Mangano Lab

Mangano Research Lab

Pediatric hydrocephalus is one of the most commonly encountered pathology in pediatric neurosurgery with an overall incidence of three in 1,000 children under 2 years of age. Cerebrospinal fluid (CSF) abnormally accumulates in different regions of the brain and can raise intracranial pressure resulting in severe brain damage or mortality if left untreated. Various etiologies of hydrocephalus exist, including intracranial hemorrhage, brain tumors, congenital brain malformations, neural tube defects, as well as others. Unfortunately, for a significant population, this condition has an unknown etiology.

Several surgical treatments are available for pediatric hydrocephalus. These include resection of lesions that physically obstruct CSF flow, or CSF diversionary surgery to control CSF accumulation and ventricular size. These options have greatly reduced the morbidity and mortality associated with this condition. However, the long-term management of optimal shunt function is a challenge especially in young children and may require multiple brain surgeries during the patient’s life time.

Research in the Mangano Lab is directed at understanding pathogenesis of pediatric hydrocephalus, that will lead us to develop new surgical and medical treatment options and to improve patient outcomes and quality of life. To establish the goals, we study essential brain anatomy, neural cell types, and genes involved in pediatric hydrocephalus utilizing advanced MR imaging methods (diffusion tensor imaging), mouse genetic models, and several surgical techniques.

Two main aspects of research are currently ongoing in the lab. Each project includes active collaborations with multidisciplinary researchers across divisions at Cincinnati Children’s, including the Division of Radiology, Division of Developmental Biology, and Division of Human Genetics.

Our current projects include:

  1. Diffusion tensor imaging and neural stem cell behavior in infantile rat model of obstructive hydrocephalus.
  2. Molecular mechanism of non-obstructive pediatric hydrocephalus in mouse genetic mutants.


Heyer, JH; Anari, JB; Baldwin, KD; Mitchell, SL; Luhmann, SJ; Sturm, PF; Flynn, JM; Cahill, PJ; Abdulfattah Abdullah, AS; Ahn, E; et al. Lengthening Behavior of Magnetically Controlled Growing Rods in Early-Onset Scoliosis: A Multicenter Study. Journal of Bone and Joint Surgery - Series A. 2022.

Patel, SK; Gibson, JL; Lovha, M; Leach, JL; Arya, R; Tenney, JR; Holland, KD; Aungaroon, G; Greiner, HM; Skoch, J; et al. Posterior Quadrant Disconnection Procedure for Intractable Epilepsy: A Case Series of 5 Young Pediatric Patients. Operative Neurosurgery. 2022; 23:449-456.

Holloway, T; Leach, JL; Tenney, JR; Byars, AW; Horn, PS; Greiner, HM; Mangano, FT; Holland, KD; Arya, R. Functional MRI and electrical stimulation mapping for language localization: A comparative meta-analysis. Clinical Neurology and Neurosurgery. 2022; 222.

Hartnett, SM; Greiner, HM; Arya, R; Tenney, JR; Aungaroon, G; Holland, K; Leach, JL; Air, EL; Skoch, J; Mangano, FT. Responsive neurostimulation device therapy in pediatric patients with complex medically refractory epilepsy. Journal of Neurosurgery: Pediatrics. 2022; 1-8.

Petito, GT; Housekeeper, J; Buroker, J; Scholle, C; Ervin, B; Frink, C; Greiner, HM; Skoch, J; Mangano, FT; Dye, TJ; et al. Diurnal rhythms of spontaneous intracranial high-frequency oscillations. Seizure : the journal of the British Epilepsy Association. 2022; 102:105-112.

Fujiwara, H; Kadis, DS; Greiner, HM; Holland, KD; Arya, R; Aungaroon, G; Fong, SL; Arthur, TM; Kremer, KM; Lin, N; et al. Clinical validation of magnetoencephalography network analysis for presurgical epilepsy evaluation. Electromyography and Clinical Neurophysiology. 2022; 142:199-208.

