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Brun G, Testud B, Girard OM, Lehmann P, de Rochefort L, Besson P, Massire A, Ridley B, Girard N, Guye M, Ranjeva JP, Le Troter A. Automatic segmentation of Deep Grey Nuclei using a high-resolution 7T MRI Atlas - quantification of T1 values in healthy volunteers. Eur J Neurosci 2021; 55:438-460. [PMID: 34939245 DOI: 10.1111/ejn.15575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 11/30/2022]
Abstract
We present a new consensus atlas of deep grey nuclei obtained by shape-based averaging of manual segmentation of two experienced neuroradiologists and optimized from 7T MP2RAGE images acquired at (0.6mm)3 in 60 healthy subjects. A group-wise normalization method was used to build a high-contrast and high-resolution T1 -weighted brain template (0.5mm)3 using data from 30 out of the 60 controls. Delineation of 24 deep grey nuclei per hemisphere, including the claustrum and twelve thalamic nuclei, was then performed by two expert neuroradiologists and reviewed by a third neuroradiologist according to tissue contrast and external references based on the Morel atlas. Corresponding deep grey matter structures were also extracted from the Morel and CIT168 atlases. The data-derived, Morel and CIT168 atlases were all applied at the individual level using non-linear registration to fit the subject reference and to extract absolute mean quantitative T1 values derived from the 3D-MP2RAGE volumes, after correction for residual B1 + biases. Three metrics (The Dice and the volumetric similarity coefficients, and a novel Hausdorff distance) were used to estimate the inter-rater agreement of manual MRI segmentation and inter-atlas variability, and these metrics were measured to quantify biases due to image registration and their impact on the measurements of the quantitative T1 values was highlighted. This represents a fully-automated segmentation process permitting the extraction of unbiased normative T1 values in a population of young healthy controls as a reference for characterizing subtle structural alterations of deep grey nuclei relevant to a range of neurological diseases.
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Affiliation(s)
- Gilles Brun
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, Service de Neuroradiologie, Marseille, France
| | - Benoit Testud
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, Service de Neuroradiologie, Marseille, France
| | - Olivier M Girard
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
| | - Pierre Lehmann
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, Service de Neuroradiologie, Marseille, France
| | - Ludovic de Rochefort
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
| | - Pierre Besson
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
| | - Aurélien Massire
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
| | - Ben Ridley
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France.,IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italia
| | - Nadine Girard
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, Service de Neuroradiologie, Marseille, France
| | - Maxime Guye
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
| | - Jean-Philippe Ranjeva
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
| | - Arnaud Le Troter
- Aix Marseille Univ, CNRS, CRMBM, Marseille, France.,AP-HM, CHU Timone, Pôle d'Imagerie Médicale, CEMEREM, Marseille, France
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Kumar KK, Appelboom G, Lamsam L, Caplan AL, Williams NR, Bhati MT, Stein SC, Halpern CH. Comparative effectiveness of neuroablation and deep brain stimulation for treatment-resistant obsessive-compulsive disorder: a meta-analytic study. J Neurol Neurosurg Psychiatry 2019; 90:469-473. [PMID: 30679237 DOI: 10.1136/jnnp-2018-319318] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 12/25/2018] [Accepted: 01/04/2019] [Indexed: 12/30/2022]
Abstract
BACKGROUND The safety and efficacy of neuroablation (ABL) and deep brain stimulation (DBS) for treatment refractory obsessive-compulsive disorder (OCD) has not been examined. This study sought to generate a definitive comparative effectiveness model of these therapies. METHODS A EMBASE/PubMed search of English-language, peer-reviewed articles reporting ABL and DBS for OCD was performed in January 2018. Change in quality of life (QOL) was quantified based on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) and the impact of complications on QOL was assessed. Mean response of Y-BOCS was determined using random-effects, inverse-variance weighted meta-analysis of observational data. FINDINGS Across 56 studies, totalling 681 cases (367 ABL; 314 DBS), ABL exhibited greater overall utility than DBS. Pooled ability to reduce Y-BOCS scores was 50.4% (±22.7%) for ABL and was 40.9% (±13.7%) for DBS. Meta-regression revealed no significant change in per cent improvement in Y-BOCS scores over the length of follow-up for either ABL or DBS. Adverse events occurred in 43.6% (±4.2%) of ABL cases and 64.6% (±4.1%) of DBS cases (p<0.001). Complications reduced ABL utility by 72.6% (±4.0%) and DBS utility by 71.7% (±4.3%). ABL utility (0.189±0.03) was superior to DBS (0.167±0.04) (p<0.001). INTERPRETATION Overall, ABL utility was greater than DBS, with ABL showing a greater per cent improvement in Y-BOCS than DBS. These findings help guide success thresholds in future clinical trials for treatment refractory OCD.
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Affiliation(s)
- Kevin K Kumar
- Department of Neurosurgery, Stanford University, Stanford, California, USA
| | - Geoffrey Appelboom
- Department of Neurosurgery, Stanford University, Stanford, California, USA
| | - Layton Lamsam
- Department of Neurosurgery, Stanford University, Stanford, California, USA
| | - Arthur L Caplan
- Department of Population Health, Division of Medical Ethics, New York University, New York City, New York, USA
| | - Nolan R Williams
- Department of Psychiatry, Stanford University, Stanford, California, USA
| | - Mahendra T Bhati
- Department of Neurosurgery, Stanford University, Stanford, California, USA.,Department of Psychiatry, Stanford University, Stanford, California, USA
| | - Sherman C Stein
- Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Casey H Halpern
- Department of Neurosurgery, Stanford University, Stanford, California, USA
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Graupe D, Khobragade N, Tuninetti D, Basu I, Slavin KV, Verhagen Metman L. Who May Benefit From On-Demand Control of Deep Brain Stimulation? Noninvasive Evaluation of Parkinson Patients. Neuromodulation 2018; 21:611-616. [PMID: 29345392 DOI: 10.1111/ner.12752] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2017] [Revised: 10/18/2017] [Accepted: 11/21/2017] [Indexed: 11/29/2022]
Abstract
BACKGROUND In closed-loop on-demand control (ODC) of deep brain stimulation (DBS), stimulation is applied only when symptoms appear. Following stimulation of a fixed duration, DBS is switched off until the symptoms reappear. By repeating these demand-driven cycles, the amount of stimulation delivered can be decreased, thereby reducing DBS side-effects and improving battery-life of the pulse-generator. This article introduces Ro metric for quantification of degree of benefit of ODC and explores candidate selection in tremor-dominant Parkinson's disease (PD). METHOD The study was performed on nine PD patients previously implanted with Medtronic DBS systems. Accelerometer sensor was placed on the tremor-dominant hand to detect onset of tremor. Fixed duration of stimulation (DS) of 20-80 sec was applied. Once the tremor was observed, stimulation was switched on. These trials were repeated during resting, postural, and kinetic conditions. Ro metric was calculated as the ratio of stimulation-off tremor-free period to the DS. Ro calculated at different DS were compared for each patient. RESULTS We found that for each patient, Ro varied with DS and an optimal DS* gave a higher percentage of stimulation-off time. Average Ro at DS* varied from 0.554 to 4.24 for eight patients giving 35%-80% stimulation-off time. CONCLUSIONS Ro values can be used for selection of optimal DS* in ODC. Three of nine patients were found to be tremor-free without stimulation for >50% of total time with even up to 80% in one patient. Patients with low Ro may not benefit from ODC in DBS, where the trade-off between having side-effects and using ODC system will need to be assessed.
