Michael Fox
@foxmdphd
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Neurologist and Neuroscientist focused on brain imaging and brain stimulation @harvardmed @brighamWomens
Boston, MA
Joined July 2018
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23 years ago, I received my rejection letter from
@harvardmed
. Today, I was promoted to full
#professor
@harvardmed
@Harvard
. Grateful to my mentors, colleagues, and students
@WUSTLmed
@harvardmed
@Brain_Circuits
that made this possible!
#Persistence
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20 years ago I was an electrical engineer who decided to go to medical school. Today, I started building a “Center for Brain Circuit Therapeutics”
@BrighamWomens
@MassGenBrigham
@BWHNeurology
@BWHNeurosurgery
@harvardmed
@harvardbrainsci
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Focal brain damage can lead to loss of
#addiction
- can we use these cases to identify therapeutic targets? New paper by
@JJoutsa
out in
@NatureMedicine
suggests we can.
@shansiddiqi
@MoussawiKhaled
@boeslab
@NIDAnews
@NIMHgov
.
#OpenAccess
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The seminal 1995 paper by
@restingstate
was rejected by 4 journals and took over 2 years to publish. Now cited over 11k times!
#persistance
. Great talk by the father of resting state functional connectivity at
#connectbrain2024
.
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144 MRI studies of addiction identified different brain regions - but could they all be seeing the same brain circuit? New paper by
@StubbsyJ
@Brain_Circuits
says YES - one circuit across different substances of abuse.
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Can a focal lesion to a specific brain circuit cause a schizophrenia-like syndrome? Great talk by
@PinesAndrew
at BWH neuroscience day says YES w hub in the hippocampus.
@shansiddiqi
@Brain_Circuits
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A mysterious brain network may underlie many psychiatric disorders | Live Science
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FMRI is tool, and like any tool it can be used well or used poorly. It’s valuable to stop and ask whether we’re using it well and rise to the challenge of using it better.
Thought-provoking editorial in BRAIN:
“functional fMRI is ~30 years old and continues to divert many young talented researchers...”
And response by
@fMRI_today
and
@vdcalhoun
:
h/t
@dngman
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Possible solution to the reproducibility crisis in neuroimaging? New paper out today in Brain. Network localization of heterogeneous neuroimaging findings
@russpoldrack
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Humbled to be the first incumbent of a chair honoring Raymond D. Adams. He felt neurology should be “inclusive of all diseases in which there was a lesion in the nervous system, or … a lesion would be found by the development of refined methods.”
@Brain_Circuits
So many congratulations to "Captain"
@foxmdphd
, recipient of the new Raymond D. Adams, MD Distinguished Chair in Neurology!!
It's an honor and a pleasure to be part of this amazing "crew" at
@Brain_Circuits
and
@BWHNeurology
.
#science
#medicine
#neurology
@harvardmed
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Did you know some patients w epilepsy can develop Parkinson's - and then their seizures can disappear? New work by
@fredschaper_
@Brain_Circuits
unravels this mystery using brain lesions that cause these two disorders
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Honored to see our team's work recognized with the inaugural International Brain Stimulation Early Career Award. Thank you to my mentors, students, and collaborators who made this work possible.
Congratulations to Michael Fox
@foxmdphd
@harvardmed
@BrighamWomens
awarded the 2021 Int.
#BrainStimulation
Early Career Award. Join him in-person
#BrainStimConf
, discount reg deadline 10 Sept.
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The word "causal" is so controversial I often avoid it in papers / grants, but it's critical for translating brain mapping research into treatments. Honored to partner with
@shansiddiqi
@josef_parvizi
@KordingLab
to explore this concept in
@NatRevNeurosci
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Privledged to have worked with so many great coauthors whose ideas are making an impact.
@foxmdphd
has been identified as the world’s most influential researchers by Clarivate™. Each year, they identify the world’s most influential researchers based on who has been cited most frequently by their peers over the last decade.
To learn more:
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Why do some
#DBS
electrodes cause cognitive decline in
#parkinsons
? Maybe because they’re connected to the
#memory
circuit. New paper out in
@Brain1878
relevant for avoiding or even reversing this side effect.
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When will rTMS expand from psychiatric to neurological indications? Could be closer than we think.
