Stimulating Brains

Benjamin Stecher is doing impressive work in is role a scientific writer and patient advocate. He co-authored the book “Brain Fables” together with Alberto Espay, which recently won the prose award by the Association of American Publishers in the category Neuroscience. The book is truly unique in its way to combine both the views of patient and health professional on the history and misconceptions of Parkinson's Disease and what should change in our field to make progress.

Benjamin was diagnosed with Parkinson's disease at 29. Since then, he left a successful managing partner position in Shanghai to study the disease full time. He has been traveling the world to witness the latest and greatest progress being made in over 100 research laboratories around the globe. He has interviewed over 80 international experts and shares his insights on the website tmrwedition.com.

On June 2nd, Benjamin underwent deep brain stimulation surgery to the subthalamic nucleus. We are incredibly grateful that a mere nine days after that, he shares this experience lived from the most direct and intimate, the most important perspective: the one of the patient.

Katrin Amunts is the Scientific Research Director of the Human Brain Project and leads two centers at Forschungszentrum Jülich and the University Hospital Düsseldorf. With her internationally recognized work that includes the BigBrain and JuBrain projects and use of novel methodology such as polarized light imaging, she follows the footsteps of famous anatomists of the past, such as Cecile and Oskar Vogt, name givers of her institute.

Cameron McIntyre and I talk about biophysically plausible deep brain stimulation models that his laboratory has established and continues to refine since about 20 years. Cameron shares insights from a time where DBS modeling was not a thing – how his career choice to step into the realms of medical hospitals as a biomedical engineer had been risky or at least unusual at the time. We learn why the VTA model was originally a step backwards and why there is a large difference between inventions & prototypes vs. commercially useable products with direct clinical impact. Cameron shares his insight on why DBS modeling for movement disorders and for neuropsychiatric diseases are currently asking very different levels of questions. We touch upon amazing recent inventions by the McIntyre lab – such as the holographic basal ganglia pathway atlas and the HoloDBS system to plan surgeries – collaboratively and remotely from different living rooms throughout the United States.

Mac Shine and I talk about Mac's recent intriguing opinion paper that may have radical implications for systems and clinical neuroscience. In it, the thalamus mediates between feed-forward type input from cerebellum, sensori nuclei and cortex one one hand and input from the basal ganglia that introduces an element of randomness. By projecting to the cortex in a specific manner, the thalamus can recruit these inputs to shape the attractor landscape of cortical activations. Mac develops this a theory from the cell- to the systems neuroscience level and hints at how Kahneman's system I and II levels of thinking fast and slow could be implemented in the brain. The theory radically extends and partly opposes existing concepts such as the thalamus as a mere relay station and the model of the basal ganglia for action selection proposed by Alexander, DeLong and Strick in 1989 – so there is vast potential of this becoming transformative for deep brain stimulation, as well.

In this guest episode, Luka Milosevic talks with Mojgan Hodaie about the neuromodulation for neuropathic pain, how serendipity may lead to a whole novel research field, how our teachers shape the way we think about the brain and how we may learn from each single patient we get in contact with. Prof. Hodaie is a world-wide expert in stereotactic surgery with a special focus on (imaging guided targeting of) neuropathic pain.

The Hodaie lab published the seminal article demonstrating the feasibility of detailed imaging of the course of the cranial nerves in the posterior fossa and a method in which these relate to tumours that arise there, particularly acoustic neuromas.

Prof. Hodaie is a member of the executive board of the Foundation for International Education in Neurological Surgery (FIENS) and the founder of the NEURON project (www.neuronproject.org).

In this episode, Lone Frank shares insight about her book “The Pleasure Shock: The Rise of Deep Brain Stimulation and Its Forgotten Inventor” in which she delved into the academic life of a true pioneer of our field. Robert Heath invented deep brain stimulation in the 1950ies and was a remarkable pioneer of our field. Lone's book takes us on a trip delving deep into the discoveries – but also controversies around Heath and his contemporaries, such as José Delgado and Frank Ervin.

In this episode, Lone Frank shares insight about her book “The Pleasure Shock: The Rise of Deep Brain Stimulation and Its Forgotten Inventor” in which she delved into the academic life of a true pioneer of our field. Robert Heath invented deep brain stimulation in the 1950ies and was a remarkable pioneer of our field. Lone's book takes us on a trip delving deep into the discoveries – but also controversies around Heath and his contemporaries, such as José Delgado and Frank Ervin.

In this episode, Günther Deuschl shares insight about his life in neurology and the endeavors to transform deep brain stimulation for movement disorders as established treatment options supported by class one evidence. He has been instrumental in multiple major clinical trials, such as the randomized double-blind clinical trial for DBS to the subthalamic nucleus in Parkinson's Disease (Deuschl et al. 2006), a similar study for modulation of the internal pallidum in dystonia (Kupsch et al. 2006) and later the Earlystim trial (Schuepbach et al. 2013) – all published in the New England Journal of Medicine. He was president of the International Movement Disorders Society (MDS) from 2011-2013, Editor in Chief of the journal Movement Disorders and has been awarded numerous high-class awards in our field. He is an international capacity in the field of tremor and leads the study group for tremor in the MDS.

Günther Deuschl takes us on a fascinating journey into the past – where DBS was not as established as it is today – the present and the future – with emerging technologies such as MR-guided focused ultrasound and neuromodulation for psychiatric diseases.

In this episode, Pierre Pollak shares insight about his life in neurology, music and sports and how he introduced modern-day deep brain stimulation for movement disorders together with Alim Louis Benabid and the team in Grenoble in 1987. After his retirement from academia and neurology, Pierre took up playing piano and spending time with physical activity (cycling, winter sports, etc) – and he mentioned that our conversation was the first about deep brain stimulation he had in over five years.

He talks about the first patients that received deep brain stimulation for tremor – the first one using an externalized stimulator approved for animal use only over the course of three weeks. We then advance to the incredible anecdote of how Patricia Limousin switched on the first bilateral STN stimulation to treat a patient suffering from severe akinetic Parkinson’s Disease. For both, it was incredible how the patient could walk – without any help from pharmacological drugs.