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Affiliation(s)
- Daniel Graupe
- Department of Electrical and Computer Engineering, University of Illinois at Chicago, Chicago, IL, USA.,Department of Neurology & Rehabilitation Medicine, University of Illinois at Chicago, Chicago, IL, USA
| | - Nivedita Khobragade
- Department of Electrical and Computer Engineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Daniela Tuninetti
- Department of Electrical and Computer Engineering, University of Illinois at Chicago, Chicago, IL, USA
| | - Ishita Basu
- Department of Neurosurgery, Massachusetts General Hospital, Boston, MA, USA
| | - Konstantin V Slavin
- Department of Neurosurgery, University of Illinois at Chicago, Chicago, IL, USA
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Roberts JA, Friston KJ, Breakspear M. Clinical Applications of Stochastic Dynamic Models of the Brain, Part II: A Review. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2017. [DOI: 10.1016/j.bpsc.2016.12.009] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
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Karamintziou SD, Custódio AL, Piallat B, Polosan M, Chabardès S, Stathis PG, Tagaris GA, Sakas DE, Polychronaki GE, Tsirogiannis GL, David O, Nikita KS. Algorithmic design of a noise-resistant and efficient closed-loop deep brain stimulation system: A computational approach. PLoS One 2017; 12:e0171458. [PMID: 28222198 PMCID: PMC5319757 DOI: 10.1371/journal.pone.0171458] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2016] [Accepted: 01/20/2017] [Indexed: 11/19/2022] Open
Abstract
Advances in the field of closed-loop neuromodulation call for analysis and modeling approaches capable of confronting challenges related to the complex neuronal response to stimulation and the presence of strong internal and measurement noise in neural recordings. Here we elaborate on the algorithmic aspects of a noise-resistant closed-loop subthalamic nucleus deep brain stimulation system for advanced Parkinson’s disease and treatment-refractory obsessive-compulsive disorder, ensuring remarkable performance in terms of both efficiency and selectivity of stimulation, as well as in terms of computational speed. First, we propose an efficient method drawn from dynamical systems theory, for the reliable assessment of significant nonlinear coupling between beta and high-frequency subthalamic neuronal activity, as a biomarker for feedback control. Further, we present a model-based strategy through which optimal parameters of stimulation for minimum energy desynchronizing control of neuronal activity are being identified. The strategy integrates stochastic modeling and derivative-free optimization of neural dynamics based on quadratic modeling. On the basis of numerical simulations, we demonstrate the potential of the presented modeling approach to identify, at a relatively low computational cost, stimulation settings potentially associated with a significantly higher degree of efficiency and selectivity compared with stimulation settings determined post-operatively. Our data reinforce the hypothesis that model-based control strategies are crucial for the design of novel stimulation protocols at the backstage of clinical applications.
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Affiliation(s)
- Sofia D. Karamintziou
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
- Department of Mechanical Engineering, University of California, Riverside, California, United States of America
- * E-mail: (SDK); (KSN)
| | | | - Brigitte Piallat
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, France
- Inserm, U1216, Grenoble, France
| | - Mircea Polosan
- Inserm, U1216, Grenoble, France
- Department of Psychiatry, University Hospital of Grenoble, Grenoble, France
| | - Stéphan Chabardès
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, France
- Inserm, U1216, Grenoble, France
- Department of Neurosurgery, University Hospital of Grenoble, Grenoble, France
| | | | - George A. Tagaris
- Department of Neurology, ‘G. Gennimatas’ General Hospital of Athens, Athens, Greece
| | - Damianos E. Sakas
- Department of Neurosurgery, University of Athens Medical School, ‘Evangelismos’ General Hospital, Athens, Greece
| | - Georgia E. Polychronaki
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - George L. Tsirogiannis
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
| | - Olivier David
- Univ. Grenoble Alpes, Grenoble Institut des Neurosciences, GIN, Grenoble, France
- Inserm, U1216, Grenoble, France
| | - Konstantina S. Nikita
- School of Electrical and Computer Engineering, National Technical University of Athens, Athens, Greece
- * E-mail: (SDK); (KSN)
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A Multichannel Recording System with Optical Stimulation for Closed-Loop Optogenetic Experiments. Methods Mol Biol 2016; 1408:333-44. [PMID: 26965134 DOI: 10.1007/978-1-4939-3512-3_23] [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] [Indexed: 01/07/2023]
Abstract
Selective perturbation of the activity of specific cell types in the brain tissue is essential in understanding the function of neuronal circuits involved in cognition and behavior and might also provide therapeutic neuromodulation strategies. Such selective neuronal addressing can be achieved through the optical activation of light-sensitive proteins called opsins that are expressed in specific cell populations through genetic methods-hence the name "optogenetics." In optogenetic experiments, the electrical activity of the targeted cell populations is optically triggered and monitored using arrays of microelectrodes. In closed-loop studies, the optical stimulation parameters are adjusted based on the recorded activity, ideally in real time. Here we describe the basic tools and the protocols allowing closed-loop optogenic experiments in vivo.
