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Hapakova L, Necpal J, Kosutzka Z. The antisaccadic paradigm: A complementary neuropsychological tool in basal ganglia disorders. Cortex 2024; 178:116-140. [PMID: 38991475 DOI: 10.1016/j.cortex.2024.06.005] [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: 01/07/2024] [Revised: 04/20/2024] [Accepted: 06/17/2024] [Indexed: 07/13/2024]
Abstract
This review explores the role of the antisaccadic task in understanding inhibitory mechanisms in basal ganglia disorders. It conducts a comparative analysis of saccadic profiles in conditions such as Parkinson's disease, Tourette syndrome, obsessive-compulsive disorder, Huntington's disease, and dystonia, revealing distinct patterns and proposing mechanisms for impaired performance. The primary focus is on two inhibitory mechanisms: global, pre-emptive inhibition responsible for suppressing prepotent responses, and slower, selective response inhibition. The antisaccadic task demonstrates practicality in clinical applications, aiding in differential diagnoses, treatment monitoring and reflecting gait control. To further enhance its differential diagnostic value, future directions should address issues such as the standardization of eye-tracking protocol and the integration of eye-tracking data with other disease indicators in a comprehensive dataset.
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Affiliation(s)
- Lenka Hapakova
- 2nd Department of Neurology, Comenius University Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia.
| | - Jan Necpal
- Neurology Department, Hospital Zvolen, a. s., Zvolen, Slovakia.
| | - Zuzana Kosutzka
- 2nd Department of Neurology, Comenius University Faculty of Medicine, University Hospital Bratislava, Bratislava, Slovakia.
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2
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Prasad AA, Wallén-Mackenzie Å. Architecture of the subthalamic nucleus. Commun Biol 2024; 7:78. [PMID: 38200143 PMCID: PMC10782020 DOI: 10.1038/s42003-023-05691-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 12/11/2023] [Indexed: 01/12/2024] Open
Abstract
The subthalamic nucleus (STN) is a major neuromodulation target for the alleviation of neurological and neuropsychiatric symptoms using deep brain stimulation (DBS). STN-DBS is today applied as treatment in Parkinson´s disease, dystonia, essential tremor, and obsessive-compulsive disorder (OCD). STN-DBS also shows promise as a treatment for refractory Tourette syndrome. However, the internal organization of the STN has remained elusive and challenges researchers and clinicians: How can this small brain structure engage in the multitude of functions that renders it a key hub for therapeutic intervention of a variety of brain disorders ranging from motor to affective to cognitive? Based on recent gene expression studies of the STN, a comprehensive view of the anatomical and cellular organization, including revelations of spatio-molecular heterogeneity, is now possible to outline. In this review, we focus attention to the neurobiological architecture of the STN with specific emphasis on molecular patterns discovered within this complex brain area. Studies from human, non-human primate, and rodent brains now reveal anatomically defined distribution of specific molecular markers. Together their spatial patterns indicate a heterogeneous molecular architecture within the STN. Considering the translational capacity of targeting the STN in severe brain disorders, the addition of molecular profiling of the STN will allow for advancement in precision of clinical STN-based interventions.
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Affiliation(s)
- Asheeta A Prasad
- University of Sydney, School of Medical Sciences, Faculty of Medicine and Health, Sydney, NSW, Australia.
