About

Christopher R Butson is a Professor of Neurology and the Fixel Endowed Chair of Neurotherapeutics at the University of Florida. He received a B.S. in Mechanical Engineering from the University of Maryland, an M.S. in Electrical Engineering from George Washington University, and a Ph.D. in Biomedical Engineering from the University of Utah. His post-doctoral training was completed at the Cleveland Clinic, and he was a faculty member at the Medical College of Wisconsin from 2008 to 2014. From 2014 to 2020, he led a research laboratory in the Scientific Computing & Imaging (SCI) Institute and the Department of Biomedical Engineering at the University of Utah. Starting in 2021, he has been a faculty member at the University of Florida. His research focuses on neuromodulation, specifically therapeutic and diagnostic brain stimulation. He holds ten patents in this area, some of which were licensed to Intelect Medical, a spinoff company that was sold to Boston Scientific in 2011. He is also the CEO of a consulting company that specializes in neurostimulation devices and neuromodulation therapy. Dr. Butson is an active member of several professional societies, including the Society for Neuroscience, IEEE, the Engineering in Medicine & Biology Society, the International Parkinson and Movement Disorder Society, and the American Society for Engineering Education. His accomplishments include mentoring students, receiving awards for teaching and research funding, and contributing significantly to the field of neuromodulation.

Research topics

• Computer Science
• Medicine
• Psychology
• Neuroscience
• Artificial Intelligence
• Psychiatry
• Internal medicine
• Radiology

Selected publications

• A comparative study of video-based and electromyography-based detection of tics

  SSRN Electronic Journal · 2026-01-01

  preprintOpen access
  PublisherDOI

• Optimal Deep Brain Stimulation Locations for Gilles de la Tourette Syndrome

  medRxiv · 2026-02-23

  articleOpen access

  Background: Deep brain stimulation has emerged as an effective investigational treatment for select cases of severe Gilles de la Tourette Syndrome. Defining the optimal stimulation sites within different targets and the specific tic improvement network across targets will be important to guide neuromodulation therapies. Methods: This retrospective multi-center cohort study analyzed stimulation locations in patients who received bilateral deep brain stimulation for Gilles de la Tourette Syndrome across 12 centers world-wide. The brain targets included the thalamus (n=43), pallidum (n=56) and subthalamic nucleus (n=16). The median follow-up period was 6 months. Imaging data were processed using a dedicated pipeline and a recently introduced voxel-wise sweetspot mapping technique. Since tic response landscapes visually resembled streamline tract connections, we carried out extensive anatomical delineations of pallidothalamic and thalamostriatal fibers. This anatomical information was used to interpret sweetspot landscapes across the three target regions. Results: Tic response maps revealed three tic-response peaks in both thalamus and pallidum. Based on thalamic and pallidal response maps, outcomes in the subthalamic DBS cohort, stimulated between the two other targets, could be explained (R=0.58, p=0.019). Across the three targets, response maps followed the anatomical course of three bundles. Namely, specific subregions of the ansa lenticularis, the fasciculus lenticularis, and projections from the posterior intralaminar thalamic nuclei to the lentiform nucleus. Stimulation overlaps with these bundles explained 19% of the variance in tic improvement across the three targets. Response maps could explain variance in an independent test cohort (n=8, R=0.70, p=0.026). Response maps were also calculated for obsessive compulsive behavior, which revealed similarities to the tic response sites in pallidum but clearly distinct results and generally less efficacy in the thalamus. Conclusion: Our analyses identified tic response targets that followed the course of known structural projections interconnecting pallidum and thalamus.

  PublisherOA PDFDOI

• Stimulation of the Thalamus for Arousal Restoral in Temporal Lobe Epilepsy (START) Clinical Trial: Modulation of Natural Sleep and Focal Seizures

