September 18, 2026

@michaelokun

What resonated with me from this morning’s DBS Think Tank session on advanced imaging in neuromodulation was how imaging is rapidly evolving from a picture of anatomy into a roadmap of the circuits we want to understand and modulate. Nico Dosenbach took us into the somato-cognitive action network (SCAN) and the provocative idea that Parkinson’s may involve abnormal SCAN-subcortical connectivity, with successful therapies including DBS appearing to normalize aspects of this network. Erik Middlebrooks showed how sequences such as FGATIR can reveal structures and boundaries that conventional MRI may miss, moving us toward direct visualization and increasingly individualized DBS targeting. Mallory Hacker then tackled one of our field’s most difficult questions: as we explore DBS earlier in Parkinson’s disease, can sophisticated imaging and connectivity analyses help us separate symptomatic neuromodulation from true disease modification, and perhaps identify the fiber pathways associated with progression? What struck me is that the next generation of imaging may help us move beyond asking where is the electrode? Should we be asking what network did we engage, how did we change it, and did we alter the trajectory of disease?