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Lawler NB, Bhatt U, Agarwal V, Evans CW, Kaluskar P, Amos SE, Chen K, Yao Y, Jiang H, Choi YS, Zheng M, Spagnoli D, Suarez-Martinez I, Zetterlund PB, Wallace VP, Harvey AR, Hodgetts SI, Iyer KS. Transcriptomic Analysis Reveals the Heterogeneous Role of Conducting Films Upon Electrical Stimulation. Adv Healthc Mater 2024:e2400364. [PMID: 39221662 DOI: 10.1002/adhm.202400364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 07/17/2024] [Indexed: 09/04/2024]
Abstract
Central nervous system (CNS) injuries and neurodegenerative diseases have markedly poor prognoses and can result in permanent dysfunction due to the general inability of CNS neurons to regenerate. Differentiation of transplanted stem cells has emerged as a therapeutic avenue to regenerate tissue architecture in damaged areas. Electrical stimulation is a promising approach for directing the differentiation outcomes and pattern of outgrowth of transplanted stem cells, however traditional inorganic bio-electrodes can induce adverse effects such as inflammation. This study demonstrates the implementation of two organic thin films, a polymer/reduced graphene oxide nanocomposite (P(rGO)) and PEDOT:PSS, that have favorable properties for implementation as conductive materials for electrical stimulation, as well as an inorganic indium tin oxide (ITO) conductive film. Transcriptomic analysis reveals that electrical stimulation improves neuronal differentiation of SH-SY5Y cells on all three films, with the greatest effect for P(rGO). Unique material- and electrical stimuli-mediated effects are observed, associated with differentiation, cell-substrate adhesion, and translation. The work demonstrates that P(rGO) and PEDOT:PSS are highly promising organic materials for the development of biocompatible, conductive scaffolds that will enhance electrically-aided stem cell therapeutics for CNS injuries and neurodegenerative diseases.
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Affiliation(s)
- Nicholas B Lawler
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
- School of Physics, Mathematics and Computing, The University of Western Australia, Perth, WA, 6009, Australia
- ARC Training Centre for Next-Gen Technologies in Biomedical Analysis, School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - Uditi Bhatt
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
- ARC Training Centre for Next-Gen Technologies in Biomedical Analysis, School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - Vipul Agarwal
- Cluster for Advanced Macromolecular Design (CAMD), School of Chemical Engineering, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Cameron W Evans
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
- ARC Training Centre for Next-Gen Technologies in Biomedical Analysis, School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - Priya Kaluskar
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
- ARC Training Centre for Next-Gen Technologies in Biomedical Analysis, School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
- Perron Institute for Neurological and Translational Science, Perth, WA, 6009, Australia
- Centre for Orthopaedic Research, The UWA Medical School, The University of Western Australia, Perth, WA, 6009, Australia
- Australian Research Council Centre for Personalised Therapeutics Technologies, University of Melbourne, Melbourne, Victoria, 3010, Australia
| | - Sebastian E Amos
- School of Human Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - Kai Chen
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
- ARC Training Centre for Next-Gen Technologies in Biomedical Analysis, School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
- Department of Chemistry, The University of Hong Kong, Hong Kong, China
| | - Yin Yao
- Electron Microscope Unit, Mark Wainwright Analytical Centre, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Haibo Jiang
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
- ARC Training Centre for Next-Gen Technologies in Biomedical Analysis, School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
- Department of Chemistry, The University of Hong Kong, Hong Kong, China
| | - Yu Suk Choi
- ARC Training Centre for Next-Gen Technologies in Biomedical Analysis, School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
- School of Human Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - Minghao Zheng
- Perron Institute for Neurological and Translational Science, Perth, WA, 6009, Australia
- Centre for Orthopaedic Research, The UWA Medical School, The University of Western Australia, Perth, WA, 6009, Australia
| | - Dino Spagnoli
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | | | - Per B Zetterlund
- Cluster for Advanced Macromolecular Design (CAMD), School of Chemical Engineering, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Vincent P Wallace
- School of Physics, Mathematics and Computing, The University of Western Australia, Perth, WA, 6009, Australia
| | - Alan R Harvey
- Perron Institute for Neurological and Translational Science, Perth, WA, 6009, Australia
- School of Human Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - Stuart I Hodgetts
- Perron Institute for Neurological and Translational Science, Perth, WA, 6009, Australia
- School of Human Sciences, The University of Western Australia, Perth, WA, 6009, Australia
| | - K Swaminathan Iyer
- School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
- ARC Training Centre for Next-Gen Technologies in Biomedical Analysis, School of Molecular Sciences, The University of Western Australia, Perth, WA, 6009, Australia
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Fischer QS, Kalikulov D, Viana Di Prisco G, Williams CA, Baldwin PR, Friedlander MJ. Synaptic Plasticity in the Injured Brain Depends on the Temporal Pattern of Stimulation. J Neurotrauma 2024. [PMID: 38818799 DOI: 10.1089/neu.2024.0129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2024] Open
Abstract
Neurostimulation protocols are increasingly used as therapeutic interventions, including for brain injury. In addition to the direct activation of neurons, these stimulation protocols are also likely to have downstream effects on those neurons' synaptic outputs. It is well known that alterations in the strength of synaptic connections (long-term potentiation, LTP; long-term depression, LTD) are sensitive to the frequency of stimulation used for induction; however, little is known about the contribution of the temporal pattern of stimulation to the downstream synaptic plasticity that may be induced by neurostimulation in the injured brain. We explored interactions of the temporal pattern and frequency of neurostimulation in the normal cerebral cortex and after mild traumatic brain injury (mTBI), to inform therapies to strengthen or weaken neural circuits in injured brains, as well as to better understand the role of these factors in normal brain plasticity. Whole-cell (WC) patch-clamp recordings of evoked postsynaptic potentials in individual neurons, as well as field potential (FP) recordings, were made from layer 2/3 of visual cortex in response to stimulation of layer 4, in acute slices from control (naive), sham operated, and mTBI rats. We compared synaptic plasticity induced by different stimulation protocols, each consisting of a specific frequency (1 Hz, 10 Hz, or 100 Hz), continuity (continuous or discontinuous), and temporal pattern (perfectly regular, slightly irregular, or highly irregular). At the individual neuron level, dramatic differences in plasticity outcome occurred when the highly irregular stimulation protocol was used at 1 Hz or 10 Hz, producing an overall LTD in controls and shams, but a robust overall LTP after mTBI. Consistent with the individual neuron results, the plasticity outcomes for simultaneous FP recordings were similar, indicative of our results generalizing to a larger scale synaptic network than can be sampled by individual WC recordings alone. In addition to the differences in plasticity outcome between control (naive or sham) and injured brains, the dynamics of the changes in synaptic responses that developed during stimulation were predictive of the final plasticity outcome. Our results demonstrate that the temporal pattern of stimulation plays a role in the polarity and magnitude of synaptic plasticity induced in the cerebral cortex while highlighting differences between normal and injured brain responses. Moreover, these results may be useful for optimization of neurostimulation therapies to treat mTBI and other brain disorders, in addition to providing new insights into downstream plasticity signaling mechanisms in the normal brain.
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Affiliation(s)
- Quentin S Fischer
- Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA
- FBRI Center for Neurobiology Research, Roanoke, Virginia, USA
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
| | - Djanenkhodja Kalikulov
- Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA
- FBRI Center for Neurobiology Research, Roanoke, Virginia, USA
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
| | | | - Carrie A Williams
- Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA
- FBRI Center for Neurobiology Research, Roanoke, Virginia, USA
| | - Philip R Baldwin
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
| | - Michael J Friedlander
- Fralin Biomedical Research Institute at VTC, Roanoke, Virginia, USA
- FBRI Center for Neurobiology Research, Roanoke, Virginia, USA
- Department of Neuroscience, Baylor College of Medicine, Houston, Texas, USA
- Department of Biological Sciences, Virginia Tech, Blacksburg, Virginia, USA
- Department of Psychiatry and Behavioral Medicine, Virginia Tech Carilion School of Medicine, Roanoke, Virginia, USA
- Faculty of Health Sciences, Virginia Tech, Roanoke, Virginia, USA
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Ranke D, Lee I, Gershanok SA, Jo S, Trotto E, Wang Y, Balakrishnan G, Cohen-Karni T. Multifunctional Nanomaterials for Advancing Neural Interfaces: Recording, Stimulation, and Beyond. Acc Chem Res 2024; 57:1803-1814. [PMID: 38859612 PMCID: PMC11223263 DOI: 10.1021/acs.accounts.4c00138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/29/2024] [Revised: 05/30/2024] [Accepted: 05/30/2024] [Indexed: 06/12/2024]
Abstract
ConspectusNeurotechnology has seen dramatic improvements in the last three decades. The major focus in the field has been to design electrical communication platforms with high spatial resolution, stability, and translatability for understanding and affecting neural pathways. The deployment of nanomaterials in bioelectronics has enhanced the capabilities of conventional approaches employing microelectrode arrays (MEAs) for electrical interfaces, allowing the construction of miniaturized, high-performance neuroelectronics (Garg, R.; et al. ACS Appl. Nano Mater. 2023, 6, 8495). While these advancements in the electrical neuronal interface have revolutionized neurotechnology both in scale and breadth, an in-depth understanding of neurons' interactions is challenging due to the complexity of the environments where the cells and tissues are laid. The activity of large, three-dimensional neuronal systems has proven difficult to accurately monitor and modulate, and chemical cell-cell communication is often completely neglected. Recent breakthroughs in nanotechnology have provided opportunities to use new nonelectric modes of communication with neurons and to significantly enhance electrical signal interface capabilities. The enhanced electrochemical activity and optical activity of nanomaterials owing to their nonbulk electronic properties and surface nanostructuring have seen extensive utilization. Nanomaterials' enhanced optical activity enables remote neural state modulation, whereas the defect-rich surfaces provide an enormous number of available electrocatalytic sites for neurochemical detection and electrochemical modulation of cell microenvironments through Faradaic processes. Such unique properties can allow multimodal neural interrogation toward generating closed-loop interfaces with access to more complete neural state descriptors. In this Account, we will review recent advances and our efforts spearheaded toward utilizing nanostructured electrodes for enhanced bidirectional interfaces with neurons, the application of unique hybrid nanomaterials for remote nongenetic optical stimulation of neurons, tunable nanomaterials for highly sensitive and selective neurotransmitter detection, and the utilization of nanomaterials as electrocatalysts toward electrochemically modulating cellular activity. We highlight applications of these technologies across cell types through nanomaterial engineering with a focus on multifunctional graphene nanostructures applied though several modes of neural modulation but also an exploration of broad material classes for maximizing the potency of closed-loop bioelectronics.
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Affiliation(s)
- Daniel Ranke
- Department
of Materials Science and Engineering, Carnegie
Mellon University, Pittsburgh, Pennsylvania 15213, United States of America
| | - Inkyu Lee
- Department
of Materials Science and Engineering, Carnegie
Mellon University, Pittsburgh, Pennsylvania 15213, United States of America
| | - Samuel A. Gershanok
- Department
of Materials Science and Engineering, Carnegie
Mellon University, Pittsburgh, Pennsylvania 15213, United States of America
| | - Seonghan Jo
- Department
of Materials Science and Engineering, Carnegie
Mellon University, Pittsburgh, Pennsylvania 15213, United States of America
| | - Emily Trotto
- Department
of Materials Science and Engineering, Carnegie
Mellon University, Pittsburgh, Pennsylvania 15213, United States of America
| | - Yingqiao Wang
- Department
of Materials Science and Engineering, Carnegie
Mellon University, Pittsburgh, Pennsylvania 15213, United States of America
| | - Gaurav Balakrishnan
- Department
of Materials Science and Engineering, Carnegie
Mellon University, Pittsburgh, Pennsylvania 15213, United States of America
| | - Tzahi Cohen-Karni
- Department
of Materials Science and Engineering, Carnegie
Mellon University, Pittsburgh, Pennsylvania 15213, United States of America
- Department
of Biomedical Engineering, Carnegie Mellon
University, Pittsburgh, Pennsylvania 15213, United States of America
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Varela RB, Boschen SL, Yates N, Houghton T, Blaha CD, Lee KH, Bennet KE, Kouzani AZ, Berk M, Quevedo J, Valvassori SS, Tye SJ. Anti-manic effect of deep brain stimulation of the ventral tegmental area in an animal model of mania induced by methamphetamine. Bipolar Disord 2024; 26:376-387. [PMID: 38558302 DOI: 10.1111/bdi.13423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
BACKGROUND Treatment of refractory bipolar disorder (BD) is extremely challenging. Deep brain stimulation (DBS) holds promise as an effective treatment intervention. However, we still understand very little about the mechanisms of DBS and its application on BD. AIM The present study aimed to investigate the behavioural and neurochemical effects of ventral tegmental area (VTA) DBS in an animal model of mania induced by methamphetamine (m-amph). METHODS Wistar rats were given 14 days of m-amph injections, and on the last day, animals were submitted to 20 min of VTA DBS in two different patterns: intermittent low-frequency stimulation (LFS) or continuous high-frequency stimulation (HFS). Immediately after DBS, manic-like behaviour and nucleus accumbens (NAc) phasic dopamine (DA) release were evaluated in different groups of animals through open-field tests and fast-scan cyclic voltammetry. Levels of NAc dopaminergic markers were evaluated by immunohistochemistry. RESULTS M-amph induced hyperlocomotion in the animals and both DBS parameters reversed this alteration. M-amph increased DA reuptake time post-sham compared to baseline levels, and both LFS and HFS were able to block this alteration. LFS was also able to reduce phasic DA release when compared to baseline. LFS was able to increase dopamine transporter (DAT) expression in the NAc. CONCLUSION These results demonstrate that both VTA LFS and HFS DBS exert anti-manic effects and modulation of DA dynamics in the NAc. More specifically the increase in DA reuptake driven by increased DAT expression may serve as a potential mechanism by which VTA DBS exerts its anti-manic effects.