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Karamintziou SD, Deligiannis NG, Piallat B, Polosan M, Chabardès S, David O, Stathis PG, Tagaris GA, Boviatsis EJ, Sakas DE, Polychronaki GE, Tsirogiannis GL, Nikita KS. Dominant efficiency of nonregular patterns of subthalamic nucleus deep brain stimulation for Parkinson’s disease and obsessive-compulsive disorder in a data-driven computational model. J Neural Eng 2015; 13:016013. [DOI: 10.1088/1741-2560/13/1/016013] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Wood J, Ahmari SE. A Framework for Understanding the Emerging Role of Corticolimbic-Ventral Striatal Networks in OCD-Associated Repetitive Behaviors. Front Syst Neurosci 2015; 9:171. [PMID: 26733823 PMCID: PMC4681810 DOI: 10.3389/fnsys.2015.00171] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 11/23/2015] [Indexed: 11/13/2022] Open
Abstract
Significant interest in the mechanistic underpinnings of obsessive-compulsive disorder (OCD) has fueled research on the neural origins of compulsive behaviors. Converging clinical and preclinical evidence suggests that abnormal repetitive behaviors are driven by dysfunction in cortico-striatal-thalamic-cortical (CSTC) circuits. These findings suggest that compulsive behaviors arise, in part, from aberrant communication between lateral orbitofrontal cortex (OFC) and dorsal striatum. An important body of work focused on the role of this network in OCD has been instrumental to progress in the field. Disease models focused primarily on these regions, however, fail to capture an important aspect of the disorder: affective dysregulation. High levels of anxiety are extremely prevalent in OCD, as is comorbidity with major depressive disorder. Furthermore, deficits in processing rewards and abnormalities in processing emotional stimuli are suggestive of aberrant encoding of affective information. Accordingly, OCD can be partially characterized as a disease in which behavioral selection is corrupted by exaggerated or dysregulated emotional states. This suggests that the networks producing OCD symptoms likely expand beyond traditional lateral OFC and dorsal striatum circuit models, and highlights the need to cast a wider net in our investigation of the circuits involved in generating and sustaining OCD symptoms. Here, we address the emerging role of medial OFC, amygdala, and ventral tegmental area projections to the ventral striatum (VS) in OCD pathophysiology. The VS receives strong innervation from these affect and reward processing regions, and is therefore poised to integrate information crucial to the generation of compulsive behaviors. Though it complements functions of dorsal striatum and lateral OFC, this corticolimbic-VS network is less commonly explored as a potential source of the pathology underlying OCD. In this review, we discuss this network's potential role as a locus of OCD pathology and effective treatment.
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Affiliation(s)
- Jesse Wood
- Translational Neuroscience Program, Department of Psychiatry, University of PittsburghPittsburgh, PA, USA
- Center for Neuroscience, University of PittsburghPittsburgh, PA, USA
| | - Susanne E. Ahmari
- Translational Neuroscience Program, Department of Psychiatry, University of PittsburghPittsburgh, PA, USA
- Center for Neuroscience, University of PittsburghPittsburgh, PA, USA
- Center for the Neural Basis of Cognition, University of PittsburghPittsburgh, PA, USA
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Feng H, Zhuang P, Hallett M, Zhang Y, Li J, Li Y. Characteristics of subthalamic oscillatory activity in parkinsonian akinetic-rigid type and mixed type. Int J Neurosci 2015; 126:819-828. [PMID: 26268485 DOI: 10.3109/00207454.2015.1074225] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE To explore neurons with β oscillatory activity in the subthalamic nucleus (STN) in relation to parkinsonian motor signs. METHODS We studied 27 patients with Parkinson's disease (PD) who underwent electrode implantation for STN deep brain stimulation. Thirteen patients were classified as akinetic-rigid (AR) type and 14 patients were classified as mixed type. Microelectrode recording was performed in the STN and the electromyogram (EMG) was simultaneously recorded. Single-unit and spectral analyses were performed. Coherence analysis was used to explore the relationship between β oscillatory activity and EMG activity. Unpaired t-test and chi-square were used to compare the differences between the two PD types. RESULTS Of 130 neurons identified in the AR type, 43.8% were β oscillatory neurons (mean: 21.3 ± 6.87 Hz, βFB) and 0.8% were tremor frequency oscillatory neurons (4-6 Hz, TFB). Of 102 neurons identified in the mixed type, 19.6% were β oscillatory neurons and 26.5% were TFB oscillatory neurons. There was a significant difference in proportion of neurons with βFB and TFB oscillations between the two PD groups. Additionally, 12% of the βFB oscillatory neurons were coherent with limb EMG of the AR type, but there was no coherence in the mixed type. Most oscillatory neurons were localized in the dorsal portion of the STN. CONCLUSION The STN βFB oscillatory neurons correlate with parkinsonian rigidity-bradykinesia. The high proportion of βFB oscillatory neurons found in the AR type of PD is indirect evidence for their importance in generating motor impairment.
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Affiliation(s)
- Huanhuan Feng
- a 1 Beijing Institute of Functional Neurosurgery, Xuanwu Hospital , Capital Medical University , Beijing , China.,b 2 Center of Parkinson's Disease , Beijing Institute for Brain Disorders , Beijing , China.,c 3 Key Laboratory of Neurodegenerative Diseases (Capital Medical University) , Ministry of Education , Beijing , China
| | - Ping Zhuang
- a 1 Beijing Institute of Functional Neurosurgery, Xuanwu Hospital , Capital Medical University , Beijing , China.,b 2 Center of Parkinson's Disease , Beijing Institute for Brain Disorders , Beijing , China.,c 3 Key Laboratory of Neurodegenerative Diseases (Capital Medical University) , Ministry of Education , Beijing , China
| | - Mark Hallett
- d 4 Human Motor Control Section, Medical Neurology Branch , National Institute of Neurological Disorders and Stroke, NIH , Bethesda , MD , USA
| | - Yuqing Zhang
- a 1 Beijing Institute of Functional Neurosurgery, Xuanwu Hospital , Capital Medical University , Beijing , China.,b 2 Center of Parkinson's Disease , Beijing Institute for Brain Disorders , Beijing , China.,c 3 Key Laboratory of Neurodegenerative Diseases (Capital Medical University) , Ministry of Education , Beijing , China
| | - Jianyu Li
- a 1 Beijing Institute of Functional Neurosurgery, Xuanwu Hospital , Capital Medical University , Beijing , China.,b 2 Center of Parkinson's Disease , Beijing Institute for Brain Disorders , Beijing , China.,c 3 Key Laboratory of Neurodegenerative Diseases (Capital Medical University) , Ministry of Education , Beijing , China
| | - Yongjie Li
- a 1 Beijing Institute of Functional Neurosurgery, Xuanwu Hospital , Capital Medical University , Beijing , China.,b 2 Center of Parkinson's Disease , Beijing Institute for Brain Disorders , Beijing , China.,c 3 Key Laboratory of Neurodegenerative Diseases (Capital Medical University) , Ministry of Education , Beijing , China
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Alhourani A, McDowell MM, Randazzo MJ, Wozny TA, Kondylis ED, Lipski WJ, Beck S, Karp JF, Ghuman AS, Richardson RM. Network effects of deep brain stimulation. J Neurophysiol 2015; 114:2105-17. [PMID: 26269552 DOI: 10.1152/jn.00275.2015] [Citation(s) in RCA: 53] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2015] [Accepted: 08/10/2015] [Indexed: 11/22/2022] Open
Abstract
The ability to differentially alter specific brain functions via deep brain stimulation (DBS) represents a monumental advance in clinical neuroscience, as well as within medicine as a whole. Despite the efficacy of DBS in the treatment of movement disorders, for which it is often the gold-standard therapy when medical management becomes inadequate, the mechanisms through which DBS in various brain targets produces therapeutic effects is still not well understood. This limited knowledge is a barrier to improving efficacy and reducing side effects in clinical brain stimulation. A field of study related to assessing the network effects of DBS is gradually emerging that promises to reveal aspects of the underlying pathophysiology of various brain disorders and their response to DBS that will be critical to advancing the field. This review summarizes the nascent literature related to network effects of DBS measured by cerebral blood flow and metabolic imaging, functional imaging, and electrophysiology (scalp and intracranial electroencephalography and magnetoencephalography) in order to establish a framework for future studies.
