Norman M Spivak- MD/PhD Student at University of California, Los Angeles
Norman M Spivak
- MD/PhD Student at University of California, Los Angeles
About
58
Publications
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Introduction
Norman Spivak is an MD/PhD student at the UCLA DGSOM. His clinical interests include epilepsy and traumatic brain injury, and his research focus is on neuroimaging and neuromodulation.
Skills and Expertise
Current institution
Additional affiliations
April 2018 - July 2021
July 2018 - August 2021
Education
October 2014 - March 2018
Publications
Publications (58)
Non-invasive LIFUP (Low Intensity Focused Ultrasound Pulsation) neuromodulation provides a unique approach to both investigating and treating the brain. This work describes a well-calibrated, simple-to-use ultrasound stimulation system for neuromodulation studies. It provides a single element 650 kHz transducer design and a straightforward control...
Anxiety Disorders are prevalent and often chronic, recurrent conditions that reduce quality of life. The first-line treatments, such as serotonin reuptake inhibitors and cognitive behavioral therapy, leave a significant proportion of patients symptomatic. As psychiatry moves toward targeted circuit-based treatments, there is a need for a theory tha...
Over the last 30 years, there has been a growing trend in clinical trials towards assessing novel interventions not only against the benchmark of statistical significance, but also with respect to whether they lead to clinically meaningful changes for patients. In the context of Disorders of Consciousness (DOC), despite a growing landscape of exper...
Objective:
Transcranial Focused Ultrasound (tFUS) is a promising new potential neuromodulation tool. However, the safety of tFUS neuromodulation has not yet been assessed adequately. Patients with refractory temporal lobe epilepsy electing to undergo an anterior temporal lobe resection present a unique opportunity to evaluate the safety and effica...
Background: The gut–brain axis, significantly influenced by the gut microbiome, is a growing focus in mental health research. This study aimed to investigate gut microbiome differences between anxious and non-anxious participants. Methods: A convenience sample of 119 participants consisted of 56 participants with self-assessed low to zero levels of...
Background
Low-intensity transcranial focused ultrasound (tFUS) is a brain stimulation approach that holds promise for the treatment of brain-based disorders. Studies in humans have shown that tFUS can successfully modulate perfusion in focal sonication targets, including the amygdala; however, limited research has explored how tFUS impacts large-s...
Transcranial Focused Ultrasound Stimulation (tFUS) is a new, rapidly growing field related to the study and treatment of brain circuits. Establishing safety cutoffs for focused ultrasound is crucial for non-ablative neurological ultrasound experiments. In addition to potential focal heating, there is concern about temperature elevation at the skin...
Essential tremor (ET) is a prevalent movement disorder characterized by action tremors, predominantly affecting the upper limbs. While various pharmacological and non-pharmacological interventions have shown efficacy in managing ET, the therapeutic role of repetitive transcranial magnetic stimulation (rTMS) remains uncertain. This systematic review...
Background
Low-intensity transcranial focused ultrasound (tFUS) is a brain stimulation approach that holds immense promise for the treatment of brain-based disorders. Several studies in humans have shown that tFUS can successfully modulate perfusion in focal sonication targets including the amygdala; however, limited research has explored how tFUS...
Background
The amygdala is highly implicated in an array of psychiatric disorders but is not accessible using currently available noninvasive neuromodulatory techniques. Low-intensity transcranial focused ultrasound (TFUS) is a neuromodulatory technique that has the capability of reaching subcortical regions noninvasively.
Methods
We studied healt...
Over the past 30 years, there have been significant advances in the understanding of the mechanisms associated with loss and recovery of consciousness following severe brain injury. This work has provided a strong grounding for the development of novel restorative therapeutic interventions. Although all interventions are aimed at modulating and the...
Background. Over the past thirty years, there have been significant advances in the understanding of the mechanisms associated with loss and recovery of consciousness following severe brain injury. This work has provided a strong grounding for the development of novel restorative therapeutic interventions. While all interventions are aimed at modul...
Over the last 30 years, there has been a growing trend in clinical trials towards assessing novel interventions not only against the benchmark of statistical significance, but also with respect to whether they lead to clinically meaningful changes for patients. In the context of Disorders of Consciousness (DOC), despite a growing landscape of exper...
Background
Treatments aimed at hastening recovery from disorders of consciousness (DOC; e.g., coma, the vegetative state) have lagged behind a rapidly advancing science of these conditions. In part, this is due to the difficulty in selectively targeting the many deep regions of the brain known to be key for recovery from DOC. The (re)emergence of l...
Background
Low intensity, transcranial focused ultrasound (tFUS) is a re-emerging brain stimulation technique with the unique capability of reaching deep brain structures non-invasively.
Objective/Hypothesis
We sought to demonstrate that tFUS can selectively and accurately target and modulate deep brain structures in humans important for emotional...
Initial studies suggested that the fluctuations in the quantity, variety, and composition of the gut microbiota can significantly affect disease processes. This change in the gut microbiota causing negative health benefits was coined dysbiosis. Initial research focused on gastrointestinal illnesses. However, the gut microbiome was found to affect m...
Disclosure Statement The authors have nothing to disclose.
Overview of low-intensity focused ultrasound technology and mechanism. The pilot study on the potential treatment of anxiety disorders using low-intensity focused ultrasound technology is summarized.