Larrew, T; Skoch, J; Ihnen, SK Z; Arya, R; Holland, KD; Tenney, JR; Horn, PS; Leach, JL; Krueger, DA; Greiner, HM; et al. Comparison of outcomes after stereoelectroencephalography and subdural grid monitoring in pediatric tuberous sclerosis complex. Neurosurgical Focus. 2022; 53.

Mena, R; Mendoza, E; Mangano, FT; Henrickson, M; Scott, M; DeFoor, WR; Little, KJ; Ruschman, J; Prada, CE. International Pediatric Multidisciplinary Management Using Telemedicine to Promote Equitable Care. Telemedicine Journal and e-Health. 2022.

Mangano, FT; Altaye, M; Stevenson, CB; Yuan, W. The Construction of a Predictive Composite Index for Decision-Making of CSF Diversion Surgery in Pediatric Patients following Prenatal Myelomeningocele Repair. American Journal of Neuroradiology. 2022; 43:1214-1221.

Akbari, HS A; Yahanda, AT; Ackerman, LL; Adelson, PD; Ahmed, R; Albert, GW; Aldana, PR; Alden, TD; Anderson, RC E; Bauer, DF; et al. Complications and outcomes of posterior fossa decompression with duraplasty versus without duraplasty for pediatric patients with Chiari malformation type I and syringomyelia: a study from the Park-Reeves Syringomyelia Research Consortium. Journal of Neurosurgery: Pediatrics. 2022; 1-13.

McMahon, R; Morgan, SJ; Brooks, JT; Fitzgerald, R; Li, Y; Abdullah, AS A; Ahn, E; Akbarnia, B; Akoto, H; Albanese, S; et al. Does the presence of programmable implanted devices in patients with early onset scoliosis alter typical operative and postoperative practices? A survey of spine surgeons. Spine Deformity. 2022; 10:951-964.

Arya, R; Ervin, B; Buroker, J; Greiner, HM; Byars, AW; Rozhkov, L; Skoch, J; Horn, PS; Frink, C; Scholle, C; et al. Neuronal Circuits Supporting Development of Visual Naming Revealed by Intracranial Coherence Modulations. Frontiers in Neuroscience. 2022; 16.

Mishreky, A; Parent, S; Miyanji, F; Smit, K; Murphy, J; Bowker, R; Al Khatib, N; Abdullah, AS A; Ahn, E; Akbarnia, B; et al. Body mass index affects outcomes after vertebral body tethering surgery. Spine Deformity. 2022; 10:563-571.

Roth, J; Perekopaiko, Y; Kozyrev, DA; Constantini, S; Myers, HE; Chern, BL; Reisner, A; Mena-Bernal, JH; Bartoli, A; Paun, L; et al. Pediatric colloid cysts: a multinational, multicenter study. An IFNE-ISPN-ESPN collaboration. Journal of Neurosurgery: Pediatrics. 2022; 1-8.

Iwasawa, E; Brown, FN; Shula, C; Kahn, F; Lee, SH; Berta, T; Ladle, DR; Campbell, K; Mangano, FT; Goto, J. The Anti-Inflammatory Agent Bindarit Attenuates the Impairment of Neural Development through Suppression of Microglial Activation in a Neonatal Hydrocephalus Mouse Model. Journal of Neuroscience. 2022; 42:1820-1844.

Sidler, E; Greiner, H; Mangano, F; Skoch, J; Arya, R; Holland, K; Aungaroon, G; Arthur, T; Fujiwara, H; Horn, P; et al. Improving Detection of Hippocampal Epileptiform Activity Using Magnetoencephalography. Journal of Clinical Neurophysiology. 2022; 39:240-246.

Akbari, SH A; Rizvi, AA; CreveCoeur, TS; Han, RH; Greenberg, JK; Torner, J; Brockmeyer, DL; Wellons, JC; Leonard, JR; Mangano, FT; et al. Socioeconomic and demographic factors in the diagnosis and treatment of Chiari malformation type I and syringomyelia. Journal of Neurosurgery: Pediatrics. 2022; 1-10.

Harpster, K; Weckherlin, N; Engsberg, JR; Powell, SK; Barnard, H; Kadis, D; Dodd, JN; Garrett, ML; Mangano, FT; Limbrick, DD; et al. An iPad-based intervention to improve visual-motor, visual-attention, and visual-perceptual skills in children with surgically treated hydrocephalus: A pilot study. Child's Nervous System. 2022; 38:303-310.