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3
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Biria M, Banca P, Keser E, Healy MP, Sawiak SJ, Frota Lisbôa Pereira de Souza AM, Marzuki AA, Sule A, Robbins TW. Excessive Checking in Obsessive-Compulsive Disorder: Neurochemical Correlates Revealed by 7T Magnetic Resonance Spectroscopy. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2024; 4:363-373. [PMID: 38298778 PMCID: PMC10829650 DOI: 10.1016/j.bpsgos.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 02/02/2024] Open
Abstract
Background Compulsive checking, a common symptom of obsessive-compulsive disorder (OCD), has been difficult to capture experimentally. Therefore, determination of its neural basis remains challenging despite some evidence suggesting that it is linked to dysfunction of cingulostriatal systems. This study introduces a novel experimental paradigm to measure excessive checking and its neurochemical correlates. Methods Thirty-one patients with OCD and 29 healthy volunteers performed a decision-making task requiring them to decide whether 2 perceptually similar visual representations were the same or different under a high-uncertainty condition without feedback. Both groups underwent 7T magnetic resonance spectroscopy scans on the same day. Correlations between out-of-scanner experimental measures of checking and the glutamate/GABA (gamma-aminobutyric acid) ratio in the anterior cingulate cortex, supplementary motor area, and occipital cortex were assessed. Their relationship with subjective ratings of doubt, anxiety, and confidence was also investigated. Results Patients with OCD exhibited excessive and dysfunctional checking, which was significantly correlated with changes in the glutamate/GABA ratio within the anterior cingulate cortex. No behavioral/neurochemical relationships were evident for either the supplementary motor area or occipital cortex. The excessive checking observed in patients was negatively correlated with their confidence levels and positively related to doubt, anxiety, and compulsivity traits. Conclusions We conclude that experimental measures of excessive and dysfunctional checking in OCD, which have been linked to increased doubt, anxiety, and lack of confidence, are related to an imbalance between excitatory and inhibitory neural activity within the anterior cingulate cortex. This study adds to our understanding of the role of this region in OCD by providing a laboratory model of the possible development of compulsive checking.
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Affiliation(s)
- Marjan Biria
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Division of Psychiatry and Division of Psychology and Language Sciences, University College London, London, United Kingdom
| | - Paula Banca
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Engin Keser
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
| | - Máiréad P. Healy
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Stephen J. Sawiak
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
- Wolfson Brain Imaging Centre, Department of Clinical Neurosciences, University of Cambridge, Cambridge, United Kingdom
| | - Ana Maria Frota Lisbôa Pereira de Souza
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
| | - Aleya A. Marzuki
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Department of Psychology, School of Medical and Life Sciences, Sunway University, Selangor, Malaysia
| | - Akeem Sule
- Department of Psychiatry, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom
| | - Trevor W. Robbins
- Department of Psychology, University of Cambridge, Cambridge, United Kingdom
- Behavioural and Clinical Neuroscience Institute, University of Cambridge, Cambridge, United Kingdom
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Sherif MA, Fotros A, Greenberg BD, McLaughlin NCR. Understanding cingulotomy's therapeutic effect in OCD through computer models. Front Integr Neurosci 2023; 16:889831. [PMID: 36704759 PMCID: PMC9871832 DOI: 10.3389/fnint.2022.889831] [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: 03/04/2022] [Accepted: 12/05/2022] [Indexed: 01/12/2023] Open
Abstract
Cingulotomy is therapeutic in OCD, but what are the possible mechanisms? Computer models that formalize cortical OCD abnormalities and anterior cingulate cortex (ACC) function can help answer this. At the neural dynamics level, cortical dynamics in OCD have been modeled using attractor networks, where activity patterns resistant to change denote the inability to switch to new patterns, which can reflect inflexible thinking patterns or behaviors. From that perspective, cingulotomy might reduce the influence of difficult-to-escape ACC attractor dynamics on other cortical areas. At the functional level, computer formulations based on model-free reinforcement learning (RL) have been used to describe the multitude of phenomena ACC is involved in, such as tracking the timing of expected outcomes and estimating the cost of exerting cognitive control and effort. Different elements of model-free RL models of ACC could be affected by the inflexible cortical dynamics, making it challenging to update their values. An agent can also use a world model, a representation of how the states of the world change, to plan its actions, through model-based RL. OCD has been hypothesized to be driven by reduced certainty of how the brain's world model describes changes. Cingulotomy might improve such uncertainties about the world and one's actions, making it possible to trust the outcomes of these actions more and thus reduce the urge to collect more sensory information in the form of compulsions. Connecting the neural dynamics models with the functional formulations can provide new ways of understanding the role of ACC in OCD, with potential therapeutic insights.