In a randomized, double-blind, phase II trial, Koch et al. find that 24 weeks of repetitive transcranial magnetic stimulation of the precuneus slows down cognitive and functional decline in patients with Alzheimer’s disease.
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Where should we target brain stimulation to treat
#addiction
? New review led by
@SoleimaniGhazal
@EkhtiariHamed
show many different lines of evidence converging on the frontopolar cortex.
@Brain_Circuits
@APAPubJournals
Converging evidence supports potential for treatment optimization among individuals with substance use disorders through brain stimulation targeting the frontopolar cortex
@foxmdphd
@brainstimgrl
@mpwpaulus
@MaromBikson
@SoleimaniGhazal
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Patients with
#Alzheimer
’s have areas of brain atrophy, but could they have areas of brain growth? New paper in
@ANA_journals
says yes w implications for resilience. Collaboration
@Brain_Circuits
@BWHNeurology
@VUMChealth
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How can some
#blind
patients still see? Welcome
@IsaiahNeurology
to Twitter and check out his paper on
#blindsight
, one of the most interesting mysteries in
#neurology
with implications for
#consciousness
.
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Honored to have my lab’s work recognized by this award from
@SOBP
. Psychiatrists, neurologists, neurosurgeons, radiologists, and many others are working together to help solve psychiatric problems. Thanks
@NIMHgov
@NIMHDirector
for the support!
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Very cool "video tour through brain circuits" by
@andreashorn_
, incoming Director of
#DBS
research at the Center for Brain Circuit Therapeutics
@BrighamWomens
@MassGenBrigham
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Thrilled to announce that
@andreashorn_
, THE world expert in connectomic
#DBS
, will be joining the Center for Brain Circuit Therapeutics
@BrighamWomens
@harvardmed
. He will lead DBS collaborations with
@RMarkRichardson
@MGHNeurosurg
@MGHNeurology
and across
@MassGenBrigham
.
We are excited to announce the addition of Andreas Horn, M.D., Ph.D.
@andreashorn_
, a world expert in using brain circuit imaging, as new faculty member to the Center for Brain Circuit Therapeutics at Brigham and Women’s Hospital
@foxmdphd
. Read more
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Cool to see “lesion network map” make it into the official medical glossary
@NEJM
. Coined by
@boeslab
in 2015, used by
@JJoutsa
@DrDrXanderLi
@DrAlfonsoFasano
@danieltcorp
@shansiddiqi
@neuromichael
@andreashorn_
@IsaiahNeurology
others
@Brain_Circuits
Lesion network map: A brain atlas in which lesions in different locations that cause the same symptoms are mapped.
Explore more terms from the NEJM Illustrated Glossary:
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Great article by
@grace_huckins
in
@WIRED
on network neuroscience and the wiring diagram of the human brain. Fantastic quotes by
@DaniSBassett
@spornslab
@petra_vertes
@esfinn
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Huge congrats to
@shansiddiqi
winner of the 2022 Klerman Award from the Brain & Behavior Research Foundation
@BrighamWomens
@MassGenBrigham
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Excited to have lesion network mapping featured in todays issue of
@NEJM
. Thanks to all that have contributed to this field!
Mapping Symptoms to Brain Networks with the Human Connectome | NEJM
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After a collaboration spanning three continents, 5 datasets, and over 450 lesions, we found a brain circuit causally linked to depression.
@andreashorn_
@MauCorbetta
@cookeD13
@JJoutsa
@shansiddiqi
@neuromichaelphd
@LSoussand
@Vosstacular
@NIMHDirector
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Absolutely thrilled to announce that
@RolstonJohn
, a world expert in
#DBS
,
#MRIgFUS
, and
#epilepsy
will be joining
@BWHNeurosurgery
and the Center for Brain Circuit Therapeutics to lead new initiatives in "network neurosurgery".
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Awesome study of 2950 lesion locations and post stroke cognition! Lesion location matters, but it’s a network not a single location, and these heat maps are a major step towards identifying this network.
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Tour de force grand rounds
@BWHNeurology
by
@andreashorn_
on connectomic
#DBS
. Amazing to see convergent circuits across different DBS targets, diseases, and symptoms.
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Major news. Respect for the courage of this group of editors.
