Speaker : Alfonso FASANO, Chair in neuromodulation and multi-disciplinary care university of Toronto university health network.
"DBS for freezing of gait: new parameters, new targets and the path forward"
Subthalamic nucleus (STN) and globus pallidus pars interna (GPI) are established and effective targets for deep brain stimulation (DBS) in Parkinson's disease (PD)-related freezing of gait (FOG). In recent years we learned how to optimize their stimulation but FOG outcome might be disappointing. Many programming strategies have been tried, generally with variable/poor results. Adaptive DBS is a promising, fast-evolving approach with the potential of introducing an alternating modulation and improving the sequence effect. Upcoming studies with cortical control of DBS are ongoing. Other targets with variable effects and mechanisms largely unknown have been proposed: substantia nigra pars reticulata, nucleus basalis of Meynert, pedunculopontine and cuneiform nuclei. Neuromodulation is not just DBS and alternative approaches have been considered: patterned dorsal roots stimulation is promising but it’s not yet feasible on a large scale. The role of cerebellar DBS and cortical stimulation with brain computer interfaces are still unknown. Finally, non-invasive neuromodulatory techniques (e.g. temporal interference stimulation and transcranial ultrasound stimulation) can be used to identify new targets for chronic stimulation through permanent elec- trodes.
Hosted by Marie-Laure WELTER.
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Conference location
Please join the conference in Paris Brain Institute auditorium.