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Affiliation(s)
- Mohamed A. Sherif
- Department of Psychiatry, Brown University, Providence, RI, United States,Carney Institute for Brain Science, Brown University, Providence, RI, United States,Department of Psychiatry Lifespan Health System, Providence, RI, United States,*Correspondence: Mohamed A. Sherif,
| | - Aryandokht Fotros
- Department of Psychiatry, Brown University, Providence, RI, United States,Department of Psychiatry Lifespan Health System, Providence, RI, United States
| | - Benjamin D. Greenberg
- Department of Psychiatry, Brown University, Providence, RI, United States,Carney Institute for Brain Science, Brown University, Providence, RI, United States,Butler Hospital, Providence, RI, United States,United States Department of Veterans Affairs, Providence VA Medical Center, Providence, RI, United States
| | - Nicole C. R. McLaughlin
- Department of Psychiatry, Brown University, Providence, RI, United States,Carney Institute for Brain Science, Brown University, Providence, RI, United States,Butler Hospital, Providence, RI, United States
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Miletić S, Keuken MC, Mulder M, Trampel R, de Hollander G, Forstmann BU. 7T functional MRI finds no evidence for distinct functional subregions in the subthalamic nucleus during a speeded decision-making task. Cortex 2022; 155:162-188. [DOI: 10.1016/j.cortex.2022.06.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2021] [Revised: 03/18/2022] [Accepted: 06/07/2022] [Indexed: 11/03/2022]
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Chen YC, Wu HT, Tu PH, Yeh CH, Liu TC, Yeap MC, Chao YP, Chen PL, Lu CS, Chen CC. Theta Oscillations at Subthalamic Region Predicts Hypomania State After Deep Brain Stimulation in Parkinson's Disease. Front Hum Neurosci 2022; 15:797314. [PMID: 34987369 PMCID: PMC8721814 DOI: 10.3389/fnhum.2021.797314] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 11/26/2021] [Indexed: 12/11/2022] Open
Abstract
Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective treatment for the motor impairments of patients with advanced Parkinson's disease. However, mood or behavioral changes, such as mania, hypomania, and impulsive disorders, can occur postoperatively. It has been suggested that these symptoms are associated with the stimulation of the limbic subregion of the STN. Electrophysiological studies demonstrate that the low-frequency activities in ventral STN are modulated during emotional processing. In this study, we report 22 patients with Parkinson's disease who underwent STN DBS for treatment of motor impairment and presented stimulation-induced mood elevation during initial postoperative programming. The contact at which a euphoric state was elicited by stimulation was termed as the hypomania-inducing contact (HIC) and was further correlated with intraoperative local field potential recorded during the descending of DBS electrodes. The power of four frequency bands, namely, θ (4–7 Hz), α (7–10 Hz), β (13–35 Hz), and γ (40–60 Hz), were determined by a non-linear variation of the spectrogram using the concentration of frequency of time (conceFT). The depth of maximum θ power is located approximately 2 mm below HIC on average and has significant correlation with the location of contacts (r = 0.676, p < 0.001), even after partializing the effect of α and β, respectively (r = 0.474, p = 0.022; r = 0.461, p = 0.027). The occurrence of HIC was not associated with patient-specific characteristics such as age, gender, disease duration, motor or non-motor symptoms before the operation, or improvement after stimulation. Taken together, these data suggest that the location of maximum θ power is associated with the stimulation-induced hypomania and the prediction of θ power is frequency specific. Our results provide further information to refine targeting intraoperatively and select stimulation contacts in programming.
