Lench Lab

Welcome

Welcome to the Lench Lab at the Medical University of South Carolina (MUSC).

Our Mission

Parkinson's disease doesn't just affect a brain — it affects the life of a person. At the Lench Lab, we search for new ways to help a spouse, parent, or grandparent regain the ability to live life to the fullest. To do this, we are advancing high-precision brain stimulation and brain imaging to develop treatments for Parkinson's disease that have a real-world impact on patients and their communities.

What We Do

Our lab studies the brain using two main sets of tools.

Brain stimulation (neuromodulation)
These techniques gently change brain activity to improve symptoms:

• Transcranial Magnetic Stimulation (TMS) — a non-invasive method that uses magnetic pulses, applied through a small paddle held near the scalp, to nudge brain activity. No surgery is involved.
• Deep Brain Stimulation (DBS) — a surgical treatment in which thin wires placed in the brain deliver gentle electrical pulses to reduce movement symptoms.
• Transcutaneous auricular Vagus Nerve Stimulation (taVNS) — a non-invasive approach that delivers mild electrical signals through small electrodes placed on the skin just in front of and behind the ear (over the mastoid bone, the bony area behind the ear). It is not a clip worn on the ear.

Brain imaging (neuroimaging)
These techniques let us take detailed pictures of the brain and watch how it works:

• Functional MRI (fMRI) — shows which brain areas are active and how different regions communicate.
• Diffusion MRI (dMRI) — maps the brain's wiring, or the connections between regions.
• Electroencephalography (EEG) — records the brain's electrical activity using sensors placed on the scalp.

Why This Matters

We look for signals in brain images that help explain why symptoms differ from person to person, and that predict who is most likely to benefit from a given therapy. By mapping the key brain
networks involved, we aim to create individualized treatments that better target the wide range of symptoms this condition causes.

The Lench Lab is led by Dr. Daniel Lench and works closely with colleagues across several departments including Neurology, Psychiatry, and Gastroenterology. This interdisciplinary approach bringsmany perspectives together to drive research and innovation.

Join a Study

We are currently recruiting people with Parkinson's disease, as well as healthy volunteers, for several studies. These studies explore topics such as thinking and memory changes related to DBS, low motivation (apathy), and walking difficulty. If you are interested in taking part, please visit our Study Participation page or contact Emily Laramie at laramie@musc.edu or 843-792-3873.

What is Parkinson's Disease?

Parkinson's disease is the fasted growing neurodegenerative disorder and affects more than 1.1 million people in the United States. Parkinson's is known for its movement symptoms, such as slowness and shaking (tremor), or stiffness, however many non-motor symptoms have also been recognized. Because a few other conditions can look similar, it is important to be evaluated by a movement disorders neurologist, a doctor who specializes in these conditions. Standard care included evaluation by a movement disorders neurologist, medications, and physical therapy.

The most common medications are dopamine-based drugs such as levodopa. These help people. but over time they can cause side effects, including fluctuations (ups and downs in how well the medication is working) and involuntary movements (dyskinesias). For some people, deep brain stimulation (DBS) surgery may be an option. When it works well, people are able to lower their medication dose and medication side effects while still managing many movement symptoms. Unfortunately, not all symptoms respond to medications and DBS including gait, cognition, and mood. Our lab is dedicated to improving existing and studying novel neuromodulation treatments to address these untreated symptoms.

What are the movement (motor) symptoms? 

• Tremor - shaking, often in a hand or arm
• Bradykinesia - slowness of movement
• Rigidity - muscle stiffness
• Gait disturbance - trouble walking 
• Postural instability - balance problems 

Other symptoms can include small handwriting, speech changes, reduced facial expression, and freezing of gait (a sudden, temporary feeling that the feet are stuck to the floor).

What are the non-movement (non-motor) symptoms?

Non-movement symptoms often appear before movement symptoms and can have a major effect on quality of life. They include:

• Mood changes - depression, anxiety, and apathy (low motivation)
• Sleep problems - insomnia and acting out dreams
• Thinking changes - memory, planning, and word finding difficulty
• Sensory changes - reduced sense of smell
• Body-system changes - constipation, blood pressure drops, and bladder issues
• Other - difficulty swallowing, pain, and fatigue

Research — Our Current Studies

Below are studies which are currently running and actively recruiting participants.

Accelerated Transcranial magnetic stimulation (TMS) for apathy

Now Enrolling | ClinicalTrials.gov: NCT07399496

Apathy is a loss of motivation or interest in everyday activities and can occur in Parkinson's Disease. It is linked to lower quality of life and can be hard to treat with current options. This study tests a non-invasive, "accelerated" schedule TMS, which delivers several short sessions in a single day so fewer visits are needed. We use brain imaging and EEG to see whether the treatment impacts brain areas involved in motivation.

