The future of non-invasive brain neuromodulation
10^th February 2023 - Strasbourg, France, EU

Chair: Dr Dormegny-Jeanjean & Dr Jack Foucher, University of Strasbourg.
Organization: Dr Dormegny-Jeanjean (CEMNIS, Strasbourg, France), PhDr Pascale Piguet (Neurex, Basel, Switzerland), Mmes Domitille Boudard et Stéphanie Kliepfel (Neurex, University of Strasbourg, France).
Program (pdf), see Neurex. (or workshop) - organized with STEP.

The spirit of the workshop

Non-invasive brain stimulation (NIBS) techniques have demonstrated their efficacy in treating psychiatric disorders. They also showed some limitations, such as those intrinsic to the one-size-fits-all targeting and stimulation methods. If we want NIBS to go beyond their own limits, we will have to take into consideration the heterogeneity of neuropsychiatric disorders in terms of targets and response to different stimulation protocols and technics, i.e., to enter into the era of precision / personalized medicine. This question will be addressed along different axes.

1 - It seems necessary to go beyond the atheoretical and consensual diagnostic categories, derived from traditional classifications, and identify the pathophysiological mechanisms involved in the different subtypes of psychiatric disorders. Deep phenotyping and machine learning are potential tools for this paradigm shift.

2 - This comes with the development of new brain imaging acquisitions and analyses tools that could help the identification individualized specific targets for neuromodulation. Progress in individual functional imaging will be discussed (e.g., BOLD-connectivity, ASL-perfusion MRI, analysis of the brain dynamics).

3 - Personalized stimulation necessarily implies that the identified targets may actually be reached and modulated in the right way. Innovations in precision (e.g., neuronavigated robotized positioning, deep-stimulation techniques like focused ultrasound) and the on-line monitoring of the therapeutic effect (e.g., pre/post-EEG, online NIRS) are likely to change our future practice.

By bringing together experts in this rapidly evolving field, our ambition is to promote fruitful discussions and identify complementarities. We believe that if each contribution would already be an indisputable progress, the most decisive advances for our patients will come from their combination. .

Session 1: Focalized Ultra-Sound (FUS)

1. FUS neuromodulation, a French experience. Drs Marion Plaze and David Attali (St Anne hospital - GHU and Physics for Medicine Lab, Paris, France, UE)
   Lecture & discussion (30 min), slideshow (pdf)
2. The vision of epidural focused ultrasound neuromodulation for treatment-resistant depression. PhD Máté Döbrössy (Medical Centre Department of Stereotactic and Functional Neurosurgery, University Freiburg, Germany, EU) and PhDr Tiago Costa (Microelectronics Department, TU Delft Faculty EEMCS, Netherlands, UE)
   Lecture & discussion (39 min), slideshow (pdf)
3. FUS and indirect neuromodulation. PhD Jonathan Vappou (Robotics, Data Science and Healthcare Technologies team, ICube Laboratory, Strasbourg, France, UE)
   Not available

Session 2: Personalizing neuromodulation n°1

1. Imagery guided, robotized, rTMS in treatment resistant depression. Dr. Ludovic Dormegny-Jeanjean (center for non-invasive brain stimulation, University hospital, Strasbourg, France, UE)
   Lecture & discussion (17 min), slideshow (pdf)
2. The use of biomarkers in progressive periodic catatonia. Dr. Clément de Billy (center for non-invasive brain stimulation, University hospital, Strasbourg, France, UE)
   Lecture & discussion (15 min), slideshow (pdf)
3. Keynote lecture
   Metaplasticity and rTMS. PhD John Rothwell (UCL Queen Square Institute of Neurology, London, UK)
   Lecture & discussion (50 min), slideshow (pdf)

Session 3: Meet the engineers

1. Demonstration of robotic assistance for neuromodulation. Dr Michel Berg (Axilum Robotics)
   (no video available - see website)
2. In-ear EEG on the go to refine brain stimulation. PhD Michel Le Van Quyen (INSERM U1146 - SU - CNRS 7371, Paris, France, UE)
   Lecture & discussion (38 min), slideshow (pdf)
3. Measuring conductance with MRI to improve TMS electric current induction modelling. PhD Paulo Loureiro de Sousa (Integrative Multimodal Imaging for Health, ICube Laboratory, Strasbourg, France, UE)
   Lecture & discussion (29 min), slideshow (pdf)

Session 4: Personalizing neuromodulation n°2

1. Stimulating the brain or stimulating brain state? PhD. Demian Battaglia (Institut de Neurosciences des Systèmes, Aix-Marseille Université, Marseille & Institut d'Études Avancés de l'Université de Strasbourg, Strasbourg, France, EU)
   Lecture & discussion (45 min), slideshow (pdf)
2. System based clinical phenotyping: who, where and how should we stimulate? Dr Jack Foucher (center for non-invasive brain stimulation, University hospital, Strasbourg, France, UE)
   Lecture & discussion (35 min), slideshow (pdf)
3. SAINT protocol and accelerated rTMS. PhD Eleanor Cole (Magnus Medical, Palo Alto, California, USA)
   Lecture & discussion (28 min)

Psychomotricity: next move in neuropsychiatry
22^nd-24^th June 2022 - Strasbourg, France, EU

Chair: Dr Jack Foucher & Prof Fabrice Berna, University of Strasbourg.
Organization: MDr Clément de Billy (CEMNIS, Strasbourg, France), PhDr Pascale Piguet (Neurex, Basel, Switzerland), Mme Domitille Boudard (Neurex, University of Strasbourg, France).
Program (pdf), see Neurex.

