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Restorative Neurosurgery From Motion to Emotion Kendall Lee, M.D., Ph.D.

Restorative Neurosurgery From Motion to Emotion Kendall Lee, M.D., Ph.D. Department of Neurosurgery Mayo Clinic. Neuromodulation (Deep Brain Stimulation). Established for: Parkinson’s Disease (STN, GPi) Dystonia (GPi) Tremor (Vim Thalamus) Emerging treatment for:

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Restorative Neurosurgery From Motion to Emotion Kendall Lee, M.D., Ph.D.

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  1. Restorative Neurosurgery From Motion to Emotion Kendall Lee, M.D., Ph.D. Department of Neurosurgery Mayo Clinic

  2. Neuromodulation (Deep Brain Stimulation) Established for: • Parkinson’s Disease (STN, GPi) • Dystonia (GPi) • Tremor (Vim Thalamus) Emerging treatment for: • Epilepsy (Anterior Thalamus) • Tourette’s Syndrome (CM Thalamus) • Obsessive compulsive disorder • Depression (Area 25) • Chronic Pain (PAG/PVG, Thalamus) • Chronic Pain (Motor cortex)

  3. Neuromodulation • >60 thousand DBS implants • Stimulation 24 hrs a day - 7 days a week • Immediate reduction in tremors However, • Time consuming surgery without feedback • Difficulty programming without feedback • Unknown mechanism of action Need a Closed-Loop Feedback System • Better targeting of electrode of implant HOW TO GET THERE? • Neuroelectricalmonitoring • Neurochemical monitoring

  4. Neuroelectrical monitoring

  5. Real-Time Neurochemical Recordings Electrochemistry Fast-Scan Cyclic Voltammetry (FSCV) 8

  6. Fast-Scan Cyclic Voltammetry 1.0 -0.4 -0.4 Voltage

  7. Real-Time Neurochemical Recordings 1.0V -0.4V Applied Potential (V) DA Measured Current (uA) DA DA oxidation reduction Background subtracted cyclic voltammogram Pseudo colorplot

  8. Pseudo colorplot

  9. Universal Electrochemistry Instruments system: the University of North Carolina

  10. Wireless Instantaneous Neurotransmitter Concentration Sensor System (WINCS) Hardware Software Mayo Clinic Dopamine Adenosine Serotonin

  11. Wireless Instantaneous Neurotransmitter Concentration Sensor System (WINCS): Mayo Clinic B. A. (implanted) SENSOR C. WINCS (external) (remote) HOMEBASE

  12. Concept - Intraoperative Neurochemical Monitoring during Deep Brain Stimulation Surgery

  13. Part I Human WINCS Recording Studies (Dr. Lee’s work)

  14. Part I Human WINCS Recording Studies (Dr. Lee’s work)

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