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Affiliation(s)
- Yi-Chieh Chen
- Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Neuroscience Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Hau-Tieng Wu
- Department of Mathematics, Duke University, Durham, NC, United States.,Department of Statistical Science, Duke University, Durham, NC, United States
| | - Po-Hsun Tu
- College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Neurosurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chih-Hua Yeh
- College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Department of Neuroradiology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Tzu-Chi Liu
- Neuroscience Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Mun-Chun Yeap
- Department of Neurosurgery, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Yi-Ping Chao
- Graduate Institute of Biomedical Engineering, Chang Gung University, Taoyuan, Taiwan
| | - Po-Lin Chen
- Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan
| | - Chin-Song Lu
- Professor Lu Neurological Clinic, Taoyuan, Taiwan
| | - Chiung-Chu Chen
- Division of Movement Disorders, Department of Neurology, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,Neuroscience Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,College of Medicine, Chang Gung Memorial Hospital, Taoyuan, Taiwan
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Joint contributions of metacognition and self-beliefs to uncertainty-guided checking behavior. Sci Rep 2021; 11:19017. [PMID: 34561475 PMCID: PMC8463683 DOI: 10.1038/s41598-021-97958-1] [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: 12/27/2020] [Accepted: 08/24/2021] [Indexed: 02/08/2023] Open
Abstract
Checking behavior is a natural and adaptive strategy for resolving uncertainty in everyday situations. Here, we aimed at investigating the psychological drivers of checking and its regulation by uncertainty, in non-clinical participants and controlled experimental settings. We found that the sensitivity of participants' explicit confidence judgments to actual performance (explicit metacognition) predicted the extent to which their checking strategy was regulated by uncertainty. Yet, a more implicit measure of metacognition (derived from asking participants to opt between trials) did not contribute to the regulation of checking behavior. Meanwhile, how participants scaled on questionnaires eliciting self-beliefs such as self-confidence and self-reported obsessive-compulsive symptoms also predicted participants' uncertainty-guided checking tendencies. Altogether, these findings demonstrate that checking behavior is likely the outcome of a core explicit metacognitive process operating at the scale of single decisions, while remaining influenced by general self-beliefs. Our findings are thus consistent with two mechanisms (micro vs. macro) through which this otherwise adaptive behavior could go awry in certain psychiatric disorders such as obsessive-compulsive disorder.
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Polosan M, Figee M. Electrical deep neuromodulation in psychiatry. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2021; 159:89-110. [PMID: 34446252 DOI: 10.1016/bs.irn.2021.06.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Addressing treatment refractoriness in psychiatric diseases is an essential public health objective. The last two decades have seen an increasing interest for deep brain stimulation (DBS) of several brain targets. In this chapter, we have reviewed the main DBS clinical trials in psychiatric diseases, mainly obsessive compulsive disorders (OCD) and depression, but also emerging research in other psychiatric disorders. While its efficacy and safety are confirmed, DBS is still not considered as standard therapy in psychiatry. However, advances in neuroimaging research combined to behavioral and electrophysiological data uniquely provided by DBS studies improve knowledge on physiopathology in these brain diseases. This will help define the optimal brain targets according to specific phenotype dimensions. Revealing the mechanisms of action and effects of DBS will support that its impact goes beyond a loco-regional brain stimulation and confirms that electrical neuromodulation influences brain networks. Added to the progress in neuromodulation technology, these insights will hopefully facilitate a more widespread application of this promising treatment. Future development of a personalized multimodal assessment of underlying dysfunctional brain networks will open new circuit-specific treatment perspectives that may facilitate better patient outcomes.
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Affiliation(s)
- Mircea Polosan
- Univ. Grenoble Alpes, Inserm, U1216, CHU Grenoble Alpes, Grenoble Institut Neurosciences, Grenoble, France.
