Neuromodulation Program

Program Lead: Dr. Zelma Kiss

Neuromodulation is the altering/modulation of nervous system function by means of implantable devices or neural prostheses. It includes peripheral nerve, spinal cord and brain electrical stimulation, as well as drug delivery devices. Many conditions are treated, including movement disorders, epilepsy, pain, angina, depression, spinal cord injury, headache, and spasticity. 

Education

Drs. Darren Clark and Elliot Brown completed their AIHS fellowships, with Dr. Clark moving on to receive a Parkinson Alberta fellowship. Rachel Sondergaard and Linda Kim continued in their PhD programs studying the pathophysiology of dystonia and new targets for DBS in humans and animal models. Catherine Wiener joined as a new PhD student and is studying DBS vs. focused ultrasound in rodent brain slice. Dr. Vishal Varshney started his residency in pain medicine and was very active in screening and managing patients for spinal cord stimulation. The Neuromodulation Program funded several summer students from Mount Royal, Queens, and the University of Calgary. Importantly, we established methods to provide funding for trainees, nursing, and Allied Health to attend neuromodulation conferences in the future. 

Research 

We continued collecting prospective data on all patients undergoing stimulator procedures. For example, we completed our local study of occipital nerve region stimulation for headache and craniofacial pain syndromes and embarked upon a study of predictors of outcome in thalamic DBS for essential tremor.

Publications included a collaboration with a group in the US sharing cases of a particular type of hereditary dystonia and their response to DBS (Movement Disorders 2019), a review article about medical methods patents (Neuromodulation 2019), transcranial magnetic stimulation protocols to inhibit cerebellar activity (Cerebellum 2019), and a paper in the Journal of Neuroscience (2019) identifying a novel potential mechanism of action of DBS for dystonia comparing responses in rodent brain slice to electrophysiology in patients undergoing DBS surgery.

Our trainees figured prominently in these papers, with the program’s summer student being first author on one paper and six trainees contributing to the others.

Dr. Varshney published two reviews on intrathecal drug delivery for pain management.  

Trainees presented posters at the Brain Stimulation meeting and oral presentations at the Alberta Motor Control meeting. A Neuromodulation summer student won a best presentation prize at the Biomedical Engineering Undergraduate Research Symposium. We were invited to give two talks and sit on a panel at the NYC Neuromodulation Conference & NANS Summer Series in New York City and give one workshop, one plenary, and chair a symposium at the International Brain Stimulation Conference.

Our team presented five posters at the Society for Biological Psychiatry, as well as an oral presentation at the International Neuromodulation Society and the Canadian Neuromodulation Society meetings.

Future Directions

Based on the positive results of our DBS for treatment resistant depression study (to be published in Lancet Psychiatry), we plan to implant very selected patients with DBS for this condition.  

Members

Cardiology: Dr. Todd Anderson

Neurology: Dr. Werner Becker, Dr. Veronica Bruno, Dr. Davide Martino

Neurosurgery: Dr. Walter Hader, Dr. Mark Hamilton, Dr. Zelma Kiss

Nursing: Laina McAusland (UofC research), Cheri Gray, Kara Hallett, Colleen Harris, Brittany Hoffarth-Palchewich, Karen Hunka, Pia Lawrence, Jackie Martini, Raj Parmar, Valerie Sherwood, Sandy Stephen, Meredith Wild

Pain Physicians: Dr. Ted Findlay, Dr. John Pereira, Dr. Kelly Shinkaruk (Chronic Pain Centre) 

Physical Medicine and Rehabilitation: Dr. Rebecca Charbonneau, Dr. Dan McGowan 

Physiotherapy: Philis Heffner 

Psychiatry: Dr. Aaron Mackie, Dr. Brienne McLane, Dr. Raj Ramasubbu 

Psychology: Dr. Arlene Cox, Dr. Angela Haffenden

Respirology/Thoracic surgery: Dr. Sean McFadden, Dr. Karen Rimmer

(Updated December 2019)