  medRxiv · 2025-09-21 · 1 citations

  preprintOpen access

  Abstract Thalamic stimulation has emerged as a promising neuromodulation target for treating disorders of consciousness. Impaired consciousness, a debilitating outcome in temporal lobe epilepsy (TLE) remains a central problem for patients whose seizures cannot be treated pharmacologically and cannot be stopped with conventional surgery or responsive hippocampal stimulation. Although prior studies suggest an essential role of the thalamic intralaminar central lateral (CL) nucleus in arousal and sleep, evidence for a direct effect of thalamic intralaminar stimulation on human arousal has been limited. To address these gaps, the START (stimulation of the thalamus for arousal restoral in TLE) clinical trial investigated the efficacy of bilateral CL thalamic stimulation to restore consciousness during human sleep and TLE seizures. Five patients with medically refractory mesial temporal lobe epilepsy were implanted with an investigational neurostimulator, the Medtronic Summit RC+S TM . Optimal CL stimulation parameters were obtained through individualized titration in slow wave sleep, evaluated through analysis of patient movement from video recordings and electrophysiology from simultaneously recorded scalp and hippocampal electroencephalography (EEG). We found that bilateral CL stimulation led to robust arousal from sleep characterized by increased body movements and decreased low frequency power (2-15 Hz) in both cortical and hippocampal EEG during 5 minute epochs of stimulation compared to baseline slow wave sleep. We evaluated impaired consciousness during seizures using verbal and non-verbal behavioral tests administered automatically by smartwatch, and found significant behavioral impairment in three of five patients during seizures with hippocampal stimulation. Administering CL stimulation in patients with impaired consciousness during TLE seizures showed significant improvement in behavioral outcomes in two of three patients, with one patient reaching their baseline performance comparable to non-seizure times. Overall, we found that stimulation of the thalamic CL in TLE patients increased arousal during both sleep and seizures. These findings demonstrate the potential of CL as a therapeutic target for mitigating impaired consciousness in TLE and can serve as a foundation for additional studies to test generalizability of CL stimulation effects on other disorders of consciousness.

  PublisherOA PDFDOI

• Identification of Brain Circuits that Mediate Improvements in Executive Function in Moderate to Severe Traumatic Brain Injury Patients Treated with Deep Brain Stimulation (DBS)

  Neurotherapeutics · 2025-07-01

  articleOpen accessSenior author

  With the exception of migraine therapeutics, there have been no novel drugs approved for pain in the last five years.One reason for this is the continued reduction in clinical success rates for pain drugs relative to novel drugs for other indications.Reasons most cited for these clinical failures include the following: poor predictive validity of preclinical pain models, significant heterogeneity in pain patient populations, lack of target engagement or patient selection biomarkers, large placebo effects in clinical trials and therapeutic index challenges.This ASENT symposium attempts to address these issues by highlighting emerging new therapeutics, innovative clinical trial design and new multi-modal approaches to pain biomarker development.These concepts will be discussed through three presentations and an interactive panel discussion focused on the pain therapeutic landscape of the future.

  PublisherOA PDFDOI

• A Multi-Symptom Circuit Architecture of Obsessive–Compulsive Disorder

  medRxiv · 2025-12-15

  articleOpen access

  Abstract Obsessive–compulsive disorder (OCD) manifests with diverse symptom constellations that likely arise from dysfunction in partially distinct neural circuits. Deep brain stimulation (DBS), paired with high-resolution connectomics, offers a unique window into these pathways in humans. Here, we analyzed clinical outcomes and stimulation sites from 77 treatment-refractory patients with OCD and 39 with Tourette’s syndrome (TS) exhibiting comorbid obsessive–compulsive behaviors (244 electrodes across 15 cohorts and eight targets). Engagement of the previously defined OCD response tract predicted global obsessive-compulsive symptom improvement across heterogeneous targets and diagnoses, spanning both OCD and TS. Beyond broad symptoms, obsessions, compulsions, anxiety, and depression mapped onto distinct yet overlapping subcircuits fragmenting the anterior limb of the internal capsule along a dorsoventral axis. This fine-scale architecture of OCD circuit dysfunction was reproducible across cross-validation schemes and patient subsets. Exploratory analyses identified additional subcircuits for cognitive control and flexibility. Global functional recovery was better explained by combined engagement of multiple symptom-specific rather than a single tract. Collectively, these findings illustrate how invasive neuromodulation can delineate a multi-symptom circuit taxonomy of compulsivity that may guide personalized neuromodulation.

  PublisherOA PDFDOI

• In Vivo and In Vitro Electrochemical Impedance Spectroscopy of Acute and Chronic Intracranial Electrodes

  Data · 2024-06-06 · 4 citations

  articleOpen accessSenior authorCorresponding

  Invasive intracranial electrodes are used in both clinical and research applications for recording and stimulation of brain tissue, providing essential data in acute and chronic contexts. The impedance characteristics of the electrode–tissue interface (ETI) evolve over time and can change dramatically relative to pre-implantation baseline. Understanding how ETI properties contribute to the recording and stimulation characteristics of an electrode can provide valuable insights for users who often do not have access to complex impedance characterizations of their devices. In contrast to the typical method of characterizing electrical impedance at a single frequency, we demonstrate a method for using electrochemical impedance spectroscopy (EIS) to investigate complex characteristics of the ETI of several commonly used acute and chronic electrodes. We also describe precise modeling strategies for verifying the accuracy of our instrumentation and understanding device–solution interactions, both in vivo and in vitro. Included with this publication is a dataset containing both in vitro and in vivo device characterizations, as well as some examples of modeling and error structure analysis results. These data can be used for more detailed interpretation of neural recordings performed on common electrode types, providing a more complete picture of their properties than is often available to users.