All NeuroImage and NeuroImage:Reports editors have resigned over the high publication fee, and are starting a new non-profit journal
This comes with great regret, and a huge amount of thought and discussion- please read announcement to get more details.
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Where is the optimal TMS target for depression? Brilliant keynote by the pioneer of neuro-navigated TMS
@PBFitzgerald
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What do patients experience after you turn on DBS for depression? Great keynote by
@HelenMaybergMD
summarized in one slide, drawn by a DBS depression patient who was a graphic artist!
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Does human
#memory
map to a brain circuit?
@neuromichaelphd
used lesions causing amnesia to find out.
#openaccess
article out today
@nresearchnews
.
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Very proud of this team and this commentary. So fun to work with diverse experts across
#TMS
,
#DBS
, brain imaging,
#neurology
, and
#psychiatry
to think about paths for clinical translation. I particularly like the analogies by
@shansiddiqi
.
Commentary out by
@shansiddiqi
w/ Joe Taylor &
@foxmdphd
on how we could bring human brain connectomics into clinical practice in psychiatry (imho directly translatable to neurology).
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I hadn’t pictured
@b_hollunder
and
@andreashorn_
in a scuba diving outfits until now :) Great piece of cover art illustrating exploration of
@Brain_Circuits
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Packed house at
#DBS2022
to hear
@andreashorn_
discuss his vision for the future of DBS.
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Excited as
@shansiddiqi
kicks off the brain stimulation subspecialty submit
#BRASSS
@Brain_Circuits
@harvardmed
@BrighamWomens
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“Models predicted patient outcomes with high accuracy within the trial in which the model was developed but performed no better than chance when applied out-of-sample.”
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“A single patient noticed relief in her Parkinson disease (PD) symptoms after taking amantadine for a flu infection, and this observation sparked an interest”. One of the MANY examples of the critical role of serendipitous observations in patients for Tx.
What drug was the blockbuster for Parkinson's before L-Dopa? It was the 1960’s and it was a colorless crystalline solution. The drug was used to treat flu, but one man Robert Schwab, a Harvard neurologist, followed a single person's experience and it evolved into a new path for a
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Where is language in the brain? Great keynote by
@StephForkel
redefining how we answer this question using brain connectivity.
#connectbrain2024
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Excited to see the Center for Brain Circuit Therapeutics website go live
@BrighamWomens
. Offering
#DBS
,
#TMS
, and
#FUS
treatments, all under one roof. Already 10 additional faculty members to add to the next update:
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We need more case reports of incidental brain lesions that improve patient’s symptoms. These cases can be extremely valuable in identifying therapeutic targets!
Really cool case: a person with schizophrenia whose hallucinations and delusions largely RESOLVED after a right frontal stroke: Consistent with our observation of hyperengagement of rDLPFC prediction error and delusions
@CogNPsychiatry
FTW
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@LucinaUddin
Thanks, but no feeling of revenge. Good people get rejected from good things every day, and find great opportunity. Rejection is a challenge and a chance for learning. Rejections are just temporary obstacles waiting to be overcome.
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We need more studies comparing different lesion mapping techniques, even if my favorite technique seems to perform poorly. Challenge accepted!
Salvalaggio et al. show that indirect atlas-based estimates of structural connectivity damage predict behavioural deficits after stroke as accurately as lesion information, whereas indirect estimates of functional disconnection do not.
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Exciting results from
@DoctorAliRezai
@ASSFNeurosurg
using focused ultrasound to modulate the nucleus accumbens - big and long lasting effects in 8 patients w opiate addiction.
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Amazing history of functional
#Neuroimaging
from Marc Raichle. Includes contributions from people long ago that are sometimes forgotten. Important reading for anyone using
#pet
or
#fmri
.
In our latest
#OHBM
Oral History series
@nilsmuhlert
speaks to Marcus Raichle! Find out about his journey into neuroimaging (and trips up the Himalayas) and his work on the 'default mode' of the brain's resting state of activity.
READ --->
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Nothing better than catching up with old friends and colleagues. Thank you
@WUSTLmed
@ndosenbach
@gordonneuro
@ChadMSylvester
Josh, Avi, and Tim.
In today’s
#GrandRounds
, Michael Fox, MD, PhD (
@foxmdphd
), with
@harvardmed
@brighamWomens
and
#WashUMSTP
alumni, discussed using
#lesions
,
#DBS
and
#TMS
to map brain connectivity networks in their relation to neuropsychiatric symptoms and for neuromodulation targets.