Ervin, B; Buroker, J; Byars, AW; Rozhkov, L; Leach, JL; Horn, PS; Scholle, C; Mangano, FT; Greiner, HM; Holland, KD; et al. A distributed network supports spatiotemporal cerebral dynamics of visual naming. Electromyography and Clinical Neurophysiology. 2021; 132:2948-2958.

Bdaiwi, AS; Greiner, HM; Leach, J; Mangano, FT; DiFrancesco, MW. Categorizing cortical dysplasia lesions for surgical outcome using network functional connectivity. Journal of Neurosurgery: Pediatrics. 2021; 28:600-608.

Ervin, B; Rozhkov, L; Buroker, J; Leach, JL; Mangano, FT; Greiner, HM; Holland, KD; Arya, R. Fast Automated Stereo-EEG Electrode Contact Identification and Labeling Ensemble. Stereotactic and Functional Neurosurgery. 2021; 99:393-404.

Aungaroon, G; Trout, AT; Radhakrishnan, R; Horn, PS; Arya, R; Tenney, JR; Holland, KD; Mangano, FT; Leach, JL; Rozhkov, L; et al. Subtraction ictal SPECT co-registered to MRI (SISCOM) patterns in children with temporal lobe epilepsy. Epilepsy and Behavior. 2021; 121.

Roth, J; Constantini, S; Ekstein, M; Weiner, HL; Tripathi, M; Chandra, PS; Cossu, M; Rizzi, M; Bollo, RJ; Machado, HR; et al. Epilepsy surgery in infants up to 3 months of age: Safety, feasibility, and outcomes: A multicenter, multinational study. Epilepsia. 2021; 62:1897-1906.

Sadler, B; Skidmore, A; Gewirtz, J; Anderson, RC E; Haller, G; Ackerman, LL; Adelson, PD; Ahmed, R; Albert, GW; Aldana, PR; et al. Extradural decompression versus duraplasty in Chiari malformation type I with syrinx: outcomes on scoliosis from the Park-Reeves Syringomyelia Research Consortium. Journal of Neurosurgery: Pediatrics. 2021; 1-9.

Patel, SK; Tari, R; Mangano, FT. Pediatric Hydrocephalus and the Primary Care Provider. Pediatric Clinics of North America. 2021; 68:793-809.

Wissel, BD; Greiner, HM; Glauser, TA; Pestian, JP; Kemme, AJ; Santel, D; Ficker, DM; Mangano, FT; Szczesniak, RD; Dexheimer, JW. Early identification of epilepsy surgery candidates: A multicenter, machine learning study. Acta Neurologica Scandinavica. 2021; 144:41-50.

Xiang, J; Maue, E; Tong, H; Mangano, FT; Greiner, H; Tenney, J. Neuromagnetic high frequency spikes are a new and noninvasive biomarker for localization of epileptogenic zones. Seizure : the journal of the British Epilepsy Association. 2021; 89:30-37.

Alexiades, NG; Shao, B; Braga, BP; Bonfield, CM; Brockmeyer, DL; Browd, SR; DiLuna, M; Groves, ML; Hankinson, TC; Jea, A; et al. Development of best practices in the utilization and implementation of pediatric cervical spine traction: a modified Delphi study. Journal of Neurosurgery: Pediatrics. 2021; 27:649-660.

Xiang, J; Maue, E; Fujiwara, H; Mangano, FT; Greiner, H; Tenney, J. Delineation of epileptogenic zones with high frequency magnetic source imaging based on kurtosis and skewness. Epilepsy Research. 2021; 172.

Yuan, W; Stevenson, CB; Altaye, M; Jones, BV; Leach, J; Lovha, M; Rennert, N; Mangano, FT. Diffusion tensor imaging in children following prenatal myelomeningocele repair and its predictive value for the need and timing of subsequent CSF diversion surgery for hydrocephalus. Journal of Neurosurgery: Pediatrics. 2021; 27:391-399.

