Abstract

Abstract Deep Brain Stimulation (DBS) research is currently experiencing a paradigm shift away from the focal effects of stimulation on the target anatomical structure toward its impact on distributed brain networks. The most commonly used DBS target for obsessive-compulsive disorder (OCD), the anterior limb of the internal capsule (ALIC), impacts distributed brain networks for reward processing, error salience and inhibitory control. These networks include ALIC -projections to the orbitofrontal cortex, dorsal anterior cingulate cortex and ventrolateral and dorsolateral prefrontal cortex. The recent development of directional segmented DBS leads may allow for selective stimulation of these cortical projections. Here, I will discuss ongoing work on developing directional white matter tractography stimulation models in OCD patients with ALIC DBS identifying which projections may be most therapeutic. Ultimately, these circuit-response maps can be used to guide personalized neuromodulation for OCD and other cross-diagnostic symptom domains involving these circuits.

Biography Dr. Figee is a psychiatrist and associate professor of Psychiatry, Neurosurgery, Neurology and Neuroscience working at the Nash Family Center for Advanced Circuit Therapeutics (C-ACT). He is director of the Mount Sinai Interventional Psychiatry Program, focusing on the psychiatric application and study of neuromodulation, in particular deep brain stimulation (DBS) and transcranial magnetic stimulation (TMS). His research focuses on the role of reward and mood circuits in neuropsychiatric disorders, such as obsessive-compulsive disorder (OCD), depression and Parkinson’s disease, and how these circuits can be modulated with DBS . He pioneered the first application of fMRI in DBS -implanted individuals. Dr. Figee aims to progress DBS and other types of neuromodulation as neuropsychiatric interventions, by investigating its effects on cross-diagnostic outcomes and associated neural networks. For more information about Dr Figee, please visit: https://icahn.mssm.edu/profiles/martijn-figee