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A privilege of being an Associate Editor for
@ANA_journals
was seeing different groups converge on similar answers. Honored to write this editorial re converging DBS targets for tremor with the great Günther Deuschl.
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Our paper using brain lesions to identify a human
#depression
circuit is freely available for the next 50 days! Thanks
@SOBP
#openaccess
.
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I thought that connectomic DBS would see its first clear success in movement disorders, but it looks like it may be in psychiatry. Replication of an
#OCD
therapeutic target identified by
@andreashorn_
et al. by
@HMayberg
@martijn_figee
et al.
The latest from
@smithandrewh
,
@allisoncwaters
,
@hmayberg
,
@martijn_figee
, & Drs. Choi, Aloysi, and Kopell of
@MountSinaiDBS
& the Nash Family Center for Advanced Circuit Therapeutics in
@brainstimj
: Replicable effects of deep brain stimulation for
#OCD
. 👏
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Want to know what’s coming next for brain implants? Keep track of what’s happening in cardiology. Technology developed for the heart can often be repurposed for the brain.
A new Review Article highlights recent developments in cardiac implantable electronic devices, with an emphasis on pacemakers, newer modes of pacing, and implantable cardioverter–defibrillators. Read the full article:
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Every Parkinson’s neurologist uses mental tasks to bring out resting tremor. Love research focused on why: “both the bottom-up arousal system and a top-down cognitive control network amplify tremor”
@basbloem
Dirkx et al. show that both the ascending arousal system and a cognitive control network amplify tremor when patients with
#Parkinson
's disease experience cognitive load. Reducing noradrenergic activity or cognitive demands could help reduce tremor.
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New work by
@DrDrXanderLi
out in
@Brain1878
: Lesion network mapping predicts post-stroke behavioural deficits and improves localization
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Gotta love that new robot smell! Launching a robot-administered
#TMS
service at the Center for Brain Circuit Therapeutics
@BrighamWomens
. Minimizes contact during
#COVID19
@MagVentureUK
@axilumrobotics
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Super proud of this landmark paper by
@fredschaper3
on lesion network mapping of
#epilepsy
, but equally proud of this great 29 tweet description of his interesting findings!
Thrilled to share our work on mapping a human brain network for lesion-related
#epilepsy
, now published in
@JAMANeuro
, which all started because of the following question:
- Why do brain lesions to some locations cause epilepsy and others don’t?🧠⚡️
A🧵
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Hoping to help spread the word about deep brain stimulation (
#DBS
) as a treatment option for patients with
#parkinson
's disease. Informational video by
@MassGenBrigham
@BWHNeurology
@BWHNeurosurgery
via
@YouTube
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Announcing a new article format for Annals of Neurology. Send me your best
#lesion
cases, unusual
#MRI
scans,
#DBS
electrode locations, etc.
@TheNewANA1
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Pleased to share our paper out today in
@jclinicalinvest
: Mapping mania based on focal brain damage. . Implications for
#DBS
and
#TMS
.
@DrDrXanderLi
@nsanar
@LSoussand
@joey_k_hsu
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Great TMS work by
@brainstimgrl
. “iTBS (1200) and cTBS (3600) are, respectively, the most effective doses for decreasing and increasing cortical excitability.” This is the OPPOSITE of what many expect based on standard 600 pulse doses.
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Nice paper by
@cashmachine15
using coordinate network mapping to study depression. Prior findings fail to reproduce if looking for a brain region, but do reproduce if looking for a brain network.
A recent meta-analysis of 99 MRI studies in depression found no convergence in anatomical loci, raising serious concerns around reproducibility.
Here we show that these divergent regions delineate robust distributed brain networks in depression...
🧵1/n
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Great talk by
@brainstimgrl
showing converging evidence from
@EkhtiariHamed
@shansiddiqi
@JJoutsa
implicating the frontopolar cortex as a brain stimulation target for
#addiction
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8
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Does neuronal activity and connectivity drive brain tumor growth?