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Affiliation(s)
- Ahmad Alhourani
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael M McDowell
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Michael J Randazzo
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Thomas A Wozny
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | | | - Witold J Lipski
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Sarah Beck
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Jordan F Karp
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania; and
| | - Avniel S Ghuman
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for the Neural Basis of Cognition, Pittsburgh, Pennsylvania
| | - R Mark Richardson
- Department of Neurosurgery, University of Pittsburgh, Pittsburgh, Pennsylvania; Center for the Neural Basis of Cognition, Pittsburgh, Pennsylvania
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Salgado S, Kaplitt MG. The Nucleus Accumbens: A Comprehensive Review. Stereotact Funct Neurosurg 2015; 93:75-93. [PMID: 25720819 DOI: 10.1159/000368279] [Citation(s) in RCA: 271] [Impact Index Per Article: 30.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2014] [Accepted: 09/10/2014] [Indexed: 11/19/2022]
Affiliation(s)
- Sanjay Salgado
- Laboratory of Molecular Neurosurgery, Department of Neurological Surgery, Weill Cornell Medical College, New York, N.Y., USA
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12
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Ballester González J, Dvorkin-Gheva A, Silva C, Foster JA, Szechtman H. Nucleus accumbens core and pathogenesis of compulsive checking. Behav Pharmacol 2015; 26:200-16. [PMID: 25426580 PMCID: PMC5398318 DOI: 10.1097/fbp.0000000000000112] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 10/16/2014] [Indexed: 11/26/2022]
Abstract
To investigate the role of the nucleus accumbens core (NAc) in the development of quinpirole-induced compulsive checking, rats received an excitotoxic lesion of NAc or sham lesion and were injected with quinpirole (0.5 mg/kg) or saline; development of checking behavior was monitored for 10 biweekly tests. The results showed that even after the NAc lesion, quinpirole still induced compulsive checking, suggesting that the pathogenic effects produced by quinpirole lie outside the NAc. Although the NAc lesion did not prevent the induction of compulsive checking, it altered how quickly it develops, suggesting that the NAc normally contributes toward the induction of compulsive checking. Saline-treated rats with an NAc lesion were hyperactive, but did not develop compulsive checking, indicating that hyperactivity by itself is not sufficient for the pathogenesis of compulsive checking. It is proposed that compulsive checking is the exaggerated output of a security motivation system and that the NAc serves as a neural hub for coordinating the orderly activity of neural modules of this motivational system. Evidence is considered suggesting that the neurobiological condition for the pathogenesis of compulsive checking is two-fold: activation of dopamine D2/D3 receptors without concurrent stimulation of D1-like receptors and long-term plastic changes related to quinpirole-induced sensitization.
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Affiliation(s)
| | - Anna Dvorkin-Gheva
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Charmaine Silva
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Jane A. Foster
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
| | - Henry Szechtman
- Department of Psychiatry and Behavioral Neurosciences, McMaster University, Hamilton, Ontario, Canada
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Hiss S, Hesselmann V, Hunsche S, Kugel H, Sturm V, Maintz D, Visser-Vandewalle V, Liebig T, Maarouf M. Intraoperative Functional Magnetic Resonance Imaging for Monitoring the Effect of Deep Brain Stimulation in Patients with Obsessive-Compulsive Disorder. Stereotact Funct Neurosurg 2015; 93:30-7. [DOI: 10.1159/000368805] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Accepted: 10/10/2014] [Indexed: 11/19/2022]
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Activity parameters of subthalamic nucleus neurons selectively predict motor symptom severity in Parkinson's disease. J Neurosci 2014; 34:6273-85. [PMID: 24790198 DOI: 10.1523/jneurosci.1803-13.2014] [Citation(s) in RCA: 133] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Parkinson's disease (PD) is a heterogeneous disorder that leads to variable expression of several different motor symptoms. While changes in firing rate, pattern, and oscillation of basal ganglia neurons have been observed in PD patients and experimental animals, there is limited evidence linking them to specific motor symptoms. Here we examined this relationship using extracellular recordings of subthalamic nucleus neurons from 19 PD patients undergoing surgery for deep brain stimulation. For each patient, ≥ 10 single units and/or multi-units were recorded in the OFF medication state. We correlated the proportion of neurons displaying different activities with preoperative Unified Parkinson's Disease Rating Scale subscores (OFF medication). The mean spectral power at sub-beta frequencies and percentage of units oscillating at beta frequencies were positively correlated with the axial and limb rigidity scores, respectively. The percentage of units oscillating at gamma frequency was negatively correlated with the bradykinesia scores. The mean intraburst rate was positively correlated with both bradykinesia and axial scores, while the related ratio of interspike intervals below/above 10 ms was positively correlated with these symptoms and limb rigidity. None of the activity parameters correlated with tremor. The grand average of all the significantly correlated subthalamic nucleus activities accounted for >60% of the variance of the combined bradykinetic-rigid and axial scores. Our results demonstrate that the occurrence of alterations in the rate and pattern of basal ganglia neurons could partly underlie the variability in parkinsonian phenotype.
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15
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Nguyen TKT, Navratilova Z, Cabral H, Wang L, Gielen G, Battaglia FP, Bartic C. Closed-loop optical neural stimulation based on a 32-channel low-noise recording system with online spike sorting. J Neural Eng 2014; 11:046005. [PMID: 24891498 DOI: 10.1088/1741-2560/11/4/046005] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVE Closed-loop operation of neuro-electronic systems is desirable for both scientific and clinical (neuroprosthesis) applications. Integrating optical stimulation with recording capability further enhances the selectivity of neural stimulation. We have developed a system enabling the local delivery of optical stimuli and the simultaneous electrical measuring of the neural activities in a closed-loop approach. APPROACH The signal analysis is performed online through the implementation of a template matching algorithm. The system performance is demonstrated with the recorded data and in awake rats. MAIN RESULTS Specifically, the neural activities are simultaneously recorded, detected, classified online (through spike sorting) from 32 channels, and used to trigger a light emitting diode light source using generated TTL signals. SIGNIFICANCE A total processing time of 8 ms is achieved, suitable for optogenetic studies of brain mechanisms online.