The spirit of the workshop

Almost 150 years after its invention by Karl Kahlbaum, catatonia has re-emerged as an independent entity with the official endorsement of the ICD-11 this year. However, it probably neither refers to the same patients, nor to the same phenomena. “Catatonia” and “psychomotricity” are polysemous; they refer to different concepts depending on the paradigmatic framework, e.g. neuropsychiatry, psychological psychiatry, dimensional research domain criteria…
This workshop aims at clarifying some of the major research programs and paradigmatic frameworks in which these phenomena are studied. It will mix philosophy of science, methods, and results, but also clinical symptoms, signs, and examination procedures.
Experts and participants will give their opinion on the same video to objectify some differences in interpretation and definition – participants are welcome to bring questions and clinical material to be discussed. The goal is not to decide who is right or wrong, but to build bridges between different views which might ultimately permit to confront them through crucial experimental series.
This dialectic approach promotes cross-fertilization and ambition to speed-up the discovery process.

Session 1: Philosophy of/in science

1. From the philosophy of scientific models to the philosophy in scientific models. Prof. Cédric Brun (Institute of neurodegenrative diseases, UMR 5392 CNRS,University of Bordeaux, France, UE)
   Lecture (60 min), Discussion (11 min)
2. Crucial experimental series. Prof. Jack Foucher (center for non-invasive brain stimulation, University hospital, Strasbourg, France, UE)
   Lecture (34 min), Discussion (22 min)

Session 2: Research programs in psychomotricity n°1

1. Multimodal brain imaging of catatonia and other psychomotorabnormalities in psychiatric disorders. Prof. Dusan Hirjak (Central Institute for Mental Health, Mannheim, Germany, UE)
   Lecture (43 min), Discussion (18 min)
2. When motor behavior disturbs social interaction:The impact of psychomotor abnormalities on nonverbal communication. Prof. Sebastian Walther (Psychiatry and Psychotherapy, University Hospital of Bern, Switzerland)
   Lecture (55 min), Discussion (24 min)
3. Round table: minimal clinical explorations for data sharing
   Discussion (raw data - 62 min)

Session 3: Clinical signs and video presentations

1. Gegenhalten & psychomotor paratonia - a proposal. Prof. Jack Foucher and Dr Clément de Billy
   Discussion (raw data - 92 min)
2. Discussing videos cases of catatonia. Prof Dusan Hirjak (no recording)
3. Videos on parakinesias - discussion around a neglected sign. Prof Jack Foucher and Dr Clément de Billy (no recording)

Session 4: Research programs in psychomotricity n°2

1. Psychomotor behavior in the nosology of psychotic disorders. Prof. Stephan Heckers (University Medical Center, Nashville, Tennessee, USA)
   Lecture (47 min), Discussion (30 min)
2. Progress in the biomarkers in diagnosis and treatment of catatonia. Prof. Fabrice Berna (Psychiatric University Hospital, Strasbourg, France, UE)
   Lecture (37 min), Discussion (9 min)
3. Round table (postponed)

Session 5: WKL clinical training, expert level - video cases in French (no recording)

Various presentations made in the context of a seminar, national or international congress:

• 2021 (28th of October) "Past and future of catatonia and psychomotor phenomena -  a neuropsychiatric perspective" (65 min). 29° Congreso, Asociación Argentina de Psiquiatras. Chair: Prof. Marcelo Cetkovich-Bakmas, Buenos Aires (Argentina)  J Foucher. 
• 2021 (24th of Septembre) "A historical analysis of the catatonia and psychomotricity concepts" (17 min): European Collaboration on movement and Sensorimotor-Psychomotor functioning in schizophrenia and other psychoses. European Neuropsychopharmacology. 2022; 56(3):60-73 (Suppl).
• 2018 (26th of March) "A double dissociation between two psychotic phenotypes: Periodic catatonia and cataphasia" (6 min): Commentary on the article published in Progress in Neuropsychopharmacology and Biological Psychiatry (citation, article).
• 2017 (27th of Novembre) "Looking at differences rather than commonalities: Reconsidering the Wernicke-Kleist-Leonhard School" (31 min). Neurex symposium "The beginning and end of schizophrenia: does neuropsychiatry terminate the era?" Freiburg - Germany.