Center for Brain Circuit Therapeutics

Patients with brain disorders often have symptoms that don’t respond to medication (also called medication-refractory symptoms). Some of these symptoms can be improved by directly targeting brain circuits. Brain circuits are sets of connected brain cells that together perform a certain function such as speaking or walking. These circuits can be damaged by brain disease, leading to neurological or psychiatric symptoms. Recent advances in brain imaging allow us to identify these brain circuits and determine which brain circuit is responsible for which symptom. Neuromodulation therapies such as deep brain stimulation (DBS), transcranial magnetic stimulation (TMS), and MRI-guided focused ultrasound (MRIg-FUS) allow us to directly target brain circuits and improve symptoms in ways not possible with medication.

The Center for Brain Circuit Therapeutics is a joint initiative across the departments of neurology, psychiatry, neurosurgery, and neuroradiology, all located within the Hale Building for Transformative Medicine at Brigham and Women’s Hospital Neurosciences Center. The mission of the center is to improve treatment for patients with neurological and psychiatric symptoms by identifying and modulating brain circuits. The center is multidisciplinary because symptoms of brain disease cross traditional boundaries as does the expertise needed to develop and administer brain circuit therapies. The center offers multiple forms of therapeutic neuromodulation because the same brain circuit can potentially be targeted in different ways. The Center combines research and clinical care to speed up the development of new treatments.

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What Brain Circuit Therapies Do We Provide?

Clinical services include DBS, MRIg-FUS, and TMS. A second-opinion service is available for patients who previously received these treatments but were not satisfied with their outcome. Additional neuromodulation technologies may be available as part of research trials.

Who Can Benefit From Brain Circuit Therapies?

We treat patients with medication-refractory symptoms from brain disorders including depression, Parkinson’s disease, essential tremor, dystonia, epilepsy, bipolar disorder, obsessive-compulsive disorder and several other diagnoses. We also offer treatment as part of research trials for a range of different brain disorders.

How Can The Center for Brain Circuit Therapeutics Help?

The Center for Brain Circuit Therapeutics offers the full range of neuromodulation treatments in a unique multidisciplinary environment.

Patients are first evaluated by an expert in brain stimulation therapies matched to their specific symptom or diagnosis. This evaluation can occur in person or via a video appointment. Patients often see multiple experts across multiple departments. Appointments are organized into a single day at a single location to maximize patient convenience. For example, a patient undergoing DBS evaluation for Parkinson’s disease may see a neurosurgeon, neurologist, neuropsychologist, social worker and get an MRI, all in back-to-back appointments in the same building on the same day.

For patients who have previously received neuromodulation treatment at another institution but were not satisfied with their outcome, we offer a second opinion service. We will evaluate your diagnosis, symptoms, treatment, and response to determine whether changes can be made to improve your outcome. This service includes advanced analysis of the location of your neuromodulation treatment, so please send MRI scans (on disk) and records prior to your appointment.

What Sets Us Apart?

In the Center for Brain Circuit Therapeutics, we treat both neurological and psychiatric symptoms as brain circuit problems. We use a multi-disciplinary approach and offer a variety of neuromodulation therapies to target these brain circuits for symptom relief. This unique approach fosters innovation, collaboration and new perspectives on delivering better treatments for patients with brain disorders.

Specific examples of what makes us different include:

We are one of the few centers in the world to offer the full range of neuromodulation treatments including DBS, TMS, and MRI-guided focused ultrasound. Bringing these treatments together ensures the right patient gets the right treatment. It also helps advance the development of new treatments.
Linking clinical care and research. Our mission is to treat patients with existing neuromodulation therapies, but also to develop new and improved neuromodulation therapies. All clinical patients have the opportunity to take part in research and help with these new therapies.
Advanced on-site neuroimaging for mapping brain circuits and guiding neuromodulation therapies. There are four on-site MRI scanners in the Hale Building for Transformative Medicine, including a high-powered 7 Tesla MRI scanner.
Advanced facilities for administering neuromodulation treatment including:
- The AMIGO operating suite, which allows for asleep DBS and implantation of DBS electrodes within an MRI scanner
- One of the first MRI-guided focused ultrasound suites, which allows for neurosurgical lesions to be placed without a skin incision or risk of infection. Brigham and Women’s hospital was the first hospital in the United States to treat 100 patients using this technology
- Two TMS suites within the Hale Building, including robot administered TMS, which allows for more accurate and consistent TMS delivery
A focus on safety during COVID19. All clinical services have been optimized for safety and social distancing during COVID19, including video appointments for neuromodulation evaluations, video-guided DBS programming, robot administered TMS, and video conferencing equipment in each TMS room for remote check-ins and treatment monitoring.