.jpeg)
Focused Ultrasound Thalamotomy
Individuals with severe tremors who do not respond to medication may explore advanced surgical options. Focused ultrasound represents a groundbreaking treatment that precisely targets and ablates a small area of thalamic tissue, effectively alleviating tremors. Our research shows that this procedure is safe from a cognitive standpoint, allows patients to patients to successfully achieve their pre-treatment goals (e.g., eating/drinking without difficulty, dressing, hobbies), and leads to reduced burden on caregivers.
.jpeg)
Relevant Publications
Petersen et al., 2024. Cognitive outcomes following unilateral magnetic resonance–guided focused ultrasound thalamotomy for essential tremor: findings from two cohorts. Brain Communications.
Gopinath et al., 2024. Changes in caregiver burden following unilateral magnetic resonance-guided focused ultrasound thalamotomy for essential tremor. Movement Disorders Clinical Practice.
Rabin et al., 2023. Patient satisfaction following unilateral MR-guided focused ultrasound for tremor: Who is satisfied and who is not? Parkinson's & Related Dementia.
rTMS for Refractory Depression
Major depressive disorder (MDD) affects about 10% of Canadians and can be very disabling. While standard treatments like medication and therapy help many, up to one-third of people with MDD don’t respond to these options.
For those who don’t improve with standard treatments, doctors may use repetitive transcranial magnetic stimulation (rTMS). This therapy uses magnetic pulses to stimulate a part of the brain involved in mood regulation. rTMS is effective for about 40-60% of patients, but not everyone benefits. We are working to identify markers that can predict which individuals are likely to respond well to rTMS. This would ensure that rTMS is offered to those most likely to benefit.
.jpeg)
Surgical Therapies for Severe Psychiatric Disorders
My team has shown that several novel neuromodulation treatments are safe from a cognitive perspective. This includes focused ultrasound capsulotomy for depression and obsessive compulsive disorder (OCD), deep brain stimulation for alcohol use disorder and PTSD, as well as focused ultrasound for tremor. This research has provided valuable reassurance to patients considering these treatments.
We have also written extensively about the need for neuromodulation outcome measures that truly reflect what is meaningful to patients. Traditional outcome measures often focus on clinical or physiological markers, but they may not capture the full scope of how treatments impact patients’ daily lives, mental health, and overall well-being. By developing patient-centered outcome measures, we can ensure that clinical trials more accurately assess the real-world effectiveness of neuromodulation therapies, aligning with what matters most to those undergoing treatment. This approach fosters more relevant, personalized, and impactful evaluations of therapeutic interventions.