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Affiliation(s)
- T K T Nguyen
- Imec, 3001 Leuven, Belgium. Department of Electrical Engineering, Katholieke Universiteit Leuven, 3001 Leuven, Belgium
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16
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Abstract
Although first introduced about 25 years ago deep brain stimulation (DBS) technology is still evolving at a high rate and most innovations have been developed as a result of pressure from increasing commercial competition. Technical innovations from recent years include rechargeable generators and new stimulation paradigms. Current and upcoming developments mainly aim at prediction of stimulation and unwanted side effects and hence improvement in safety and treatment efficacy. Some of the future keynote DBS technologies are summarized in this survey.
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17
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Nucleus Accumbens Surgery for Addiction. World Neurosurg 2013; 80:S28.e9-19. [DOI: 10.1016/j.wneu.2012.10.007] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2012] [Revised: 07/29/2012] [Accepted: 10/02/2012] [Indexed: 02/07/2023]
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18
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Neto LL, Oliveira E, Correia F, Ferreira AG. The human nucleus accumbens: where is it? A stereotactic, anatomical and magnetic resonance imaging study. Neuromodulation 2013; 11:13-22. [PMID: 22150987 DOI: 10.1111/j.1525-1403.2007.00138.x] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Objectives. Identification, delimitation, and stereotactic localization of the human nucleus accumbens (Acc) in order to allow its accurate definition and three-dimensional targeting on magnetic resonance imaging (MRI) enabling its use for deep brain stimulation. Methods. Magnetic resonance imaging and anatomical coronal serial cuts were performed on 24 Acc from human cadaver brains perpendicular to the anterior commissure-posterior commissure line; identification, localization, and determination of its dimensions and three-dimensional stereotactic coordinates. Results. Twenty Acc were studied anatomically, 14 by MRI and 12 by both methods. The contours of the Acc were traced and the dimensions measured; mean values: length 10.5 mm, width 14.5 mm and height 7.0 mm. The stereotactic coordinates were obtained every millimeter along its length. Conclusion. It was possible to identify well the human Acc, define its limits and establish its three-dimensional coordinates as potential MRI-guided stereotactic target.
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Affiliation(s)
- Lia Lucas Neto
- Anatomy Institute, Lisbon Faculty of Medicine, Lisbon, Portugal; Department of Neuroradiology, Santa Maria Hospital, Lisbon, Portugal; and Department of Neurosurgery, Santa Maria Hospital, Lisbon, Portugal
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Albelda N, Joel D. Current animal models of obsessive compulsive disorder: an update. Neuroscience 2012; 211:83-106. [PMID: 21925243 DOI: 10.1016/j.neuroscience.2011.08.070] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2011] [Revised: 08/29/2011] [Accepted: 08/31/2011] [Indexed: 12/30/2022]
Affiliation(s)
- N Albelda
- Department of Psychology, Tel Aviv University, Ramat-Aviv, Tel Aviv 69978, Israel
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20
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Tsang EW, Hamani C, Moro E, Mazzella F, Saha U, Lozano AM, Hodaie M, Chuang R, Steeves T, Lim SY, Neagu B, Chen R. Subthalamic deep brain stimulation at individualized frequencies for Parkinson disease. Neurology 2012; 78:1930-8. [PMID: 22592373 DOI: 10.1212/wnl.0b013e318259e183] [Citation(s) in RCA: 48] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES The oscillation model of Parkinson disease (PD) states that, in the subthalamic nucleus (STN), increased θ (4-10 Hz) and β (11-30 Hz) frequencies were associated with worsening whereas γ frequencies (31-100 Hz) were associated with improvement of motor symptoms. However, the peak STN frequency in each band varied widely from subject to subject. We hypothesized that STN deep brain stimulation (DBS) at individualized γ frequencies would improve whereas θ or β frequencies would worsen PD motor signs. METHODS We prospectively studied 13 patients with PD. STN local field potential (LFP) was recorded after electrode implantations, in the OFF and then in ON dopaminergic medication states while patients performed wrist movements. Six individual peak frequencies of the STN LFP power spectra were obtained: the greatest decrease in θ and β and greatest increase in γ frequencies in the ON state (MED) and during movements (MOVE). Eight DBS frequencies were applied including 6 MED and MOVE frequencies, high frequency (HF) used for chronic stimulation, and no stimulation. The patients were assessed using the motor Unified Parkinson's Disease Rating Scale (mUPDRS). RESULTS STN DBS at γ frequencies (MED and MOVE) and HF significantly improved mUPDRS scores compared to no stimulation and both γ frequencies were not different from HF. DBS at θ and β frequencies did not worsen mUPDRS scores compared to no stimulation. CONCLUSION Short-term administration of STN DBS at peak dopamine-dependent or movement-related γ frequencies were as effective as HF for reducing parkinsonian motor signs but DBS at θ and β frequencies did not worsen PD motor signs. CLASSIFICATION OF EVIDENCE This study provides Class III evidence that STN DBS at patient-specific γ frequencies and at usual high frequencies both improved mUPDRS scores compared to no stimulation and did not differ in effect.
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Affiliation(s)
- E W Tsang
- Division of Brain Imaging & Behaviour Systems–Neuroscience, Toronto Western Research Institute, University Health Network, University of Toronto, Ontario, Canada
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21
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Quinpirole-induced sensitization to noisy/sparse periodic input: temporal synchronization as a component of obsessive-compulsive disorder. Neuroscience 2011; 179:143-50. [DOI: 10.1016/j.neuroscience.2011.01.048] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2010] [Revised: 01/19/2011] [Accepted: 01/22/2011] [Indexed: 11/22/2022]
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22
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Mian MK, Campos M, Sheth SA, Eskandar EN. Deep brain stimulation for obsessive-compulsive disorder: past, present, and future. Neurosurg Focus 2010; 29:E10. [DOI: 10.3171/2010.4.focus10107] [Citation(s) in RCA: 76] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a psychiatric illness that can lead to chronic functional impairment. Some patients with severe, chronic OCD have been treated with ablative neurosurgical techniques over the past 4 decades. More recently, deep brain stimulation (DBS) has been investigated as a therapy for refractory OCD, and the procedure was granted a limited humanitarian device exemption by the FDA in 2009. In this article, the authors review the development of DBS for OCD, describe the current understanding of the pathophysiological mechanisms of the disorder and how the underlying neural circuits might be modulated by DBS, and discuss the clinical studies that provide evidence for the use of this evolving therapy. The authors conclude with suggestions for how a combined basic science and translational research approach could drive the understanding of the neural mechanisms underlying OCD as well as the clinical effectiveness of DBS in the setting of recalcitrant disease.