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Affiliation(s)
- Roger B Varela
- Functional Neuromodulation and Novel Therapeutics Laboratory, Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Suelen L Boschen
- Department of Neurologic Surgery, Neural Engineering Laboratories, Mayo Clinic, Rochester, Minnesota, USA
- Department of Neurologic Surgery, Applied Computational Neurophysiology and Neuromodulation Laboratory, Mayo Clinic, Rochester, Minnesota, USA
| | - Nathanael Yates
- Functional Neuromodulation and Novel Therapeutics Laboratory, Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Tristan Houghton
- Functional Neuromodulation and Novel Therapeutics Laboratory, Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - Charles D Blaha
- Department of Neurologic Surgery, Neural Engineering Laboratories, Mayo Clinic, Rochester, Minnesota, USA
| | - Kendall H Lee
- Department of Neurologic Surgery, Neural Engineering Laboratories, Mayo Clinic, Rochester, Minnesota, USA
| | - Kevin E Bennet
- Department of Neurologic Surgery, Neural Engineering Laboratories, Mayo Clinic, Rochester, Minnesota, USA
- Division of Engineering, Mayo Clinic, Rochester, Minnesota, USA
| | - Abbas Z Kouzani
- School of Engineering, Deakin University, Geelong, Victoria, Australia
| | - Michael Berk
- School of Medicine, IMPACT-The Institute for Mental and Physical Health and Clinical Translation, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - João Quevedo
- Faillace Department of Psychiatry and Behavioral Sciences, Center for Interventional Psychiatry, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth Houston), Houston, Texas, USA
- Faillace Department of Psychiatry and Behavioral Sciences, Center of Excellence on Mood Disorders, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
- Faillace Department of Psychiatry and Behavioral Sciences, Translational Psychiatry Program, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, Texas, USA
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Santa Catarina, Brazil
| | - Samira S Valvassori
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, Santa Catarina, Brazil
| | - Susannah J Tye
- Functional Neuromodulation and Novel Therapeutics Laboratory, Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
- Department of Psychiatry and Psychology, Translational Neuroscience Laboratory, Mayo Clinic, Rochester, Minnesota, USA
- Department of Psychiatry, University of Minnesota, Minneapolis, Minnesota, USA
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, Georgia, USA
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Morton A, Fraser H, Green C, Drovandi A. Effectiveness of Deep Brain Stimulation in Improving Balance in Parkinson's Disease: A Systematic Review and Meta-Analysis. World Neurosurg 2024; 186:242-251.e3. [PMID: 38608807 DOI: 10.1016/j.wneu.2024.04.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2024] [Revised: 04/02/2024] [Accepted: 04/03/2024] [Indexed: 04/14/2024]
Abstract
BACKGROUND Balance dysfunction is a debilitating feature of advanced Parkinson's disease (PD), potentially improved by deep brain stimulation (DBS). This systematic review and meta-analysis pooled evidence from randomized controlled trials (RCTs) on DBS effectiveness in improving balance in PD. METHODS A systematic search was conducted to identify eligible RCTs investigating the effectiveness of DBS on improving balance in people with PD. Meta-analysis was performed using random effects models and reported as mean difference and 95% confidence intervals. Risk of bias was assessed using Cochrane's ROB-2 tool. RESULTS Seventeen RCTs were eligible (n = 333), utilizing a range of stimulation sites, parameters, reporting tools for balance outcomes, and control/comparator groups, making the identification of clear trends and recommendations difficult. Eleven studies were deemed as having some risk of bias, 4 having low risk of bias and 2 having high risk of bias. One small meta-analysis was conducted and found no significant difference in balance outcomes. Most studies reported no significant improvement in Timed Up-and-Go scores, Berg Balance Scale scores, frequency of falls, and balance-related items of the Movement Disorder Society's Unified Parkinson's Disease Rating Scales. Some studies reported improvements in the Tinetti balance test, posturography readings, and reduction in falls though these were not supported by other studies due to a lack of reporting on these items or conflicting findings. CONCLUSIONS Current research suggests that DBS results in no significant improvement in balance dysfunction for people with PD, though such assertions require larger RCTs with clear reporting methods using validated reporting tools.
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Affiliation(s)
- Amy Morton
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Holly Fraser
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Chloe Green
- School of Biomedical Sciences, Faculty of Biological Sciences, University of Leeds, Leeds, United Kingdom
| | - Aaron Drovandi
- School of Medical Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, United Kingdom.
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Chao-Chia Lu D, Boulay C, Chan ADC, Sachs AJ. A Systematic Review of Neurophysiology-Based Localization Techniques Used in Deep Brain Stimulation Surgery of the Subthalamic Nucleus. Neuromodulation 2024; 27:409-421. [PMID: 37462595 DOI: 10.1016/j.neurom.2023.02.081] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 01/13/2023] [Accepted: 02/09/2023] [Indexed: 04/05/2024]
Abstract
OBJECTIVE This systematic review is conducted to identify, compare, and analyze neurophysiological feature selection, extraction, and classification to provide a comprehensive reference on neurophysiology-based subthalamic nucleus (STN) localization. MATERIALS AND METHODS The review was carried out using the methods and guidelines of the Kitchenham systematic review and provides an in-depth analysis on methods proposed on STN localization discussed in the literature between 2000 and 2021. Three research questions were formulated, and 115 publications were identified to answer the questions. RESULTS The three research questions formulated are answered using the literature found on the respective topics. This review discussed the technologies used in past research, and the performance of the state-of-the-art techniques is also reviewed. CONCLUSION This systematic review provides a comprehensive reference on neurophysiology-based STN localization by reviewing the research questions other new researchers may also have.
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Affiliation(s)
| | | | | | - Adam J Sachs
- The Ottawa Hospital Research Institute, Ottawa, ON, Canada
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7
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Wang Z, Zheng Z, Huang J, Cai X, Liu X, Xue C, Yao L, Lu G. Neurocognitive changes at different follow-up times after bilateral subthalamic nucleus deep brain stimulation in patients with Parkinson's disease. Heliyon 2024; 10:e26303. [PMID: 38379975 PMCID: PMC10877422 DOI: 10.1016/j.heliyon.2024.e26303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2023] [Revised: 02/08/2024] [Accepted: 02/09/2024] [Indexed: 02/22/2024] Open
Abstract
Background Bilateral deep thalamic nucleus brain stimulation (STN-DBS) surgery is often used to treat the motor symptoms of patients with Parkinson's disease. The change of neurocognitive symptoms in patients is, however, still unclear. Objective We aimed at analyzing the deterioration of neurocognitive symptoms in patients with Parkinson's disease after deep brain stimulation surgery under different follow-up times. Methods A comprehensive literature review was conducted using Pubmed, Cochrane Library, and Web of Science to screen eligible study records, the meta-analysis was performed using an inverse variance method and a random-effects model. Additionally, the areas of analysis include five: cognition, executive function, memory capacity, and verbal fluency (phonetic fluency and semantic fluency). They were analyzed for changes at six and twelve months postoperatively compared to baseline. The Meta-analysis has been registered with PROSPERO under the registration number: CRD42022308786. Results In terms of overall cognitive performance, executive function, and memory capacity, the original studies show a trend of improvement in these areas at 12 months postoperatively compared with 6 months, at variance, patients did not improve or deteriorated in phonetic fluency(d = -0.42 at both 6-month and 12-month follow-up) and semantic fluency from 6 to 12 months postoperatively. Conclusion In terms of most neurocognitive symptoms, including cognitive ability, executive function, and learning memory capacity, bilateral STN-DBS surgery appears to be safe at relatively long follow-up times. However, postoperative phonetic and semantic fluency changes should still not be underestimated, and clinicians should pay more attention to patients' changes in both.
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Affiliation(s)
- Zhuohang Wang
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Zijian Zheng
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Junwen Huang
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Xu Cai
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Xinjie Liu
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Cheng Xue
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
| | - Longping Yao
- Institute for Anatomy and Cell Biology, Medical Faculty, Heidelberg University, 69120, Heidelberg, Germany
| | - Guohui Lu
- Department of Neurosurgery, The First Affiliated Hospital of Nanchang University, Nanchang, 330006, China
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8
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Huang H, Shakkottai VG. Targeting Ion Channels and Purkinje Neuron Intrinsic Membrane Excitability as a Therapeutic Strategy for Cerebellar Ataxia. Life (Basel) 2023; 13:1350. [PMID: 37374132 DOI: 10.3390/life13061350] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 06/03/2023] [Accepted: 06/06/2023] [Indexed: 06/29/2023] Open
Abstract
In degenerative neurological disorders such as Parkinson's disease, a convergence of widely varying insults results in a loss of dopaminergic neurons and, thus, the motor symptoms of the disease. Dopamine replacement therapy with agents such as levodopa is a mainstay of therapy. Cerebellar ataxias, a heterogeneous group of currently untreatable conditions, have not been identified to have a shared physiology that is a target of therapy. In this review, we propose that perturbations in cerebellar Purkinje neuron intrinsic membrane excitability, a result of ion channel dysregulation, is a common pathophysiologic mechanism that drives motor impairment and vulnerability to degeneration in cerebellar ataxias of widely differing genetic etiologies. We further propose that treatments aimed at restoring Purkinje neuron intrinsic membrane excitability have the potential to be a shared therapy in cerebellar ataxia akin to levodopa for Parkinson's disease.
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Affiliation(s)
- Haoran Huang
- Medical Scientist Training Program, The Ohio State University College of Medicine, Columbus, OH 43210, USA
| | - Vikram G Shakkottai
- Department of Neurology, The University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
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9
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Cota VR, Cançado SAV, Moraes MFD. On temporal scale-free non-periodic stimulation and its mechanisms as an infinite improbability drive of the brain's functional connectogram. Front Neuroinform 2023; 17:1173597. [PMID: 37293579 PMCID: PMC10244597 DOI: 10.3389/fninf.2023.1173597] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 05/02/2023] [Indexed: 06/10/2023] Open
Abstract
Rationalized development of electrical stimulation (ES) therapy is of paramount importance. Not only it will foster new techniques and technologies with increased levels of safety, efficacy, and efficiency, but it will also facilitate the translation from basic research to clinical practice. For such endeavor, design of new technologies must dialogue with state-of-the-art neuroscientific knowledge. By its turn, neuroscience is transitioning-a movement started a couple of decades earlier-into adopting a new conceptual framework for brain architecture, in which time and thus temporal patterns plays a central role in the neuronal representation of sampled data from the world. This article discusses how neuroscience has evolved to understand the importance of brain rhythms in the overall functional architecture of the nervous system and, consequently, that neuromodulation research should embrace this new conceptual framework. Based on such support, we revisit the literature on standard (fixed-frequency pulsatile stimuli) and mostly non-standard patterns of ES to put forward our own rationale on how temporally complex stimulation schemes may impact neuromodulation strategies. We then proceed to present a low frequency, on average (thus low energy), scale-free temporally randomized ES pattern for the treatment of experimental epilepsy, devised by our group and termed NPS (Non-periodic Stimulation). The approach has been shown to have robust anticonvulsant effects in different animal models of acute and chronic seizures (displaying dysfunctional hyperexcitable tissue), while also preserving neural function. In our understanding, accumulated mechanistic evidence suggests such a beneficial mechanism of action may be due to the natural-like characteristic of a scale-free temporal pattern that may robustly compete with aberrant epileptiform activity for the recruitment of neural circuits. Delivering temporally patterned or random stimuli within specific phases of the underlying oscillations (i.e., those involved in the communication within and across brain regions) could both potentiate and disrupt the formation of neuronal assemblies with random probability. The usage of infinite improbability drive here is obviously a reference to the "The Hitchhiker's Guide to the Galaxy" comedy science fiction classic, written by Douglas Adams. The parallel is that dynamically driving brain functional connectogram, through neuromodulation, in a manner that would not favor any specific neuronal assembly and/or circuit, could re-stabilize a system that is transitioning to fall under the control of a single attractor. We conclude by discussing future avenues of investigation and their potentially disruptive impact on neurotechnology, with a particular interest in NPS implications in neural plasticity, motor rehabilitation, and its potential for clinical translation.
