Dr. Mark George is Professor of Psychiatry, Radiology and Neurology at the Medical University of South Carolina in Charleston and a clinical neurologist and psychiatrist. George began his career doing brain imaging, identifying brain functions in patients with depression and other emotion problems. His work led to the development of brain stimulation methods and exploring their potential use to modify brain circuits to create effective treatments.
Q: Where does your work fit into the current landscape of neuroengineering?
Dr. Mark George: Although I’m not an engineer, I really respect them because all of the tools that I use are products developed by engineers. The main tool I employ is called transcranomagnetic stimulation, which is basically either wire or wire wrapped around a piece of iron, but there have been some advances in terms of how you place it on the brain, how you hold it, as well as to some of the capacitors that drive it. While that’s an area that doesn’t represent a lot of neuroengineering changes, I also do work with other technologies, vagus nerve stimulation, for instance, where we’re actually coming up with new ways of stimulating this nerve in the brain. Then, there is deep brain stimulation, where we really see an engineering impact because we’re continuing to make smaller wires that are able to focally send electricity just to very small parts of the brain. Finally, there is the engineering associated with closed loop, where the stimulation going into the brain is a function of something coming out of an individual’s brain. In effect, it’s responsive, thereby “closing the loop”, and that’s proven to be important in epilepsy treatments, as well as advancing other areas of brain stimulation.
Q: Why is it important to have a perspective of somebody who isn’t an engineer in this field?
Dr. Mark George: I’d have to say it is because engineers solve the physics of it, the actual development of a device, but you really have to then put that into the hands of clinicians and neuroscientists who understand the brain and who can use these tools in applications. Really successful products and teams involve collaborations between engineers and neuroscientists or clinicians. Ideally, this working together relationship comes together to advance neuroscience technology across the board.
Q: What are your primary applications? Is it for neuro rehabilitation, is it clinical, diagnostic?
Dr. Mark George: In fact, there’s not much in the area of diagnostics as of yet, other than brain imaging, which is not really all that helpful in addressing depression. Most of the work that I do is in the area of depression and treatment of depression. That said, we are also starting to work with stroke and some of the technologies have been deployed and shown to be helpful in stroke rehabilitation.
Q: If a student was interested in getting into this field, working in the same area of research that you are at the moment, what advice would you give them? What path should they follow?
Dr. Mark George: I would tell them that they need to be open-minded and able to get out of their comfort zone. As a student, seek out a team environment, where there are clinicians and neuroscientists, as well as some engineers working with you. In effect, you need a primary kind of engineering, neuroengineering mentor, but you also want to be in a place with access to patients and clinicians. So, if you’re choosing where to go and where to start, I would say it’s almost like planting seeds. There’s certain soil that’s more likely to be fertile and having a team that’s a reasonable size with the right elements is important early on. Later, as you make connections, you may be able to work somewhere on your own, through the internet, and collaborations you’ve already established. That said, when first starting out, it’s really good to rub elbows with a team that’s multidisciplinary.