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Affiliation(s)
- Matthew K. Mian
- 1Department of Neurosurgery, Massachusetts General Hospital; and
- 2Harvard Medical School, Boston, Massachusetts
| | - Michael Campos
- 1Department of Neurosurgery, Massachusetts General Hospital; and
- 2Harvard Medical School, Boston, Massachusetts
| | - Sameer A. Sheth
- 1Department of Neurosurgery, Massachusetts General Hospital; and
| | - Emad N. Eskandar
- 1Department of Neurosurgery, Massachusetts General Hospital; and
- 2Harvard Medical School, Boston, Massachusetts
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23
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Abdallah CG, Tang CY, Mathew SJ, Martinez J, Hof PR, Perera TD, Shungu DC, Gorman JM, Coplan JD. Diffusion tensor imaging in studying white matter complexity: a gap junction hypothesis. Neurosci Lett 2010; 475:161-4. [PMID: 20371267 DOI: 10.1016/j.neulet.2010.03.070] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2010] [Revised: 03/05/2010] [Accepted: 03/29/2010] [Indexed: 01/08/2023]
Abstract
The role of the prefrontal cortex as an executive oversight of posterior brain regions raises the question of the extent to which the anterior regions of the brain interconnect with the posterior regions. The aim of this study is to test the complexity of rostral white matter tracts, which connect anterior and posterior brain regions, in comparison to caudal white matter tracts and the corpus callosum. Diffusion tensor imaging (DTI) is a modality that measures fractional anisotropy (FA). Higher white matter complexity could result in a decrease of FA, possibly through denser intersection of fiber tracts. DTI was used to determine regional FA in 9 healthy bonnet macaques (Macaca radiata). Four regions of interest were included: anterior and posterior limbs of the internal capsule, the occipital lobe white matter, and the corpus callosum. FA of the anterior limbs of the internal capsule was lowest compared to all other regions of interest (Newman-Keuls (N-K); p<0.0001), whereas FA of the corpus callosum was highest (N-K; p<0.0001). The posterior limbs of the internal capsule and the occipital white matter were not distinguishable but exhibited intermediate FA in comparison to the former (N-K; p<0.0001) and the latter (N-K; p<0.0001). The current study demonstrates that FA, a measure of white matter complexity, can vary markedly as a function of region of interest. Moreover, validation of these findings using neurohistological studies and replication in human samples appears warranted.
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Affiliation(s)
- Chadi G Abdallah
- Department of Psychiatry, Division of Neuropsychopharmacology, State University of New York, Downstate Medical Center, 450 Clarkson Avenue, Brooklyn, NY 11023, USA.
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24
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Andrade P, Carrillo-Ruiz JD, Ramírez Y, Jiménez F. Effects of Thalamic Reticular Nucleus Electrical Stimulation in Rats in a T-maze Perseverative Behavior Model Induced by 8-OH-DPAT. Neuromodulation 2009; 13:2-9. [DOI: 10.1111/j.1525-1403.2009.00242.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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25
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van der Meer MAA, Redish AD. Low and High Gamma Oscillations in Rat Ventral Striatum have Distinct Relationships to Behavior, Reward, and Spiking Activity on a Learned Spatial Decision Task. Front Integr Neurosci 2009; 3:9. [PMID: 19562092 PMCID: PMC2701683 DOI: 10.3389/neuro.07.009.2009] [Citation(s) in RCA: 102] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Accepted: 05/14/2009] [Indexed: 11/18/2022] Open
Abstract
Local field potential (LFP) oscillations in the brain reflect organization thought to be important for perception, attention, movement, and memory. In the basal ganglia, including dorsal striatum, dysfunctional LFP states are associated with Parkinson's disease, while in healthy subjects, dorsal striatal LFPs have been linked to decision-making processes. However, LFPs in ventral striatum have been less studied. We report that in rats running a spatial decision task, prominent gamma-50 (45–55 Hz) and gamma-80 (70–85 Hz) oscillations in ventral striatum had distinct relationships to behavior, task events, and spiking activity. Gamma-50 power increased sharply following reward delivery and before movement initiation, while in contrast, gamma-80 power ramped up gradually to reward locations. Gamma-50 power was low and contained little structure during early learning, but rapidly developed a stable pattern, while gamma-80 power was initially high before returning to a stable level within a similar timeframe. Putative fast-spiking interneurons (FSIs) showed phase, firing rate, and coherence relationships with gamma-50 and gamma-80, indicating that the observed LFP patterns are locally relevant. Furthermore, in a number of FSIs such relationships were specific to gamma-50 or gamma-80, suggesting that partially distinct FSI populations mediate the effects of gamma-50 and gamma-80.
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26
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Berlin HA, Hamilton H, Hollander E. Experimental therapeutics for refractory obsessive-compulsive disorder: translational approaches and new somatic developments. ACTA ACUST UNITED AC 2008; 75:174-203. [DOI: 10.1002/msj.20045] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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27
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Münte TF, Heldmann M, Hinrichs H, Marco-Pallares J, Krämer UM, Sturm V, Heinze HJ. Nucleus Accumbens is Involved in Human Action Monitoring: Evidence from Invasive Electrophysiological Recordings. Front Hum Neurosci 2008; 1:11. [PMID: 18958225 PMCID: PMC2525987 DOI: 10.3389/neuro.09.011.2007] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2007] [Accepted: 01/03/2008] [Indexed: 11/13/2022] Open
Abstract
The Nucleus accumbens (Nacc) has been proposed to act as a limbic-motor interface. Here, using invasive intraoperative recordings in an awake patient suffering from obsessive-compulsive disease (OCD), we demonstrate that its activity is modulated by the quality of performance of the subject in a choice reaction time task designed to tap action monitoring processes. Action monitoring, that is, error detection and correction, is thought to be supported by a system involving the dopaminergic midbrain, the basal ganglia, and the medial prefrontal cortex. In surface electrophysiological recordings, action monitoring is indexed by an error-related negativity (ERN) appearing time-locked to the erroneous responses and emanating from the medial frontal cortex. In preoperative scalp recordings the patient's ERN was found to be significantly increased compared to a large (n = 83) normal sample, suggesting enhanced action monitoring processes. Intraoperatively, error-related modulations were obtained from the Nacc but not from a site 5 mm above. Importantly, cross-correlation analysis showed that error-related activity in the Nacc preceded surface activity by 40 ms. We propose that the Nacc is involved in action monitoring, possibly by using error signals from the dopaminergic midbrain to adjust the relative impact of limbic and prefrontal inputs on frontal control systems in order to optimize goal-directed behavior.
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Affiliation(s)
- Thomas F Münte
- Department of Neuropsychology, University of Magdeburg Magdeburg, Germany
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28
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Nenadic I. Targeting brain regions and symptoms: neuronal single-unit recordings and deep brain stimulation in obsessive-compulsive disorder. Biol Psychiatry 2008; 63:542-3. [PMID: 18295658 DOI: 10.1016/j.biopsych.2008.01.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2008] [Revised: 01/25/2008] [Accepted: 01/25/2008] [Indexed: 11/16/2022]
Affiliation(s)
- Igor Nenadic
- Department of Psychiatry and Psychotherapy, Friedrich-Schiller-University of Jena, Philosophenweg 3, D-07743 Jena, Germany.