| | - Martijn Figee
- Center for Advanced Circuit Therapeutics, Mount Sinai West, Icahn School of Medicine at Mount Sinai, New York, United States
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Emotions Modulate Subthalamic Nucleus Activity: New Evidence in Obsessive-Compulsive Disorder and Parkinson's Disease Patients. BIOLOGICAL PSYCHIATRY: COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2020; 6:556-567. [PMID: 33060034 DOI: 10.1016/j.bpsc.2020.08.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 11/22/2022]
Abstract
BACKGROUND Subthalamic nucleus (STN) deep brain stimulation alleviates obsessive-compulsive disorder (OCD) symptoms, suggesting that this basal ganglia structure may play a key role in integrating limbic and motor information. We explored the modulation of STN neural activity by visual emotional information under different motor demands. METHODS We compared STN local field potentials acquired in 7 patients with OCD and 15 patients with Parkinson's disease off and on levodopa while patients categorized pictures as unpleasant, pleasant, or neutral and pressed a button for 1 of these 3 categories depending on the instruction. RESULTS During image presentation, theta power increased for unpleasant compared with neutral images in both patients with OCD and patients with Parkinson's disease. Only in patients with OCD was theta power also increased in pleasant compared with neutral trials. During the button press in patients with OCD, no modification of STN activity was seen on average, but theta power increased when the image triggering the motor response was unpleasant. Conversely, in patients with Parkinson's disease, a beta decrease was observed during the button press unrelated to the valence of the stimulus. Finally, in patients with OCD, a significant positive relationship was observed between the amplitude of the emotionally related theta response and symptom severity (measured using the Yale-Brown Obsessive Compulsive Scale). CONCLUSIONS We highlighted modulations of STN theta band activity related to emotions that were specific to OCD and correlated with OCD symptom severity. STN theta-induced activity might therefore underlie dysfunction of the limbic STN and its related network leading to OCD pathophysiology.
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Biomarkers for closed-loop deep brain stimulation in Parkinson disease and beyond. Nat Rev Neurol 2019; 15:343-352. [DOI: 10.1038/s41582-019-0166-4] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Rappel P, Marmor O, Bick AS, Arkadir D, Linetsky E, Castrioto A, Tamir I, Freedman SA, Mevorach T, Gilad M, Bergman H, Israel Z, Eitan R. Subthalamic theta activity: a novel human subcortical biomarker for obsessive compulsive disorder. Transl Psychiatry 2018; 8:118. [PMID: 29915200 PMCID: PMC6006433 DOI: 10.1038/s41398-018-0165-z] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2018] [Accepted: 04/22/2018] [Indexed: 11/24/2022] Open
Abstract
Obsessive-compulsive disorder (OCD) is a common and serious psychiatric disorder. Although subthalamic nucleus deep brain stimulation (DBS) has been studied as a treatment for OCD patients the underlying mechanism of this treatment and the optimal method of stimulation are unknown. To study the neural basis of subthalamic nucleus DBS in OCD patients we used a novel, implantable DBS system with long-term local field potential sensing capability. We focus our analysis on two patients with OCD who experienced severe treatment-resistant symptoms and were implanted with subthalamic nucleus DBS systems. We studied them for a year at rest and during provocation of OCD symptoms (46 recording sessions) and compared them to four Parkinson's disease (PD) patients implanted with subthalamic nucleus DBS systems (69 recording sessions). We show that the dorsal (motor) area of the subthalamic nucleus in OCD patients displays a beta (25-35 Hz) oscillatory activity similar to PD patients whereas the ventral (limbic-cognitive) area of the subthalamic nucleus displays distinct theta (6.5-8 Hz) oscillatory activity only in OCD patients. The subthalamic nucleus theta oscillatory activity decreases with provocation of OCD symptoms and is inversely correlated with symptoms severity over time. We conclude that beta oscillations at the dorsal subthalamic nucleus in OCD patients challenge their pathophysiologic association with movement disorders. Furthermore, theta oscillations at the ventral subthalamic nucleus in OCD patients suggest a new physiological target for OCD therapy as well as a promising input signal for future emotional-cognitive closed-loop DBS.