@humsav
kicking off neuroscience day
@BWHNeurology
@BWHNeurosurgery
@Brain_Circuits
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“If we build a better human connectome, can you use it to improve
#DBS
” asked
@nastasiayendiki
. Thanks to a new $23mil
#NIH
grant and collaborations with
@Haber_Lab
@andreashorn_
@Brain_Circuits
we’re about to find out!
Using advanced imaging technologies, researchers been able to identify some of the major highways in the brain that signals travel along. But the side roads—those smaller connections that can’t be visualized yet—remain a mystery.
@nastasiayendiki
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Huge congrats to
@andreashorn_
, now Assoc Prof
@harvardmed
and recipient of an R01 grant from
@NIMHgov
- both in the same week! Even bigger congrats for staying focused on what matters most: “winning an Oscar”.
6 months after moving to the US and I already won an Oscar* – I love this country!
*less importantly: also got appointed Assoc. Prof
@harvardmed
and received an R01 from
@NIMHgov
🙏
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Excited by our new fleeces
@Brain_Circuits
. Thanks
@WilliamDrew_1
for designing, organizing, and ordering!
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Off to
#BrainStimConf
in Charleston. Excited for great talks and posters from our new Center for Brain Circuit Therapeutics
@BrighamWomens
@harvardmed
:
@shansiddiqi
@andreashorn_
@EndEpilepsyNow
Joe Taylor
@jli_neuro
and many others!
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Honored that my lab's work on
#brain
circuits is one of ten finalists for the
@Nature
Research Award for Driving Global Impact. Humbled to part of this amazing group.
@BIDMChealth
@harvardmed
@Tencentglobal
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Great talk by
@neuromichael
@Brain_Circuits
connecting
@harvardmed
and
@HarvardDivinity
to identify human brain circuits underlying spirituality
#sobp2023
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10
55
Great talk by
@saratheriver
@ohbm
on her toolbox (brainstat) for generating single subject atrophy maps, along w tons of other cool functions.
@Brain_Circuits
@BorisBernhardt
#ohbm2023
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Andres Lozano predicting the future of DBS, including depression, Alzheimer’s, and even cosmetic neurosurgery / enhancement.
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“Level A evidence was reached for: high-frequency rTMS of the primary motor cortex for neuropathic pain; HF-rTMS of the left dorsolateral prefrontal cortex for depression; and low-frequency rTMS of contralesional M1 for hand motor recovery in the post-acute stage of stroke.”
Evidence-based guidelines on the therapeutic use of repetitive transcranial magnetic stimulation (rTMS): An update (2014–2018)
#TMSresearch
#TMS
#neuromodulation
#TMStherapy
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Awesome idea and an amazing resource! I hope this database of publicly available PET data continues to grow. Can’t wait to see how these receptor maps line up w lesion networks. Thanks
@INM7_ISN
and team.
Interested in bridging the gap between MR-findings and molecular data?
Check out this open-source tool by
@DukartJuergen
for relating structural and functional data to PET-based neurotransmitter distributions
Paper:
Software:
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Can we use lesions causing
#pain
to find better neuromodulation targets for pain? New paper by Na Young Kim, Joe Taylor,
@JJoutsa
et al. in
@ANA_journals
suggests yes.
Network Effects of Brain Lesions Causing Central Poststroke Pain
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Inspired by the great conversations, collaborations, friendships, and ideas that emerged from our leadership retreat
@Brain_Circuits
.
@andreashorn_
@shansiddiqi
@IsaiahNeurology
@fredschaper3
@RolstonJohn
@neuromichael
@Yogi_Spoke
@DrDrXanderLi
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Is it time to shift our therapeutic focus away from the seizure onset zone in
#epilepsy
and towards brain circuits? Amazing symposium on brain circuits in epilepsy organized by
@fredschaper3
@RolstonJohn
@Brain_Circuits
@BWHNeurology
@BWHNeurosurgery
Interested in epilepsy, brain circuits, or brain stimulation? Join today’s symposium
@Brain_Circuits
in person or online and hear from an outstanding line up of speakers!
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Had a great time writing this review on connectomic
#DBS
with
@andreashorn_
. So many great studies have now shown that brain connectivity can help us understand and improve DBS - it’s hard to keep up!
Very happy to have been working with
@foxmdphd
on a review about connectomic deep brain stimulation now out in
@NeuroImage_EiC
.
