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Published September 12, 2019 | Published
Journal Article Open

Proceedings of the Sixth Deep Brain Stimulation Think Tank Modulation of Brain Networks and Application of Advanced Neuroimaging, Neurophysiology, and Optogenetics


The annual deep brain stimulation (DBS) Think Tank aims to create an opportunity for a multidisciplinary discussion in the field of neuromodulation to examine developments, opportunities and challenges in the field. The proceedings of the Sixth Annual Think Tank recapitulate progress in applications of neurotechnology, neurophysiology, and emerging techniques for the treatment of a range of psychiatric and neurological conditions including Parkinson's disease, essential tremor, Tourette syndrome, epilepsy, cognitive disorders, and addiction. Each section of this overview provides insight about the understanding of neuromodulation for specific disease and discusses current challenges and future directions. This year's report addresses key issues in implementing advanced neurophysiological techniques, evolving use of novel modulation techniques to deliver DBS, ans improved neuroimaging techniques. The proceedings also offer insights into the new era of brain network neuromodulation and connectomic DBS to define and target dysfunctional brain networks. The proceedings also focused on innovations in applications and understanding of adaptive DBS (closed-loop systems), the use and applications of optogenetics in the field of neurostimulation and the need to develop databases for DBS indications. Finally, updates on neuroethical, legal, social, and policy issues relevant to DBS research are discussed.

