Brain Stimulation Subspecialty Summit (BraSSS)
(by invitation only)
Dates: September 14-15, 2023
Please RSVP by July 30, as space is limited
Zoom: https://partners.zoom.us/j/88578413276
Please plan to join us for a dinner reception at the Harvard Faculty Club on September 14 at 7:00 pm.
Host Institution: Brigham & Women’s Hospital, Boston, MA
Hotel info:
1. If you’d like to find the closest hotel, the Longwood hotel is currently booking for $220 as of 8/16/23 (click here)
2. Also nearby is the Hilton Garden Inn, which is a bit nicer than the Longwood. We have a group discount, but it’s actually currently cheaper to book without the discount (click here)
3. The Sheraton is about 10 min away by taxi or 20 minutes by train, and is about $250 + tax as of 8/16/23 (click here)
4. Our group rate at the Eliot Hotel is now fully booked
Discussion leaders:
Shan Siddiqi, MD, Brigham & Women’s Hospital, Harvard Medical School
Nolan Williams, MD, Stanford University School of Medicine
Goals:
We aim for this summit to:
- Establish an intellectual framework along which this subspecialty can launch and grow.
- Create a network of experts that can guide the subspecialty forward as it evolves.
- Yield a consensus statement on specific debates in this field (see below)
Provisional agenda (subject to change)
Thursday, September 14, 2023
| Time | Topic | Presenters |
| Morning session: Introduction Zinner Boardroom By invitation only | ||
| 8:00 – 8:45 | Open breakfast, coffee | |
| 9:00 | Opening comments | Michael Fox, MD, PhD |
| 9:05 | Welcome | Shan Siddiqi, MD and Nolan Williams, MD |
| 9:15 | The questions up for debate | |
| 9:45 | Update from the Clinical TMS Society subspecialty debate | Joshua Brown, MD, PhD |
| 10:00 | Insurance considerations | Sam Huber, MD |
| 10:15 | Training considerations: experience from Mt Sinai | Andrew Smith, MD, PhD |
| 10:30 | Motivation, history, and structure of the MGH Interventional Neuropsychiatry and Neuromodulation fellowship | Joan Camprodon, MD, PhD |
| 10:40 | Open discussion – pros/cons of subspecialty | Joseph Taylor, MD, PhD |
| 11:00 | Lunch break | |
Afternoon session: State of the Science Bornstein Amphitheater 10-minute lectures from attendees Open to all, not only invitees | ||
| 12:00 – 1:00 | Stimulating brain circuits from different vantage points: Recent data suggest that TMS, DBS, and lesions can treat the same symptom by modulating different parts of the same brain circuit. However, different tools are used by different specialists with minimal cross-talk. There may be ways for these tools to complement each other; for instance, TMS may be used to noninvasively probe a circuit to identify the right DBS/FUS targets and the right candidate patients before surgery. In this session, speakers will present ideas for using these techniques to complement one another. | Shan Siddiqi (neuropsychiatrist) Brigham & Women’s Hospital Darin Dougherty (psychiatrist/interventional) Massachusetts General Hospital Nick Trapp (neuropsychiatrist) University of Iowa Binith Cheeran (neurologist/movement) Abbott Laboratories Martijn Figee (psychiatrist/interventional) Mount Sinai School of Medicine John Rolston (neurosurgeon) Brigham & Women’s Hospital |
| 1:00 – 2:00 | Complementary, competing, and converging tools: There are different approaches to identifying treatment targets and parameters beyond those that are currently in use. Some of these approaches are complementary and others are competing, but in many cases these different approaches may converge on a common answer. In this session, participants will present their latest unpublished data on new treatment targets. We anticipate learning that different teams are converging on common answers. These convergent solutions will reveal the path forward for treatment development. | Michael Sugrue (neurosurgeon) Omniscient Neurotech, Cingulum Health, and Barrow Neurological Institute Mark Eldaief (neurologist/cognitive) Massachusetts General Hospital Desmond Oathes (clinical psychologist) University of Pennsylvania Damiaan Denys (psychiatrist/interventional) University of Amsterdam Noreen Bukhari (neurologist/movement) Duke University Nolan Williams (neurologist/psychiatrist) Stanford University |
| 2:00 – 2:30 | Break | |
| 2:30 – 3:30 | Exploring the parameter space and monitoring outcomes: There are very few brain stimulation protocols that are currently in clinical practice, and they are often oversimplified as “excitatory” versus “inhibitory.” Several components can be further optimized, such as treatment parameters (e.g. frequency, intensity), state dependence, and synergistic pharmacotherapy. There are emerging data for how each of these components may be optimized and their outcomes may be monitored. In this session, participants will share their latest data on optimizing the parameter space, again aiming to identify convergence. | Moushin Shafi (neurologist/epilepsy) Beth Israel Deaconess Medical Center Alik Widge (psychiatrist/interventional) University of Minnesota Joshua Brown (psychiatrist/neurologist) McLean Hospital Andrew Leuchter (psychiatrist/TMS-EEG) University of California – Los Angeles Conor Liston (psychiatrist/basic science) Weill-Cornell Medical College Alex McGirr (psychiatrist/TMS) University of Calgary |
