We investigate the brain networks and neurotransmitters involved in symptoms of movement disorders, such as Parkinson's disease, and the mechanisms by which modulating these networks through electrical stimulation affects these symptoms. We are particularly interested in the mechanisms through which neuromodulation therapies like deep brain stimulation affect non-motor brain functions, such as cognitive function and mood. We use imaging of specific neurotransmitters, such as acetylcholine and dopamine, to understand the changes in brain chemistry associated with the clinical effects of deep brain stimulation and to predict which patients are likely to have changes in non-motor symptoms following DBS. Through collaborations with our neurosurgery colleagues, we explore brain function by making recordings during DBS surgery during motor and non-motor tasks. Dr. Mills collaborates with researchers in the Department of Neurosurgery, the Division of Geriatric and Neuropsychiatry in the Department of Psychiatry and Behavioral Sciences and in the Division of Nuclear Medicine within the Department of Radiology to translate neuroimaging and neurophysiology findings into clinical applications.

Work in the Sivanesan Neuromodulation Laboratory (SNL) focuses on developing electrical stimulation therapies for treating neuropathic pain conditions and discovering novel applications for patients suffering from painful conditions. We study mechanisms of all modalities of spinal cord stimulation in the laboratory and aim to rapidly translate these discoveries to patient care. This bench to bedside approach facilitates a unique integration of the latest science with the clinical care of patients.

We are exploring whether anodal tDCS when administered in combination with spelling, naming, or working memory therapy can improve language performance of PPA and MCI participants at least in the short term more than behavioral therapy alone. We are also investigating whether and how tDCS alters the neuropeptide signature in participants with PPA and MCI. We use proton magnetic resonance spectroscopy (1H-MRS) to monitor neuropeptide concentrations at the areas of stimulation. We hypothesize that tDCS will stabilize the decline of specific neuropeptides, but only in those areas of the brain where tDCS effectively results in more efficient gains in language compared to language therapy alone (with sham tDCS). Study results may help optimize future intervention in individuals with PPA and MCI by providing treatment alternatives in a neurodegenerative condition with no proven effective treatment. A better understanding of the therapeutic and neuromodulatory effects of tDCS in PPA and MCI will offer insight into ways of impeding neurodegeneration that may improve quality of life for individuals with PPA and MCI and may provide insights into the mechanisms of this treatment for augmenting therapy for stroke as well.

The Kayode Williams Lab conducts translational research on neuromodulation. We primarily examine the mechanisms and efficacy of spinal cord stimulation in treating neuropathic pain, peripheral neuropathies and peripheral vascular disease. Our clinical trials explore spinal cord stimulation in the treatment of painful diabetic neuropathy and the treatment of critical non-reconstructible critical leg ischemia. We also have a longstanding interest in the business of medicine and seek to enhance value propositions for hospitals and physician groups through more effective management of resources.

The neuroimaging and Modulation Laboratory (NIMLAB) investigates neural correlates of cognition and behavior using neuroimaging methods such as functional magnetic resonance imaging (fMRI) and neuromodulation techniques such as transcranial magnetic stimulation (TMS). We are looking in depth at the contributions of the cerebellum and cerebro-cerebellar circuits to cognition; the effects of chronic heavy alcohol consumption on cognition and brain activation underlying cognitive function; how aging in humans affects neural systems that are important for associative learning and stimulus awareness; and the integration of transcranial magnetic stimulation with functional MRI.

The research goals of the Functional Neurosurgery Laboratory include the development of computational models to understand how brain function is affected by neurological conditions and how this abnormal function might be corrected or minimized by neuromodulation through electrical stimulation. The lab uses data collected from patients during epilepsy monitoring or in the operating room during DBS procedures to construct and calibrate the computational models. The models can be manipulated to explore functional changes and treatment possibilities. The other primary goal of the laboratory is the development of a neuromodulation system that applies stimulation pulses at specific phases of brain oscillatory activity. This technique is being explored in the context of Parkinson's disease as well as memory function, and may lead to less invasive therapeutic treatment system with more effective stimulation.