Yahanda, AT; David Adelson, P; Hassan, S; Albert, GW; Aldana, PR; Alden, TD; Anderson, RC E; Bauer, DF; Bethel-Anderson, T; Brockmeyer, DL; et al. Dural augmentation approaches and complication rates after posterior fossa decompression for Chiari I malformation and syringomyelia: a Park-Reeves Syringomyelia Research Consortium study. Journal of Neurosurgery: Pediatrics. 2021; 27:459-468.

Crevecoeur, TS; Yahanda, AT; Maher, CO; Johnson, GW; Ackerman, LL; David Adelson, PD; Ahmed, R; Albert, GW; Aldana, PR; Alden, TD; et al. Occipital-Cervical Fusion and Ventral Decompression in the Surgical Management of Chiari-1 Malformation and Syringomyelia: Analysis of Data From the Park-Reeves Syringomyelia Research Consortium. Neurosurgery. 2021; 88:332-341.

Ervin, B; Buroker, J; Rozhkov, L; Holloway, T; Horn, PS; Scholle, C; Byars, AW; Mangano, FT; Leach, JL; Greiner, HM; et al. High-gamma modulation language mapping with stereo-EEG: A novel analytic approach and diagnostic validation. Electromyography and Clinical Neurophysiology. 2020; 131:2851-2860.

Hadjinicolaou, A; Jain, P; Arya, R; Roth, C; Whitney, R; Yau, I; Greiner, HM; Mangano, FT; Rutka, JT; Go, C. Generator replacement with cardiac-based VNS device in children with drug-resistant epilepsy: An observational study. Epilepsy Research. 2020; 167.

Jin, SC; Dong, W; Kundishora, AJ; Panchagnula, S; Moreno-De-Luca, A; Furey, CG; Allocco, AA; Walker, RL; Nelson-Williams, C; Smith, H; et al. Exome sequencing implicates genetic disruption of prenatal neuro-gliogenesis in sporadic congenital hydrocephalus. Nature Medicine. 2020; 26:1754-1765.

Kraus, D; Vannest, J; Arya, R; Hutton, JS; Leach, JL; Mangano, FT; Tenney, JR; Byars, AW; DeWitt, TG; Horowitz-Kraus, T. Reading in children with drug-resistant epilepsy was related to functional connectivity in cognitive control regions. Acta Paediatrica, International Journal of Paediatrics. 2020; 109:2105-2111.

Patel, SK; Zamorano-Fernandez, J; Nagaraj, U; Bierbrauer, KS; Mangano, FT. Not all ventriculomegaly is created equal: diagnostic overview of fetal, neonatal and pediatric ventriculomegaly. Child's Nervous System. 2020; 36:1681-1696.

Arya, R; Ervin, B; Holloway, T; Dudley, J; Horn, PS; Buroker, J; Rozhkov, L; Scholle, C; Byars, AW; Leach, JL; et al. Electrical stimulation sensorimotor mapping with stereo-EEG. Electromyography and Clinical Neurophysiology. 2020; 131:1691-1701.

Sakpichaisakul, K; Byars, AW; Horn, PS; Aungaroon, G; Greiner, HM; Mangano, FT; Holland, KD; Arya, R. Neuropsychological outcomes after pediatric epilepsy surgery: Role of electrical stimulation language mapping. Seizure : the journal of the British Epilepsy Association. 2020; 80:183-191.

Arocho-Quinones, EV; Lew, SM; Handler, MH; Tovar-Spinoza, Z; Smyth, M; Bollo, R; Donahue, D; Perry, MS; Levy, ML; Gonda, D; et al. Magnetic resonance-guided stereotactic laser ablation therapy for the treatment of pediatric brain tumors: a multiinstitutional retrospective study. Journal of Neurosurgery: Pediatrics. 2020; 26:13-21.

Roth, J; Bercovich, O; Roach, A; Mangano, FT; Mohan, AC; Aldave, G; Weiner, HL; Thomale, U; Schaumann, A; Uliel-Sibony, S; et al. Seizures following surgery for supratentorial extratemporal low-grade tumors in children: a multicenter retrospective study. Journal of Neurosurgery: Pediatrics. 2020; 26:27-33.