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Affiliation(s)
- Pnina Rappel
- 0000 0004 1937 0538grid.9619.7Department of Medical Neurobiology (Physiology), Institute of Medical Research – Israel-Canada, the Hebrew University-Hadassah Medical School, Jerusalem, Israel ,0000 0004 1937 0538grid.9619.7The Edmond and Lily Safra Center for Brain Research, the Hebrew University, Jerusalem, Israel
| | - Odeya Marmor
- 0000 0004 1937 0538grid.9619.7Department of Medical Neurobiology (Physiology), Institute of Medical Research – Israel-Canada, the Hebrew University-Hadassah Medical School, Jerusalem, Israel ,0000 0004 1937 0538grid.9619.7The Edmond and Lily Safra Center for Brain Research, the Hebrew University, Jerusalem, Israel
| | - Atira S Bick
- 0000 0004 1937 0538grid.9619.7Department of Medical Neurobiology (Physiology), Institute of Medical Research – Israel-Canada, the Hebrew University-Hadassah Medical School, Jerusalem, Israel ,0000 0001 2221 2926grid.17788.31The Brain Division, Hadassah–Hebrew University Medical Center, Jerusalem, Israel
| | - David Arkadir
- 0000 0001 2221 2926grid.17788.31The Brain Division, Hadassah–Hebrew University Medical Center, Jerusalem, Israel
| | - Eduard Linetsky
- 0000 0001 2221 2926grid.17788.31The Brain Division, Hadassah–Hebrew University Medical Center, Jerusalem, Israel
| | - Anna Castrioto
- 0000 0004 0429 3736grid.462307.4Grenoble Institute of Neuroscience, Grenoble, France
| | - Idit Tamir
- 0000 0001 2221 2926grid.17788.31The Brain Division, Hadassah–Hebrew University Medical Center, Jerusalem, Israel ,0000 0001 2221 2926grid.17788.31The Center for Functional and Restorative Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel ,0000 0001 2297 6811grid.266102.1Department of Neurosurgery, University of California San Francisco, San Francisco, CA USA
| | - Sara A. Freedman
- 0000 0001 2221 2926grid.17788.31The Brain Division, Hadassah–Hebrew University Medical Center, Jerusalem, Israel ,0000 0004 1937 0503grid.22098.31School of Social Work, Bar Ilan University, Ramat Gan, Israel
| | - Tomer Mevorach
- 0000 0001 2221 2926grid.17788.31The Brain Division, Hadassah–Hebrew University Medical Center, Jerusalem, Israel
| | - Moran Gilad
- 0000 0001 2221 2926grid.17788.31The Brain Division, Hadassah–Hebrew University Medical Center, Jerusalem, Israel
| | - Hagai Bergman
- 0000 0004 1937 0538grid.9619.7Department of Medical Neurobiology (Physiology), Institute of Medical Research – Israel-Canada, the Hebrew University-Hadassah Medical School, Jerusalem, Israel ,0000 0004 1937 0538grid.9619.7The Edmond and Lily Safra Center for Brain Research, the Hebrew University, Jerusalem, Israel
| | - Zvi Israel
- 0000 0001 2221 2926grid.17788.31The Brain Division, Hadassah–Hebrew University Medical Center, Jerusalem, Israel ,0000 0001 2221 2926grid.17788.31The Center for Functional and Restorative Neurosurgery, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Renana Eitan
- Department of Medical Neurobiology (Physiology), Institute of Medical Research - Israel-Canada, the Hebrew University-Hadassah Medical School, Jerusalem, Israel. .,The Brain Division, Hadassah-Hebrew University Medical Center, Jerusalem, Israel. .,Department of Psychiatry, Functional Neuroimaging Laboratory, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
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Bonnevie T, Zaghloul KA. The Subthalamic Nucleus: Unravelling New Roles and Mechanisms in the Control of Action. Neuroscientist 2018; 25:48-64. [PMID: 29557710 DOI: 10.1177/1073858418763594] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
How do we decide what we do? This is the essence of action control, the process of selecting the most appropriate response among multiple possible choices. Suboptimal action control can involve a failure to initiate or adapt actions, or conversely it can involve making actions impulsively. There has been an increasing focus on the specific role of the subthalamic nucleus (STN) in action control. This has been fueled by the clinical relevance of this basal ganglia nucleus as a target for deep brain stimulation (DBS), primarily in Parkinson's disease but also in obsessive-compulsive disorder. The context of DBS has opened windows to study STN function in ways that link neuroscientific and clinical fields closely together, contributing to an exceptionally high level of two-way translation. In this review, we first outline the role of the STN in both motor and nonmotor action control, and then discuss how these functions might be implemented by neuronal activity in the STN. Gaining a better understanding of these topics will not only provide important insights into the neurophysiology of action control but also the pathophysiological mechanisms relevant for several brain disorders and their therapies.
