolism during Interventional MRI-Guided Stereotactic Surgery. Stereotact Funct Neurosurg. 2018;96(1):40-45. doi: 10.1159/000486642. Epub 2018 Mar 1. PubMed PMID: 29495014.

Ramirez-Zamora A, Giordano JJ, Gunduz A, Brown P, Sanchez JC, Foote KD, Almeida L, Starr PA, Bronte-Stewart HM, Hu W, McIntyre C, Goodman W, Kumsa D, Grill WM, Walker HC, Johnson MD, Vitek JL, Greene D, Rizzuto DS, Song D, Berger TW, Hampson RE, Deadwyler SA, Hochberg LR, Schiff ND, Stypulkowski P, Worrell G, Tiruvadi V, Mayberg HS, Jimenez-Shahed J, Nanda P, Sheth SA, Gross RE, Lempka SF, Li L, Deeb W, Okun MS. Evolving Applications, Technological Challenges and Future Opportunities in Neuromodulation: Proceedings of the Fifth Annual Deep Brain Stimulation Think Tank. Front Neurosci. 2018 Jan 24;11:734. doi: 10.3389/fnins.2017.00734. eCollection 2017. PubMed PMID: 29416498; PubMed Central PMCID: PMC5787550.

Miocinovic S, Swann NC, de Hemptinne C, Miller A, Ostrem JL, Starr PA. Cortical gamma oscillations in isolated dystonia. Parkinsonism Relat Disord. 2018 Apr;49:104-105. doi: 10.1016/j.parkreldis.2018.01.017. Epub 2018 Jan 20. PubMed PMID: 29371063.

Larson PS, Starr PA, Martin AJ. Deep Brain Stimulation: Interventional and Intraoperative MRI Approaches. Prog Neurol Surg. 2018;33:187-197. doi: 10.1159/000481103. Epub 2018 Jan 12. PubMed PMID: 29332083.

Miocinovic S, Miller A, Swann NC, Ostrem JL, Starr PA. Chronic deep brain stimulation normalizes scalp EEG activity in isolated dystonia. Clin Neurophysiol. 2017 Nov 26;129(2):368-376. doi: 10.1016/j.clinph.2017.11.011. [Epub ahead of print] PubMed PMID: 29288993.

Southwell DG, Rutkowski MJ, San Luciano M, Racine C, Ostrem J, Starr PA, Larson PS. Before and after the veterans affairs cooperative program 468 study: Deep brain stimulator target selection for treatment of Parkinson's disease. Parkinsonism Relat Disord. 2018 Mar;48:40-44. doi: 10.1016/j.parkreldis.2017.12.013. Epub 2017 Dec 12. PubMed PMID: 29249683.

Martin AJ, Starr PA, Ostrem JL, Larson PS. Hemorrhage Detection and Incidence during Magnetic Resonance-Guided Deep Brain Stimulator Implantations. Stereotact Funct Neurosurg. 2017;95(5):307-314. doi: 10.1159/000479287. Epub 2017 Sep 9. PubMed PMID: 28889128.

Merola A, Fasano A, Hassan A, Ostrem JL, Contarino MF, Lyons M, Krauss JK, Wolf ME, Klassen BT, van Rootselaar AF, Regidor I, Duker AP, Ondo W, Guridi J, Volkmann J, Wagle Shukla A, Mandybur GT, Okun MS, Witt K, Starr PA, Deuschl G, Espay AJ. Thalamic deep brain stimulation for orthostatic tremor: A multicenter international registry. Mov Disord. 2017 Aug;32(8):1240-1244. doi: 10.1002/mds.27082. Epub 2017 Jun 20. PubMed PMID: 28631862.

LaHue SC, Ostrem JL, Galifianakis NB, San Luciano M, Ziman N, Wang S, Racine CA, Starr PA, Larson PS, Katz M. Parkinson's disease patient preference and experience with various methods of DBS lead placement. Parkinsonism Relat Disord. 2017 Aug;41:25-30. doi: 10.1016/j.parkreldis.2017.04.010. Epub 2017 Apr 17. PubMed PMID: 28615151.

