Killam Seminar Series: DBS in the MRI Scanner: From Contra-Indication to New Method of Optimizing Treatment of Neurological Disease
Gr芒ce 脿 la g茅n茅rosit茅 des fiducies Killam, Le Neuro convoque lors d鈥檜ne s茅rie de s茅minaires des conf茅renciers d鈥檈xception dont les travaux passionnent ses chercheurs et ceux de l鈥橴niversit茅 McGill.听
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Alexandre Boutet, PhD
Professeur adjoint, Universit茅 de Toronto, Canada
贬么迟别:听abbas.sadikot [at] mcgill.ca (Abbas Sadikot)
Abstract:听Deep brain stimulation (DBS) has become a standard of care therapy for movement disorders, particularly Parkinson鈥檚 disease, essential tremor and dystonia, and is being investigated in psychiatric and cognitive disorders. To date, more than 244 000 individuals have been implanted with DBS worldwide. During DBS surgery, electrodes are inserted into precise brain structures, usually part of the underlying aberrant circuit. The therapeutic effects achieved with DBS hinge upon selective stimulation of the intended structure through accurate and precise delivery of the stimulation鈥攎aximizing therapeutic benefits while minimizing spillover onto neighbouring structures that may produce adverse effects. Recent neuroimaging data have shown that the therapeutic effect of DBS may be better understood as a network effect. Thanks to recent advances in MRI safety, fMRI can now be used to probe the consequences of stimulation on brain networks. Specifically, it can be used to predict optimal DBS stimulation parameters, which could represent an objective biomarker of clinical response. This could streamline the current empirical process of individually titrating the stimulation, which is cumbersome for patients and costly for the healthcare system. This may represent a step towards the possibility of autonomous, closed-loop functional imaging-assisted DBS programming.