  PublisherOA PDFDOI

• Electrical rejuvenation of chronically implanted macroelectrodes in nonhuman primates

  Journal of Neural Engineering · 2024-06-01 · 6 citations

  articleOpen access

  Abstract Objective. Electrodes chronically implanted in the brain undergo complex changes over time that can lower the signal to noise ratio (SNR) of recorded signals and reduce the amount of energy delivered to the tissue during therapeutic stimulation, both of which are relevant for the development of robust, closed-loop control systems. Several factors have been identified that link changes in the electrode-tissue interface (ETI) to increased impedance and degraded performance in micro- and macro-electrodes. Previous studies have demonstrated that brief pulses applied every few days can restore SNR to near baseline levels during microelectrode recordings in rodents, a process referred to as electrical rejuvenation. However, electrical rejuvenation has not been tested in clinically relevant macroelectrode designs in large animal models, which could serve as preliminary data for translation of this technique. Here, several variations of this approach were tested to characterize parameters for optimization. Approach . Alternating-current (AC) and direct-current (DC) electrical rejuvenation methods were explored in three electrode types, chronically implanted in two adult male nonhuman primates (NHP) ( Macaca mulatta ), which included epidural electrocorticography (ECoG) electrodes and penetrating deep-brain stimulation (DBS) electrodes. Electrochemical impedance spectroscopy (EIS) was performed before and after each rejuvenation paradigm as a gold standard measure of impedance, as well as at subsequent intervals to longitudinally track the evolution of the ETI. Stochastic error modeling was performed to assess the standard deviation of the impedance data, and consistency with the Kramers–Kronig relations was assessed to evaluate the stationarity of EIS measurement. Main results . AC and DC rejuvenation were found to quickly reduce impedance and minimize the tissue component of the ETI on all three electrode types, with DC and low-frequency AC producing the largest impedance drops and reduction of the tissue component in Nyquist plots. The effects of a single rejuvenation session were found to last from several days to over 1 week, and all rejuvenation pulses induced no observable changes to the animals’ behavior. Significance . These results demonstrate the effectiveness of electrical rejuvenation for diminishing the impact of chronic ETI changes in NHP with clinically relevant macroelectrode designs.

  PublisherOA PDFDOI

• Targeting thalamocortical circuits for closed-loop stimulation in Lennox–Gastaut syndrome

  Brain Communications · 2024-01-01 · 19 citations

  articleOpen access

  Abstract This paper outlines the therapeutic rationale and neurosurgical targeting technique for bilateral, closed-loop, thalamocortical stimulation in Lennox–Gastaut syndrome, a severe form of childhood-onset epilepsy. Thalamic stimulation can be an effective treatment for Lennox–Gastaut syndrome, but complete seizure control is rarely achieved. Outcomes may be improved by stimulating areas beyond the thalamus, including cortex, but the optimal targets are unknown. We aimed to identify a cortical target by synthesizing prior neuroimaging studies, and to use this knowledge to advance a dual thalamic (centromedian) and cortical (frontal) approach for closed-loop stimulation. Multi-modal brain network maps from three group-level studies of Lennox–Gastaut syndrome were averaged to define the area of peak overlap: simultaneous EEG-functional MRI of generalized paroxysmal fast activity, [18F]fluorodeoxyglucose PET of cortical hypometabolism and diffusion MRI structural connectivity associated with clinical efficacy in a previous trial of thalamic deep brain stimulation. The resulting ‘hotspot’ was used as a seed in a normative functional MRI connectivity analysis to identify connected networks. Intracranial electrophysiology was reviewed in the first two trial patients undergoing bilateral implantations guided by this hotspot. Simultaneous recordings from cortex and thalamus were analysed for presence and synchrony of epileptiform activity. The peak overlap was in bilateral premotor cortex/caudal middle frontal gyrus. Functional connectivity of this hotspot revealed a distributed network of frontoparietal cortex resembling the diffuse abnormalities seen on EEG-functional MRI and PET. Intracranial electrophysiology showed characteristic epileptiform activity of Lennox–Gastaut syndrome in both the cortical hotspot and thalamus; most detected events occurred first in the cortex before appearing in the thalamus. Premotor frontal cortex shows peak involvement in Lennox–Gastaut syndrome and functional connectivity of this region resembles the wider epileptic brain network. Thus, it may be an optimal target for a range of neuromodulation therapies, including thalamocortical stimulation and emerging non-invasive treatments like focused ultrasound or transcranial magnetic stimulation. Compared to thalamus-only approaches, the addition of this cortical target may allow more rapid detections of seizures, more diverse stimulation paradigms and broader modulation of the epileptic network. A prospective, multi-centre trial of closed-loop thalamocortical stimulation for Lennox–Gastaut syndrome is currently underway.