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Affiliation(s)
- Vinícius Rosa Cota
- Rehab Technologies - INAIL Lab, Istituto Italiano di Tecnologia, Genoa, Italy
- Laboratory of Neuroengineering and Neuroscience, Department of Electrical Engineering, Federal University of São João del-Rei, São João del Rei, Brazil
| | - Sérgio Augusto Vieira Cançado
- Núcleo Avançado de Tratamento das Epilepsias (NATE), Felício Rocho Hospital, Fundação Felice Rosso, Belo Horizonte, Brazil
| | - Márcio Flávio Dutra Moraes
- Department of Physiology and Biophysics, Núcleo de Neurociências, Federal University of Minas Gerais, Belo Horizonte, Brazil
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10
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Branco LRF, Viswanathan A, Tarakad A, Ince NF. Construction of semi-supervised spatial projections to identify the source of beta- and high frequency oscillations in Parkinson's disease. INTERNATIONAL IEEE/EMBS CONFERENCE ON NEURAL ENGINEERING : [PROCEEDINGS]. INTERNATIONAL IEEE EMBS CONFERENCE ON NEURAL ENGINEERING 2023; 2023:10.1109/ner52421.2023.10123890. [PMID: 37601420 PMCID: PMC10440159 DOI: 10.1109/ner52421.2023.10123890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/22/2023]
Abstract
Traditional deep brain stimulation (DBS) treatment for Parkinson's disease (PD) targets the placement of DBS leads into subthalamic nucleus (STN). Extraction of neurobiomarkers from STN local field potential activity can be used for the optimization of DBS. Beta (12-30 Hz) and high frequency oscillations (200-450 Hz, HFO) of STN and their phase-amplitude coupling have been previously correlated with symptom severity in PD. The typical approach is to take bipolar derivations of electrode contacts in order to enhance recordings of local brain activity and suppress noise levels. This approach can often cancel the signals in correlated neighboring contacts and create ambiguity in which monopolar contact to select for the identification of the main source of the oscillatory signal. To improve local specificity and help identify the source of beta and HFO in terms of electrode contact, we propose a semi supervised blind-source separation method. This approach presents a novel perspective to investigate electrophysiology by projecting the recorded channels into a subspace of virtual channels. We show the contribution of each channel to the identified source and correlate the spatial information with imaging and postoperative programming parameters. We anticipate such a source identification strategy can be used in the future to investigate the distribution of beta and HFO on individual contacts of the DBS lead and can improve the interpretation of these signals.
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Affiliation(s)
- Luciano R F Branco
- Department of Biomedical Engineering, University of Houston, Houston, TX, USA
| | - Ashwin Viswanathan
- Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA
| | - Arjun Tarakad
- Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - Nuri F Ince
- Department of Biomedical Engineering, University of Houston, Houston, TX, USA
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11
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Fan JP, Zhang X, Han Y, Ji Y, Gu WX, Wu HC, Zhou C, Xiao C. Subthalamic neurons interact with nigral dopaminergic neurons to regulate movement in mice. Acta Physiol (Oxf) 2023; 237:e13917. [PMID: 36598331 DOI: 10.1111/apha.13917] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 11/05/2022] [Accepted: 01/02/2023] [Indexed: 01/05/2023]
Abstract
AIM This study aims to address the role of the interaction between subthalamic (STN) neurons and substantia nigra pars compacta (SNc) dopaminergic (DA) neurons in movement control. METHODS Fiber photometry and optogenetic/chemogenetic techniques were utilized to monitor and manipulate neuronal activity, respectively. Locomotion in mice was recorded in an open field arena and on a head-fixed apparatus. A hemiparkinsonian mouse model was established by unilateral injection of 6-OHDA in the medial forebrain bundle. Whole-cell patch-clamp techniques were applied to record electrophysiological signals in STN neurons and SNc DA neurons. c-Fos-immunostaining was used to label activated neurons. A rabies virus-based retrograde tracing system was used to visualize STN neurons projecting to SNc DA neurons. RESULTS The activity of STN neurons was enhanced upon locomotion in an open field arena and on a head-fixed apparatus, and the enhancement was significantly attenuated in parkinsonian mice. Optogenetic stimulation of STN neurons enhanced locomotion, increased activity of SNc DA neurons, meanwhile, reduced latency to movement initiation. Combining optogenetics with patch-clamp recordings, we confirmed that STN neurons innervated SNc DA neurons through glutamatergic monosynaptic connections. Moreover, STN neurons projecting to SNc DA neurons were evenly distributed in the STN. Either 6-OHDA-lesion or chemogenetic inhibition of SNc DA neurons attenuated the enhancement of locomotion by STN stimulation. CONCLUSION SNc DA neurons not only affect the response of STN neurons to movement, but also contribute to the enhancement of movement by STN stimulation. This study demonstrates the role of STN-SNc interaction in movement control.
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Affiliation(s)
- Jiang-Peng Fan
- School of basic medical sciences, Xuzhou Medical University, Xuzhou, China.,Institute of Nervous System Diseases, Xuzhou Medical University, Xuzhou, China
| | - Xue Zhang
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Yu Han
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Ying Ji
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Wei-Xin Gu
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China.,Department of Anesthesiology, Drum Tower Hospital, affiliated to Nanjing University, Nanjing, China
| | - Hai-Chuan Wu
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China.,Department of Anesthesiology, Drum Tower Hospital, affiliated to Nanjing University, Nanjing, China
| | - Chunyi Zhou
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China.,Jiangsu Province Key Laboratory in Anesthesiology, Xuzhou Medical University, Xuzhou, China
| | - Cheng Xiao
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, China.,Jiangsu Province Key Laboratory in Anesthesiology, Xuzhou Medical University, Xuzhou, China
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12
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Ji YW, Zhang X, Fan JP, Gu WX, Shen ZL, Wu HC, Cui G, Zhou C, Xiao C. Differential remodeling of subthalamic projections to basal ganglia output nuclei and locomotor deficits in 6-OHDA-induced hemiparkinsonian mice. Cell Rep 2023; 42:112178. [PMID: 36857188 DOI: 10.1016/j.celrep.2023.112178] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Revised: 11/04/2022] [Accepted: 02/13/2023] [Indexed: 03/02/2023] Open
Abstract
The subthalamic nucleus (STN) controls basal ganglia outputs via the substantia nigra pars reticulata (SNr) and the globus pallidus internus (GPi). However, the synaptic properties of these projections and their roles in motor control remain unclear. We show that the STN-SNr and STN-GPi projections differ markedly in magnitude and activity-dependent plasticity despite the existence of collateral STN neurons projecting to both the SNr and GPi. Stimulation of either STN projection reduces locomotion; in contrast, inhibition of either the STN-SNr projection or collateral STN neurons facilitates locomotion. In 6-OHDA-hemiparkinsonian mice, the STN-SNr projection is dramatically attenuated, but the STN-GPi projection is robustly enhanced; apomorphine inhibition of the STN-GPi projection through D2 receptors is significantly augmented and improves locomotion. Optogenetic inhibition of either the STN-SNr or STN-GPi projection improves parkinsonian bradykinesia. These results suggest that the STN-GPi and STN-SNr projections are differentially involved in motor control in physiological and parkinsonian conditions.
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Affiliation(s)
- Ya-Wei Ji
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China; Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China; NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, School of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Xue Zhang
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China; Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou 221006, China
| | - Jiang-Peng Fan
- Department of Biochemistry and Molecular Biology, School of Basic Medicine, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China; Jiangsu Province Key Laboratory in Brain Diseases, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China
| | - Wei-Xin Gu
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China; Department of Anesthesiology, Nanjing Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu 210008, China
| | - Zi-Lin Shen
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China
| | - Hai-Chuan Wu
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China; Department of Anesthesiology, Nanjing Drum Tower Hospital, School of Medicine, Nanjing University, Nanjing, Jiangsu 210008, China
| | - Guiyun Cui
- Department of Neurology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou Medical University, Xuzhou 221006, China.
| | - Chunyi Zhou
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China; Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China; NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, School of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China.
| | - Cheng Xiao
- School of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu, China; Jiangsu Province Key Laboratory of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China; NMPA Key Laboratory for Research and Evaluation of Narcotic and Psychotropic Drugs, School of Anesthesiology, Xuzhou Medical University, Xuzhou, Jiangsu 221004, China.
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13
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Honma M, Sasaki F, Kamo H, Nuermaimaiti M, Kujirai H, Atsumi T, Umemura A, Iwamuro H, Shimo Y, Oyama G, Hattori N, Terao Y. Role of the subthalamic nucleus in perceiving and estimating the passage of time. Front Aging Neurosci 2023; 15:1090052. [PMID: 36936495 PMCID: PMC10017994 DOI: 10.3389/fnagi.2023.1090052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 01/25/2023] [Indexed: 03/06/2023] Open
Abstract
Sense of time (temporal sense) is believed to be processed by various brain regions in a complex manner, among which the basal ganglia, including the striatum and subthalamic nucleus (STN), play central roles. However, the precise mechanism for processing sense of time has not been clarified. To examine the role of the STN in temporal processing of the sense of time by directly manipulating STN function by switching a deep brain stimulation (DBS) device On/Off in 28 patients with Parkinson's disease undergoing STN-DBS therapy. The test session was performed approximately 20 min after switching the DBS device from On to Off or from Off to On. Temporal sense processing was assessed in three different tasks (time reproduction, time production, and bisection). In the three temporal cognitive tasks, switching STN-DBS to Off caused shorter durations to be produced compared with the switching to the On condition in the time production task. In contrast, no effect of STN-DBS was observed in the time bisection or time reproduction tasks. These findings suggest that the STN is involved in the representation process of time duration and that the role of the STN in the sense of time may be limited to the exteriorization of memories formed by experience.
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Affiliation(s)
- Motoyasu Honma
- Department of Medical Physiology, Kyorin University of School of Medicine, Tokyo, Japan
- *Correspondence: Motoyasu Honma,
| | - Fuyuko Sasaki
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Hikaru Kamo
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | | | - Hitoshi Kujirai
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Takeshi Atsumi
- Department of Medical Physiology, Kyorin University of School of Medicine, Tokyo, Japan
| | - Atsushi Umemura
- Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Hirokazu Iwamuro
- Department of Neurosurgery, Juntendo University School of Medicine, Tokyo, Japan
| | - Yasushi Shimo
- Department of Neurology, Juntendo University Nerima Hospital, Tokyo, Japan
| | - Genko Oyama
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Nobutaka Hattori
- Department of Neurology, Juntendo University School of Medicine, Tokyo, Japan
| | - Yasuo Terao
- Department of Medical Physiology, Kyorin University of School of Medicine, Tokyo, Japan
- Yasuo Terao,
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14
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Alosaimi F, Boonstra JT, Tan S, Temel Y, Jahanshahi A. The role of neurotransmitter systems in mediating deep brain stimulation effects in Parkinson’s disease. Front Neurosci 2022; 16:998932. [PMID: 36278000 PMCID: PMC9579467 DOI: 10.3389/fnins.2022.998932] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 09/14/2022] [Indexed: 11/24/2022] Open
Abstract
Deep brain stimulation (DBS) is among the most successful paradigms in both translational and reverse translational neuroscience. DBS has developed into a standard treatment for movement disorders such as Parkinson’s disease (PD) in recent decades, however, specific mechanisms behind DBS’s efficacy and side effects remain unrevealed. Several hypotheses have been proposed, including neuronal firing rate and pattern theories that emphasize the impact of DBS on local circuitry but detail distant electrophysiological readouts to a lesser extent. Furthermore, ample preclinical and clinical evidence indicates that DBS influences neurotransmitter dynamics in PD, particularly the effects of subthalamic nucleus (STN) DBS on striatal dopaminergic and glutamatergic systems; pallidum DBS on striatal dopaminergic and GABAergic systems; pedunculopontine nucleus DBS on cholinergic systems; and STN-DBS on locus coeruleus (LC) noradrenergic system. DBS has additionally been associated with mood-related side effects within brainstem serotoninergic systems in response to STN-DBS. Still, addressing the mechanisms of DBS on neurotransmitters’ dynamics is commonly overlooked due to its practical difficulties in monitoring real-time changes in remote areas. Given that electrical stimulation alters neurotransmitter release in local and remote regions, it eventually exhibits changes in specific neuronal functions. Consequently, such changes lead to further modulation, synthesis, and release of neurotransmitters. This narrative review discusses the main neurotransmitter dynamics in PD and their role in mediating DBS effects from preclinical and clinical data.
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Affiliation(s)
- Faisal Alosaimi
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Rabigh, Saudi Arabia
- *Correspondence: Faisal Alosaimi,
| | - Jackson Tyler Boonstra
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Sonny Tan
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands
| | - Ali Jahanshahi
- Department of Neurosurgery, Maastricht University Medical Centre, Maastricht, Netherlands
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, Netherlands
- Ali Jahanshahi,
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15
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Ghodratitoostani I, Gonzatto OA, Vaziri Z, Delbem ACB, Makkiabadi B, Datta A, Thomas C, Hyppolito MA, Santos ACD, Louzada F, Leite JP. Dose-Response Transcranial Electrical Stimulation Study Design: A Well-Controlled Adaptive Seamless Bayesian Method to Illuminate Negative Valence Role in Tinnitus Perception. Front Hum Neurosci 2022; 16:811550. [PMID: 35677206 PMCID: PMC9169505 DOI: 10.3389/fnhum.2022.811550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Accepted: 03/23/2022] [Indexed: 11/30/2022] Open
Abstract
The use of transcranial Electrical Stimulation (tES) in the modulation of cognitive brain functions to improve neuropsychiatric conditions has extensively increased over the decades. tES techniques have also raised new challenges associated with study design, stimulation protocol, functional specificity, and dose-response relationship. In this paper, we addressed challenges through the emerging methodology to investigate the dose-response relationship of High Definition-transcranial Direct Current Stimulation (HD tDCS), identifying the role of negative valence in tinnitus perception. In light of the neurofunctional testable framework and tES application, hypotheses were formulated to measure clinical and surrogate endpoints. We posited that conscious pairing adequately pleasant stimuli with tinnitus perception results in correction of the loudness misperception and would be reinforced by concurrent active HD-tDCS on the left Dorsolateral Prefrontal Cortex (dlPFC). The dose-response relationship between HD-tDCS specificity and the loudness perception is also modeled. We conducted a double-blind, randomized crossover pilot study with six recruited tinnitus patients. Accrued data was utilized to design a well-controlled adaptive seamless Bayesian dose-response study. The sample size (n = 47, for 90% power and 95% confidence) and optimum interims were anticipated for adaptive decision-making about efficacy, safety, and single session dose parameters. Furthermore, preliminary pilot study results were sufficient to show a significant difference (90% power, 99% confidence) within the longitudinally detected self-report tinnitus loudness between before and under positive emotion induction. This study demonstrated a research methodology used to improve emotion regulation in tinnitus patients. In the projected method, positive emotion induction is essential for promoting functional targeting under HD-tDCS anatomical specificity to indicate the efficacy and facilitate the dose-finding process. The continuous updating of prior knowledge about efficacy and dose during the exploratory stage adapts the anticipated dose-response model. Consequently, the effective dose range to make superiority neuromodulation in correcting loudness misperception of tinnitus will be redefined. Highly effective dose adapts the study to a standard randomized trial and transforms it into the confirmatory stage in which active HD-tDCS protocol is compared with a sham trial (placebo-like). Establishing the HD-tDCS intervention protocols relying on this novel method provides reliable evidence for regulatory agencies to approve or reject the efficacy and safety. Furthermore, this paper supports a technical report for designing multimodality data-driven complementary investigations in emotion regulation, including EEG-driven neuro markers, Stroop-driven attention biases, and neuroimaging-driven brain network dynamics.
