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Lin Z, Zhou W, Huang X, Wang K, Tang J, Niu L, Meng L, Zheng H. On-Chip Ultrasound Modulation of Pyramidal Neuronal Activity in Hippocampal Slices. ACTA ACUST UNITED AC 2018. [DOI: 10.1002/adbi.201800041] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Zhengrong Lin
- Institute of Biomedical and Health Engineering; Shenzhen Institutes of Advanced Technology; Chinese Academy of Sciences; 1068 Xueyuan Avenue Shenzhen 518055 China
| | - Wei Zhou
- Institute of Biomedical and Health Engineering; Shenzhen Institutes of Advanced Technology; Chinese Academy of Sciences; 1068 Xueyuan Avenue Shenzhen 518055 China
| | - Xiaowei Huang
- Institute of Biomedical and Health Engineering; Shenzhen Institutes of Advanced Technology; Chinese Academy of Sciences; 1068 Xueyuan Avenue Shenzhen 518055 China
| | - Kaiyue Wang
- Institute of Biomedical and Health Engineering; Shenzhen Institutes of Advanced Technology; Chinese Academy of Sciences; 1068 Xueyuan Avenue Shenzhen 518055 China
| | - Jie Tang
- Department of Physiology; School of Basic Medical Sciences; Southern Medical University; 1023-1063 Shatai South Avenue Guangzhou 510515 China
| | - Lili Niu
- Institute of Biomedical and Health Engineering; Shenzhen Institutes of Advanced Technology; Chinese Academy of Sciences; 1068 Xueyuan Avenue Shenzhen 518055 China
| | - Long Meng
- Institute of Biomedical and Health Engineering; Shenzhen Institutes of Advanced Technology; Chinese Academy of Sciences; 1068 Xueyuan Avenue Shenzhen 518055 China
| | - Hairong Zheng
- Institute of Biomedical and Health Engineering; Shenzhen Institutes of Advanced Technology; Chinese Academy of Sciences; 1068 Xueyuan Avenue Shenzhen 518055 China
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152
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Bobola MS, Chen L, Ezeokeke CK, Kuznetsova K, Lahti AC, Lou W, Myroniv AN, Schimek NW, Selby ML, Mourad PD. A Review of Recent Advances in Ultrasound, Placed in the Context of Pain Diagnosis and Treatment. Curr Pain Headache Rep 2018; 22:60. [PMID: 29987680 PMCID: PMC6061208 DOI: 10.1007/s11916-018-0711-7] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Ultrasound plays a significant role in the diagnosis and treatment of pain, with significant literature reaching back many years, especially with regard to diagnostic ultrasound and its use for guiding needle-based delivery of drugs. Advances in ultrasound over at least the last decade have opened up new areas of inquiry and potential clinical efficacy in the context of pain diagnosis and treatment. Here we offer an overview of the recent literature associated with ultrasound and pain in order to highlight some promising frontiers at the intersection of these two subjects. We focus first on peripheral application of ultrasound, for which there is a relatively rich, though still young, literature. We then move to central application of ultrasound, for which there is little literature but much promise.
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Affiliation(s)
- Michael S Bobola
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Lucas Chen
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | | | - Katy Kuznetsova
- Applied Physics Laboratory, University of Washington, Seattle, WA, USA
| | - Annamarie C Lahti
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Weicheng Lou
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Aleksey N Myroniv
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Nels W Schimek
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Madison L Selby
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA
| | - Pierre D Mourad
- Department of Neurological Surgery, University of Washington, Seattle, WA, USA.
- Applied Physics Laboratory, University of Washington, Seattle, WA, USA.
- Division of Engineering and Mathematics, University of Washington, Bothell, WA, USA.
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153
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Xia X, Yang Y, Guo Y, Bai Y, Dang Y, Xu R, He J. Current Status of Neuromodulatory Therapies for Disorders of Consciousness. Neurosci Bull 2018; 34:615-625. [PMID: 29916112 DOI: 10.1007/s12264-018-0244-4] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Accepted: 04/25/2018] [Indexed: 11/26/2022] Open
Abstract
Treatment for disorders of consciousness (DOCs) is still a Gordian knot. Evidence-based guidelines on the treatment of DOC patients are not currently available, while neuromodulation techniques are seen as a potential treatment. Multiple neuromodulation therapies have been applied. This article reviews the most relevant studies in the literature in order to describe a clear picture of the current state of neuromodulation therapies that could be used to treat DOC patients. Both invasive and non-invasive brain stimulation is discussed. Significant behavioral improvements in prolonged DOCs under neuromodulation therapies are rare. The efficacy of various such therapies remains a matter of debate. Further clinical investigations of existing techniques in larger samples properly controlling for spontaneous recovery are needed, and new approaches are awaited.