Hale, AT; David Adelson, P; Albert, GW; Aldana, PR; Alden, TD; Anderson, RC E; Bauer, DF; Bonfield, CM; Brockmeyer, DL; Chern, JJ; et al. Factors associated with syrinx size in pediatric patients treated for Chiari malformation type I and syringomyelia: a study from the Park-Reeves Syringomyelia Research Consortium. Journal of Neurosurgery: Pediatrics. 2020; 1-11.

Goulding, DS; Vogel, RC; Pandya, CD; Shula, C; Gensel, JC; Mangano, FT; Goto, J; Miller, BA. Neonatal hydrocephalus leads to white matter neuroinflammation and injury in the corpus callosum of Ccdc39 hydrocephalic mice. Journal of Neurosurgery: Pediatrics. 2020; 1-8.

Bartoli, A; Soleman, J; Berger, A; Wisoff, JH; Hidalgo, ET; Mangano, FT; Keating, RF; Thomale, UW; Boop, F; Roth, J; et al. Treatment Options for Hydrocephalus Following Foramen Magnum Decompression for Chiari I Malformation: A Multicenter Study. Neurosurgery. 2020; 86:500-508.

Mangano, FT; Stevenson, CB; Nagaraj, U; Conley, A; Yuan, W. Abnormal anisotropic diffusion properties in pediatric myelomeningocele patients treated with fetal surgery: an initial DTI study. Child's Nervous System. 2020; 36:827-833.

Guerin, JB; Greiner, HM; Mangano, FT; Leach, JL. Functional MRI in Children: Current Clinical Applications. Seminars in Pediatric Neurology. 2020; 33.

Emmert, AS; Vuong, SM; Shula, C; Lindquist, D; Yuan, W; Hu, Y; Mangano, FT; Goto, J. Characterization of a novel rat model of X-linked hydrocephalus by CRISPR-mediated mutation in L1cam. Journal of Neurosurgery. 2020; 132:945-958.

Matur, AV; Nouri, A; Huang, S; Elson, NC; Jeong, W; Bierbrauer, KS; Mangano, FT; Cheng, JS. Complications in Children with Ehlers-Danlos Syndrome Following Spine Surgery: Analysis of the Pediatric National Surgery Quality Improvement Program Database. World Neurosurgery. 2020; 133:e473-e478.

Wissel, BD; Greiner, HM; Glauser, TA; Holland-Bouley, KD; Mangano, FT; Santel, D; Faist, R; Zhang, N; Pestian, JP; Szczesniak, RD; et al. Prospective validation of a machine learning model that uses provider notes to identify candidates for resective epilepsy surgery. Epilepsia. 2020; 61:39-48.

Xiang, J; Maue, E; Fan, Y; Qi, L; Mangano, FT; Greiner, H; Tenney, J. Kurtosis and skewness of high-frequency brain signals are altered in paediatric epilepsy. Brain Communications. 2020; 2.

Emmert, AS; Iwasawa, E; Shula, C; Schultz, P; Lindquist, D; Dunn, RS; Fugate, EM; Hu, Y; Mangano, FT; Goto, J. Impaired neural differentiation and glymphatic CSF flow in the Ccdc39 rat model of neonatal hydrocephalus: genetic interaction with L1cam. DMM Disease Models and Mechanisms. 2019; 12.

Strahle, JM; Taiwo, R; Averill, C; Torner, J; Shannon, CN; Bonfield, CM; Tuite, GF; Bethel-Anderson, T; Rutlin, J; Brockmeyer, DL; et al. Radiological and clinical predictors of scoliosis in patients with Chiari malformation type I and spinal cord syrinx from the Park-Reeves Syringomyelia Research Consortium. Journal of Neurosurgery: Pediatrics. 2019; 1-8.

Arya, R; Ervin, B; Dudley, J; Buroker, J; Rozhkov, L; Scholle, C; Horn, PS; Vannest, J; Byars, AW; Leach, JL; et al. Electrical stimulation mapping of language with stereo-EEG. Epilepsy and Behavior. 2019; 99.

