Darren B. Orbach, MD, PhD

Department	Radiology
Hospital Title	Neurointerventional Radiologist
Academic Title	Assistant Professor
Phone	617-355-5012
Fax	617-730-0382
Email	darren.orbach@childrens.harvard.edu
Location	Main South 1 - CB 1113 300 Longwood Avenue Boston MA 02115

Research Overview

Dr. Orbach's basic research revolves around the development of a high-speed MR technique for directly imaging rapid neuronal activity. This stands in contrast to all current functional neuroimaging techniques, which assess changes in local cerebral metabolism or blood flow. The high-speed MR technique is currently being used to help further the understanding of the pathophysiology of various epilepsy syndromes.

Clinical research on central nervous system (CNS) and non-CNS head and neck vascular anomalies flows naturally from the hospital’s wide clinical referral base, as described below.

About Darren B. Orbach, MD, PhD

Dr. Orbach received his BA from Princeton University, his MD from Cornell University Medical College, and his PhD from Rockefeller University. He completed a seven-year combined training program in neurology, diagnostic radiology and neuroradiology, followed by a neurointerventional radiology fellowship, all at New York University Medical Center. He is board certified in diagnostic radiology, neuroradiology and neurology.

Key Publications

• Wang H, Oh A, Orbach DB. Arteriovenous Shunting as a New Feature of PHACES—A Case Report. J Neurosurg Pediatr 2009 Jan; 3(1):53-6.
   
• Viswanathan V, Smith ER, Mulliken JB, Fishman SJ, Kozakewich HPW, Burrows PE, Orbach DB. Infantile hemangiomas involving the neuraxis: Clinical and imaging findings. AJNR 2009; 30:1005-13.
   
• Choi D, Alomari A, Chaudry G, Orbach DB. Neurointerventional management of low-flow vascular malformations of the head and neck. In: Interventional Neuroradiology of the Head and Neck, editor: Dheeraj Ghandi. Neuroimaging Clin N Am 2009; 19:199-218.
   
• Wu I, Orbach DB. Neurointerventional management of high-flow vascular malformations of the head and neck. In: Interventional Neuroradiology of the Head and Neck, editor: Dheeraj Ghandi. Neuroimaging Clin N Am 2009; 19:219-40.
   
• Greene A, Orbach DB. Management of arteriovenous malformations. In: Vascular Anomalies, editors: Arin Greene, Chad Perlyn. Clin Plast Surg 2010 (in press).
   
• Thiex R, Williams A, Smith ER, Scott RM, Orbach DB. The use of onyx for embolization of central nervous system arteriovenous lesions in pediatric patients. AJNR 2010 (in press).
   
• Thiex R, Mulliken JB, Revencu N, Boon LM, Burrows PE, Cordisco M, Yim D, Smith ER, Vikkula M, Orbach DB. A novel association between RASA1 mutations and spinal arteriovenous anomalies. AJNR 2010 (in press).
   
• Sundaram P, Wells WM, Mulkern RV, Bubrick EJ, Bromfield EB, Münch M, Orbach DB, Magnetic Resonance Imaging of Cerebral Electromagnetic Activity in Epilepsy using efMRI (manuscript in preparation). 

Focus of Research

Dr. Orbach and his associates are working to develop a novel technique for directly imaging cerebral electromagnetic activity, encephalographic functional magnetic resonance imaging (efMRI). They have established efMRI data acquisition and analysis protocols in adult patients with focal epilepsy at Brigham and Women's Hospital. An analogous research protocol for pediatric epilepsy patients is being established at Children's Hospital Boston in collaboration with the Department of Neurology.

In addition to potential clinical benefit in the form of significantly improved seizure focus localization, direct imaging of epileptiform discharges is likely to offer new insights into the underlying pathophysiology of epilepsy, and to be helpful in developing and monitoring novel therapies. In addition, efMRI has the potential for application in basic and clinical neuroscience beyond epilepsy.

Translational Research:

Because Children's draws patients with relatively rare cerebrovascular, spine, and extracranial head-and neck vascular malformations from all over the world, Dr. Orbach and his colleagues have had rich opportunities to deepen their understanding of pediatric vascular malformations and their optimal treatment. Several publications describing the relationship between CNS vascular malformations and more broad vascular anomalies have resulted, and several others are under way. Also ongoing, with rich opportunities for clinical research, are: (i) Implementation of a multidisciplinary pediatric stroke service, and (ii) Implementation of protocols for intra-arterial chemotherapy in children with poorly responsive CNS and non-CNS tumors.