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Affiliation(s)
- Xiaoyu Xia
- Department of Neurosurgery, PLA Army General Hospital, Beijing, 100700, China
| | - Yi Yang
- Department of Neurosurgery, PLA Army General Hospital, Beijing, 100700, China
| | - Yongkun Guo
- Department of Neurosurgery, Zhengzhou Central Hospital Affiliated to Zhengzhou University, Zhengzhou, 450007, China
| | - Yang Bai
- International Vegetative State and Consciousness Science Institute, Hangzhou Normal University, Hangzhou, 311121, China
| | - Yuanyuan Dang
- Department of Neurosurgery, PLA Army General Hospital, Beijing, 100700, China
| | - Ruxiang Xu
- Department of Neurosurgery, PLA Army General Hospital, Beijing, 100700, China
| | - Jianghong He
- Department of Neurosurgery, PLA Army General Hospital, Beijing, 100700, China.
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154
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Munoz F, Aurup C, Konofagou EE, Ferrera VP. Modulation of Brain Function and Behavior by Focused Ultrasound. Curr Behav Neurosci Rep 2018; 5:153-164. [PMID: 30393592 PMCID: PMC6208352 DOI: 10.1007/s40473-018-0156-7] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
PURPOSE OF REVIEW The past decade has seen rapid growth in the application of focused ultrasound (FUS) as a tool for basic neuroscience research and potential treatment of brain disorders. Here, we review recent developments in our understanding of how FUS can alter brain activity, perception and behavior when applied to the central nervous system, either alone or in combination with circulating agents. RECENT FINDINGS Focused ultrasound in the central nervous system can directly excite or inhibit neuronal activity, as well as affect perception and behavior. Combining FUS with intravenous microbubbles to open the blood-brain barrier also affects neural activity and behavior, and the effects may be more sustained than FUS alone. Opening the BBB also allows delivery of drugs that do not cross the intact BBB including viral vectors for gene delivery. SUMMARY While further research is needed to elucidate the biophysical mechanisms, focused ultrasound, alone or in combination with other factors, is rapidly maturing as an effective technology for altering brain activity. Future challenges include refining control over targeting specificity, the volume of affected tissue, cell-type specificity (excitatory or inhibitory), and the duration of neural and behavioral effects.
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Affiliation(s)
- Fabian Munoz
- Department of Neuroscience, Columbia University, New York, NY, 10027 USA
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, 10027 USA
- Kavli Institute for Brain Science, Columbia University, New York, NY, 10027 USA
| | - Christian Aurup
- Department of Biomedical Engineering, Columbia University, New York, NY, 10027 USA
| | - Elisa E Konofagou
- Department of Biomedical Engineering, Columbia University, New York, NY, 10027 USA
- Department of Radiology, Columbia University, New York, NY, 10027 USA
| | - Vincent P Ferrera
- Department of Neuroscience, Columbia University, New York, NY, 10027 USA
- Zuckerman Mind Brain Behavior Institute, Columbia University, New York, NY, 10027 USA
- Kavli Institute for Brain Science, Columbia University, New York, NY, 10027 USA
- Department of Psychiatry, Columbia University, New York, NY, 10027 USA
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155
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Khalsa SS, Adolphs R, Cameron OG, Critchley HD, Davenport PW, Feinstein JS, Feusner JD, Garfinkel SN, Lane RD, Mehling WE, Meuret AE, Nemeroff CB, Oppenheimer S, Petzschner FH, Pollatos O, Rhudy JL, Schramm LP, Simmons WK, Stein MB, Stephan KE, Van den Bergh O, Van Diest I, von Leupoldt A, Paulus MP. Interoception and Mental Health: A Roadmap. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2018; 3:501-513. [PMID: 29884281 PMCID: PMC6054486 DOI: 10.1016/j.bpsc.2017.12.004] [Citation(s) in RCA: 401] [Impact Index Per Article: 66.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Revised: 11/20/2017] [Accepted: 12/10/2017] [Indexed: 12/29/2022]
Abstract
Interoception refers to the process by which the nervous system senses, interprets, and integrates signals originating from within the body, providing a moment-by-moment mapping of the body's internal landscape across conscious and unconscious levels. Interoceptive signaling has been considered a component process of reflexes, urges, feelings, drives, adaptive responses, and cognitive and emotional experiences, highlighting its contributions to the maintenance of homeostatic functioning, body regulation, and survival. Dysfunction of interoception is increasingly recognized as an important component of different mental health conditions, including anxiety disorders, mood disorders, eating disorders, addictive disorders, and somatic symptom disorders. However, a number of conceptual and methodological challenges have made it difficult for interoceptive constructs to be broadly applied in mental health research and treatment settings. In November 2016, the Laureate Institute for Brain Research organized the first Interoception Summit, a gathering of interoception experts from around the world, with the goal of accelerating progress in understanding the role of interoception in mental health. The discussions at the meeting were organized around four themes: interoceptive assessment, interoceptive integration, interoceptive psychopathology, and the generation of a roadmap that could serve as a guide for future endeavors. This review article presents an overview of the emerging consensus generated by the meeting.