  PublisherOA PDFDOI

• A critical role of action-related functional networks in Gilles de la Tourette syndrome

  Nature Communications · 2024-12-16 · 20 citations

  articleOpen access

  Gilles de la Tourette Syndrome (GTS) is a chronic tic disorder, characterized by unwanted motor actions and vocalizations. While brain stimulation techniques show promise in reducing tic severity, optimal target networks are not well-defined. Here, we leverage datasets from two independent deep brain stimulation (DBS) cohorts and a cohort of tic-inducing lesions to infer critical networks for treatment and occurrence of tics by mapping stimulation sites and lesions to a functional connectome derived from 1,000 healthy participants. We find that greater tic reduction is linked to higher connectivity of DBS sites (N = 37) with action-related functional resting-state networks, i.e., the cingulo-opercular (r = 0.62; p < 0.001) and somato-cognitive action networks (r = 0.47; p = 0.002). Regions of the cingulo-opercular network best match the optimal connectivity profiles of thalamic DBS. We replicate the significance of targeting cingulo-opercular and somato-cognitive action network connectivity in an independent DBS cohort (N = 10). Finally, we demonstrate that tic-inducing brain lesions (N = 22) exhibit similar connectivity to these networks. Collectively, these results suggest a critical role for these action-related networks in the pathophysiology and treatment of GTS.

  PublisherOA PDFDOI

• A Critical Role of Action-Related Functional Networks in Gilles de la Tourette Syndrome

  2024-03-28 · 1 citations

  preprintOpen access

  Gilles de la Tourette Syndrome (GTS) is the most severe form of chronic tic disorders, characterized by uncontrollable motor actions and vocalizations. While brain stimulation techniques show promise in reducing tic severity, optimal target networks are not well-defined. Here, we leveraged datasets from two independent deep brain stimulation (DBS) cohorts and a cohort of tic-inducing lesions to infer critical networks for treatment and occurrence of tics by mapping stimulation sites and lesions to a functional connectome derived from 1,000 healthy participants. We found that greater tic reduction is linked to higher connectivity of DBS sites (N = 37) with action-related functional resting-state networks, i.e., the cingulo-opercular (R = 0.62; p &amp;lt; 0.001) and somato-cognitive action networks (R = 0.47; p = 0.002). Hubs within the cingulo-opercular network best matched the optimal connectivity profiles of thalamic DBS. We replicated the significance of targeting cingulo-opercular and somato-cognitive action network connectivity in an independent DBS cohort (N = 10). Finally, we demonstrate that tic-inducing brain lesions (N = 22) exhibit similar connectivity to these networks. Collectively, these results suggest a critical role for these action-related networks in the pathophysiology and treatment of GTS.

  PublisherDOI

Recent grants

• US Ignite: Track 1: Remote Management of Deep Brain Stimulation (DBS) Patients Using Utah Telehealth Network (UTN)

  NSF · $595k · 2015–2018

• NIH Grant F32NS052042

  NIH · $137k · 2008

• Central thalamic stimulation for traumatic brain injury

  NIH · $6.9M · 2015–2024

• NIH Grant R01NS067249

  NIH · $3.2M · 2015

Frequent coauthors

• Michael S. Okun

  71 shared

• Kelly D. Foote

  University of Florida

  67 shared

• Jill L. Ostrem

  University of California, San Francisco

  58 shared

• Michael Pourfar

  NYU Langone Health

  57 shared

• Aysegul Gunduz

  University of Florida

  56 shared

• Philip A. Starr

  Neurological Surgery

  55 shared

• Joohi Jimenez‐Shahed

  Icahn School of Medicine at Mount Sinai

  54 shared

• Darin D. Dougherty

  53 shared

Labs

• iBRAIN LabPI

Education

• B.S., Mechanical Engineering

  University of Maryland

• M.S., Electrical Engineering

  George Washington University

• Ph.D., Biomedical Engineering

  University of Utah

Awards & honors

• Winner of Outstanding Dissertation Award to Biomedical Engin…