Michael Fox, MD, PhD, Brigham and Women's Hospital & Harvard Medical School, Boston, MA, shares insights on the use of lesion network mapping to identify and optimize neuromodulation targets. Deep brain stimulation (DBS) is a widely used treatment for movement disorders and can be very effective for treating specific symptoms, such as tremor. Much of our understanding of how specific brain regions link to specific movement disorder symptoms comes from iatrogenic lesioning. Dr Fox talks on how this approach is being translated for the development of new DBS targets. Using data from stroke patients, lesion locations can be mapped out for individual symptoms to generate casual circuits. When the connectome was used to map these lesion locations, it was demonstrated that they all linked to a specific brain circuit. The circuit involved in parkinsonism was shown to center around the claustrum, a region not typically associated with Parkinson’s disease. Dr Fox discusses the potential of this approach to discover new targets for many different symptoms. This interview took place during the 2021 International Congress of Parkinson's Disease and Movement Disorders.

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