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Affiliation(s)
- Sahib S Khalsa
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma.
| | - Ralph Adolphs
- California Institute of Technology, Pasadena, California
| | - Oliver G Cameron
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan
| | - Hugo D Critchley
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
| | - Paul W Davenport
- Department of Physiology, University of Florida, Gainesville, Florida
| | - Justin S Feinstein
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma
| | - Jamie D Feusner
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, California
| | - Sarah N Garfinkel
- Sackler Centre for Consciousness Science, University of Sussex, Brighton, United Kingdom
| | - Richard D Lane
- Department of Psychiatry, University of Arizona, Tucson, Arizona
| | - Wolf E Mehling
- Department of Family and Community Medicine, University of California, San Francisco, San Francisco, California
| | - Alicia E Meuret
- Department of Psychology, Southern Methodist University, Dallas, Texas
| | - Charles B Nemeroff
- Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, Florida
| | | | - Frederike H Petzschner
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland
| | - Olga Pollatos
- Department of Clinical and Health Psychology, Institute of Psychology and Education, Ulm University, Ulm, Germany
| | - Jamie L Rhudy
- Department of Psychology, University of Tulsa, Tulsa, Oklahoma
| | - Lawrence P Schramm
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, Maryland; Department of Neuroscience, Johns Hopkins University, Baltimore, Maryland
| | - W Kyle Simmons
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma; Oxley College of Health Sciences, University of Tulsa, Tulsa, Oklahoma
| | - Murray B Stein
- Department of Psychiatry, University of California, San Diego, San Diego, California
| | - Klaas E Stephan
- Translational Neuromodeling Unit, Institute for Biomedical Engineering, University of Zurich, Zurich, Switzerland
| | | | - Ilse Van Diest
- Department of Health Psychology, University of Leuven, Leuven, Belgium
| | | | - Martin P Paulus
- Laureate Institute for Brain Research, University of Tulsa, Tulsa, Oklahoma
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156
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Abstract
PURPOSE OF REVIEW Very few options exist for patients who survive severe traumatic brain injury but fail to fully recover and develop a disorder of consciousness (e.g. vegetative state, minimally conscious state). RECENT FINDINGS Among pharmacological approaches, Amantadine has shown the ability to accelerate functional recovery. Although with very low frequency, Zolpidem has shown the ability to improve the level of consciousness transiently and, possibly, also in a sustained fashion. Among neuromodulatory approaches, transcranial direct current stimulation has been shown to transiently improve behavioral responsiveness, but mostly in minimally conscious patients. New evidence for thalamic deep brain stimulation calls into question its cost/benefit trade-off. SUMMARY The growing understanding of the biology of disorders of consciousness has led to a renaissance in the development of therapeutic interventions for patients with disorders of consciousness. High-quality evidence is emerging for pharmacological (i.e. Amantadine) and neurostimulatory (i.e. transcranial direct current stimulation) interventions, although further studies are needed to delineate preconditions, optimal dosages, and timing of administration. Other exciting new approaches (e.g. low intensity focused ultrasound) still await systematic assessment. A crucial future direction should be the use of neuroimaging measures of functional and structural impairment as a means of tailoring patient-specific interventions.