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Affiliation(s)
- Iman Ghodratitoostani
- Neurocognitive Engineering Laboratory, Center for Engineering Applied to Health, Institute of Mathematics and Computer Science, University of São Paulo, São Carlos, Brazil
- *Correspondence: Iman Ghodratitoostani
| | - Oilson A. Gonzatto
- Institute of Mathematics and Computer Science, University of São Paulo, São Carlos, Brazil
| | - Zahra Vaziri
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
| | - Alexandre C. B. Delbem
- Neurocognitive Engineering Laboratory, Center for Engineering Applied to Health, Institute of Mathematics and Computer Science, University of São Paulo, São Carlos, Brazil
| | - Bahador Makkiabadi
- Research Center for Biomedical Technologies and Robotics, Institute for Advanced Medical Technologies, Tehran, Iran
- Department of Medical Physics and Biomedical Engineering, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | | | | | - Miguel A. Hyppolito
- Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirao Preto, Brazil
| | - Antonio C. D. Santos
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
| | - Francisco Louzada
- Institute of Mathematics and Computer Science, University of São Paulo, São Carlos, Brazil
| | - João Pereira Leite
- Department of Neuroscience and Behavior, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirao Preto, Brazil
- João Pereira Leite
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16
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Battista VD, Hey-Hawkins E. Development of Prodrugs for Treatment of Parkinson's Disease: New Inorganic Scaffolds for Blood-Brain Barrier Permeation. J Pharm Sci 2022; 111:1262-1279. [PMID: 35182542 DOI: 10.1016/j.xphs.2022.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/13/2022] [Accepted: 02/14/2022] [Indexed: 10/19/2022]
Abstract
The treatment of Parkinson's disease (PD) has not been consistently modified for more than 60 years. L-DOPA, the blood-brain barrier permeable precursor prodrug of dopamine, is to date the only effective therapy on the market. However, it is well known that prolonged treatment with L-DOPA leads to several side effects, which may affect the patient's life expectancy (i.e., the wearing-off phenomenon, on-off fluctuations, and dyskinesia). For this reason, modifications, and supplements to L-DOPA treatment have been and are being studied, which, however, have not yet resulted in a valid alternative to the cornerstone drug. This review aims to summarize the main formulations currently in use for PD treatment, explaining advantages and disadvantages for each class. The attention will be focused on the promising prodrug concept, aimed at finding a suitable L-DOPA substitute with improved pharmacokinetic behavior. In this respect, new potential candidates which show interesting properties for the intended scope, the so-called dicarba-closo-dodecaboranes(12) (carboranes), will be discussed. Carboranes are inorganic molecular icosahedral boron-carbon clusters with 12 vertices and 20 deltahedral faces. They have been extensively studied for applications in medicine as potential pharmacophores, reagents in boron neutron capture therapy (BNCT) and radiotherapy. Here, we discuss them as inorganic scaffolds for dopamine delivery at the central nervous system (CNS) level.
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Key Words
- %F, Oral Bioavailability
- 5-HTP, L-5-Hydroxy-Tryptophan
- AADC, Aromatic L-Amino Acid Decarboxylase
- AGPs, Arabinogalactan Proteins
- AUC, Area Under the Plasma Concentration Curve
- Abbreviations
- BBB, Blood–Brain Barrier
- BNCT, Boron Neutron Capture Therapy
- CNS, Central Nervous System
- COMT, Catechol-O-Methyltransferase
- DBS, Deep Brain Stimulation
- DDC, Dopamine Decarboxylase
- DMSO, Dimethylsulfoxide
- FAD, Flavin Adenine Dinucleotide
- FDA, Food and Drug Administration
- GPCRs, G-Protein-Coupled Receptors
- HIV, Human Immunodeficiency Virus
- HSA, Human Serum Albumin
- ICT, Intramolecular Charge Transfer
- IPG, Implanted Pulse Generator
- IUPAC, International Union of Pure and Applied Chemistry
- IV, Intravenous Injection
- LDEE, L-DOPA Ethyl Ester
- LNAA, Large Neutral Amino Acid transport system
- MAO-A/B, Monoamine Oxidase-A/B
- MPO, Multiparameter Optimization
- Mw, Molecular Weight
- NMDAR, N-Methyl D-Aspartate Receptor
- P, Partition Coefficient
- PAMPA, Parallel Artificial Membrane Permeability Assay
- PD, Parkinson's Disease
- PLP, Pyridoxal Phosphate
- PNS, Peripheral Nervous System
- Parkinson's disease, Dopamine, Blood–brain barrier, Permeability, Bioavailability, L-DOPA, Prodrugs, Inorganic scaffold, Icosahedral carborane
- SAM, S-Adenosyl L-Methionine
- STN, Subthalamic Nucleus
- TBP, Tetrahydrobiopterin
- UPDRS, Unified Parkinson's Disease Rating Scale
- VTA, Ventral Tegmental Are
- hBMECs, human Brain Microvascular Endothelial Cells
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Affiliation(s)
- Veronica Di Battista
- Leipzig University, Faculty of Chemistry and Mineralogy, Institute of Inorganic Chemistry, Johannisallee 29, 04103 Leipzig, Germany
| | - Evamarie Hey-Hawkins
- Leipzig University, Faculty of Chemistry and Mineralogy, Institute of Inorganic Chemistry, Johannisallee 29, 04103 Leipzig, Germany.
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17
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Corripio I, Roldán A, McKenna P, Sarró S, Alonso-Solís A, Salgado L, Álvarez E, Molet J, Pomarol-Clotet E, Portella M. Target selection for deep brain stimulation in treatment resistant schizophrenia. Prog Neuropsychopharmacol Biol Psychiatry 2022; 112:110436. [PMID: 34517055 DOI: 10.1016/j.pnpbp.2021.110436] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 08/28/2021] [Accepted: 09/07/2021] [Indexed: 11/19/2022]
Abstract
The use of deep brain stimulation (DBS) in treatment resistant patients with schizophrenia is of considerable current interest, but where to site the electrodes is challenging. This article reviews rationales for electrode placement in schizophrenia based on evidence for localized brain abnormality in the disorder and the targets that have been proposed and employed to date. The nucleus accumbens and the subgenual anterior cingulate cortex are of interest on the grounds that they are sites of potential pathologically increased brain activity in schizophrenia and so susceptible to the local inhibitory effects of DBS; both sites have been employed in trials of DBS in schizophrenia. Based on other lines of reasoning, the ventral tegmental area, the substantia nigra pars reticulata and the habenula have also been proposed and in some cases employed. The dorsolateral prefrontal cortex has not been suggested, probably reflecting evidence that it is underactive rather than overactive in schizophrenia. The hippocampus is also of theoretical interest but there is no clear functional imaging evidence that it shows overactivity in schizophrenia. On current evidence, the nucleus accumbens may represent the strongest candidate for DBS electrode placement in schizophrenia, with the substantia nigra pars reticulata also showing promise in a single case report; the ventral tegmental area is also of potential interest, though it remains untried.
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Affiliation(s)
- Iluminada Corripio
- Psychiatry Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Alexandra Roldán
- Psychiatry Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Peter McKenna
- FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain.
| | - Salvador Sarró
- FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Anna Alonso-Solís
- Psychiatry Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Laura Salgado
- Neurosurgery Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
| | - Enric Álvarez
- Psychiatry Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Joan Molet
- Neurosurgery Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona, Spain
| | - Edith Pomarol-Clotet
- FIDMAG Germanes Hospitalàries, Sant Boi de Llobregat, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
| | - Maria Portella
- Psychiatry Department, Hospital de la Santa Creu i Sant Pau, Biomedical Research Institute Sant Pau (IIB-Sant Pau), Universitat Autònoma de Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain
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18
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Waschk A, Parpaley Y, Kruger J. A Multi-Modular System for the Visualization and Classification of MER Data During Neurostimulation Procedures. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2021; 2021:6281-6284. [PMID: 34892549 DOI: 10.1109/embc46164.2021.9631088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
This paper proposes an interactive analysis and visualization tool for the accuracy improvement of electrode placement during neurostimulation therapy surgery. During the procedure, the presented system assists the surgeon in the crucial tissue type detection by providing a fused visualization of the current electrode location and the microelectrode recordings (MER). The system processes the MER in real-time and utilizes a convolutional neural network (CNN) to classify the targeted tissue type. In addition to presenting the MER in its raw waveform, the system also offers the visualization of the frequency domain and the result of the neural network. To further assist the decision-making process, additional visualization methods are integrated into the system. Using the pre-operative taken CT and MRI scans, the system offers 3D visualization in the form of direct volume rendering (DVR) and axis-aligned slice views in 2D. Both domains are enriched by the MER readings and the result of the machine learning classifier.
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Farokhniaee A, Lowery MM. Cortical network effects of subthalamic deep brain stimulation in a thalamo-cortical microcircuit model. J Neural Eng 2021; 18. [DOI: 10.1088/1741-2552/abee50] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 03/12/2021] [Indexed: 11/12/2022]
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Parakkal Unni M, Menon PP, Livi L, Wilson MR, Young WR, Bronte-Stewart HM, Tsaneva-Atanasova K. Data-Driven Prediction of Freezing of Gait Events From Stepping Data. FRONTIERS IN MEDICAL TECHNOLOGY 2020; 2:581264. [PMID: 35047881 PMCID: PMC8757792 DOI: 10.3389/fmedt.2020.581264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 10/22/2020] [Indexed: 11/30/2022] Open
Abstract
Freezing of gait (FoG) is typically a symptom of advanced Parkinson's disease (PD) that negatively influences the quality of life and is often resistant to pharmacological interventions. Novel treatment options that make use of auditory or sensory cues might be optimized by prediction of freezing events. These predictions might help to trigger external sensory cues—shown to improve walking performance—when behavior is changed in a manner indicative of an impending freeze (i.e., when the user needs it the most), rather than delivering cue information continuously. A data-driven approach is proposed for predicting freezing events using Random Forrest (RF), Neural Network (NN), and Naive Bayes (NB) classifiers. Vertical forces, sampled at 100 Hz from a force platform were collected from 9 PD subjects as they stepped in place until they at least had one freezing episode or for 90 s. The F1 scores of RF/NN/NB algorithms were computed for different IL (input to the machine learning algorithm), and GL (how early the freezing event is predicted). A significant negative correlation between the F1 scores and GL, highlighting the difficulty of early detection is found. The IL that maximized the F1 score is approximately equal to 1.13 s. This indicates that the physiological (and therefore neurological) changes leading to freezing take effect at-least one step before the freezing incident. Our algorithm has the potential to support the development of devices to detect and then potentially prevent freezing events in people with Parkinson's which might occur if left uncorrected.
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Affiliation(s)
- Midhun Parakkal Unni
- Department of Mathematics, College of Engineering Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
- *Correspondence: Midhun Parakkal Unni
| | - Prathyush P. Menon
- Department of Mathematics, College of Engineering Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
| | - Lorenzo Livi
- Department of Computer Science, College of Engineering Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
- Departments of Computer Science and Mathematics, University of Manitoba, Winnipeg, MB, Canada
| | - Mark R. Wilson
- Sport & Health Sciences, University of Exeter, Exeter, United Kingdom
| | - William R. Young
- Sport & Health Sciences, University of Exeter, Exeter, United Kingdom
| | - Helen M. Bronte-Stewart
- Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Stanford, CA, United States
| | - Krasimira Tsaneva-Atanasova
- Department of Mathematics, College of Engineering Mathematics and Physical Sciences, University of Exeter, Exeter, United Kingdom
- Department of Bioinformatics and Mathematical Modeling, Institute of Biophysics and Biomedical Engineering, Bulgarian Academy of Sciences, Sofia, Bulgaria
- Living Systems Institute, University of Exeter, Exeter, United Kingdom
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Rüegge D, Mahendran S, Stieglitz LH, Oertel MF, Gassert R, Lambercy O, Baumann CR, Imbach LL. Tremor analysis with wearable sensors correlates with outcome after thalamic deep brain stimulation. Clin Park Relat Disord 2020; 3:100066. [PMID: 34316646 PMCID: PMC8298798 DOI: 10.1016/j.prdoa.2020.100066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 06/12/2020] [Accepted: 08/02/2020] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Thalamic deep brain stimulation (DBS) provides excellent tremor control in most patients with essential tremor (ET). However, not all tremor patients show clinically significant improvement after DBS surgery. Currently, there is no reliable clinical or instrument-based measure to predict how patients respond to DBS. Therefore, we set out to provide a method for tremor outcome prediction prior to surgery. METHODS We retrospectively analysed quantitative tremor data collected with inertial measurement units (IMU) in 13 patients who underwent DBS surgery in the ventral intermediate nucleus of the thalamus (VIM). All patients were diagnosed with either ET or ET-plus according to current diagnostic criteria of the movement disorder society. We used linear and logistic regression models to evaluate the influence of different tremor characteristics on tremor outcome. RESULTS We found that the ratio between the amplitude of the first overtone and the amplitude of the fundamental frequency, denoted as the Harmonic Index, has a significant influence on tremor reduction after DBS surgery. This measure shows a strong correlation with the post-operative improvement of tremor outcome based on the Whiget Tremor Rating Scale. CONCLUSION Based on these findings, we propose a novel approach to predict tremor outcome after DBS surgery. Quantitative tremor assessment adds to the preoperative prediction of DBS response and might therefore have a relevant clinical impact in the management of patients suffering from pharmacoresistant tremor.