Arya, R; Babajani-Feremi, A; Byars, AW; Vannest, J; Greiner, HM; Wheless, JW; Mangano, FT; Holland, KD. A model for visual naming based on spatiotemporal dynamics of ECoG high-gamma modulation. Epilepsy and Behavior. 2019; 99.

Wissel, BD; Greiner, HM; Glauser, TA; Mangano, FT; Santel, D; Pestian, JP; Szczesniak, RD; Dexheimer, JW. Investigation of bias in an epilepsy machine learning algorithm trained on physician notes. Epilepsia. 2019; 60:e93-e98.

Arya, R; Mangano, FT; Horn, PS; Kaul, SK; Kaul, SK; Roth, C; Leach, JL; Turner, M; Holland, KD; Greiner, HM. Long-term seizure outcomes after pediatric temporal lobectomy: does brain MRI lesion matter?. Journal of Neurosurgery: Pediatrics. 2019; 24:200-208.

Dave, P; Venable, GT; Jones, TL; Khan, NR; Albert, GW; Chern, JJ; Wheelus, JL; Governale, LS; Huntoon, KM; Maher, CO; et al. The Preventable Shunt Revision Rate: A Multicenter Evaluation. Neurosurgery. 2019; 84:788-798.

Arya, R; Roth, C; Leach, JL; Middeler, D; Wilson, JA; Vannest, J; Rozhkov, L; Greiner, HM; Buroker, J; Scholle, C; et al. Neuropsychological outcomes after resection of cortical sites with visual naming associated electrocorticographic high-gamma modulation. Epilepsy Research. 2019; 151:17-23.

Arya, R; Ervin, B; Wilson, JA; Byars, AW; Rozhkov, L; Buroker, J; Horn, PS; Scholle, C; Fujiwara, H; Greiner, HM; et al. Development of information sharing in language neocortex in childhood-onset drug-resistant epilepsy. Epilepsia. 2019; 60:393-405.

Agresta, L; Salloum, R; Hummel, TR; Ratner, N; Mangano, FT; Fuller, C; McMasters, RL; Pater, L; Jones, BV; Szabo, S; et al. Malignant peripheral nerve sheath tumor: Transformation in a patient with neurofibromatosis type 2. Pediatric Blood and Cancer. 2019; 66.

Patel, SK; Vuong, SM; Yuan, W; Mangano, FT. Anatomy and Physiology-Based Magnetic Resonance Imaging in Hydrocephalus. Cerebrospinal Fluid Disorders. 2019.

Crawford, AH; Gr, HC; Schumaier, AP; Mangano, FT. Management of Cervical Instability as a Complication of Neurofibromatosis Type 1 in Children: A Historical Perspective With a 40-Year Experience. Spine Deformity. 2018; 6:719-729.

Noh, T; Vogt, MS; Pruitt, DW; Hummel, TR; Mangano, FT. Pediatric intramedullary spinal cord tumor outcomes using the WeeFIM scale. Child's Nervous System. 2018; 34:1753-1758.

Aungaroon, G; Trout, A; Radhakrishnan, R; Horn, PS; Arya, R; Tenney, JR; Arthur, TM; Holland, KD; Mangano, FT; Leach, JL; et al. Impact of radiotracer injection latency and seizure duration on subtraction ictal SPECT co-registered to MRI (SISCOM) performance in children. Electromyography and Clinical Neurophysiology. 2018; 129:1842-1848.

Arya, R; Wilson, JA; Fujiwara, H; Vannest, J; Byars, AW; Rozhkov, L; Leach, JL; Greiner, HM; Buroker, J; Scholle, C; et al. Electrocorticographic high-gamma modulation with passive listening paradigm for pediatric extraoperative language mapping. Epilepsia. 2018; 59:792-801.

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In the News

October 2019

Dr. Goto presented at Society for Neuroscience nano symposium and selected as a hot topic 100, 2019

April 2019

Scott Emmert received the UC Presidential Leadership Medal of Excellence. Read the full article.

First Author Interviews

Scott Emmert and Eri Iwasawa’s work was highlighted in first author interviews. Read the full text here.