The goal of the lab is to understand how disruptions of brain network activity lead to movement disorders such as Parkinson’s disease, dystonia and tremor, and how to treat these conditions by modulating neural activity with electrical deep brain stimulation (DBS).
1) Intraoperative cortical physiology
The goal of this project is to understand which neural pathways are directly activated by DBS applied to the subthalamic area of patients with Parkinson’s disease. This is accomplished by measuring stimulation evoked potentials using a high-resolution subdural cortical recording strip, visualizing specific fiber pathways using MRI tractography and estimating the spread of stimulation effects using 3-dimensional biophysical computational models. The main focus is on the cortico-subthalamic hyperdirect pathway.
2) Non-invasive electrophysiologic signals in movement disorders
The goal of this project is to determine how electrophysiologic signals (EEG, EMG) change in patients with movement disorders compared to healthy controls, at rest and during task performance. Additionally, the effects of dopaminergic medications and DBS are studied to define objective markers of clinical response that could be used to monitor disease progression and adjust therapies.
3) Automated DBS programming
The goal of this project is to develop advanced optimization algorithms to implement decision strategies for closed loop DBS programming. Symptom severity is measured using accelerometer in a smartwatch worn by the patient. Accelerometer signal is streamed to a computer where data is processed and updated stimulation settings are automatically sent to patient’s DBS device.
4) DBS clinical outcomes
Emory is one of the oldest and largest centers in the U.S. providing DBS surgery. More than a 1000 patients have been implanted with DBS since late 1990s. We maintain a large clinical database for quality improvement purposes and to study how various clinical and perioperative factors affect patient outcomes.