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This book will be a great resource for an emerging field. It is also a testament to the skill of
@andreashorn_
in organizing and collaborating across so many wonderful people working in
#dbs
. Honored to have been able to contribute.
Very excited to announce our book on Connectomic Deep Brain Stimulation is out for preorder here:
w/
@foxmdphd
@AndreaKhn1
@HarithAkram
@richardfbetzel
@jmacshine
@ThijsDhollander
@neumann_wj
@jclauneuro
@shansiddiqi
@DembekTill
@eduardo_alho
@BaldermannJC
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Would love to see whether this tractography atlas improves our ability to map or predict lesion induced language deficits.
Sonoda et al. present a 6D tractography atlas which reveals the dynamics, strength, and direction specificity of neural communication between language areas via the white matter tracts.
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Me too. Not sure I’ve watched myself give a talk before. I look forward to answering questions in the chat room during the talk.
Stoked for
@foxmdphd
's
#OHBM2020
keynote talk this afternoon (5 PM EST)! Causal
#brain
mapping is essential for translational research in brain circuit therapeutics & precision
#medicine
.
#science
#neuroscience
#neurology
#psychiatry
#OHBM
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Great keynote by
@DesmondOathes
emphasizing the need for causal testing of circuit hypotheses.
#sobp2023
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@DrAlfonsoFasano
@FNDSociety
@FndPortal
@FNDHope
I look forward to the day when we can replace the term “functional” with “disorder of brain circuit A” and the term “organic” with “disorder of brain circuit B”. Even better if we can offer treatments targeting each circuit!
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Great talk by
@cashmachine15
showing that proximity of TMS sites to personalized connectivity based targets correlates w outcomes in depression, memory, and addiction!
2
7
48
Great talk by
@shansiddiqi
@Brain_Circuits
using causal mapping to identify and test a TMS target for
#anxiety
.
0
8
49
Headed to Portugal for the EUROPEAN CONFERENCE ON BRAIN STIMULATION IN MENTAL HEALTH. Excited to see colleagues and showcase new work by
@Brain_Circuits
@shansiddiqi
@andreashorn_
and more!
3
7
49
Why do anti-amyloid antibodies get rid of amyloid but have such a small effect on symptoms? Great talk by
@MH_DoFI_QST
proposing network effects as the missing link.
6
13
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Strongest evidence to date of M1 TMS for pain. “Our results support the clinical relevance of M1-rTMS, but not of DLPFC-rTMS, for peripheral neuropathic pain with an excellent safety profile.”
Attal et al. present the results of a randomized double-blind sham-controlled trial of neuronavigated rTMS in 149 patients with peripheral neuropathic pain.
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3
48
Great collaboration on human brain lesions causing
#hallucinations
including
@PhilCorlett1
@joey_k_hsu
@nsanar
@dtalmasov
@LSoussand
@alvaropleone
@JJoutsa
and many others.
0
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Love testing the fMRI results against electrophysiological mapping. However begs the question of what stimulating these regions does do if it doesn’t cause movements.
@josef_parvizi
?
Roux et al. () reported an M1 region where stimulation never produced movement across N=100 patients. We mapped their successful stimulations to the cortical surface. They cleanly avoided the middle inter-effector.
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This commentary reflects the goals of the Center for Brain Circuit Therapeutics: Smart people with different backgrounds / training debating how to best translate research advances into better treatments. Thanks
@shansiddiqi
, Joe Taylor,
@andreashorn_
Our commentary “Bringing human brain connectomics to clinical practice in psychiatry” by
@shansiddiqi
&
@foxmdphd
is now online, a sharable link w/ free access is here:
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46
What would you like to watch while getting
#TMS
for
#depression
? Excited by our updates to the TMS rooms
@BrighamWomens
that also allow for socially distanced video check ins with physicians.
3
5
47
Huge congratulations to Ryan Darby of
@VanderbiltU
@VUMChealth
, winner of the 2020 Geschwind award from
@AANMember
. Amazing work on lesion network mapping of
#delusions
,
#criminality
,
#freewill
. Honored to have worked with him!
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Thanks again
@MGHMartinos
for the invitation: Recent talk is now freely available online for anyone who may be interested: BrainMap: Causal Mapping of Symptoms onto Human Brain Circuits
@Brain_Circuits
via
@YouTube
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