PLENARY SESSION: Emerging Applications of Non-Invasive Neuromodulation in Neurology
JEC
Time: 8:45 AM to 10:45 AM
Description
Recent years have witnessed the conceptualization of many brain diseases as circuit-level and/or network-level disorders. This view of brain diseases as network disorders coincides with and contributes to increased use of neuromodulation approaches which aim to treat certain neurological conditions by altering patterns of activity in dysfunctional neural circuits. Transcranial magnetic stimulation, while commonly employed in psychiatry, has begun to work their way into the armamentarium of therapeutics for neurologists. At the same time, other emerging noninvasive neuromodulation techniques such as focused ultrasound and transcranial electrical stimulation are showing considerable therapeutic promise across a wide range of neurologic disorders. This symposium will address novel approaches to stimulating brain circuits and networks using noninvasive neuromodulation techniques. It will bring together several globally renowned experts in brain networks and neuromodulation and will point toward the future use of brain stimulation for disorders in clinical neurology.
Objectives
Differentiate between various noninvasive brain stimulation techniques such as transcranial magnetic stimulation (TMS), transcranial electrical stimulation (tES), and focused ultrasound (FUS) and understand their underlying principles and mechanisms of action.
Explain how noninvasive brain stimulation techniques are being explored to enable the diagnosis and treatment of specific neurological disorders.
Demonstrate a fundamental understanding of how patient-specific factors such as neuroanatomical targets, stimulation parameters, and individual brain response patterns influence the effects of noninvasive neuromodulation.
Speakers
Brain Circuit-Targeted Neuromodulation
DescriptionDiscussion of how modulating brain circuits with TMS can improve symptoms of neurologic and psychiatric disease.
SpeakersCausal Entrainment of Cortical Rhythms Improves Memory in Aging and Alzheimer’s Disease
ObjectivesPersonalized HD-tACS can enhance visual and auditory-verbal working memory in older adults, with lasting benefits from repeated stimulation. Preliminary clinical trial data indicate that personalized HD-tACS may partially restore memory in mild Alzheimer's, suggesting potential for non-pharmacological memory interventions.
SpeakersEmerging Focused Ultrasound Techniques for Diagnosis and Treatment of Brain Disorders
DescriptionUltrasound technology offers a non-surgical alternative to traditional brain interventions, which typically involve exposing the brain or inserting implants. This talk explores the emerging ultrasound techniques for brain disease diagnosis and treatment.
SpeakersHighly Epileptiform EEG Trajectories and Functional Recovery Post-Cardiac Arrest (Emerging Scholar Presentation)
DescriptionSeizures happen in one out of five patients after a cardiac arrest and nearly half of the patients develop epileptiform activity in the cital-interictal continuum. Clinicians do not know which patterns are signs of irreversible brain injury destined for poor outcomes or potential targets for rescue therapies to promote neurological recovery. This study involved a multicenter cohort, partly prospective and partly retrospective involving seven academic or teaching hospitals from the U.S. and Europe. One thousand and twenty patients (56,676 hours of EEG) were analyzed and 320 (31.4%) had a highly epileptiform EEG based on automated analysis. After expert review, 247 (24%) met the criteria for periodic epileptiform activity or seizures. Three dominant epileptiform activity trajectories post-cardiac arrest were identified. While nearly all patients with early epileptiform activity had poor functional recovery, almost a third of patients with delayed onset of highly epileptiform activity had good recovery.
Insights from Centromedian Thalamic Stimulation Evoked Responses to Improve Brain Stimulation Therapies (Emerging Scholar Presentation)
DescriptionThis study investigates the cortical and intra-thalamic effects of centromedian nucleus (CMN) deep brain stimulation (DBS) during implantation in patients with drug-resistant epilepsy. The effects of high-frequency stimulation (40-50 Hz) were evaluated across eight electrode contact pairs in seven patients (ages 11-29) with refractory epilepsy at our institution. EEG recordings from the scalp and intra-thalamic regions were analyzed, revealing increases in beta- and theta-frequency activity during stimulation. The spatial dependence of these effects suggests potential therapeutic significance. These findings indicate that evoked EEG responses to high-frequency stimulation may be helpful as biomarkers to guide DBS implantation and settings toward improving the therapeutic effect of stimulation in epilepsy patients.
Non-invasive Approaches to Treating Seizures
DescriptionThis talk will survey experimental approaches in non-invasive stimulation to treat seizures and interictal discharges, including tDCS, TMS, and ISP. We will discuss putative mechanisms of action and identify the clinical challenges in developing these therapies.
Speakers