P. Justin Rossi

NewYork–Presbyterian Hospital

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Co-Authors

Michael S. Okun

University of Florida

Aysegul Gunduz

University of Florida

Kelly D. Foote

University of Florida

Daniel Martinez‐Ramirez

Tecnológico de Monterrey

Enrico Opri

University of Michigan–Ann Arbor

Rene Molina

University of Florida

James Giordano

Georgetown University Medical Center

Jonathan B. Shute

University of Florida

Jack W. Judy

University of Florida

Darin D. Dougherty

Massachusetts General Hospital

Cooperative Institutions

Queen's University Belfast

University of Zurich

University of Florida

University Hospital Bonn

Charité - Universitätsmedizin Berlin

Neurological Surgery

Universidade de São Paulo

Rutgers, The State University of New Jersey

University of California, San Francisco

Trinity College Dublin

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Scheduled, intermittent stimulation of the thalamus reduces tics in Tourette syndrome

Parkinsonism & Related Disorders (2016)

P. Justin Rossi Enrico Opri Jonathan B. Shute Rene Molina Dawn Bowers

Thalamic stimulator

10.1016/j.parkreldis.2016.05.033

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Citations (27)

The Subthalamic Nucleus, Limbic Function, and Impulse Control

Neuropsychology Review (2015)

P. Justin Rossi Aysegul Gunduz Michael S. Okun

Subthalamic Nucleus

Impulse control

Impulse control disorder

Limbic system

10.1007/s11065-015-9306-9

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Citations (46)

Proceedings of the Second Annual Deep Brain Stimulation Think Tank: What's in the Pipeline

International Journal of Neuroscience (2014)

Aysegul Gunduz Hokuto Morita P. Justin Rossi William L. Allen Ron L. Alterman

The proceedings of the 2nd Annual Deep Brain Stimulation Think Tank summarize the most contemporary clinical, electrophysiological, and computational work on DBS for the treatment of neurological and neuropsychiatric disease and represent the insights of a unique multidisciplinary ensemble of expert neurologists, neurosurgeons, neuropsychologists, psychiatrists, scientists, engineers and members of industry. Presentations and discussions covered a broad range of topics, including advocacy for DBS, improving clinical outcomes, innovations in computational models of DBS, understanding of the neurophysiology of Parkinson's disease (PD) and Tourette syndrome (TS) and evolving sensor and device technologies.

Neurologic disease

Neurophysiology

10.3109/00207454.2014.999268

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Citations (16)

Report of a patient undergoing chronic responsive deep brain stimulation for Tourette syndrome: proof of concept

Journal of neurosurgery (2017)

Rene Molina Michael S. Okun Jonathan B. Shute Enrico Opri P. Justin Rossi

Deep brain stimulation (DBS) has emerged as a promising intervention for the treatment of select movement and neuropsychiatric disorders. Current DBS therapies deliver electrical stimulation continuously and are not designed to adapt to a patient’s symptoms. Continuous DBS can lead to rapid battery depletion, which necessitates frequent surgery for battery replacement. Next-generation neurostimulation devices can monitor neural signals from implanted DBS leads, where stimulation can be delivered responsively, moving the field of neuromodulation away from continuous paradigms. To this end, the authors designed and chronically implemented a responsive stimulation paradigm in a patient with medically refractory Tourette syndrome. The patient underwent implantation of a responsive neurostimulator, which is capable of responsive DBS, with bilateral leads in the centromedian-parafascicular (Cm-Pf) region of the thalamus. A spectral feature in the 5- to 15-Hz band was identified as the control signal. Clinical data collected prior to and after 12 months of responsive therapy revealed improvements from baseline scores in both Modified Rush Tic Rating Scale and Yale Global Tic Severity Scale scores (64% and 48% improvement, respectively). The effectiveness of responsive stimulation (p = 0.16) was statistically identical to that of scheduled duty cycle stimulation (p = 0.33; 2-sided Wilcoxon unpaired rank-sum t-test). Overall, responsive stimulation resulted in a 63.3% improvement in the neurostimulator’s projected mean battery life. Herein, to their knowledge, the authors present the first proof of concept for responsive stimulation in a patient with Tourette syndrome.