Cole SR, van der Meij R, Peterson EJ, de Hemptinne C, Starr PA, Voytek B. Nonsinusoidal Beta Oscillations Reflect Cortical Pathophysiology in Parkinson's Disease. J Neurosci. 2017 May 3;37(18):4830-4840. doi: 10.1523/JNEUROSCI.2208-16.2017. Epub 2017 Apr 17. PubMed PMID: 28416595; PubMed Central PMCID: PMC5426572.

Swann NC, de Hemptinne C, Miocinovic S, Qasim S, Ostrem JL, Galifianakis NB, Luciano MS, Wang SS, Ziman N, Taylor R, Starr PA. Chronic multisite brain recordings from a totally implantable bidirectional neural interface: experience in 5 patients with Parkinson's disease. J Neurosurg. 2018 Feb;128(2):605-616. doi: 10.3171/2016.11.JNS161162. Epub 2017 Apr 14. PubMed PMID: 28409730; PubMed Central PMCID: PMC5641233.

Khanna P, Swann NC, de Hemptinne C, Miocinovic S, Miller A, Starr PA, Carmena JM. Neurofeedback Control in Parkinsonian Patients Using Electrocorticography Signals Accessed Wirelessly With a Chronic, Fully Implanted Device. IEEE Trans Neural Syst Rehabil Eng. 2017 Oct;25(10):1715-1724. doi: 10.1109/TNSRE.2016.2597243. Epub 2016 Aug 24. PubMed PMID: 28113590; PubMed Central PMCID: PMC5745199.

Deeb W, Giordano JJ, Rossi PJ, Mogilner AY, Gunduz A, Judy JW, Klassen BT, Butson CR, Van Horne C, Deny D, Dougherty DD, Rowell D, Gerhardt GA, Smith GS, Ponce FA, Walker HC, Bronte-Stewart HM, Mayberg HS, Chizeck HJ, Langevin JP, Volkmann J, Ostrem JL, Shute JB, Jimenez-Shahed J, Foote KD, Wagle Shukla A, Rossi MA, Oh M, Pourfar M, Rosenberg PB, Silburn PA, de Hemptine C, Starr PA, Denison T, Akbar U, Grill WM, Okun MS. Proceedings of the Fourth Annual Deep Brain Stimulation Think Tank: A Review of Emerging Issues and Technologies. Front Integr Neurosci. 2016 Nov 22;10:38. eCollection 2016. PubMed PMID: 27920671; PubMed Central PMCID: PMC5119052.

Ostrem JL, San Luciano M, Dodenhoff KA, Ziman N, Markun LC, Racine CA, de Hemptinne C, Volz MM, Heath SL, Starr PA. Subthalamic nucleus deep brain stimulation in isolated dystonia: A 3-year follow-up study. Neurology. 2017 Jan 3;88(1):25-35. doi: 10.1212/WNL.0000000000003451. Epub 2016 Nov 30. PubMed PMID: 27903810.

Ritaccio AL, Williams J, Denison T, Foster BL, Starr PA, Gunduz A, Zijlmans M, Schalk G. Proceedings of the Eighth International Workshop on Advances in Electrocorticography. Epilepsy Behav. 2016 Nov;64(Pt A):248-252. doi: 10.1016/j.yebeh.2016.08.020. Epub 2016 Oct 24. PubMed PMID: 27780085; PubMed Central PMCID: PMC5323263.

Rolston JD, Englot DJ, Starr PA, Larson PS. An unexpectedly high rate of revisions and removals in deep brain stimulation surgery: Analysis of multiple databases. Parkinsonism Relat Disord. 2016 Dec;33:72-77. doi: 10.1016/j.parkreldis.2016.09.014. Epub 2016 Sep 12. PubMed PMID: 27645504; PubMed Central PMCID: PMC5240785.