Additional Information

© 2019 Ramirez-Zamora, Giordano, Boyden, Gradinaru, Gunduz, Starr, Sheth, McIntyre, Fox, Vitek, Vedam-Mai, Akbar, Almeida, Bronte-Stewart, Mayberg, Pouratian, Gittis, Singer, Creed, Lazaro-Munoz, Richardson, Rossi, Cendejas-Zaragoza, D'Haese, Chiong, Gilron, Chizeck, Ko, Baker, Wagenaar, Harel, Deeb, Foote and Okun. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms. Received: 05 February 2019; Accepted: 21 August 2019; Published: 12 September 2019. Ethics Statement: Individual studies were approved by the local Institutional Review Board of participating institutions in this technical report and written informed consent was obtained from all participants. Author Contributions: AR-Z, JG, EB, VG, AG, PS, SS, CM, MF, JV, VV-M, UA, LA, HB-S, HM, NP, AHG, AS, MC, GL-M, MR, MAR, LC-Z, P-FD, WC, RG, HC, AK, KB, JW, WD, NH, WD, KF, and MO fulfilled the authorship criteria by substantial contributions to the conception of the work, providing data for the work, revisiting it critically for important intellectual content, approving the final version, and agreeing to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved. Conflict of Interest Statement: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The reviewer VV-V declared a past co-authorship with one of the authors MO to the handling Editor. AR-Z serves as a consultant for the National Parkinson Foundation, and has received consulting honoraria from Medtronic, Boston Scientific, and Wilson Therapeutics and has participated as a site PI and/or co-PI for several NIH, Foundation, and industry sponsored trials over the years but has not received honoraria. JG work was supported in part by the European Union's Horizon 2020 Research and Innovation Programme under grant agreement 720270: HBP SGA1; by federal funds UL1TR001409 from the National Center for Advancing Translational Sciences (NCATS), National Institutes of Health, through the Clinical and Translational Science Awards Program (CTSA), a trademark of the Department of Health and Human Services, part of the Roadmap Initiative, "Re-Engineering the Clinical Research Enterprise"; by funding from the AEHS Foundation, in conjunction with Project Neuro-HOPE; and from the Austin and Ann O'Malley Visiting Chair in Bioethics of Loyola Marymount University. EB was supported by J. Doerr, the HHMI-Simons Faculty Scholars Program, the Open Philanthropy Project, Human Frontier Science Program (RGP0015/2016), US Army Research Laboratory and the US Army Research Office (W911NF1510548), US-Israel Binational Science Foundation (2014509), and NIH (2R01-DA029639 and 1R01-GM104948). VG work was primarily supported by the National Institutes of Health (NIH) Director's New Innovator grant DP2NS087949 and PECASE, National Institute on Aging grant R01AG047664, BRAIN grant U01NS090577, SPARC grant OT2OD023848-01, and the Defense Advanced Research Projects Agency (DARPA) Biological Technologies Office. Additional funding included the NSF NeuroNex Technology Hub grant 1707316 and funds from the Curci Foundation, the Beckman Institute, and the Rosen Center at Caltech. AG is supported by the NIH/NCATS Clinical and Translational Science Awards to the University of Florida UL1TR001427, KL2TR001429, and TL1TR001428. PS is a recipient of funding from the National Institutes of Health (R01 NS090913 and UH3 NS 100544) and from the Defense Advanced Research Projects Agency (DARPA). SS acknowledges support from the DARPA Restoring Active Memory (RAM) program (Co-operative Agreement N66001-14-2-4032) and NIH Grants MH104606 and 1S10OD018211-01. CM work was supported by the National Institutes of Health Grants R01 MH106173 and R01 NS086100. CM is a paid consultant for Boston Scientific Neuromodulation and Kernel, as well as a shareholder in the following companies: Surgical Information Sciences, Autonomic Technologies, Cardionomic, Enspire DBS, and Neuros Medical. MF work was supported by the NIH National Institute of Neurological Disorders and Stroke (K23NS083741) and Dystonia Medical Research Foundation. HB-S work was supported by the NINDS Grant 5 R21 NS096398-02, the Michael J. Fox Foundation, the Robert and Ruth Halperin Foundation, the John A. Blume Foundation, the Helen M. Cahill Award for Research in Parkinson's Disease, and Medtronic, Inc., who provided the devices used in this study but no additional financial support. HM work was supported by the NIH Brain Research through Advancing Innovative Neurotechnologies (BRAIN) Initiative (UH3NS103550) and the Hope for Depression Research Foundation. NP reports support by grants UH3NS103549, R01NS097782, and U01NS098961 from the National Institute of Neurological Disorders and Stroke (NINDS). AHG work was supported by grants from the Brain and Behavior Research Foundation (National Alliance for Research on Schizophrenia and Depression Young Investigator Grant), the Parkinson's Disease Foundation, and the NIH Intramural Research Program. MC work was funded by a Whitehall Research grant (Grant ID# 2017-12-54). GL-M work has been funded by the National Institutes of Health (NIH) grant R00HG008689. MR work has been supported by the National Institutes of Health through Grant Number UL1-TR-001857. P-FD acknowledges the National Institutes of Health (NIH) for their support of Neurotargetting LLC and their CranialSuite clinical software (R01-EB006136 and R01-NS095291). NH is a shareholder of Surgical Information Sciences, Inc. and holds a patent related to high-resolution brain image system (U.S. Patent 9600778). This study was partially supported by the National Institutes of Health (R01-NS085188, P41 EB015894, and P30 NS076408) and the University of Minnesota Udall center (P50NS098573). JW acknowledges grant support by NIH 1K01ES025436. KB reports support from NIH NINDS NS092730. AK and HC work was supported by National Institutes of Health grant T90 DA032436, National Science Foundation grant EEC-1028725, the Department of Defense through the National Defense and Engineering Graduate Fellowship program, and a donation by Medtronic. RG work was supported by NIH grants (NS090913-01 and NS100544-02) and the UC President's Postdoctoral Fellowship. MO serves as a consultant for the National Parkinson Foundation, and has received research grants from NIH, NPF, the Michael J. Fox Foundation, the Parkinson Alliance, Smallwood Foundation, the Bachmann-Strauss Foundation, the Tourette Syndrome Association, and the UF Foundation. MO's DBS research is supported by grants R01 NR014852 and R01NS096008 from the National Institutes of Health. MO has previously received honoraria, but in the past >60 months has received no support from industry. MO has received royalties for publications with Demos, Manson, Amazon, Smashwords, Books4Patients, and Cambridge (movement disorders books). MO is an associate editor for New England Journal of Medicine Journal Watch Neurology. MO has participated in CME and educational activities on movement disorders (in the last 36 months) sponsored by PeerView, Prime, QuantiaMD, WebMD, Medicus, MedNet, Henry Stewart, and by Vanderbilt University. The institution and not MO receives grants from Medtronic, Abbvie, Allergan, and ANS/St. Jude, and the PI has no financial interest in these grants. MO has participated as a site PI and/or co-PI for several NIH, Foundation, and industry sponsored trials over the years but has not received honoraria. MO acknowledges the support of Tyler's Hope for a Dystonia Cure and the Parkinson's Foundation Center of Excellence. AS acknowledges the Packard Foundation, Friends and Alumni of Georgia Tech, and the Lane Family.

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