BOSTON – Aaron D. Boes, MD, PhD, Clinical Neuroscience Fellow in the Berenson-Allen Center for Noninvasive Brain Stimulation at Beth Israel Deaconess Medical Center (BIDMC) has received the 2016 S. Weir Mitchell Award from the American Academy of Neurology (AAN) at a ceremony held during the AAN annual meeting in Vancouver. This prestigious honor recognizes a junior investigator based on a manuscript likely to make a significant contribution to the field of neurology.
“I am honored to receive this award from the American Academy of Neurology and inspired to be part of an extraordinary community of researchers working to better understand the brain’s complex circuitry,” Boes said.
Boes’s research explores the network effects of brain lesions, as well as how the brain maintains consciousness and what happens in cases of coma or vegetative states. “We are investigating what regions of the brainstem are most critical to consciousness,” he said. “Knowing the anatomy of this system offers great potential for the development of targeted therapeutic stimulation strategies to improve recovery from coma and other devastating disorders of consciousness.”
In his new research, which has not yet been published, Boes first used brain network imaging to identify and map brain networks. “We identified 12 patients who became comatose following a focal brainstem injury and then mapped the location of the injury relative to 24 other patients with brainstem injury that did not cause coma,” he explained. The results showed that injury to a small area in the pons is predictive of coma. “We were excited to discover that this single tiny area is critical to consciousness. When it is damaged, almost every patient became comatose.”
Boes and his coauthors next used data from the brain “connectome” – a database of the brain’s complex wiring system in healthy adults – to identify the network of brain regions connected to this coma-specific brainstem site in order to gain insights into how this specific area may enable the maintenance of consciousness. Finally, the investigators examined functional MRIs of 45 patients in a coma or vegetative state; they discovered that activity in this novel brain network was selectively disrupted in these patients.
“By knowing the intricacy of the brain’s network connections, clinicians can pinpoint regions that may respond to brain stimulation techniques,” said coauthor Michael D. Fox, MD, PhD, a key mentor to Boes and the 2014 recipient of the S. Weir Mitchell Award from the AAN. “Dr. Boes’s work has identified a specific area of the brain that seems to be critical for maintaining consciousness and has shown that, when this small area is damaged, affected patients become comatose, almost without exception.” Fox is Associate Director of the Deep Brain Stimulation Program and Associate Director of the Berenson-Allen Center for Noninvasive Brain Stimulation at BIDMC.
Alvaro Pascual-Leone, MD, PhD, also a mentor to Boes and a study coauthor, added, “The field of brain stimulation has been rapidly advancing, with effective treatments now available for disorders as diverse as major depression and Parkinson’s disease. This paper may help identify brain stimulation targets for the treatment of coma.” Pascual-Leone is Chief of the Division of Cognitive Neurology and Director of the Berenson-Allen Center for Noninvasive Brain Stimulation at BIDMC.
“Dr. Boes is to be congratulated on a very innovative and illuminating approach to understanding the origin of human consciousness,” said Clifford Saper, MD, PhD, Chair of the Department of Neurology at BIDMC and James Jackson Putnam Professor of Neurology at Harvard Medical School, also a study coauthor. “The Weir Mitchell award is named for one of the first neurologists in the United States, and a founder of the American Neurological Association. Only one is given out each year for the entire country, and many previous recipients have become leaders in the field.”
Boes earned his medical degree and PhD in neuroscience, as well as his undergraduate degree in integrative physiology and exercise science, from the University of Iowa. He completed his residency in pediatrics at Rady Children’s Hospital and his residency in pediatric neurology at Massachusetts General Hospital.
About Beth Israel Deaconess Medical Center
Beth Israel Deaconess Medical Center is a patient care, teaching and research affiliate of Harvard Medical School and consistently ranks as a national leader among independent hospitals in National Institutes of Health funding.
BIDMC is in the community with Beth Israel Deaconess Hospital-Milton, Beth Israel Deaconess Hospital-Needham, Beth Israel Deaconess Hospital-Plymouth, Anna Jaques Hospital, Cambridge Health Alliance, Lawrence General Hospital, Signature Healthcare, Beth Israel Deaconess HealthCare, Community Care Alliance and Atrius Health. BIDMC is also clinically affiliated with the Joslin Diabetes Center and Hebrew Rehabilitation Center and is a research partner of Dana-Farber/Harvard Cancer Center and the Jackson Laboratory. BIDMC is the official hospital of the Boston Red Sox. For more information, visit www.bidmc.org.