Swann NC, de Hemptinne C, Miocinovic S, Qasim S, Wang SS, Ziman N, Ostrem JL, San Luciano M, Galifianakis NB, Starr PA. Gamma Oscillations in the Hyperkinetic State Detected with Chronic Human Brain Recordings in Parkinson's Disease. J Neurosci. 2016 Jun 15;36(24):6445-58. doi: 10.1523/JNEUROSCI.1128-16.2016. PubMed PMID: 27307233; PubMed Central PMCID: PMC5015781.

Southwell DG, Narvid JA, Martin AJ, Qasim SE, Starr PA, Larson PS. Comparison of Deep Brain Stimulation Lead Targeting Accuracy and Procedure Duration between 1.5- and 3-Tesla Interventional Magnetic Resonance Imaging Systems: An Initial 12-Month Experience. Stereotact Funct Neurosurg. 2016;94(2):102-7. doi: 10.1159/000443407. Epub 2016 Apr 20. PubMed PMID: 27093443.

Martin AJ, Larson PS, Ziman N, Levesque N, Volz M, Ostrem JL, Starr PA. Deep brain stimulator implantation in a diagnostic MRI suite: infection history over a 10-year period. J Neurosurg. 2017 Jan;126(1):108-113. doi: 10.3171/2015.7.JNS15750. Epub 2016 Mar 25. PubMed PMID: 27015399.

Coleman RR, Starr PA, Katz M, Glass GA, Volz M, Khandhar SM, Ostrem JL. Bilateral Ventral Intermediate Nucleus Thalamic Deep Brain Stimulation in Orthostatic Tremor. Stereotact Funct Neurosurg. 2016;94(2):69-74. doi: 10.1159/000444127. Epub 2016 Mar 23. PubMed PMID: 27002536.

Ziman N, Coleman RR, Starr PA, Volz M, Marks WJ Jr, Walker HC, Guthrie SL, Ostrem JL. Pregnancy in a Series of Dystonia Patients Treated with Deep Brain Stimulation: Outcomes and Management Recommendations. Stereotact Funct Neurosurg. 2016;94(1):60-5. doi: 10.1159/000444266. Epub 2016 Mar 16. PubMed PMID: 26977859.

Panov F, Levin E, de Hemptinne C, Swann NC, Qasim S, Miocinovic S, Ostrem JL, Starr PA. Intraoperative electrocorticography for physiological research in movement disorders: principles and experience in 200 cases. J Neurosurg. 2017 Jan;126(1):122-131. doi: 10.3171/2015.11.JNS151341. Epub 2016 Feb 26. PubMed PMID: 26918474; PubMed Central PMCID: PMC5001942.

Wang DD, de Hemptinne C, Miocinovic S, Qasim SE, Miller AM, Ostrem JL, Galifianakis NB, San Luciano M, Starr PA. Subthalamic local field potentials in Parkinson's disease and isolated dystonia: An evaluation of potential biomarkers. Neurobiol Dis. 2016 May;89:213-22. doi: 10.1016/j.nbd.2016.02.015. Epub 2016 Feb 14. PubMed PMID: 26884091; PubMed Central PMCID: PMC4790450.

Kilbane C, Ramirez-Zamora A, Ryapolova-Webb E, Qasim S, Glass GA, Starr PA, Ostrem JL. Response. J Neurosurg. 2015 Nov;123(5):1349-50. PubMed PMID: 26870866.

Ostrem JL, Starr PA. Correspondence related to published material title "Deep brain stimulation may reduce the relative risk of clinically important worsening in early stage Parkinson's disease" by Hacker ML and colleague recently published electronically before print. Parkinsonism Relat Disord. 2016 Apr;25:112-3. doi: 10.1016/j.parkreldis.2015.11.022. Epub 2015 Nov 22. PubMed PMID: 26698683.

Qasim SE, de Hemptinne C, Swann NC, Miocinovic S, Ostrem JL, Starr PA. Electrocorticography reveals beta desynchronization in the basal ganglia-cortical loop during rest tremor in Parkinson's disease. Neurobiol Dis. 2016 Feb;86:177-86. doi: 10.1016/j.nbd.2015.11.023. Epub 2015 Nov 27. PubMed PMID: 26639855; PubMed Central PMCID: PMC4842026.