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29
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Comparative study of the effects of electrical stimulation in the nucleus accumbens, the mediodorsal thalamic nucleus and the bed nucleus of the stria terminalis in rats with schedule-induced polydipsia. Brain Res 2008; 1201:93-9. [DOI: 10.1016/j.brainres.2008.01.043] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2007] [Revised: 12/12/2007] [Accepted: 01/15/2008] [Indexed: 11/22/2022]
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30
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Shields DC, Cheng ML, Flaherty AW, Gale JT, Eskandar EN. Microelectrode-guided deep brain stimulation for Tourette syndrome: within-subject comparison of different stimulation sites. Stereotact Funct Neurosurg 2007; 86:87-91. [PMID: 18073521 DOI: 10.1159/000112429] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND As medical therapy for Tourette syndrome (TS) is ineffective in a small subset of patients, surgical interventions, including deep brain stimulation at various sites, have been developed in recent years. CASE DESCRIPTION We present the case of a 40-year-old woman with TS whose severe tics had caused unilateral blindness. Despite trials of more than 40 medications, her symptoms improved significantly only after placement of bilateral deep brain stimulators in the anterior inferior internal capsule. However, symptomatic improvement was not complete, and her electrode connections eventually became permanently damaged by the remaining retrocollic jerks. She underwent removal of the internal capsule electrodes and placement of centromedian nucleus thalamic stimulators with significantly improved tic control. CONCLUSION Whereas the anterior internal capsule site had also produced psychiatric side effects such as altered mood and impulse control, the thalamic site has not done so to date. Thus, distinct surgical targets for TS may be appropriate for patients with specific comorbidities.
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Affiliation(s)
- Donald C Shields
- Department of Neurosurgery, Massachusetts General Hospital and Harvard Medical School, Boston, Mass., USA
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31
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van Kuyck K, Gabriëls L, Cosyns P, Arckens L, Sturm V, Rasmussen S, Nuttin B. Behavioural and physiological effects of electrical stimulation in the nucleus accumbens: a review. ACTA NEUROCHIRURGICA. SUPPLEMENT 2007; 97:375-91. [PMID: 17691326 DOI: 10.1007/978-3-211-33081-4_43] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Electrical stimulation (ES) in the brain is becoming a new treatment option in patients with treatment-resistant obsessive-compulsive disorder (OCD). A possible brain target might be the nucleus accumbens (NACC). This review aims to summarise the behavioural and physiological effects of ES in the NACC in humans and in animals and to discuss these findings with regard to neuroanatomical, electrophysiological and behavioural insights. The results clearly demonstrate that ES in the NACC has an effect on reward, activity, fight-or-flight, exploratory behaviour and food intake, with evidence for only moderate physiological effects. Seizures were rarely observed. Finally, the results of ES studies in patients with treatment-resistant OCD and in animal models for OCD are promising.
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Affiliation(s)
- K van Kuyck
- Laboratory of Experimental Neurosurgery and Neuroanatomy, Department of Neuroscience and Psychiatry, Leuven Provisorium, Belgium
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32
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Kringelbach ML, Jenkinson N, Owen SLF, Aziz TZ. Translational principles of deep brain stimulation. Nat Rev Neurosci 2007; 8:623-35. [PMID: 17637800 DOI: 10.1038/nrn2196] [Citation(s) in RCA: 505] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Deep brain stimulation (DBS) has shown remarkable therapeutic benefits for patients with otherwise treatment-resistant movement and affective disorders. This technique is not only clinically useful, but it can also provide new insights into fundamental brain functions through direct manipulation of both local and distributed brain networks in many different species. In particular, DBS can be used in conjunction with non-invasive neuroimaging methods such as magnetoencephalography to map the fundamental mechanisms of normal and abnormal oscillatory synchronization that underlie human brain function. The precise mechanisms of action for DBS remain uncertain, but here we give an up-to-date overview of the principles of DBS, its neural mechanisms and its potential future applications.
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Affiliation(s)
- Morten L Kringelbach
- University of Oxford, Department of Psychiatry, Warneford Hospital, Oxford, OX3 7JX, UK.
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33
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Zurowski B, Wahl K, Hohagen F, Kordon A. Symptom remission in OCD after discontinuation of pharmacotherapy with fluoxetine: a case for looking beyond serotonin. Prog Neuropsychopharmacol Biol Psychiatry 2007; 31:959-60. [PMID: 17321024 DOI: 10.1016/j.pnpbp.2006.12.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2006] [Revised: 12/20/2006] [Accepted: 12/21/2006] [Indexed: 11/26/2022]
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34
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Tateno T, Robinson HPC. Phase resetting curves and oscillatory stability in interneurons of rat somatosensory cortex. Biophys J 2007; 92:683-95. [PMID: 17192317 PMCID: PMC1751383 DOI: 10.1529/biophysj.106.088021] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Synchronous oscillations in neural activity are found over wide areas of the cortex. Specific populations of interneurons are believed to play a significant role in generating these synchronized oscillations through mutual synaptic and gap-junctional interactions. Little is known, though, about the mechanism of how oscillations are maintained stably by particular types of interneurons and by their local networks. To obtain more insight into this, we measured membrane-potential responses to small current-pulse perturbations during regular firing, to construct phase resetting curves (PRCs) for three types of interneurons: nonpyramidal regular-spiking (NPRS), low-threshold spiking (LTS), and fast-spiking (FS) cells. Within each cell type, both monophasic and biphasic PRCs were observed, but the proportions and sensitivities to perturbation amplitude were clearly correlated to cell type. We then analyzed the experimentally measured PRCs to predict oscillation stability, or firing reliability, of cells for a complex stochastic input, as occurs in vivo. To do this, we used a method from random dynamical system theory to estimate Lyapunov exponents of the simplified phase model on the circle. The results indicated that LTS and NPRS cells have greater oscillatory stability (are more reliably entrained) in small noisy inputs than FS cells, which is consistent with their distinct types of threshold dynamics.
