Think Neuro

In movement disorders such as Parkinson’s disease, essential tremor, and dystonia, normal function can be restored to the circuitry of the brain, resulting in significant improvement in function and quality of life. The goal of deep brain stimulation surgery is to modulate the activity of a specific brain region.

In DBS, thin electrodes are placed in the disruptive areas of the brain and small electrical pulses normalize or eliminate the irregular signals. DBS is the non-permanent suppression of overactivity in the autopilot structure of the brain called the basal ganglia.

Like a pacemaker for the brain, the battery (pulse generator) is implanted under the skin of the chest, and leads (wires) are tunneled under the skin via the deep part of the brain through a quarter-sized opening in the skull. The system is fully implanted under the skin, so there are no external wires or devices. The stimulator is fully programmable and therefore adjustable over time, as the disease changes. Patients can use a simple hand-held device to turn the DBS on or off, and adjust various other parameters if needed.

For people with hearing loss, properly-fitted hearing aids can be a miracle, restoring sounds of life that have been lost to aging or disease. But sometimes hearing aids aren’t enough, or a patient’s hearing deteriorates beyond the devices’ capabilities. Then, it’s time to consider cochlear implants—small electronic devices that go beyond hearing aids. They bypass damaged hair cells in the ear and send electronic signals straight to the auditory nerve. Dr. Rebecca Lewis is an audiologist who specializes in evaluating patients who might be eligible for cochlear implants. Until recently, doctors installed the devices only after people had lost almost all of their hearing. But because hearing is crucial to social connection, and social connection is key to staving off dementia, the bar for cochlear implants is coming down. Anyone who has tried a few sets of hearing aids and still can’t understand conversation should consider cochlear implants, Dr. Lewis says. Listen to this episode to learn some fascinating things about how our ears and nerves allow us to hear the world, and whether you or a family member should consider cochlear implants.

Alexander M. Solomon, MD, is a neuro-ophthalmologist and strabismus surgeon at Pacific Neuroscience Institute in Santa Monica and Torrance, CA. Dr. Solomon’s personal philosophy is that each patient is an individual and that diagnosis and optimal management of any disease is best carried out in conjunction with patient and family education, and understanding.
His skillset includes visual field analysis and optical coherence tomography interpretation, as well as advanced adult strabismus diagnosis and treatment including thyroid eye disease, cranial nerve palsies, and orbital disease.

Michelle Holmes, OD, is a full-scope optometrist at the Pacific Neuroscience Institute®. She sees patients at both the Eye, Ear and Skull Base Center as well as at the Brain Health Center. She is board certified and TLG licensed to treat and manage ocular disease. She prides herself in practicing evidence-based medicine with a genuine enthusiasm for human connection.

She earned her undergraduate degree in Molecular, Cellular, and Developmental biology from the University of Washington, Seattle. After her mother was diagnosed with a rare eye disease, she was inspired to pursue her Doctor of Optometry. She went on to complete her degree at the University of California, Berkeley. Her strong interest in ocular disease led her to successfully complete clinical externships at Omni Eye Services in the greater New York City area, the Southern Arizona VA Health Care System, and the Miami VA Hospital. She graduated with the distinction of Honors in Research and Clinical Science for her thesis on the efficacy of orthokeratology lenses for myopia control. This work was accepted for publication in Optometry and Vision Science (OVS), Journal of the American Academy of Optometry. Dr. Holmes is a current member of the American Optometric Association (AOA), the California Optometric Association (COA), and the Los Angeles County Optometric Association (LACOS).

Shanthi Gowrinathan, MD, is an accomplished inpatient and outpatient psychiatrist, specializing in both Women’s Psychiatry and Psycho-oncology (Cancer Psychiatry) who works collaboratively in the care of her patients.

Dr. Gowrinathan integrates her recommendations with the patient’s medical teams to ensure a whole person, interdisciplinary and cohesive treatment approach.

Gifted with the strong ability to empathetically connect with her patients quickly, Dr. Gowrinathan is proficient at diagnosing and treating psychiatric disease in the context of complex medical issues such as cancer diagnosis.