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Affiliation(s)
- Dayle Rüegge
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
- Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Sujitha Mahendran
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Lennart H. Stieglitz
- Department of Neurosurgery, University Hospital and University of Zurich, Zurich, Switzerland
| | - Markus F. Oertel
- Department of Neurosurgery, University Hospital and University of Zurich, Zurich, Switzerland
| | - Roger Gassert
- Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Olivier Lambercy
- Rehabilitation Engineering Laboratory, Department of Health Sciences and Technology, ETH Zurich, Zurich, Switzerland
| | - Christian R. Baumann
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
| | - Lukas L. Imbach
- Department of Neurology, University Hospital and University of Zurich, Zurich, Switzerland
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Ashok Kumar N, Chauhan M, Kandala SK, Sohn SM, Sadleir RJ. Development and testing of implanted carbon electrodes for electromagnetic field mapping during neuromodulation. Magn Reson Med 2020; 84:2103-2116. [PMID: 32301176 DOI: 10.1002/mrm.28273] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2019] [Revised: 03/01/2020] [Accepted: 03/11/2020] [Indexed: 02/05/2023]
Abstract
PURPOSE Deep brain stimulation electrodes composed of carbon fibers were tested as a means of administering and imaging magnetic resonance electrical impedance tomography (MREIT) currents. Artifacts and heating properties of custom carbon-fiber deep brain stimulation (DBS) electrodes were compared with those produced with standard DBS electrodes. METHODS Electrodes were constructed from multiple strands of 7-μm carbon-fiber stock. The insulated carbon electrodes were matched to DBS electrode diameter and contact areas. Images of DBS and carbon electrodes were collected with and without current flow and were compared in terms of artifact and thermal effects in phantoms or tissue samples in 7T imaging conditions. Effects on magnetic flux density and current density distributions were also assessed. RESULTS Carbon electrodes produced magnitude artifacts with smaller FWHM values compared to the magnitude artifacts around DBS electrodes in spin echo and gradient echo imaging protocols. DBS electrodes appeared 269% larger than actual size in gradient echo images, in sharp contrast to the negligible artifact observed in diameter-matched carbon electrodes. As expected, larger temperature changes were observed near DBS electrodes during extended RF excitations compared with carbon electrodes in the same phantom. Magnitudes and distribution of magnetic flux density and current density reconstructions were comparable for carbon and DBS electrodes. CONCLUSION Carbon electrodes may offer a safer, MR-compatible method for administering neuromodulation currents. Use of carbon-fiber electrodes should allow imaging of structures close to electrodes, potentially allowing better targeting, electrode position revision, and the facilitation of functional imaging near electrodes during neuromodulation.
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Affiliation(s)
- Neeta Ashok Kumar
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, USA
| | - Munish Chauhan
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, USA
| | - Sri Kirthi Kandala
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, USA
| | - Sung-Min Sohn
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, USA
| | - Rosalind J Sadleir
- School of Biological and Health Systems Engineering, Arizona State University, Tempe, Arizona, USA
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Corripio I, Roldán A, Sarró S, McKenna PJ, Alonso-Solís A, Rabella M, Díaz A, Puigdemont D, Pérez-Solà V, Álvarez E, Arévalo A, Padilla PP, Ruiz-Idiago JM, Rodríguez R, Molet J, Pomarol-Clotet E, Portella MJ. Deep brain stimulation in treatment resistant schizophrenia: A pilot randomized cross-over clinical trial. EBioMedicine 2020; 51:102568. [PMID: 31927311 PMCID: PMC6953640 DOI: 10.1016/j.ebiom.2019.11.029] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Accepted: 11/18/2019] [Indexed: 01/11/2023] Open
Abstract
Background Up to 30% of patients with schizophrenia are resistant to antipsychotic drug treatment, with 60% of such cases also failing to respond to clozapine. Deep brain stimulation (DBS) has been used in treatment resistant patients with other psychiatric disorders, but there is a lack of trials in schizophrenia, partly due to uncertainties over where to site the electrodes. This trial aimed to examine the effectiveness of nucleus accumbens (NAcc) and subgenual anterior cingulate cortex (subgenual ACC) targeted DBS; the primary outcome measure was PANSS total score, as assessed fortnightly. Methods Eight patients with schizophrenia, who met criteria for treatment resistance and were also resistant to/intolerant of clozapine, were randomly assigned using central allocation to receive DBS in the NAcc or subgenual ACC. An open stabilization phase lasting at least six months was followed by a randomized double-blind crossover phase lasting 24 weeks in those who met symptomatic improvement criteria. The primary end-point was a 25% improvement in PANSS total score. (ClinicalTrials.gov Identifier: NCT02377505; trial completed). Findings One implanted patient did not receive DBS due to complications of surgery. Of the remaining 7 patients, 2/3 with NAcc and 2/4 with subgenual ACC electrode placements met the symptomatic improvement criteria (58% and 86%, and 37% and 68% improvement in PANSS total score, respectively). Three of these patients entered the crossover phase and all showed worsening when the stimulation was discontinued. The fourth patient worsened after the current was switched off accidentally without her or the investigators’ knowledge. Physical adverse events were uncommon, but two patients developed persistent psychiatric adverse effects (negative symptoms/apathy and mood instability, respectively). Interpretation These preliminary findings point to the possibility of DBS having therapeutic effects in patients with schizophrenia who do not respond to any other treatment. Larger trials with careful attention to blinding will be necessary to establish the extent of the benefits and whether these can be achieved without psychiatric side-effects.
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Affiliation(s)
- Iluminada Corripio
- Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Alexandra Roldán
- Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Salvador Sarró
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, C/. Dr. Antoni Pujadas 38, 08830 Sant Boi de Llobregat, Barcelona, Spain; Psychiatry Department, Benito Menni CASM Hermanas Hospitalarias, Sant Boi de Llobregat, Spain
| | - Peter J McKenna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, C/. Dr. Antoni Pujadas 38, 08830 Sant Boi de Llobregat, Barcelona, Spain.
| | - Anna Alonso-Solís
- Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Mireia Rabella
- Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Anna Díaz
- Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Dolors Puigdemont
- Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Víctor Pérez-Solà
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Psychiatry Department, Institut de Neuropsiquiatria i Addicions, Hospital del Mar, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Enric Álvarez
- Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Antonio Arévalo
- FIDMAG Germanes Hospitalàries Research Foundation, C/. Dr. Antoni Pujadas 38, 08830 Sant Boi de Llobregat, Barcelona, Spain; Psychiatry Department, Hospital Sagrat Cor Hermanas Hospitalarias, Barcelona, Spain
| | - Pedro P Padilla
- FIDMAG Germanes Hospitalàries Research Foundation, C/. Dr. Antoni Pujadas 38, 08830 Sant Boi de Llobregat, Barcelona, Spain; Psychiatry Department, Centro Neuropsiquiátrico Nuestra Señora del Carmen Hermanas Hospitalarias, Zaragoza, Spain
| | - Jesus M Ruiz-Idiago
- FIDMAG Germanes Hospitalàries Research Foundation, C/. Dr. Antoni Pujadas 38, 08830 Sant Boi de Llobregat, Barcelona, Spain; Unitat Polivalent Barcelona Nord Hospital, Hospital Mare de Déu de la Mercè Hermanas Hospitalarias, Barcelona, Spain
| | - Rodrigo Rodríguez
- Neurosurgery Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Joan Molet
- Neurosurgery Department, Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Edith Pomarol-Clotet
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; FIDMAG Germanes Hospitalàries Research Foundation, C/. Dr. Antoni Pujadas 38, 08830 Sant Boi de Llobregat, Barcelona, Spain
| | - Maria J Portella
- Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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Optogenetic inhibition of ventral hippocampal neurons alleviates associative motor learning dysfunction in a rodent model of schizophrenia. PLoS One 2019; 14:e0227200. [PMID: 31891640 PMCID: PMC6938361 DOI: 10.1371/journal.pone.0227200] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2019] [Accepted: 12/14/2019] [Indexed: 12/23/2022] Open
Abstract
Schizophrenia (SZ) is a serious and incurable mental disorder characterized by clinical manifestations of positive and negative symptoms and cognitive dysfunction. High-frequency deep brain stimulation (DBS) of the ventral hippocampus (VHP) has been recently applied as a therapeutic approach for SZ in both experimental and clinical studies. However, little is known about the precise mechanism of VHP-DBS treatment for SZ and the role of hippocampal cell activation in the pathogenesis of SZ. With optogenetic technology in this study, we tried to inhibit neuronal activity in the VHP which has dense projections to the prefrontal cortex, before measuring long stumulus-induced delay eyeblink conditioning (long-dEBC) in a rodent model of SZ. Rats were administrated with phencyclidine (PCP, 3 mg/kg, 1/d, ip) for successive 7 days before optogenetic intervention. The current data show that PCP administration causes significant impairment in the acquisition and timing of long-dEBC; the inhibition of bilateral VHP neurons alleviates the decreased acquisition and impaired timing of longd-dEBC in PCP-administered rats. The results provide direct evidence at the cellular level that the inhibition of VHP neuronal cells may be a prominent effect of hippocampal DBS intervention, and increased activity in the hippocampal network play a pivotal role in SZ.
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Miterko LN, Baker KB, Beckinghausen J, Bradnam LV, Cheng MY, Cooperrider J, DeLong MR, Gornati SV, Hallett M, Heck DH, Hoebeek FE, Kouzani AZ, Kuo SH, Louis ED, Machado A, Manto M, McCambridge AB, Nitsche MA, Taib NOB, Popa T, Tanaka M, Timmann D, Steinberg GK, Wang EH, Wichmann T, Xie T, Sillitoe RV. Consensus Paper: Experimental Neurostimulation of the Cerebellum. CEREBELLUM (LONDON, ENGLAND) 2019; 18:1064-1097. [PMID: 31165428 PMCID: PMC6867990 DOI: 10.1007/s12311-019-01041-5] [Citation(s) in RCA: 95] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The cerebellum is best known for its role in controlling motor behaviors. However, recent work supports the view that it also influences non-motor behaviors. The contribution of the cerebellum towards different brain functions is underscored by its involvement in a diverse and increasing number of neurological and neuropsychiatric conditions including ataxia, dystonia, essential tremor, Parkinson's disease (PD), epilepsy, stroke, multiple sclerosis, autism spectrum disorders, dyslexia, attention deficit hyperactivity disorder (ADHD), and schizophrenia. Although there are no cures for these conditions, cerebellar stimulation is quickly gaining attention for symptomatic alleviation, as cerebellar circuitry has arisen as a promising target for invasive and non-invasive neuromodulation. This consensus paper brings together experts from the fields of neurophysiology, neurology, and neurosurgery to discuss recent efforts in using the cerebellum as a therapeutic intervention. We report on the most advanced techniques for manipulating cerebellar circuits in humans and animal models and define key hurdles and questions for moving forward.