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Affiliation(s)
- T Tateno
- Department of Physiology, University of Cambridge, Cambridge, United Kingdom
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35
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Stathis P, Panourias IG, Themistocleous MS, Sakas DE. Connections of the basal ganglia with the limbic system: implications for neuromodulation therapies of anxiety and affective disorders. ACTA NEUROCHIRURGICA. SUPPLEMENT 2007; 97:575-86. [PMID: 17691350 DOI: 10.1007/978-3-211-33081-4_67] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
The basal ganglia are best known for their role in motor planning and execution. However, it is currently widely accepted that they are also involved in cognitive and emotional behaviors. Parts of the basal ganglia play a key role in reward and reinforcement, addictive behaviors and habit formation. Pathophysiological processes underlying psychiatric disorders such as depression, obsessive compulsive disorder and even schizophrenia involve the basal ganglia and their connections to many other structures and particularly to the prefrontal cortex and the limbic system. In this article, we aim, on the basis of current research, to describe in a succinct manner the most important connections of the basal ganglia with the limbic system which are relevant to normal behaviors but also to psychiatric disorders. Currently, we possess sufficiently powerful tools that enable us to modulate brain networks such as cortex stimulation (CS) or deep brain stimulation (DBS). Notably, neuromodulation of basal ganglia function for the treatment of movement disorders has become a standard practice, which provides insights into the psychiatric problems that occur in patients with movement disorders. It is clear that a sound understanding of the currently available knowledge on the circuits connecting the basal ganglia with the limbic system will provide the theoretical platform that will allow precise, selective and beneficial neuromodulatory interventions for refractory psychiatric disorders.
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Affiliation(s)
- P Stathis
- P.S. Kokkalis Hellenic Center for Neurosurgical Research, Athens, Greece
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36
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Li J, Andrews RJ. Trimodal nanoelectrode array for precise deep brain stimulation: prospects of a new technology based on carbon nanofiber arrays. ACTA NEUROCHIRURGICA. SUPPLEMENT 2007; 97:537-45. [PMID: 17691345 DOI: 10.1007/978-3-211-33081-4_62] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
Although deep brain stimulation (DBS) has recently been shown to be effective for neurological disorders such as Parkinson's disease, there are many limitations of the current technology: the large size of current microelectrodes (approximately 1 mm diameter); the lack of monitoring of local brain electrical activity and neurotransmitters (e.g. dopamine in Parkinson's disease); the open-loop nature of the stimulation (i.e. not guided by brain electrochemical activity). Reducing the size of the monitoring and stimulating electrodes by orders of magnitude (to the size of neural elements) allows remarkable improvements in both monitoring (spatial resolution, temporal resolution, and sensitivity) and stimulation. Carbon nanofiber nanoelectrode technology offers the possibility of trimodal arrays (monitoring electrical activity, monitoring neurotransmitter levels, precise stimulation). DBS can then be guided by changes in brain electrical activity and/or neurotransmitter levels (i.e. closed-loop DBS). Here, we describe the basic manufacture and electrical characteristics of a prototype nanoelectrode array for DBS, as well as preliminary studies with electroconductive polymers necessary to optimize DBS in vivo. An approach such as the nanoelectrode array described here may offer a generic electrical-neural interface for use in various neural prostheses.
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Affiliation(s)
- J Li
- Center for Nanotechnology, NASA Ames Research Center, Moffett Field, CA 94035, USA
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Roessner V, Becker A, Banaschewski T, Rothenberger A. Tic disorders and obsessive compulsive disorder: where is the link? JOURNAL OF NEURAL TRANSMISSION. SUPPLEMENTUM 2006:69-99. [PMID: 16355604 DOI: 10.1007/3-211-31222-6_5] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Over the last years evidence on the overlap between tic-disorders (TD) and obsessive compulsive behavior/disorder (OCB/OCD) has increased. The main focus of research have been the phenomenological and epidemiological similarities and differences in samples of different age, primary diagnosis (TD vs. OCD) including the co-occurrence of both. Unfortunately, only a minority of studies included all three groups (TD, TD + OCD, OCD). Nevertheless, new insight concerning possible subtypes for both TD and OCD has been gained. While some authors concentrated on OCD with/without tics we will summarize the field of TD and OCB/OCD from the viewpoint of tics, since OCB plays an important role in patients with TD. Thereby we will not only sharpen the clinicans' awareness of known differences in phenomenology, epidemiology, genetics and neurobiology, aimed to improve their diagnoses and treatment but also highlight the gaps of knowledge and discuss possibilities for further research in this field.
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Affiliation(s)
- V Roessner
- Department of Child and Adolescent Psychiatry, University of Göttingen, Germany.
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Pittenger C, Krystal JH, Coric V. Glutamate-modulating drugs as novel pharmacotherapeutic agents in the treatment of obsessive-compulsive disorder. NeuroRx 2006; 3:69-81. [PMID: 16490414 PMCID: PMC3593363 DOI: 10.1016/j.nurx.2005.12.006] [Citation(s) in RCA: 160] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
SUMMARY Obsessive-compulsive disorder (OCD) is a common psychiatric disorder that produces significant morbidity. The introduction of serotonin reuptake inhibitors in the 1980s represented an important advance in the treatment of OCD. However, few patients show complete remission of their symptoms, and some patients show minimal improvement with existing treatments. We review current treatment strategies and initial data supporting the efficacy of glutamate modulating agents as a novel class of pharmaceuticals for the treatment of OCD. Functional neuroimaging studies repeatedly reported metabolic hyperactivity in the cortico-striato-thalamo-cortical circuitry in patients with OCD. Recent magnetic resonance spectroscopy studies provide evidence of elevated glutamate levels in several brain regions in patients suffering from OCD. These findings raised the possibility that agents that reduce glutamate hyperactivity or its consequences in the CNS might be efficacious as novel therapeutic interventions. Indeed, initial evidence from our group suggests that the antiglutamatergic agent riluzole (Rilutek), which was developed for the treatment of amyotrophic lateral sclerosis, is effective in treatment-resistant OCD. Case reports suggest that other agents that modulate glutamatergic activity may likewise be effective. This new application of glutamate modulating agents holds promise for the treatment of this disabling and often inadequately treated disease.
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Schruers K, Koning K, Luermans J, Haack MJ, Griez E. Obsessive-compulsive disorder: a critical review of therapeutic perspectives. Acta Psychiatr Scand 2005; 111:261-71. [PMID: 15740462 DOI: 10.1111/j.1600-0447.2004.00502.x] [Citation(s) in RCA: 79] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE Obsessive-compulsive disorder (OCD) is a chronic disabling disease with profound implications for social functioning. Thirty per cent of all patients with OCD show insufficient improvement with state-of-the-art treatment. Conventional treatment and alternative treatment options for this population were investigated. METHOD A selective review of the relevant scientific literature on OCD treatment and treatment resistance was conducted. RESULTS In addition to serotonin reuptake inhibitors (SRIs) and cognitive-behavioural therapy, alternative monotherapies, SRI augmentation strategies with a variety of drugs and electroconvulsive therapy have shown results in individual cases, but no conclusive evidence has been found in placebo-controlled trials. While studies investigating neurosurgery for refractory OCD show positive results, most of these studies have methodological shortcomings. CONCLUSION Novel approaches currently under investigation that have shown promising effects for treatment-resistant OCD include SRI augmentation with atypical antipsychotics and chronic deep brain stimulation, a new surgical technique. Placebo-controlled trials for both treatment options will be needed to confirm preliminary findings.
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Affiliation(s)
- K Schruers
- Academic Anxiety Center, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands.
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