Who can take part?

• Adults 45 to 85 years of age
• Experiencing apathy (loss of interest or motivation) because of Parkinson's disease
• Able to take part along with a caregiver or loved one who knows them well
• We are also recruiting people with Parkinson's who do not have apathy to take part as a comparison group

What is involved?

• Two study visits in total
• One TMS (non-invasive brain stimulation) visit
• Brain imaging (MRI) and EEG recordings to measure brain activity
• Questionnaires completed together with your caregiver or loved one

At-Home taVNS for Walking Difficulty

Now Enrolling | ClinicalTrials.gov: NCT07536022

This study tests a non-invasive device used at home that delivers gentle stimulation to the vagus nerve (taVNS). Rather than a clip on the ear, small electrodes are placed on the skin just in front of the ear and behind the ear, over the mastoid bone (the bony area behind the ear). Research suggests this nerve pathway may help with symptoms that current medications do not address well such as walking difficulty. We are studying whether people with Parkinson's can use the device successfully at home and whether it improves walking, using brain imaging before and after the program.

Who can take part?

• Adults 40 to 85 years of age
• Diagnosis of Parkinson's disease with some walking or balance difficulty
• Mild-to-moderate Parkinson's
• On a stable Parkinson's medication routine

What is involved?

• Using the at-home device for about one hour each day for eight weeks, applied yourself after training
• Two in-person visits — one before and one after the eight-week program
• Two MRI scans — one before and one after — to look at brain networks
• Walking assessments, both with and without a simple thinking task

Brain Imaging Markers of How Deep Brain Stimulation Affects Brain Networks

Now Enrolling | ClinicalTrials.gov: NCT06960096

Deep brain stimulation (DBS) helps many people with Parkinson's manage movement symptoms, but a smaller group have persistent or worsening non-motor symptoms. This study uses advanced brain imaging to understand how DBS interacts with brain networks underlying non-motor symptoms.

Who can take part?

• Adults with Parkinson's disease who have had subthalamic (STN) DBS surgery, generally within roughly the past 5 to 18 months, and are on stable stimulation settings
• Healthy volunteers of a similar age are also needed for comparison
• Able to have MRI scans (for example, no claustrophobia and able to lie still in the scanner)

What is involved?

• MRI scans, including structural, and functional (brain activity) imaging
• Brain scanning with the DBS device turned on and off, to compare the two
• Thinking and memory (neuropsychological) testing

Study Participation

Interested in Taking Part? We'd Love to Hear From You.

Volunteers make our research possible. Whether you are living with Parkinson's disease or are a healthy volunteer, you may be able to help us better understand the brain and develop new treatments. Taking part is always your choice, it will not affect your regular medical care, and you can ask questions at any time.

How to Get Started

1. Reach out. Email or call laramie@musc.edu or 843-876-6410.
2. Quick chat. We'll talk with you about your interests and see which study might be a good fit.
3. Learn more. If a study looks like a match, we'll explain everything and answer your questions.
4. Your choice. Taking part is completely voluntary, and you can stop at any time.

Studies Currently Enrolling

All three of our studies are enrolling now. Full details, including who can take part and what's involved, are on the Research page.

• Accelerated TMS for Apathy in Parkinson's — non-invasive brain stimulation for people with PD experiencing low motivation. NCT07399496
• At-Home taVNS for Walking Difficulty in Parkinson's — an at-home stimulation program focused on walking. NCT07536022
• Brain Imaging Markers of How DBS Affects Brain Networks — brain imaging for people with Parkinson's who have had DBS, plus healthy volunteers. NCT06960096

Training Opportunities

The Lench Lab welcomes motivated trainees who want hands-on experience in brain stimulation and brain imaging research. We offer opportunities at several levels.

Graduate Students and Postdoctoral Scholars
Positions for researchers with a doctoral degree who want to develop an independent research program in neuromodulation and neuroimaging.

Medical Student Rotations
Short research rotations for medical students interested in movement disorders, neurology, and clinical research.

Undergraduate Research
Research assistant roles and thesis project opportunities for students interested in neuroscience, psychology, engineering, and related fields.

Contact Us

For Training Positions and General Lab Questions
Please contact Dr. Daniel Lench at lenchd@musc.edu.

For Study Participation Questions
Please contact Emily Laramie at laramie@musc.edu or 843-876-6410.