Transcranial focused ultrasound sonication (tFUS) is an emerging neuromodulation technique with the potential to target deep brain regions non-invasively1,2. Precise targeting of subcortical regions is only currently accessible through invasive surgical interventions, posing high risks and costs3, ultimately restricting the applicatory potentials o...
Two service members were diagnosed with PTSD due to military trauma exposure. One presented with the classical manifestation; the other presented with the dissociative subtype. A statistical map revealed anterior localization of insula connectivity in the classical PTSD patient and posterior localization in the dissociative PTSD patient. These diff...
The promotion of recovery in patients who have entered a disorder of consciousness (DOC; e.g., coma or vegetative states) following severe brain injury remains an enduring medical challenge despite an ever-growing scientific understanding of these conditions. Indeed, recent work has consistently implicated altered cortical modulation by deep brain...
Focused ultrasound is a novel brain stimulation modality that combines the noninvasiveness of repetitive transcranial magnetic stimulation and the precision of deep brain stimulation. In this review, the authors examine low-intensity focused ultrasound for brain mapping and neuromodulation. They also discuss high-intensity focused ultrasound, which...
An ever-growing population experiences a wide range of psychopathologies, and there is now more than ever a need for clear differential diagnoses between disorders. Furthering this need is the fact that many psychological, psychiatric, and neurological disorders have overlapping features. Functional neuroimaging has been shown to differentiate not...
(Appeared originally in Brain Stimulation 2020; 13:1805-1812) Reprinted with permission from Elsevier.
This article summarizes the field of focused ultrasound for use in neuromodulation and discusses different ways of targeting, delivering, and validating focused ultrasound. A discussion is focused on parameter space and different ongoing theories of ultrasonic neuromodulation. Current and future applications of the technique are discussed.
Electroencephalography (EEG), easily deployed at the bedside, is an attractive modality for deriving quantitative biomarkers of prognosis and differential diagnosis in severe brain injury and disorders of consciousness (DOC). Prior work by Schiff has identified four dynamic regimes of progressive recovery of consciousness defined by the presence or...
While electroencephalogram (EEG) burst-suppression is often induced therapeutically using sedatives in the intensive care unit (ICU), there is hitherto no evidence with respect to its association to outcome in moderate-to-severe neurological patients. We examined the relationship between sedation-induced burst-suppression (SIBS) and outcome at hosp...
Background
To date, there are limited therapeutic options for the treatment or symptomatic relief of degenerative dementia [1]. There has been growing interest in the class of medications known as tyrosine kinase inhibitors, such as bosutinib, as a therapeutic intervention for dementia [2]. Ongoing clinical and preclinical trials also suggest focus...
Background:
This study sought to validate the clinical utility of multimodal magnetic resonance imaging (MRI) techniques in the assessment of neurodegenerative disorders. We intended to demonstrate that advanced neuroimaging techniques commonly used in research can effectively be employed in clinical practice to accurately differentiate heathy agi...
The study investigated the effects of focused ultrasound on human brain tissue to assess intensities at which focused ultrasound might cause irreversible structural cell damage. FUS does not appear to cause significant heating or cavitation to brain tissue when Ispta remains below 25 W/cm2. However, as the tissue was fixed immediately post-sonicati...
Deep brain nuclei are integral components of large-scale circuits mediating important cognitive and sensorimotor functions. However, because they fall outside the domain of conventional non-invasive neuromodulatory techniques, their study has been primarily based on neuropsychological models, limiting the ability to fully characterize their role an...
Background: Transcranial focused ultrasound (tFUS) is a noninvasive brain stimulation method that may modulate deep brain structures. This study investigates whether sonication of the right anterior thal-amus would modulate thermal pain thresholds in healthy individuals.
Methods: We enrolled 19 healthy individuals in this three-visit, double-blind...
Deep brain nuclei are integral components of large-scale circuits mediating important cognitive and sensorimotor functions. However, because they fall outside the domain of conventional non-invasive neuromodulatory techniques, their study has been primarily based on neuropsychological models, limiting the ability to fully characterize their role an...
Low-intensity transcranial focused ultrasound sonication (tFUS) selectively increases regional cerebral perfusion in deeper brain structures METHODS DESIGN A randomized, double-blind, within-subject crossover study was conducted to investigate whether tFUS can selectively increase regional blood perfusion in the amygdala (AG) or the entorhinal cort...
A 29-year-old woman presented with head and neck dystonia, as well as functional seizures. The patient was an active military service member with a history of combat-related trauma. Resting blood oxygen level dependent (BOLD) functional MRI (fMRI) scans of the brain demonstrated an increased anterior cingulate component of the salience network and...
Objective: Low-Intensity Focused Ultrasound Pulsations (LIFUP) is a promising new potential neuromodulation tool. However, the safety of LIFUP neuromodulation has not yet been adequately assessed. Patients with refractory temporal lobe epilepsy electing to undergo an anterior temporal lobe resection present a unique opportunity to evaluate the safe...
Background
Low Intensity Focused Ultrasound Pulsation (LIFUP) is a noninvasive brain stimulation method that may modulate deep brain structures using ultrasonic waves. Presently there are limited studies in humans rigorously assessing behavioral effects following LIFUP sonication of deep brain nuclei. As an initial test, we investigated whether son...
Introduction: In multiple animal models of ischemic stroke, cerebellar fastigial nucleus stimulation (FNS) via implanted electrode has been shown to exert strong neuroprotective and collateral enhancement effects. Translational studies of FNS have been precluded due to the invasive nature of direct electrical stimulation. Recently, low-intensity fo...