Neuromodulation

Neurostimulation

Occipital nerve stimulation

Subthalamic Nucleus

10.3171/2017.6.jns17626

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Citations (86)

Chasing Tics in the Human Brain: Development of Open, Scheduled and Closed Loop Responsive Approaches to Deep Brain Stimulation for Tourette Syndrome

Journal of Clinical Neurology (2015)

Leonardo Almeida Daniel Martinez‐Ramirez P. Justin Rossi Zhongxing Peng Aysegul Gunduz

Tourette syndrome is a childhood-onset disorder characterized by a combination of motor and vocal tics, often associated with psychiatric comorbidities including attention deficit and hyperactivity disorder and obsessive-compulsive disorder. Despite an onset early in life, half of patients may present symptoms in adulthood, with variable degrees of severity. In select cases, the syndrome may lead to significant physical and social impairment, and a worrisome risk for self injury. Evolving research has provided evidence supporting the idea that the pathophysiology of Tourette syndrome is directly related to a disrupted circuit involving the cortex and subcortical structures, including the basal ganglia, nucleus accumbens, and the amygdala. There has also been a notion that a dysfunctional group of neurons in the putamen contributes to an abnormal facilitation of competing motor responses in basal ganglia structures ultimately underpinning the generation of tics. Surgical therapies for Tourette syndrome have been reserved for a small group of patients not responding to behavioral and pharmacological therapies, and these therapies have been directed at modulating the underlying pathophysiology. Lesion therapy as well as deep brain stimulation has been observed to suppress tics in at least some of these cases. In this article, we will review the clinical aspects of Tourette syndrome, as well as the evolution of surgical approaches and we will discuss the evidence and clinical responses to deep brain stimulation in various brain targets. We will also discuss ongoing research and future directions as well as approaches for open, scheduled and closed loop feedback-driven electrical stimulation for the treatment of Tourette syndrome.

Putamen

10.3988/jcn.2015.11.2.122

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Citations (39)

Translational Imperatives in Deep Brain Stimulation Research: Addressing Neuroethical Issues of Consequences and Continuity of Clinical Care

AJOB Neuroscience (2014)

P. Justin Rossi Michael S. Okun James Giordano

As Johansson, Garwicz, Kanje, Schouenborg, and Halldenius (2014) note, the recent success of deep brain stimulation (DBS) in treating certain conditions has prompted further investigation of the vi...

Brain stimulation

Translational Research

Clinical Practice

10.1080/21507740.2013.863248

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Citations (15)

Proceedings of the Third Annual Deep Brain Stimulation Think Tank: A Review of Emerging Issues and Technologies

Frontiers in Neuroscience (2016)

P. Justin Rossi Aysegul Gunduz Jack W. Judy Linda Wilson André G. Machado

The proceedings of the 3rd Annual Deep Brain Stimulation Think Tank summarize the most contemporary clinical, electrophysiological, imaging, and computational work on DBS for the treatment of neurological and neuropsychiatric disease. Significant innovations of the past year are emphasized. The Think Tank's contributors represent a unique multidisciplinary ensemble of expert neurologists, neurosurgeons, neuropsychologists, psychiatrists, scientists, engineers, and members of industry. Presentations and discussions covered a broad range of topics, including policy and advocacy considerations for the future of DBS, connectomic approaches to DBS targeting, developments in electrophysiology and related strides toward responsive DBS systems, and recent developments in sensor and device technologies.

Neurologic disease

10.3389/fnins.2016.00119

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Citations (38)

Assessing Organizational Capacity for Educational Research and Development in an Academic Institution.

Educational Researcher (1976)

P. Justin Rossi

Academic institution

Institution

Educational institution

Organisation climate

Capacity development

Organizational Effectiveness

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Citations (0)

Organization of central nervous system dopaminergic pathways.

PubMed (1986)

Alberto Albanese M. C. Altavista P. Justin Rossi

In the present paper the organization of central nervous system dopaminergic pathways is concisely reviewed. Six dopaminergic systems are described: the midbrain efferent system, the tubero-infundibular, the diencephalo-spinal, the incerto-hypothalamic, the periventricular, and the retinal systems. Anatomo-functional correlations can be presently outlined for most dopamine-containing networks, and anatomo-clinical studies indicate that they are globally affected in patients suffering from Parkinson's disease.

Dopaminergic pathways

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Citations (54)

P940: Simultaneous rTMS and piano playing improve hand dexterity and induce changes in cortical excitability in a professional pianist affected by multiple sclerosis: a case report

Clinical Neurophysiology (2014)

Arturo Nuara Laura Straffi Francesca Spagnolo P. Justin Rossi Giacomo P. Comi

10.1016/s1388-2457(14)50977-7

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Citations (0)