| 3:30 – 4:30 | Clinical standards and off-label treatment: Many clinicians are using unorthodox brain stimulation protocols. Some of these protocols are designed to maximize revenue rather than maximizing risk-benefit to the patient. On the other hand, off-label protocols may be appropriate when there is early-stage evidence that the benefits outweigh the risks and the patient has not responded to conventional treatment. There are no clear guidelines for what constitutes an acceptable amount of evidence for applying off-label treatment. In this session, participants will discuss different thresholds for what constitutes “acceptable” evidence for clinical implementation. | Brian Kopell (neurosurgeon) Mount Sinai School of Medicine Leo Chen (psychiatrist/TMS) Monash University Mohammed Ahmed (neuropsychiatrist) Kaizen Brain Center David Carreon (psychiatrist/TMS) Acacia Mental Health Rebecca Allen (neuropsychiatrist) Seattle Neuropsychiatric Treatment Center Mustafa Husain (psychiatrist/ECT) University of Texas – Southwestern |
| 4:30 – 5:00 | Break | |
| 5:00 – 6:00 | Other topics Additional topics that do not fall into the above categories, but have a high probability of translating to brain stimulation clinical practice in the near future. | Volker Coenen (neurosurgeon) Freiberg University Scott Aaronson (psychiatrist/interventional) Sheppard-Pratt Hospital/University of Maryland Catherine Chu (neurologist/child) Massachusetts General Hospital Colleen Hanlon (clinical neuroscientist) BrainsWay Noah Philip (psychiatrist/interventional) Brown University/Providence VA Nicole Peterson (clinical neuroscientist) University of California – Los Angeles |
| …………………………………………………………………………………………………… | ||
| 7:00 – 10:00 | Dinner reception at the Harvard Faculty Club (Cambridge) Buffet dinner will be provided. Please inform us of any dietary restrictions. | |
Friday, September 15, 2023
On day 2, we will consider the topics below. Please feel free to submit additional topics for discussion. As it stands, we will dedicate two hours to each topic. Each topical session will be formatted as follows:
- 15-minute introduction to the different arguments on the topic, presented as a point-counterpoint by at least two different discussion leaders
- 45-minute open discussion
- 15-minute brainstorming session to narrow down a list of potential solutions/action items
- 15-minute voting session to establish a consensus and appoint a volunteer to write a consensus statement
| Time | Topic | Discussion leaders |
Topical debates Zinner Boardroom By invitation only | ||
| 9:00 – 10:30 | Nomenclature and scope: For the field to move forward together, we need to speak a common language. Many experts use different words to describe the same things, leading to confusion among non-experts. Perhaps most important is the name of the subspecialty itself (e.g. neuromodulation, noninvasive functional neurosurgery, image-guided psychiatry/neurology, interventional brain medicine). This could also include the names of different procedures and even the names or boundaries of specific brain regions.This session will focus primarily on standardizing the name of the subspecialty. By its nature, this discussion will also need to consider whether this subspecialty will be common across psychiatry, neurology, and neurosurgery. The session will conclude with a vote to establish a consensus nomenclature. | Joseph Taylor, MD, PhD Joshua Brown, MD, PhD |
| 10:30 – 11:00 | Break | |
| 11:00 – 12:30 | Board certification and fellowship training: Some experts believe that this subspecialty will quickly become complex enough to warrant its own board certification and fellowship training program. Others believe that the field has not yet reached this level of complexity, but may do so in the future. Yet others believe that this is an unnecessary restriction which will hinder the spread of this field. In this session, participants will be asked to debate these competing viewpoints. The session will conclude with a vote to establish a consensus regarding whether board certification is appropriate. | Barbara Schildkrout, MD |
| 12:30 – 1:30 | Lunch | ……………………………………………. |
| 1:30 – 3:00 | Training pathways: Currently, newcomers to TMS must resort to attending one of several competing 2-3 day courses, while newcomers to DBS must complete a disease-focused fellowship. Some experts believe that there is a need for training specific to brain stimulation across disorders, some believe that disorder-specific training is more appropriate, and some believe that it should be integrated into residency training. In this session, participants will propose and vote on different frameworks for training clinicians who are looking to enter this field. | Joan Camprodon, MD, PhD Andrew Smith, MD, PhD |
| 3:00 – 3:30 | Break | |
| 3:30 – 5:00 | Open discussion: Participants will be asked to share ideas and/or data that do not fall into the above categories, but still may be approaching clinical translation. This time slot may be replaced with other proposed ideas. | Shan Siddiqi, MD Nolan Williams, MD |