Ostrem JL, Ziman N, Galifianakis NB, Starr PA, Luciano MS, Katz M, Racine CA, Martin AJ, Markun LC, Larson PS. Clinical outcomes using ClearPoint interventional MRI for deep brain stimulation lead placement in Parkinson's disease. J Neurosurg. 2016 Apr;124(4):908-16. doi: 10.3171/2015.4.JNS15173. Epub 2015 Oct 23. PubMed PMID: 26495947.

Rowland NC, De Hemptinne C, Swann NC, Qasim S, Miocinovic S, Ostrem JL, Knight RT, Starr PA. Task-related activity in sensorimotor cortex in Parkinson's disease and essential tremor: changes in beta and gamma bands. Front Hum Neurosci. 2015 Sep 22;9:512. doi: 10.3389/fnhum.2015.00512. eCollection 2015. PubMed PMID: 26441609; PubMed Central PMCID: PMC4585033.

Miocinovic S, de Hemptinne C, Qasim S, Ostrem JL, Starr PA. Patterns of Cortical Synchronization in Isolated Dystonia Compared With Parkinson Disease. JAMA Neurol. 2015 Nov;72(11):1244-51. doi: 10.1001/jamaneurol.2015.2561. PubMed PMID: 26409266; PubMed Central PMCID: PMC4892933.

Swann NC, de Hemptinne C, Maher RB, Stapleton CA, Meng L, Gelb AW, Starr PA. Motor System Interactions in the Beta Band Decrease during Loss of Consciousness. J Cogn Neurosci. 2016 Jan;28(1):84-95. doi: 10.1162/jocn_a_00884. Epub 2015 Sep 24. PubMed PMID: 26401814; PubMed Central PMCID: PMC4881749.

Swann NC, de Hemptinne C, Aron AR, Ostrem JL, Knight RT, Starr PA. Elevated synchrony in Parkinson disease detected with electroencephalography. Ann Neurol. 2015 Nov;78(5):742-50. doi: 10.1002/ana.24507. Epub 2015 Sep 2. PubMed PMID: 26290353; PubMed Central PMCID: PMC4623949.

Ramos VF, Pillai AS, Lungu C, Ostrem J, Starr P, Hallett M. Intraoperative neurophysiology in deep brain surgery for psychogenic dystonia. Ann Clin Transl Neurol. 2015 Jun;2(6):707-10. doi: 10.1002/acn3.206. Epub 2015 Apr 17. PubMed PMID: 26125045; PubMed Central PMCID: PMC4479530.

de Hemptinne C, Swann NC, Ostrem JL, Ryapolova-Webb ES, San Luciano M, Galifianakis NB, Starr PA. Therapeutic deep brain stimulation reduces cortical phase-amplitude coupling in Parkinson's disease. Nat Neurosci. 2015 May;18(5):779-86. doi: 10.1038/nn.3997. Epub 2015 Apr 13. PubMed PMID: 25867121; PubMed Central PMCID: PMC4414895.

Kilbane C, Ramirez-Zamora A, Ryapolova-Webb E, Qasim S, Glass GA, Starr PA, Ostrem JL. Pallidal stimulation for Holmes tremor: clinical outcomes and single-unit recordings in 4 cases. J Neurosurg. 2015 Jun;122(6):1306-14. doi: 10.3171/2015.2.JNS141098. Epub 2015 Mar 20. PubMed PMID: 25794341.

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.

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; PubMed Central PMCID: PMC4426791.

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.

Mills KA, Markun LC, San Luciano M, Rizk R, Allen IE, Racine CA, Starr PA, Alberts JL, Ostrem JL. Effect of subthalamic nucleus deep brain stimulation on dual-task cognitive and motor performance in isolated dystonia. J Neurol Neurosurg Psychiatry. 2015 Apr;86(4):404-9. doi: 10.1136/jnnp-2014-307942. Epub 2014 Jul 10. PubMed PMID: 25012202; PubMed Central PMCID: PMC4392192.