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Affiliation(s)
- Lauren N Miterko
- Department of Pathology and Immunology, Department of Neuroscience, Program in Developmental Biology, Baylor College of Medicine, Jan and Dan Duncan Neurological Research Institute of Texas Children's Hospital, 1250 Moursund Street, Suite 1325, Houston, TX, 77030, USA
| | - Kenneth B Baker
- Neurological Institute, Department of Neurosurgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Jaclyn Beckinghausen
- Department of Pathology and Immunology, Department of Neuroscience, Program in Developmental Biology, Baylor College of Medicine, Jan and Dan Duncan Neurological Research Institute of Texas Children's Hospital, 1250 Moursund Street, Suite 1325, Houston, TX, 77030, USA
| | - Lynley V Bradnam
- Department of Exercise Science, Faculty of Science, University of Auckland, Private Bag 92019, Auckland, 1142, New Zealand
| | - Michelle Y Cheng
- Department of Neurosurgery, Stanford University School of Medicine, 1201 Welch Road, MSLS P352, Stanford, CA, 94305-5487, USA
| | - Jessica Cooperrider
- Neurological Institute, Department of Neurosurgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Mahlon R DeLong
- Department of Neurology, Emory University, Atlanta, GA, 30322, USA
| | - Simona V Gornati
- Department of Neuroscience, Erasmus Medical Center, 3015 AA, Rotterdam, Netherlands
| | - Mark Hallett
- Human Motor Control Section, NINDS, NIH, Building 10, Room 7D37, 10 Center Dr MSC 1428, Bethesda, MD, 20892-1428, USA
| | - Detlef H Heck
- Department of Anatomy and Neurobiology, University of Tennessee Health Science Center, 855 Monroe Ave, Memphis, TN, 38163, USA
| | - Freek E Hoebeek
- Department of Neuroscience, Erasmus Medical Center, 3015 AA, Rotterdam, Netherlands
- NIDOD Department, Wilhelmina Children's Hospital, University Medical Center Utrecht Brain Center, Utrecht, Netherlands
| | - Abbas Z Kouzani
- School of Engineering, Deakin University, Geelong, VIC, 3216, Australia
| | - Sheng-Han Kuo
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, 10032, USA
| | - Elan D Louis
- Department of Neurology, Yale School of Medicine, Department of Chronic Disease Epidemiology, Yale School of Public Health, Center for Neuroepidemiology and Clinical Research, Yale School of Medicine, Yale University, New Haven, CT, 06520, USA
| | - Andre Machado
- Neurological Institute, Department of Neurosurgery, Cleveland Clinic, 9500 Euclid Avenue, Cleveland, OH, 44195, USA
| | - Mario Manto
- Service de Neurologie, CHU-Charleroi, 6000, Charleroi, Belgium
- Service des Neurosciences, Université de Mons, 7000, Mons, Belgium
| | - Alana B McCambridge
- Graduate School of Health, Physiotherapy, University of Technology Sydney, PO Box 123, Broadway, Sydney, NSW, 2007, Australia
| | - Michael A Nitsche
- Department of Psychology and Neurosiences, Leibniz Research Centre for Working Environment and Human Factors, Dortmund, Germany
- Department of Neurology, University Medical Hospital Bergmannsheil, Bochum, Germany
| | | | - Traian Popa
- Human Motor Control Section, NINDS, NIH, Building 10, Room 7D37, 10 Center Dr MSC 1428, Bethesda, MD, 20892-1428, USA
- Defitech Chair of Clinical Neuroengineering, Center for Neuroprosthetics (CNP) and Brain Mind Institute (BMI), Ecole Polytechnique Federale de Lausanne (EPFL), Sion, Switzerland
| | - Masaki Tanaka
- Department of Physiology, Hokkaido University School of Medicine, Sapporo, 060-8638, Japan
| | - Dagmar Timmann
- Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Gary K Steinberg
- Department of Neurosurgery, Stanford University School of Medicine, 1201 Welch Road, MSLS P352, Stanford, CA, 94305-5487, USA
- R281 Department of Neurosurgery, Stanfod University School of Medicine, 300 Pasteur Drive, Stanford, CA, 94305, USA
| | - Eric H Wang
- Department of Neurosurgery, Stanford University School of Medicine, 1201 Welch Road, MSLS P352, Stanford, CA, 94305-5487, USA
| | - Thomas Wichmann
- Department of Neurology, Emory University, Atlanta, GA, 30322, USA
- Yerkes National Primate Research Center, Emory University, Atlanta, GA, 30322, USA
| | - Tao Xie
- Department of Neurology, University of Chicago, 5841 S. Maryland Avenue, MC 2030, Chicago, IL, 60637-1470, USA
| | - Roy V Sillitoe
- Department of Pathology and Immunology, Department of Neuroscience, Program in Developmental Biology, Baylor College of Medicine, Jan and Dan Duncan Neurological Research Institute of Texas Children's Hospital, 1250 Moursund Street, Suite 1325, Houston, TX, 77030, USA.
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Depleting implanted pulse generator (IPG) battery voltage is associated with worsening clinical symptoms in movement disorder patients receiving Deep brain stimulation (DBS). Clin Park Relat Disord 2019; 1:98-99. [PMID: 34316609 PMCID: PMC8288559 DOI: 10.1016/j.prdoa.2019.11.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Revised: 10/08/2019] [Accepted: 11/03/2019] [Indexed: 11/23/2022] Open
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Amoozegar S, Pooyan M, Roughani M. Toward a closed-loop deep brain stimulation in Parkinson's disease using local field potential in parkinsonian rat model. Med Hypotheses 2019; 132:109360. [PMID: 31442919 DOI: 10.1016/j.mehy.2019.109360] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 08/04/2019] [Accepted: 08/11/2019] [Indexed: 02/06/2023]
Abstract
Deep brain stimulation (DBS) is an invasive method used for treating Parkinson's disease in its advanced stages. Nowadays, the initial adjustment of DBS parameters and their automatic matching proportion to the progression of the disease is viewed as one of the research areas discussed by the researchers, which is called closed-loop DBS. Various studies were conducted regarding finding the signal(s) which reflects different symptoms of the disease. Local Field Potential (LFP) is one of the signals that is suitable for using as feedback, because it can be recorded by the same implemented electrodes for stimulation. The present study aimed to identify the distinguishing features of patients from healthy individuals using LFP signals. METHODS In the present study, LFP was recorded from the rats in sham and parkinsonian model groups. After evaluating the signals in the frequency domain, sixty-six features were extracted from power spectral density of LFPs. The features were classified by Support Vector Machine (SVM) to determine the ability of features for separating parkinsonian rats from healthy ones. Finally, the most effective features were selected for distinguishing between the sham and parkinsonian model groups using a genetic algorithm. RESULTS The results indicated that the frequency domain features of LFP signals from rats have capacity of using them as a feedback for closed-loop DBS. The accuracy of the Support Vector Machine classification using all 66 features was 80.42% which increased to 84.41% using 38 features selected by genetic algorithm. The proposed method not only increase the accuracy, but it also reduce computation by decreasing the number of the effective features. The results indicate the significant capacity of the proposed method for identifying the effective high-frequency features to control the closed-loop DBS. CONCLUSIONS The ability of using LFP signals as feedback in closed-loop DBS was shown by extracting useful information in frequency bands below and above 100 Hz regarding LFP signals of parkinsonian rats and sham ones. Based on the results, features at frequencies above 100 Hz were more powerful and robust than below 100 Hz. The genetic algorithm was used for optimizing the classification problem.
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Affiliation(s)
- Sana Amoozegar
- Department of Biomedical Engineering, Faculty of Engineering, Shahed University, Tehran, Iran
| | - Mohammad Pooyan
- Department of Biomedical Engineering, Faculty of Engineering, Shahed University, Tehran, Iran.
| | - Mehrdad Roughani
- Department of Physiology, Faculty of Medical Sciences, Shahed University, Tehran, Iran
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Segato A, Pieri V, Favaro A, Riva M, Falini A, De Momi E, Castellano A. Automated Steerable Path Planning for Deep Brain Stimulation Safeguarding Fiber Tracts and Deep Gray Matter Nuclei. Front Robot AI 2019; 6:70. [PMID: 33501085 PMCID: PMC7806057 DOI: 10.3389/frobt.2019.00070] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2019] [Accepted: 07/18/2019] [Indexed: 12/20/2022] Open
Abstract
Deep Brain Stimulation (DBS) is a neurosurgical procedure consisting in the stereotactic implantation of stimulation electrodes to specific brain targets, such as deep gray matter nuclei. Current solutions to place the electrodes rely on rectilinear stereotactic trajectories (RTs) manually defined by surgeons, based on pre-operative images. An automatic path planner that accurately targets subthalamic nuclei (STN) and safeguards critical surrounding structures is still lacking. Also, robotically-driven curvilinear trajectories (CTs) computed on the basis of state-of-the-art neuroimaging would decrease DBS invasiveness, circumventing patient-specific obstacles. This work presents a new algorithm able to estimate a pool of DBS curvilinear trajectories for reaching a given deep target in the brain, in the context of the EU's Horizon EDEN2020 project. The prospect of automatically computing trajectory plans relying on sophisticated newly engineered steerable devices represents a breakthrough in the field of microsurgical robotics. By tailoring the paths according to single-patient anatomical constraints, as defined by advanced preoperative neuroimaging including diffusion MR tractography, this planner ensures a higher level of safety than the standard rectilinear approach. Ten healthy controls underwent Magnetic Resonance Imaging (MRI) on 3T scanner, including 3DT1-weighted sequences, 3Dhigh-resolution time-of-flight MR angiography (TOF-MRA) and high angular resolution diffusion MR sequences. A probabilistic q-ball residual-bootstrap MR tractography algorithm was used to reconstruct motor fibers, while the other deep gray matter nuclei surrounding STN and vessels were segmented on T1 and TOF-MRA images, respectively. These structures were labeled as obstacles. The reliability of the automated planner was evaluated; CTs were compared to RTs in terms of efficacy and safety. Targeting the anterior STN, CTs performed significantly better in maximizing the minimal distance from critical structures, by finding a tuned balance between all obstacles. Moreover, CTs resulted superior in reaching the center of mass (COM) of STN, as well as in optimizing the entry angle in STN and in the skull surface.
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Affiliation(s)
- Alice Segato
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Valentina Pieri
- Neuroradiology Unit and CERMAC, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Alberto Favaro
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Marco Riva
- Department of Medical Biotechnology and Translational Medicine, Università degli Studi di Milano, Milan, Italy.,Unit of Oncological Neurosurgery, Humanitas Research Hospital, Rozzano, Italy
| | - Andrea Falini
- Neuroradiology Unit and CERMAC, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
| | - Elena De Momi
- Department of Electronics, Information and Bioengineering, Politecnico di Milano, Milan, Italy
| | - Antonella Castellano
- Neuroradiology Unit and CERMAC, IRCCS Ospedale San Raffaele, Vita-Salute San Raffaele University, Milan, Italy
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Ibrahim C, Rubin-Kahana DS, Pushparaj A, Musiol M, Blumberger DM, Daskalakis ZJ, Zangen A, Le Foll B. The Insula: A Brain Stimulation Target for the Treatment of Addiction. Front Pharmacol 2019; 10:720. [PMID: 31312138 PMCID: PMC6614510 DOI: 10.3389/fphar.2019.00720] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2019] [Accepted: 06/05/2019] [Indexed: 12/15/2022] Open
Abstract
Substance use disorders (SUDs) are a growing public health concern with only a limited number of approved treatments. However, even approved treatments are subject to limited efficacy with high long-term relapse rates. Current treatment approaches are typically a combination of pharmacotherapies and behavioral counselling. Growing evidence and technological advances suggest the potential of brain stimulation techniques for the treatment of SUDs. There are three main brain stimulation techniques that are outlined in this review: transcranial magnetic stimulation (TMS), transcranial direct current stimulation (tDCS), and deep brain stimulation (DBS). The insula, a region of the cerebral cortex, is known to be involved in critical aspects underlying SUDs, such as interoception, decision making, anxiety, pain perception, cognition, mood, threat recognition, and conscious urges. This review focuses on both the preclinical and clinical evidence demonstrating the role of the insula in addiction, thereby demonstrating its promise as a target for brain stimulation. Future research should evaluate the optimal parameters for brain stimulation of the insula, through the use of relevant biomarkers and clinical outcomes for SUDs.
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Affiliation(s)
- Christine Ibrahim
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
| | - Dafna S. Rubin-Kahana
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Abhiram Pushparaj
- Qunuba Sciences, Toronto, ON, Canada
- Ironstone Product Development, Toronto, ON, Canada
| | | | - Daniel M. Blumberger
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Zafiris J. Daskalakis
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Temerty Centre for Therapeutic Brain Intervention, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Abraham Zangen
- Department of Life Sciences and the Zlotowski Center for Neuroscience, Ben-Gurion University of the Negev, Beer-Sheva, Israel
| | - Bernard Le Foll
- Translational Addiction Research Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Pharmacology, University of Toronto, Toronto, ON, Canada
- Department of Psychiatry, Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Addictions Division, Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
- Alcohol Research and Treatment Clinic, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada
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Hancu I, Boutet A, Fiveland E, Ranjan M, Prusik J, Dimarzio M, Rashid T, Ashe J, Xu D, Kalia SK, Hodaie M, Fasano A, Kucharczyk W, Pilitsis J, Lozano A, Madhavan R. On the (Non‐)equivalency of monopolar and bipolar settings for deep brain stimulation fMRI studies of Parkinson's disease patients. J Magn Reson Imaging 2018; 49:1736-1749. [DOI: 10.1002/jmri.26321] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 08/17/2018] [Indexed: 11/09/2022] Open
Affiliation(s)
- Ileana Hancu
- GE Global Research Center Niskayuna New York USA
| | | | | | | | | | | | | | - Jeffrey Ashe
- GE Global Research Center Niskayuna New York USA
| | - David Xu
- University Health Network Toronto ON Canada
| | | | | | - Alfonso Fasano
- Morton and Gloria Shulman Movement Disorders Centre and the Edmond J. Safra Program in Parkinson's Disease, Toronto Western Hospital, UHN, Division of Neurology University of Toronto Toronto Ontario Canada
- Krembil Research Institute Toronto Ontario Canada
| | | | | | - Andres Lozano
- University Health Network Toronto ON Canada
- Krembil Research Institute Toronto Ontario Canada
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Plotkin JL, Goldberg JA. Thinking Outside the Box (and Arrow): Current Themes in Striatal Dysfunction in Movement Disorders. Neuroscientist 2018; 25:359-379. [PMID: 30379121 PMCID: PMC6529282 DOI: 10.1177/1073858418807887] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The basal ganglia are an intricately connected assembly of subcortical nuclei, forming the core of an adaptive network connecting cortical and thalamic circuits. For nearly three decades, researchers and medical practitioners have conceptualized how the basal ganglia circuit works, and how its pathology underlies motor disorders such as Parkinson's and Huntington's diseases, using what is often referred to as the "box-and-arrow model": a circuit diagram showing the broad strokes of basal ganglia connectivity and the pathological increases and decreases in the weights of specific connections that occur in disease. While this model still has great utility and has led to groundbreaking strategies to treat motor disorders, our evolving knowledge of basal ganglia function has made it clear that this classic model has several shortcomings that severely limit its predictive and descriptive abilities. In this review, we will focus on the striatum, the main input nucleus of the basal ganglia. We describe recent advances in our understanding of the rich microcircuitry and plastic capabilities of the striatum, factors not captured by the original box-and-arrow model, and provide examples of how such advances inform our current understanding of the circuit pathologies underlying motor disorders.
