Low Intensity Focused Ultrasound
Non-Invasive Headache Treatment
Post-traumatic headache (PTH) is the most commonly reported symptom following TBI, and is among the most persistent and disabling.
As PTH severely affects quality of life, and a substantial number of patients fail to respond to drug treatments, there is a need for more effective interventions. Neuromodulation has a localized effect on neural circuits with fewer systemic side effects than pharmacological interventions.
One of the latest forms of neuromodulation is low intensity focused ultrasound (LIFU). LIFU combines spatial precision with noninvasive application, and compared to other methods of neuromodulation, LIFU has a unique ability to directly modulate subcortical targets.
Non-Invasive Headache Treatment
The Adamson Lab is exploring the possibility that LIFU can be used to treat PTH in Veterans with TBI.
We aim to do this by using LIFU to enhance the effects of meditation, which other studies have can be an effective non-pharmaceutical headache treatment.
Potential future applications include LIFU of the amygdala for PTSD, and of the subgenual ACC for depression.
This treatment modality may eventually be useful for a variety of psychiatric and neurological conditions that are insufficiently treated with current technology.
Dr. John Coetzee obtained his B.A. in Psychology from UC Berkeley, where he worked in a sleep and psychopathology lab. He then worked in a depression lab at UCSF before entering a PhD program at UCLA, where he conducted research on the relationship between language and thought under the guidance of Dr. Martin Monti.
After completing his doctorate in Cognitive Neuroscience, he returned to the Bay Area where he currently is a Research Scientist with dual appointments at the Palo Alto VA in the lab of Dr. Maheen Adamson, where he is developing new treatments for traumatic brain injury, and the Stanford Brain Stimulation Lab, where he is developing new treatments for depression. In both labs, Dr. Coetzee’s focus is on developing treatments that are safe, highly effective, fast-acting, and long-lasting. His particular areas of interest are noninvasive neuromodulation and psychedelic therapy. Dr. Coetzee is involved in several active studies involving conditions such as posttraumatic headache, treatment-resistant depression, chronic pain, suicidal ideation, and obsessive-compulsive disorder.
Dr. Byung Chul Yoon (“Jason”) is a board-certified neuroradiologist and an assistant professor of neuroradiology at Stanford University School of Medicine and VA Palo Alto. He received a PhD in Physiology, Development, and Neuroscience from Cambridge University, UK, and an MD from Johns Hopkins School of Medicine. He completed a diagnostic radiology residency at Stanford and a neuroradiology fellowship at Massachusetts General Hospital/Harvard Medical School. He was a staff neuroradiologist at Massachusetts General Hospital before joining Stanford/VA Palo Alto.
Dr. Yoon has broad research interests and experiences in neuroradiology and neuroscience. His current interests include low-intensity focused ultrasound for neuromodulation, brain connectome, multimodal neuroimaging for dementia, and advanced ultrasound imaging for spine.
Headache Centers of Excellence
VAPAHCS is one of seven VA-designated Headache Centers of Excellence (HCoE) programs.
Outpatient programs include several headache clinics, including those dedicated to offering such newly FDA-approved treatments as calcitonin gene related peptide (CGRP) inhibitors and neuromodulatory devices, as well as injection and biofeedback clinics and virtual reality.
Research
The HCoE is heavily involved in the VA Whole Health Initiative, which focuses on utilizing complementary and integrative health and encouraging patient self-management.