# Targeted activation of select neural pathways by deep brain stimulation in patients with Parkinson's disease

> **NIH NIH K23** · EMORY UNIVERSITY · 2020 · $191,381

## Abstract

PROJECT SUMMARY/ABSTRACT
Dr. Miocinovic is establishing herself as a physician-scientist conducting patient-centered research in the field
of movement disorder electrophysiology and deep brain stimulation (DBS). This K23 will provide Dr. Miocinovic
with the support necessary to accomplish the following goals: (1) to gain knowledge in the use of advanced
imaging techniques to visualize neural pathways in the human brain; (2) to become proficient in acquisition and
analysis of intraoperative electrophysiology recordings; (3) to learn skills necessary to translate novel research
methods into clinical practice; and (4) to develop an independent research career. To achieve these goals, Dr.
Miocinovic has assembled a mentoring team consisting of a primary mentor: Dr. Philip Starr (a functional
neurosurgeon with expertise in human movement disorders electrophysiology); two co-mentors: Dr. Jill Ostrem
(a movement disorders neurologist with expertise in DBS management and clinical trials), and Dr. Pratik
Mukherjee (a neuroradiologist with expertise in MRI tractography), and two collaborators: Dr. Cameron
McIntyre (a biomedical engineer with expertise in computational modeling of DBS), and Dr. Alastair Martin (a
medical physicist with expertise in MRI technology). The goal of the proposed research project is to understand
which neural pathways are directly activated by DBS applied to the subthalamic area of patients with
Parkinson's disease. This will be accomplished by measuring stimulation evoked potentials using a high-
resolution subdural cortical recording strip, visualizing specific fiber pathways using MRI tractography and
estimating the spread of stimulation effects using 3-dimensional biophysical computational models. The main
focus is on the cortico-subthalamic hyperdirect pathway because of its potential importance in DBS therapeutic
mechanism and accessibility for direct physiologic recordings. Aim 1: Dr. Miocinovic will determine how DBS
parameter adjustments affect activation of the hyperdirect pathway using intraoperative cortical recordings.
Aim 2: Dr. Miocinovic will validate the use of tractography-based, patient-specific computational models to
predict preferential activation of the hyperdirect pathway. The ultimate goal of this project is to apply
convergent methods to identify a target for subthalamic DBS in Parkinson's disease that achieves optimal
therapeutic benefit. The proposed research is innovative because it utilizes electrocorticography to validate the
use of tractography-based, patient-specific models for DBS parameter selection. Results from the proposed
research will make significant contributions to our understanding of DBS mechanisms and advance methods
for patient-specific DBS parameter selection, thus moving away from the trial-and-error approach currently
used in clinical practice. Dr. Miocinovic's K23 training will prepare her to compete for R01 funding and translate
these novel methods into clinical practice.

## Key facts

- **NIH application ID:** 9990870
- **Project number:** 5K23NS097576-05
- **Recipient organization:** EMORY UNIVERSITY
- **Principal Investigator:** Svjetlana Miocinovic
- **Activity code:** K23 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2020
- **Award amount:** $191,381
- **Award type:** 5
- **Project period:** 2016-09-30 → 2022-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/9990870

## Citation

> US National Institutes of Health, RePORTER application 9990870, Targeted activation of select neural pathways by deep brain stimulation in patients with Parkinson's disease (5K23NS097576-05). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/9990870. Licensed CC0.

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