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157
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Yuan Y, Zhao Y, Jia H, Liu M, Hu S, Li Y, Li X. Cortical Hemodynamic Responses Under Focused Ultrasound Stimulation Using Real-Time Laser Speckle Contrast Imaging. Front Neurosci 2018; 12:269. [PMID: 29740276 PMCID: PMC5925215 DOI: 10.3389/fnins.2018.00269] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2017] [Accepted: 04/09/2018] [Indexed: 12/03/2022] Open
Abstract
Although there is increasing use of focused ultrasound stimulation (FUS) in brain studies, the real-time changes of the cerebral blood flow (CBF) due to FUS remain unclear. In this study, we developed a novel scheme combining FUS and laser speckle contrast imaging, which can be used to measure the CBF caused by FUS in real time. The results showed that the change of CBF increased from 0 to 30 s and reached up to the maximum of 115.1 ± 6.5% at 30 s and then decreased gradually from 30 to 60 s. This study demonstrates that FUS was able to increase CBF and alter cortical hemodynamic responses, which indicates that FUS is a potential non-invasive method to study ischemic stroke rehabilitation.
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Affiliation(s)
- Yi Yuan
- Institute of Electrical Engineering, Yanshan University, Qinhuangdao, China
| | - Yanchao Zhao
- Institute of Electrical Engineering, Yanshan University, Qinhuangdao, China
| | - Hongshuai Jia
- School of Clinical Medicine, North China University of Science and Technology, Tangshan, China
| | - Mengyang Liu
- Center for Medical Physics and Biomedical Engineering, Medical University of Vienna, Vienna, Austria
| | - Shuo Hu
- Institute of Electrical Engineering, Yanshan University, Qinhuangdao, China
| | - Yingwei Li
- Institute of Information Engineering, Yanshan University, Qinhuangdao, China
| | - Xiaoli Li
- State Key Laboratory of Cognitive Neuroscience and Learning and IDG, McGovern Institute for Brain Research, Beijing Normal University, Beijing, China
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158
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Fisher JAN, Gumenchuk I. Low-intensity focused ultrasound alters the latency and spatial patterns of sensory-evoked cortical responses in vivo. J Neural Eng 2018; 15:035004. [PMID: 29436519 DOI: 10.1088/1741-2552/aaaee1] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
OBJECTIVE The use of transcranial, low intensity focused ultrasound (FUS) is an emerging neuromodulation technology that shows promise for both therapeutic and research applications. Among many, one of the most exciting applications is the use of FUS to rehabilitate or augment human sensory capabilities. While there is compelling empirical evidence demonstrating this capability, basic questions regarding the spatiotemporal extent of the modulatory effects remain. Our objective was to assess the basic, yet often overlooked hypothesis that FUS in fact alters sensory-evoked neural activity within the region of the cerebral cortex at the beam's focus. APPROACH To address this knowledge gap, we developed an approach to optically interrogate patterns of neural activity in the cortex directly at the acoustic focus, in vivo. Implementing simultaneous wide-field optical imaging and FUS stimulation in mice, our experiments probed somatosensory-evoked electrical activity through the use of voltage sensitive dyes (VSDs) and, in transgenic mice expressing GCaMP6f, monitored associated Ca2+ responses. MAIN RESULTS Our results demonstrate that low-intensity FUS alters both the kinetics and spatial patterns of neural activity in primary somatosensory cortex at the acoustic focus. When preceded by 1 s of pulsed ultrasound at intensities below 1 W cm-2 (I sppa), the onset of sensory-evoked cortical responses occurred 3.0 ± 0.7 ms earlier and altered the surface spatial morphology of Ca2+ responses. SIGNIFICANCE These findings support the heretofore unconfirmed assumption that FUS-induced sensory modulation reflects, at least in part, altered reactivity in primary sensory cortex at the site of sonication. The findings are significant given the interest in using FUS to target and alter spatial aspects of sensory receptive fields on the cerebral cortex.
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Affiliation(s)
- Jonathan A N Fisher
- Department of Physiology, New York Medical College, Valhalla, NY 10595, United States of America
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159
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Abstract
Drawing upon sources in neuroethics, civil rights, and disability rights law, we argue for the reintegration of people with severe brain injury back into the nexus of their families and communities consistent with the Americans with Disabilities Act (ADA) and the UN Convention on the Rights of Persons with Disabilities, both of which call for the maximal integration of people with disability into society. To this end, we offer a rights-based argument to address the care of people with severe brain injury. Instead of viewing the provision of rehabilitation as a reimbursement issue, which it surely is, we argue that it can be productively understood as a question of civil rights for a population generally segregated from the medical mainstream and from society itself. Their segregation in the chronic care sector constitutes disrespect for persons, made all the more consequential because recent advances in brain injury rehabilitation make reintegration into civil society an aspirational, if not achievable goal.