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Affiliation(s)
- Joshua L Plotkin
- Department of Neurobiology and Behavior, Stony Brook University School of Medicine, Stony Brook, NY, USA
| | - Joshua A Goldberg
- Department of Medical Neurobiology, The Hebrew University of Jerusalem, Jerusalem, Israel
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Parupudi T, Rahimi R, Ammirati M, Sundararajan R, Garner AL, Ziaie B. Fabrication and characterization of implantable flushable electrodes for electric field-mediated drug delivery in a brain tissue-mimic agarose gel. Electrophoresis 2018; 39:2262-2269. [PMID: 29947027 DOI: 10.1002/elps.201800161] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 05/30/2018] [Accepted: 06/11/2018] [Indexed: 11/09/2022]
Affiliation(s)
- Tejasvi Parupudi
- School of Electrical and Computer Engineering; Purdue University; West Lafayette IN USA
| | - Rahim Rahimi
- School of Electrical and Computer Engineering; Purdue University; West Lafayette IN USA
- Birck Nanotechnology Center; Purdue University; West Lafayette IN USA
| | - Mario Ammirati
- Department of Neurological Surgery; The Ohio State University; Wexner Medical Center; Columbus OH USA
| | - Raji Sundararajan
- School of Engineering Technology; Purdue University; West Lafayette IN USA
| | - Allen L. Garner
- School of Electrical and Computer Engineering; Purdue University; West Lafayette IN USA
- School of Nuclear Engineering; Purdue University; West Lafayette IN USA
- Department of Agricultural and Biological Engineering; Purdue University; West Lafayette IN USA
| | - Babak Ziaie
- School of Electrical and Computer Engineering; Purdue University; West Lafayette IN USA
- Birck Nanotechnology Center; Purdue University; West Lafayette IN USA
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Chen Y, Ge S, Li Y, Li N, Wang J, Wang X, Li J, Jing J, Su M, Zheng Z, Luo T, Qiu C, Wang X. Role of the Cortico-Subthalamic Hyperdirect Pathway in Deep Brain Stimulation for the Treatment of Parkinson Disease: A Diffusion Tensor Imaging Study. World Neurosurg 2018; 114:e1079-e1085. [DOI: 10.1016/j.wneu.2018.03.149] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2018] [Revised: 03/20/2018] [Accepted: 03/21/2018] [Indexed: 01/07/2023]
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Bui HP, Tomar S, Courtecuisse H, Audette M, Cotin S, Bordas SPA. Controlling the error on target motion through real-time mesh adaptation: Applications to deep brain stimulation. INTERNATIONAL JOURNAL FOR NUMERICAL METHODS IN BIOMEDICAL ENGINEERING 2018; 34:e2958. [PMID: 29314783 DOI: 10.1002/cnm.2958] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/26/2017] [Revised: 12/07/2017] [Accepted: 12/27/2017] [Indexed: 06/07/2023]
Abstract
An error-controlled mesh refinement procedure for needle insertion simulations is presented. As an example, the procedure is applied for simulations of electrode implantation for deep brain stimulation. We take into account the brain shift phenomena occurring when a craniotomy is performed. We observe that the error in the computation of the displacement and stress fields is localised around the needle tip and the needle shaft during needle insertion simulation. By suitably and adaptively refining the mesh in this region, our approach enables to control, and thus to reduce, the error whilst maintaining a coarser mesh in other parts of the domain. Through academic and practical examples we demonstrate that our adaptive approach, as compared with a uniform coarse mesh, increases the accuracy of the displacement and stress fields around the needle shaft and, while for a given accuracy, saves computational time with respect to a uniform finer mesh. This facilitates real-time simulations. The proposed methodology has direct implications in increasing the accuracy, and controlling the computational expense of the simulation of percutaneous procedures such as biopsy, brachytherapy, regional anaesthesia, or cryotherapy. Moreover, the proposed approach can be helpful in the development of robotic surgeries because the simulation taking place in the control loop of a robot needs to be accurate, and to occur in real time.
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Affiliation(s)
- Huu Phuoc Bui
- Institute of Computational Engineering, University of Luxembourg, Faculty of Sciences Communication and Technology, Luxembourg
| | - Satyendra Tomar
- Institute of Computational Engineering, University of Luxembourg, Faculty of Sciences Communication and Technology, Luxembourg
| | | | - Michel Audette
- Department of Modeling, Simulation and Visualization Engineering, Old Dominion University, Norfolk, USA
| | | | - Stéphane P A Bordas
- Institute of Computational Engineering, University of Luxembourg, Faculty of Sciences Communication and Technology, Luxembourg
- Institute of Mechanics and Advanced Materials, School of Engineering, Cardiff University, UK
- Intelligent Systems for Medicine Laboratory, University of Western Australia, Perth, Australia
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Bentil SA, Dupaix RB. Simulations of hydrogel-coated neural microelectrodes to assess biocompatibility improvement using strain as a metric for micromotion. Biomed Phys Eng Express 2018. [DOI: 10.1088/2057-1976/aab990] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Deep Brain Stimulation in Parkinson’s Disease. PARKINSON'S DISEASE 2018; 2018:9625291. [PMID: 29755729 PMCID: PMC5821949 DOI: 10.1155/2018/9625291] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 11/02/2017] [Indexed: 11/18/2022]
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van Dijk KJ, Verhagen R, Bour LJ, Heida C, Veltink PH. Avoiding Internal Capsule Stimulation With a New Eight-Channel Steering Deep Brain Stimulation Lead. Neuromodulation 2017; 21:553-561. [DOI: 10.1111/ner.12702] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 08/22/2017] [Accepted: 08/25/2017] [Indexed: 11/30/2022]
Affiliation(s)
- Kees J. van Dijk
- MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente; Enschede NL The Netherlands
| | - Rens Verhagen
- Department of Neurology/Clinical Neurophysiology; Academic Medical Center; Amsterdam NL The Netherlands
| | - Lo J. Bour
- Department of Neurology/Clinical Neurophysiology; Academic Medical Center; Amsterdam NL The Netherlands
| | - Ciska Heida
- MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente; Enschede NL The Netherlands
| | - Peter H. Veltink
- MIRA Institute for Biomedical Engineering and Technical Medicine, University of Twente; Enschede NL The Netherlands
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Smit JV, Jahanshahi A, Janssen ML, Stokroos RJ, Temel Y. Hearing assessment during deep brain stimulation of the central nucleus of the inferior colliculus and dentate cerebellar nucleus in rat. PeerJ 2017; 5:e3892. [PMID: 29018625 PMCID: PMC5633028 DOI: 10.7717/peerj.3892] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2017] [Accepted: 09/15/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Recently it has been shown in animal studies that deep brain stimulation (DBS) of auditory structures was able to reduce tinnitus-like behavior. However, the question arises whether hearing might be impaired when interfering in auditory-related network loops with DBS. METHODS The auditory brainstem response (ABR) was measured in rats during high frequency stimulation (HFS) and low frequency stimulation (LFS) in the central nucleus of the inferior colliculus (CIC, n = 5) or dentate cerebellar nucleus (DCBN, n = 5). Besides hearing thresholds using ABR, relative measures of latency and amplitude can be extracted from the ABR. In this study ABR thresholds, interpeak latencies (I-III, III-V, I-V) and V/I amplitude ratio were measured during off-stimulation state and during LFS and HFS. RESULTS In both the CIC and the CNBN groups, no significant differences were observed for all outcome measures. DISCUSSION DBS in both the CIC and the CNBN did not have adverse effects on hearing measurements. These findings suggest that DBS does not hamper physiological processing in the auditory circuitry.
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Affiliation(s)
- Jasper V. Smit
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Ali Jahanshahi
- Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Marcus L.F. Janssen
- Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Robert J. Stokroos
- Department of Ear Nose and Throat/Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Yasin Temel
- Department of Neuroscience, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
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Bridging the Gaps in Patient Education for DBS Surgery in Parkinson's Disease. PARKINSONS DISEASE 2017; 2017:9360354. [PMID: 28848685 PMCID: PMC5564106 DOI: 10.1155/2017/9360354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 07/03/2017] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Improvements in quality of life, tremor, and other motor features have been recognized as superior in patients with advanced Parkinson's disease (PD) treated with deep brain stimulation (DBS) surgery versus best medical therapy. We studied a group of patients with PD after undergoing DBS surgery in regard to expectations and satisfaction with DBS outcomes to determine gaps in patient education. METHODS This study was a retrospective, single academic center chart review and outcome questionnaire sent to patients with PD who had undergone DBS surgery between 2007 and 2014. RESULTS All patients surveyed indicated that benefit from DBS surgery met their overall expectations at least partially, but only 46.4% (SE: 9.6%) were in complete agreement. 3.6% (SE: 3.6%) of participants strongly disagreed that preoperative education prepared them adequately for the procedure and 17.9% (SE: 7.4%) only somewhat agreed. CONCLUSIONS Our findings demonstrate that patients' expectations of DBS surgery in PD were at least partially met. However, there was a considerable percentage of patients who did not feel adequately prepared for the procedure. A structured, multidisciplinary team approach in educating PD patients throughout the different stages of DBS surgery may be helpful in optimizing patients' experience and satisfaction with surgery outcomes.
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Vuong J, Devergnas A. The role of the basal ganglia in the control of seizure. J Neural Transm (Vienna) 2017; 125:531-545. [PMID: 28766041 DOI: 10.1007/s00702-017-1768-x] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2017] [Accepted: 07/23/2017] [Indexed: 12/19/2022]
Abstract
Epilepsy is a network disorder and each type of seizure involves distinct cortical and subcortical network, differently implicated in the control and propagation of the ictal activity. The role of the basal ganglia has been revealed in several cases of focal and generalized seizures. Here, we review the data that show the implication of the basal ganglia in absence, temporal lobe, and neocortical seizures in animal models (rodent, cat, and non-human primate) and in human. Based on these results and the advancement of deep brain stimulation for Parkinson's disease, basal ganglia neuromodulation has been tested with some success that can be equally seen as promising or disappointing. The effect of deep brain stimulation can be considered promising with a 76% in seizure reduction in temporal lobe epilepsy patients, but also disappointing, since only few patients have become seizure free and the antiepileptic effects have been highly variable among patients. This variability could probably be explained by the heterogeneity among the patients included in these clinical studies. To illustrate the importance of specific network identification, electrophysiological activity of the putamen and caudate nucleus has been recorded during penicillin-induced pre-frontal and motor seizures in one monkey. While an increase of the firing rate was found in putamen and caudate nucleus during pre-frontal seizures, only the activity of the putamen cells was increased during motor seizures. These preliminary results demonstrate the implication of the basal ganglia in two types of neocortical seizures and the necessity of studying the network to identify the important nodes implicated in the propagation and control of each type of seizure.
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Affiliation(s)
- J Vuong
- Yerkes National Primate Research Center, Emory University, 954 Gatewood Road NE, Atlanta, GA, 30329, USA
| | - Annaelle Devergnas
- Yerkes National Primate Research Center, Emory University, 954 Gatewood Road NE, Atlanta, GA, 30329, USA. .,Department of Neurology, Emory University, Atlanta, GA, 30322, USA.
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Hernandez-Martinez R, Calakos N. Seq-ing the Circuit Logic of the Basal Ganglia. Trends Neurosci 2017; 40:325-327. [PMID: 28501393 DOI: 10.1016/j.tins.2017.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 04/30/2017] [Indexed: 11/28/2022]
Abstract
Recently, Wallace et al. (2017) provide an unprecedented view of the layers of molecular, cellular and circuit complexity involving a basal ganglia output structure, the entopeduncular nucleus. Their findings lend order to chaos by revealing how molecularly and functionally defined cellular subsets are organized into distinct circuitry.
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Affiliation(s)
| | - Nicole Calakos
- Department of Neurology, Duke University, Durham, NC, USA; Department of Neurobiology, Duke University, Durham, NC, USA.
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42
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Fetissov SO. [Hunger and satiety factors in the regulation of pleasure associated with feeding behavior]. Biol Aujourdhui 2017; 210:259-268. [PMID: 28327283 DOI: 10.1051/jbio/2016025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Indexed: 11/14/2022]
Abstract
Feeding is an instinctive behavior accompanied by rewarding feeling of pleasure during obtaining and ingesting food, corresponding to the preparatory and consummatory phases of motivated behavior, respectively. Perception of this emotional state together with alternating feelings of hunger and satiety drives the feeding behavior. Because alterations of feeding behavior including either overeating or anorexia may lead to obesity and cachexia, respectively, understanding the neurochemical mechanisms of regulation of feeding pleasure may help to develop new therapies of these diseases. The dopamine (DA) system of the mesolimbic projections plays a key role in behavioral reward in general and is also involved in regulating feeding-associated pleasure in the forebrain including the nucleus accumbens (NAc) and the lateral hypothalamic area (LHA). It suggests that this DA system can be selectively activated by factors specific to different types of motivated behavior including hunger- and satiety- related hormones. Indeed, central administrations of either orexigenic ghrelin or anorexigenic α-melanocyte-stimulating hormone (α-MSH) increase DA release in the NAc. However, DA has also been shown to inhibit food intake when injected into the LHA, historically known as a « hunger center », indicating DA functional involvement in regulation of both appetite and feeding pleasure. Although both NAc and LHA contain neurons expressing melanocortin receptors, only the LHA receives the α-MSH containing nerve terminals from the α-MSH producing neurons of the hypothalamic arcuate nucleus, the main relay of the peripheral hunger and satiety signals to the brain. A recent study showed that α-MSH in the LHA enhances satiety and inhibits feeding pleasure while potently stimulating DA release in this area during both preparatory and consummatory phases of feeding. It suggests that altered signaling by α-MSH to the DA system in the LHA may be involved in the pathophysiology of obesity and anorexia and the possible underlying mechanisms are discussed.