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Affiliation(s)
- Tora Bonnevie
- 1 Department of Neuromedicine and Movement Science, NTNU, Trondheim, Norway.,2 Neuroclinic, Trondheim University Hospital, Trondheim, Norway.,3 Kavli Institute for Systems Neuroscience, NTNU, Trondheim, Norway
| | - Kareem A Zaghloul
- 4 Surgical Neurology Branch, NINDS, National Institutes of Health, Bethesda, MD, USA
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Zavala B, Damera S, Dong JW, Lungu C, Brown P, Zaghloul KA. Human Subthalamic Nucleus Theta and Beta Oscillations Entrain Neuronal Firing During Sensorimotor Conflict. Cereb Cortex 2018; 27:496-508. [PMID: 26494798 DOI: 10.1093/cercor/bhv244] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Recent evidence has suggested that prefrontal cortical structures may inhibit impulsive actions during conflict through activation of the subthalamic nucleus (STN). Consistent with this hypothesis, deep brain stimulation to the STN has been associated with altered prefrontal cortical activity and impaired response inhibition. The interactions between oscillatory activity in the STN and its presumably antikinetic neuronal spiking, however, remain poorly understood. Here, we simultaneously recorded intraoperative local field potential and spiking activity from the human STN as participants performed a sensorimotor action selection task involving conflict. We identified several STN neuronal response types that exhibited different temporal dynamics during the task. Some neurons showed early, cue-related firing rate increases that remained elevated longer during high conflict trials, whereas other neurons showed late, movement-related firing rate increases. Notably, the high conflict trials were associated with an entrainment of individual neurons by theta- and beta-band oscillations, both of which have been observed in cortical structures involved in response inhibition. Our data suggest that frequency-specific activity in the beta and theta bands influence STN firing to inhibit impulsivity during conflict.
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Affiliation(s)
- Baltazar Zavala
- Surgical Neurology Branch.,Experimental Neurology Group, Nuffield Department of Clinical Neurology, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK
| | | | | | - Codrin Lungu
- Office of Clinical Director, NINDS, National Institutes of Health, Bethesda, MD 20892, USA
| | - Peter Brown
- Experimental Neurology Group, Nuffield Department of Clinical Neurology, University of Oxford, John Radcliffe Hospital, Oxford OX3 9DU, UK.,Medical Research Council Brain Network Dynamics Unit at the University of Oxford, Oxford OX1 3TH, UK
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Frontosubthalamic Circuits for Control of Action and Cognition. J Neurosci 2017; 36:11489-11495. [PMID: 27911752 DOI: 10.1523/jneurosci.2348-16.2016] [Citation(s) in RCA: 166] [Impact Index Per Article: 23.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 08/12/2016] [Accepted: 08/14/2016] [Indexed: 12/20/2022] Open
Abstract
The subthalamic nucleus (STN) of the basal ganglia appears to have a potent role in action and cognition. Anatomical and imaging studies show that different frontal cortical areas directly project to the STN via so-called hyperdirect pathways. This review reports some of the latest findings about such circuits, including simultaneous recordings from cortex and the STN in humans, single-unit recordings in humans, high-resolution fMRI, and neurocomputational modeling. We argue that a major function of the STN is to broadly pause behavior and cognition when stop signals, conflict signals, or surprise signals occur, and that the fronto-STN circuits for doing this, at least for stopping and conflict, are dissociable anatomically and in terms of their spectral reactivity. We also highlight recent evidence for synchronization of oscillations between prefrontal cortex and the STN, which may provide a preferential "window in time" for single neuron communication via long-range connections.