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Affiliation(s)
- Joseph J Fins
- a Division of Medical Ethics , Weill Medical College of Cornell University , New York , NY.,b The Consortium for the Advanced Study of Brain Injury, Weill Cornell Medical College , New York , NY.,c The Rockefeller University , New York , NY.,d Solomon Center for Health Law and Policy , Yale Law School , New Haven , CT
| | - Megan S Wright
- a Division of Medical Ethics , Weill Medical College of Cornell University , New York , NY.,b The Consortium for the Advanced Study of Brain Injury, Weill Cornell Medical College , New York , NY.,d Solomon Center for Health Law and Policy , Yale Law School , New Haven , CT
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160
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Legon W, Ai L, Bansal P, Mueller JK. Neuromodulation with single-element transcranial focused ultrasound in human thalamus. Hum Brain Mapp 2018; 39:1995-2006. [PMID: 29380485 DOI: 10.1002/hbm.23981] [Citation(s) in RCA: 173] [Impact Index Per Article: 28.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Revised: 01/04/2018] [Accepted: 01/11/2018] [Indexed: 01/26/2023] Open
Abstract
Transcranial focused ultrasound (tFUS) has proven capable of stimulating cortical tissue in humans. tFUS confers high spatial resolutions with deep focal lengths and as such, has the potential to noninvasively modulate neural targets deep to the cortex in humans. We test the ability of single-element tFUS to noninvasively modulate unilateral thalamus in humans. Participants (N = 40) underwent either tFUS or sham neuromodulation targeted at the unilateral sensory thalamus that contains the ventro-posterior lateral (VPL) nucleus of thalamus. Somatosensory evoked potentials (SEPs) were recorded from scalp electrodes contralateral to median nerve stimulation. Activity of the unilateral sensory thalamus was indexed by the P14 SEP generated in the VPL nucleus and cortical somatosensory activity by subsequent inflexions of the SEP and through time/frequency analysis. Participants also under went tactile behavioral assessment during either the tFUS or sham condition in a separate experiment. A detailed acoustic model using computed tomography (CT) and magnetic resonance imaging (MRI) is also presented to assess the effect of individual skull morphology for single-element deep brain neuromodulation in humans. tFUS targeted at unilateral sensory thalamus inhibited the amplitude of the P14 SEP as compared to sham. There is evidence of translation of this effect to time windows of the EEG commensurate with SI and SII activities. These results were accompanied by alpha and beta power attenuation as well as time-locked gamma power inhibition. Furthermore, participants performed significantly worse than chance on a discrimination task during tFUS stimulation.
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Affiliation(s)
- Wynn Legon
- Division of Physical Therapy and Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Leo Ai
- Division of Physical Therapy and Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Priya Bansal
- Division of Physical Therapy and Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota
| | - Jerel K Mueller
- Division of Physical Therapy and Division of Rehabilitation Science, Department of Rehabilitation Medicine, Medical School, University of Minnesota, Minneapolis, Minnesota
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161
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Spasticity Management in Disorders of Consciousness. Brain Sci 2017; 7:brainsci7120162. [PMID: 29232836 PMCID: PMC5742765 DOI: 10.3390/brainsci7120162] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 12/06/2017] [Accepted: 12/07/2017] [Indexed: 11/26/2022] Open
Abstract
Background: Spasticity is a motor disorder frequently encountered after a lesion involving the central nervous system. It is hypothesized to arise from an anarchic reorganization of the pyramidal and parapyramidal fibers and leads to hypertonia and hyperreflexia of the affected muscular groups. While this symptom and its management is well-known in patients suffering from stroke, multiple sclerosis or spinal cord lesion, little is known regarding its appropriate management in patients presenting disorders of consciousness after brain damage. Objectives: Our aim was to review the occurrence of spasticity in patients with disorders of consciousness and the therapeutic interventions used to treat it. Methods: We conducted a systematic review using the PubMed online database. It returned 157 articles. After applying our inclusion criteria (i.e., studies about patients in coma, unresponsive wakefulness syndrome or minimally conscious state, with spasticity objectively reported as a primary or secondary outcome), 18 studies were fully reviewed. Results: The prevalence of spasticity in patients with disorders of consciousness ranged from 59% to 89%. Current treatment options include intrathecal baclofen and soft splints. Several treatment options still need further investigation; including acupuncture, botulin toxin or cortical activation by thalamic stimulation. Conclusion: The small number of articles available in the current literature highlights that spasticity is poorly studied in patients with disorders of consciousness although it is one of the most common motor disorders. While treatments such as intrathecal baclofen and soft splints seem effective, large randomized controlled trials have to be done and new therapeutic options should be explored.