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Koenen S, Rehbock C, Heissler HE, Angelov SD, Schwabe K, Krauss JK, Barcikowski S. Optimizing in Vitro Impedance and Physico-Chemical Properties of Neural Electrodes by Electrophoretic Deposition of Pt Nanoparticles. Chemphyschem 2017; 18:1108-1117. [PMID: 28122149 DOI: 10.1002/cphc.201601180] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Indexed: 11/12/2022]
Abstract
Neural electrodes suffer from an undesired incline in impedance when in permanent contact with human tissue. Nanostructures, induced by electrophoretic deposition (EPD) of ligand-free laser-generated nanoparticles (NPs) on the electrodes are known to stabilize impedance in vivo. Hence, Pt surfaces were systematically EPD-coated with Pt NPs and evaluated for impedance as well as surface coverage, contact angle, electrochemically active surface area (ECSA) and surface oxidation. The aim was to establish a systematic correlation between EPD process parameters and physical surface properties. The findings clearly reveal a linear decrease in impedance with increasing surface coverage, which goes along with a proportional reduction of the contact angle and an increase in ECSA and surface oxidation. EPD process parameters, prone to yield surface coatings with low impedance, are long deposition times (40-60 min), while high colloid concentrations (>250 μg mL-1 ) and electric field strengths (>25 V cm-1 ) should be avoided due to detrimental NP assemblage effects.
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Affiliation(s)
- Sven Koenen
- Technical Chemistry I and, Center for Nanointegration Duisburg-Essen (CENIDE), University of Duisburg-Essen, Universitätsstrasse 7, 45141, Essen, Germany
| | - Christoph Rehbock
- Technical Chemistry I and, Center for Nanointegration Duisburg-Essen (CENIDE), University of Duisburg-Essen, Universitätsstrasse 7, 45141, Essen, Germany
| | - Hans E Heissler
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Svilen D Angelov
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Kerstin Schwabe
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Joachim K Krauss
- Department of Neurosurgery, Hannover Medical School, Carl-Neuberg-Str. 1, 30625, Hannover, Germany
| | - Stephan Barcikowski
- Technical Chemistry I and, Center for Nanointegration Duisburg-Essen (CENIDE), University of Duisburg-Essen, Universitätsstrasse 7, 45141, Essen, Germany
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Long-Latency Somatosensory Evoked Potentials of the Subthalamic Nucleus in Patients with Parkinson’s Disease. PLoS One 2017; 12:e0168151. [PMID: 28081139 PMCID: PMC5231369 DOI: 10.1371/journal.pone.0168151] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2016] [Accepted: 11/25/2016] [Indexed: 11/19/2022] Open
Abstract
Somatosensory evoked potentials (SSEPs) are a viable way to measure processing of somatosensory information. SSEPs have been described at the scalp and the cortical level by electroencephalographic, magnetoencephalographic and intracranial cortical recordings focusing on short-latency (SL; latency<40 ms) and long-latency (LL; latency>40 ms) SSEPs as well as by deep brain stimulation (DBS) electrode studies targeting SL-SSEPs. Unfortunately, LL-SSEPs have not been addressed at the subcortical level aside from the fact that studies targeting the characteristics and generators of SSEPs have been neglected for the last ten years. To cope with these issues, we investigated LL-SSEPs of the subthalamic nucleus (STN) in twelve patients with Parkinson’s disease (PD) that underwent deep brain stimulation (DBS) treatment. In a postoperative setting, LL-SSEPs were elicited by median nerve stimulation (MNS) to the patient’s wrists. Ipsilateral or contralateral MNS was applied with a 3 s inter-stimulus interval. Here, we report about four distinctive LL-SSEPs (“LL–complex” consisting of P80, N100, P140 and N200 component), which were recorded by using monopolar/bipolar reference and ipsi/contralateral MNS. Phase reversal and/or maximum amplitude provided support for the generation of such LL-SSEPs within the STN, which also underscores a role of this subcortical structure in sensory processing.
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Corripio I, Sarró S, McKenna PJ, Molet J, Álvarez E, Pomarol-Clotet E, Portella MJ. Clinical Improvement in a Treatment-Resistant Patient With Schizophrenia Treated With Deep Brain Stimulation. Biol Psychiatry 2016; 80:e69-70. [PMID: 27113497 DOI: 10.1016/j.biopsych.2016.03.1049] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 03/03/2016] [Accepted: 03/04/2016] [Indexed: 01/28/2023]
Affiliation(s)
- Iluminada Corripio
- Psychiatric, Barcelona, Spain; Neurosurgery Departments, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Salvador Sarró
- Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Peter J McKenna
- FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - Joan Molet
- Neurosurgery Departments, Hospital de la Santa Creu i Sant Pau, Institut d'Investigació Biomèdica Sant Pau, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Enric Álvarez
- Psychiatric, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
| | - Edith Pomarol-Clotet
- Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain; FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain.
| | - Maria J Portella
- Psychiatric, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental, Barcelona, Spain
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Engers DW, Blobaum AL, Gogliotti RD, Cheung YY, Salovich JM, Garcia-Barrantes PM, Daniels JS, Morrison R, Jones CK, Soars MG, Zhuo X, Hurley J, Macor JE, Bronson JJ, Conn PJ, Lindsley CW, Niswender CM, Hopkins CR. Discovery, Synthesis, and Preclinical Characterization of N-(3-Chloro-4-fluorophenyl)-1H-pyrazolo[4,3-b]pyridin-3-amine (VU0418506), a Novel Positive Allosteric Modulator of the Metabotropic Glutamate Receptor 4 (mGlu4). ACS Chem Neurosci 2016; 7:1192-200. [PMID: 27075300 PMCID: PMC5031509 DOI: 10.1021/acschemneuro.6b00035] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
The efficacy of positive allosteric modulators (PAMs) of the metabotropic glutamate receptor 4 (mGlu4) in preclinical rodent models of Parkinson's disease has been established by a number of groups. Here, we report an advanced preclinically characterized mGlu4 PAM, N-(3-chloro-4-fluorophenyl)-1H-pyrazolo[4,3-b]pyridin-3-amine (VU0418506). We detail the discovery of VU0418506 starting from a common picolinamide core scaffold and evaluation of a number of amide bioisosteres leading to the novel pyrazolo[4,3-b]pyridine head group. VU0418506 has been characterized as a potent and selective mGlu4 PAM with suitable in vivo pharmacokinetic properties in three preclinical safety species.
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Affiliation(s)
- Darren W. Engers
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Anna L. Blobaum
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Rocco D. Gogliotti
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Yiu-Yin Cheung
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - James M. Salovich
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Pedro M. Garcia-Barrantes
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - J. Scott Daniels
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Ryan Morrison
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Carrie K. Jones
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Matthew G. Soars
- Bristol-Myers Squibb Co., Research and Development, 5 Research Parkway, Wallingford, Connecticut 06492, United States
| | - Xiaoliang Zhuo
- Bristol-Myers Squibb Co., Research and Development, 5 Research Parkway, Wallingford, Connecticut 06492, United States
| | - Jeremy Hurley
- Bristol-Myers Squibb Co., Research and Development, 5 Research Parkway, Wallingford, Connecticut 06492, United States
| | - John E. Macor
- Bristol-Myers Squibb Co., Research and Development, 5 Research Parkway, Wallingford, Connecticut 06492, United States
| | - Joanne J. Bronson
- Bristol-Myers Squibb Co., Research and Development, 5 Research Parkway, Wallingford, Connecticut 06492, United States
| | - P. Jeffrey Conn
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt Kennedy Center, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Craig W. Lindsley
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
- Department of Chemistry, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Colleen M. Niswender
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt Kennedy Center, Vanderbilt University, Nashville, Tennessee 37232, United States
| | - Corey R. Hopkins
- Department of Pharmacology, Vanderbilt University, Nashville, Tennessee 37232, United States
- Department of Chemistry, Vanderbilt University, Nashville, Tennessee 37232, United States
- Vanderbilt Center for Neuroscience Drug Discovery, Vanderbilt University, Nashville, Tennessee 37232, United States
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Deep Brain Stimulation of the Subthalamic Nucleus Improves Lexical Switching in Parkinsons Disease Patients. PLoS One 2016; 11:e0161404. [PMID: 27575379 PMCID: PMC5004923 DOI: 10.1371/journal.pone.0161404] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2016] [Accepted: 08/04/2016] [Indexed: 11/19/2022] Open
Abstract
Objective Reduced verbal fluency (VF) has been reported in patients with Parkinson’s disease (PD), especially those treated by Deep Brain Stimulation of the subthalamic nucleus (STN DBS). To delineate the nature of this dysfunction we aimed at identifying the particular VF-related operations modified by STN DBS. Method Eleven PD patients performed VF tasks in their STN DBS ON and OFF condition. To differentiate VF-components modulated by the stimulation, a temporal cluster analysis was performed, separating production spurts (i.e., ‘clusters’ as correlates of automatic activation spread within lexical fields) from slower cluster transitions (i.e., ‘switches’ reflecting set-shifting towards new lexical fields). The results were compared to those of eleven healthy control subjects. Results PD patients produced significantly more switches accompanied by shorter switch times in the STN DBS ON compared to the STN DBS OFF condition. The number of clusters and time intervals between words within clusters were not affected by the treatment state. Although switch behavior in patients with DBS ON improved, their task performance was still lower compared to that of healthy controls. Discussion Beyond impacting on motor symptoms, STN DBS seems to influence the dynamics of cognitive procedures. Specifically, the results are in line with basal ganglia roles for cognitive switching, in the particular case of VF, from prevailing lexical concepts to new ones.
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Chamaa F, Sweidan W, Nahas Z, Saade N, Abou-Kheir W. Thalamic Stimulation in Awake Rats Induces Neurogenesis in the Hippocampal Formation. Brain Stimul 2016; 9:101-8. [DOI: 10.1016/j.brs.2015.09.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Revised: 09/03/2015] [Accepted: 09/09/2015] [Indexed: 11/16/2022] Open
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Suarez Castellanos IM, Balteanu B, Singh T, Zderic V. Therapeutic Modulation of Calcium Dynamics Using Ultrasound and Other Energy-Based Techniques. IEEE Rev Biomed Eng 2016; 9:177-191. [DOI: 10.1109/rbme.2016.2555760] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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Hentall ID, Luca CC, Widerstrom-Noga E, Vitores A, Fisher LD, Martinez-Arizala A, Jagid JR. The midbrain central gray best suppresses chronic pain with electrical stimulation at very low pulse rates in two human cases. Brain Res 2015; 1632:119-26. [PMID: 26711853 DOI: 10.1016/j.brainres.2015.12.021] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 11/23/2015] [Accepted: 12/14/2015] [Indexed: 01/08/2023]
Abstract
Deep brain stimulation in the midbrain׳s central gray can relieve neuropathic pain in man, but for unclear reasons sometimes fails intraoperatively or in early weeks. Here we describe continuous bilateral stimulation in the central gray of two subjects with longstanding, severe neuropathic pain from spinal cord injury. Stimulation parameters were recursively adjusted over many weeks to optimize analgesia while minimizing adverse effects. In early weeks, adjustments were made in periodic office visits; subjects later selected ad libitum at home among several blinded choices while rating pain twice daily. Both subjects received significantly better pain relief when stimulus pulse rates were low. The best relief occurred with 2 Hz cycled on for 1s and off for 2s. After inferior parameters were set, pain typically climbed slowly over 1-2 days; superior parameters led to both slow and fast improvements. Over many weeks of stimulation at low pulse rates, both subjects experienced significantly less interference from pain with sleep. One subject, with major pain relief, also showed less interference with social/recreational ability and mood; the other subject, despite minor pain relief, experienced a significantly positive global impression of change. Oscillopsia, the only observed complication of stimulation, disappeared at low mean pulse rates (≤ 3/s). These subjects׳ responses are not likely to be unique even if they are uncommon. Thus daily or more frequent pain assessment, combined with slower periodic adjustment of stimulation parameters that incorporate mean pulse rates about one per second, will likely improve success with this treatment.
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Affiliation(s)
- Ian D Hentall
- The Miami Project to Cure Paralysis and Department of Neurological Surgery, Miller School of Medicine, University of Miami, R-48, Miami, FL 33136, USA.
| | - Corneliu C Luca
- The Miami Project to Cure Paralysis and Department of Neurological Surgery, Miller School of Medicine, University of Miami, R-48, Miami, FL 33136, USA
| | - Eva Widerstrom-Noga
- The Miami Project to Cure Paralysis and Department of Neurological Surgery, Miller School of Medicine, University of Miami, R-48, Miami, FL 33136, USA
| | - Alberto Vitores
- The Miami Project to Cure Paralysis and Department of Neurological Surgery, Miller School of Medicine, University of Miami, R-48, Miami, FL 33136, USA
| | - Letitia D Fisher
- The Miami Project to Cure Paralysis and Department of Neurological Surgery, Miller School of Medicine, University of Miami, R-48, Miami, FL 33136, USA
| | - Alberto Martinez-Arizala
- The Miami Project to Cure Paralysis and Department of Neurological Surgery, Miller School of Medicine, University of Miami, R-48, Miami, FL 33136, USA; Department of Veterans Affairs Medical Center, Miami, FL 33101, USA
| | - Jonathan R Jagid
- The Miami Project to Cure Paralysis and Department of Neurological Surgery, Miller School of Medicine, University of Miami, R-48, Miami, FL 33136, USA
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