Brain meeting: Dr Harith Akram

Brain meeting

Functional neurosurgery involves carrying out an acute anatomical intervention to exact a chronic change in function. Deep brain stimulation (DBS) for central neuromodulation offers an alternative to ablative surgery and is a well-established therapy for a wide range of neurological conditions.

The list of subcortical structures targeted in DBS is extensive and the success of the procedure hinges on proper patient and target selection and accurate lead placement. Though advancements in imaging techniques in the last century provided a window into the brain; targeting deep brain structures, whether for ablation or DBS, continued to pose challenges. This is due to the difficulty in localizing the functionally distinct sub-regions within the basal ganglia and thalamic targets (e.g. the sensorimotor subthalamic nucleus [STN] or the ventrointermedial nucleus [Vim]) using conventional magnetic resonance imaging.

Structural and functional connectivity studies allow the visualization of targets not readily visible on MRI and provide new ways to define the sub-regions in target nuclei, thus optimising targeting to improve efficacy and avoid unwanted side effects. Connectivity studies also provide a tool for examining the underlying pathophysiology and mechanism of action of DBS. Moreover, the exploration of predictive biomarkers can further help in patient selection.

Here, we present several new analysis methodologies and applications of advanced connectivity imaging to: (1) build predictive models of DBS surgery outcome; (2) refine the surgical target and (3) better understand the pathogenesis of the treated conditions and the mechanism of action of DBS therapy, focusing on Parkinson’s disease, tremor, cluster headache and obsessive compulsive disorder (OCD).

There will be coffee, tea and cake in the conservatory directly after the talk.