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162
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Kim E, Anguluan E, Kim JG. Monitoring cerebral hemodynamic change during transcranial ultrasound stimulation using optical intrinsic signal imaging. Sci Rep 2017; 7:13148. [PMID: 29030623 PMCID: PMC5640689 DOI: 10.1038/s41598-017-13572-0] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 09/25/2017] [Indexed: 12/27/2022] Open
Abstract
Transcranial ultrasound stimulation (tUS) is a promising non-invasive approach to modulate brain circuits. The application is gaining popularity, however the full effect of ultrasound stimulation is still unclear and further investigation is needed. This study aims to apply optical intrinsic signal imaging (OISI) for the first time, to simultaneously monitor the wide-field cerebral hemodynamic change during tUS on awake animal with high spatial and temporal resolution. Three stimulation paradigms were delivered using a single-element focused transducer operating at 425 kHz in pulsed mode having the same intensity (ISPPA = 1.84 W/cm2, ISPTA = 129 mW/cm2) but varying pulse repetition frequencies (PRF). The results indicate a concurrent hemodynamic change occurring with all actual tUS but not under a sham stimulation. The stimulation initiated the increase of oxygenated hemoglobin (HbO) and decrease of deoxygenated hemoglobin (RHb). A statistically significant difference (p < 0.05) was found in the amplitude change of hemodynamics evoked by varying PRF. Moreover, the acoustic stimulation was able to trigger a global as well as local cerebral hemodynamic alteration in the mouse cortex. Thus, the implementation of OISI offers the possibility of directly investigating brain response in an awake animal during tUS through cerebral hemodynamic change.
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Affiliation(s)
- Evgenii Kim
- School of Electrical Engineering and Computer Science, Gwangju Institute of Science and Technology, Gwangju, 61005, Korea
| | - Eloise Anguluan
- Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, Korea
| | - Jae Gwan Kim
- School of Electrical Engineering and Computer Science, Gwangju Institute of Science and Technology, Gwangju, 61005, Korea. .,Department of Biomedical Science and Engineering, Gwangju Institute of Science and Technology, Gwangju, 61005, Korea.
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163
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Abstract
Neuroethics Now welcomes articles addressing the ethical application of neuroscience in research and patient care, as well as its impact on society.
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164
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Baek H, Pahk KJ, Kim H. A review of low-intensity focused ultrasound for neuromodulation. Biomed Eng Lett 2017; 7:135-142. [PMID: 30603160 PMCID: PMC6208465 DOI: 10.1007/s13534-016-0007-y] [Citation(s) in RCA: 90] [Impact Index Per Article: 12.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Revised: 11/05/2016] [Accepted: 11/16/2016] [Indexed: 12/14/2022] Open
Abstract
The ability of ultrasound to be focused into a small region of interest through the intact skull within the brain has led researchers to investigate its potential therapeutic uses for functional neurosurgery and tumor ablation. Studies have used high-intensity focused ultrasound to ablate tissue in localised brain regions for movement disorders and chronic pain while sparing the overlying and surrounding tissue. More recently, low-intensity focused ultrasound (LIFU) that induces reversible biological effects has been emerged as an alternative neuromodulation modality due to its bi-modal (i.e. excitation and suppression) capability with exquisite spatial specificity and depth penetration. Many compelling evidences of LIFU-mediated neuromodulatory effects including behavioral responses, electrophysiological recordings and functional imaging data have been found in the last decades. LIFU, therefore, has the enormous potential to improve the clinical outcomes as well as to replace the currently available neuromodulation techniques such as deep brain stimulation (DBS), transcranial magnetic stimulation and transcranial current stimulation. In this paper, we aim to provide a summary of pioneering studies in the field of ultrasonic neuromodulation including its underlying mechanisms that were published in the last 60 years. In closing, some of potential clinical applications of ultrasonic brain stimulation will be discussed.
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Affiliation(s)
- Hongchae Baek
- Center for Bionics, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Hwarangno 14-gil 5, Seongbuk-gu, Seoul, 02792 Republic of Korea
| | - Ki Joo Pahk
- Center for Bionics, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Hwarangno 14-gil 5, Seongbuk-gu, Seoul, 02792 Republic of Korea
| | - Hyungmin Kim
- Center for Bionics, Biomedical Research Institute, Korea Institute of Science and Technology (KIST), Hwarangno 14-gil 5, Seongbuk-gu, Seoul, 02792 Republic of Korea
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