Special Expertise: Deep Brain Stimulation
Andres Lozano is University Professor and Chairman of Neurosurgery at the University of Toronto and holds both the RR Tasker Chair in Functional Neurosurgery and a Tier 1 Canada Research Chair in Neuroscience.
He is best known for his work in Deep Brain Stimulation (DBS). His team has mapped out cortical and subcortical structures in the human brain and have pioneered applications of DBS for various disorders including Parkinson’s disease, depression, dystonia, anorexia, Huntington’s and Alzheimer’s disease.
Prof. Lozano has over 500 manuscripts published or in press and is, according to Thompson Reuters, the most cited neurosurgeon in the world for the 11 year period from 2002 to 2012. He has trained over 50 international fellows in Functional Neurosurgery, many who have become leaders in their field.
Prof. Lozano serves on the board of several international organizations and is a founding member of the scientific advisory board of the Michael J Fox Foundation and the Weston Brain Institute. He has received a number of awards including the Margolese National Brain Award, the Olivecrona medal and the Pioneer in Medicine award, has been elected a Fellow of the Royal Society of Canada and the Canadian Academy of Health Sciences and has received the Order of Spain.
Lecture: Special Joint DBS‐DGKN Lecture – The Future of Deep Brain Stimulation (Wednesday, March 16, 2016 from 17:00–17:45 hrs)
It is increasingly being recognized that neurologic and psychiatric disturbances are caused by dysfunction in specific brain circuits. Using a novel surgical technique called Deep Brain Stimulation (DBS), it is possible to introduce electrodes within malfunctioning circuits in the human brain and deliver constant electrical stimulation through implanted pacemakers.
This permits the adjustment of the activity of the malfunctioning brain circuits- turning them either up or down as required. This is being done mostly for Parkinson’s disease and over 120,000 patients worldwide have now received DBS with striking results.
With the success of modulating circuits that control movement as in Parkinson’s disease, the possibility of introducing electrodes and modifying other circuits, for example those regulating mood and cognitive function is being examined. The use of Deep Brain Stimulation in treating depression, obsessive compulsive disorder, anorexia, epilepsy and even Alzheimer’s disease is actively being investigated. The advantage of the DBS procedures is that because of the precision of the surgical techniques, specific brain areas can be targeted – influencing only those brain structures that are malfunctioning and delivering treatment only where it is needed. In addition, by controlling the dose of electrical current delivered, DBS allows the adjustment of the activity of these circuits to optimize clinical benefits and minimize any untoward effects.
These techniques are driving us to probe novel areas in the brain and allowing are us to gain a better understanding of what goes wrong in the brain in neurologic and psychiatric disorders. The application of DBS is showing promise in developing novel therapies to treat many of the patients throughout the world who continue to be disabled despite our currently best available efforts.
Special Expertise: Neurology and Neurophysiology
Jose A. Obeso is currently director of the CINAC in Madrid and full Professor of Neurology in the CEU-San Pablo University. He has concentrated in defining compensatory mechanism in early phase of PD and in determining the most relevant therapeutic challenges in PD Currently he is focused in defining the origin of cell vulnerability in Parkinson's Disease and the need to stop the neurodegeneration process rather than concentrating in restoring striatal dopamine levels only.
Lecture: Keynote Lecture – The Modern view on basal ganglia function (Tuesday, March 15, 2016 from 11:00–11:45 hrs)
The interest if not fascination for understanding the function of the Basal Ganglia started more than a century ago, when it was established that lesion of the striatum, subthalamic nucleus, and substantia nigra was associated with disorders of motor control. The description of the nigro-striatal dopaminergic projection and its degeneration in Parkinson’s disease further fueled the notion that the BG deals with movement control. That notion has been attacked over the last decades, and considered too narrow to account for the profuse cortical input to the striatum as well as BG output to the cortex and subcortical structures. Thus, evidence has accumulated favoring that the BG is engaged in the control of movement, behavior and emotions throughout parallel circuits connecting motor, associative and limbic structures. However, several enigmas remain unresolved despite extensive newer information regarding connectivity, functional features and pathological manifestations.
In this Lecture I shall review first, the basic concepts about BG functional anatomy and pathophysiology; secondly, will discuss the main unknowns and paradoxes mainly derived from clinical observations and, lastly, will propose some essential characteristics of BG function as deduced from basic observations in animals and patients with Parkinson’s disease.
Prof. José A. Obeso, CINAC, Hospital Puerta del Sur and San Pablo CEU Univ., CIBERNED