Michael D Fox|
Instructor in Neurology at Harvard Medical School
Neurology Fellow at Partners (MGH/BWH)
Department of Neurology, MGH
PhD, Washington University in St. Louis
MD, Washington University in St. Louis
DESCRIPTION OF WORK / BIOSKETCH
The over-arching purpose of my work is to advance systems neuroscience and to translate these advances into improved clinical treatments for patient’s with neurological or psychiatric diseases. Much of my work to date has focused on a non-invasive brain imaging technique termed resting state functional connectivity MRI. This technique measures correlations in spontaneous fluctuations in blood oxygenation to identify interacting brain regions and networks. As it becomes increasingly recognized that many brain diseases are disorders of networks, not just single regions, this technique has become valuable for investigating pathophysiology and is being explored as a diagnostic tool.
Most recently, I have begun investigating the utility of this imaging technique to directly guide therapeutic intervention. One application is pre-operative mapping where this technique shows promise above conventional imaging paradigms for identifying critical areas of cortex to be avoiding during brain surgery. Another application, and the focus of my current research, is using this technique to guide therapeutic focal brain stimulation.
Focal brain stimulation techniques, including repetitive transcranial magnetic stimulation (rTMS) and deep brain stimulation (DBS), can provide dramatic benefit in diseases often refractory to medication such as Parkinson’s or depression and are showing promise in conditions with no or minimally effective treatments such as Alzheimer’s. However it is often unclear what stimulation site might work best for a given patient or disease. Because the effects of stimulation appear to depend on the connectivity of the stimulated site to other brain region and networks, this imaging technique may represent a powerful approach to identify the best site to stimulate. Further, early evidence suggests that one therapeutic mechanism of focal brain stimulation may be to alter abnormal connectivity, changes which can be assessed with resting state functional connectivity MRI.