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15
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The "curved lead pathway" method to enable a single lead to reach any two intracranial targets. Sci Rep 2017; 7:40533. [PMID: 28074898 PMCID: PMC5225435 DOI: 10.1038/srep40533] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 12/07/2016] [Indexed: 12/23/2022] Open
Abstract
Deep brain stimulation is an effective way to treat movement disorders, and a powerful research tool for exploring brain functions. This report proposes a “curved lead pathway” method for lead implantation, such that a single lead can reach in sequence to any two intracranial targets. A new type of stereotaxic system for implanting a curved lead to the brain of human/primates was designed, the auxiliary device needed for this method to be used in rat/mouse was fabricated and verified in rat, and the Excel algorithm used for automatically calculating the necessary parameters was implemented. This “curved lead pathway” method of lead implantation may complement the current method, make lead implantation for multiple targets more convenient, and expand the experimental techniques of brain function research.
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16
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Mulders AEP, Plantinga BR, Schruers K, Duits A, Janssen MLF, Ackermans L, Leentjens AFG, Jahanshahi A, Temel Y. Deep brain stimulation of the subthalamic nucleus in obsessive-compulsive disorder: Neuroanatomical and pathophysiological considerations. Eur Neuropsychopharmacol 2016; 26:1909-1919. [PMID: 27838106 DOI: 10.1016/j.euroneuro.2016.10.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Revised: 07/04/2016] [Accepted: 10/29/2016] [Indexed: 11/17/2022]
Abstract
Obsessive-compulsive disorder (OCD) is among the most disabling chronic psychiatric disorders and has a significant negative impact on multiple domains of quality of life. For patients suffering from severe refractory OCD, deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been applied. Reviewing the literature of the last years we believe that through its central position within the cortico-basal ganglia-thalamocortical circuits, the STN has a coordinating role in decision-making and action-selection mechanisms. Dysfunctional information-processing at the level of the STN is responsible for some of the core symptoms of OCD. Research confirms an electrophysiological dysfunction in the associative and limbic (non-motor) parts of the STN. Compared to Parkinson׳s disease patients, STN neurons in OCD exhibit a lower firing rate, less frequent but longer bursts, increased burst activity in the anterior ventromedial area, an asymmetrical left-sided burst distribution, and a predominant oscillatory activity in the δ-band. Moreover, there is direct evidence for the involvement of the STN in both checking behavior and OCD symptoms, which are both related to changes in electrophysiological activity in the non-motor STN. Through a combination of mechanisms, DBS of the STN seems to interrupt the disturbed information-processing, leading to a normalization of connectivity within the cortico-basal ganglia-thalamocortical circuits and consequently to a reduction in symptoms. In conclusion, based on the STN׳s strategic position within cortico-basal ganglia-thalamocortical circuits and its involvement in action-selection mechanisms that are responsible for some of the core symptoms of OCD, the STN is a mechanism-based target for DBS in OCD.
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Affiliation(s)
- A E P Mulders
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
| | - B R Plantinga
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Biomedical Image Analysis, Eindhoven University of Technology, Eindhoven, The Netherlands
| | - K Schruers
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - A Duits
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - M L F Janssen
- Department of Neurology, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - L Ackermans
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - A F G Leentjens
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center, Maastricht, The Netherlands
| | - A Jahanshahi
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Y Temel
- Department of Neurosurgery, Maastricht University Medical Center, Maastricht, The Netherlands; Department of Translational Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
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17
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Response inhibition rapidly increases single-neuron responses in the subthalamic nucleus of patients with Parkinson's disease. Cortex 2016; 84:111-123. [PMID: 27745848 DOI: 10.1016/j.cortex.2016.09.006] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/12/2016] [Accepted: 09/12/2016] [Indexed: 11/22/2022]
Abstract
The subthalamic nucleus (STN) plays a critical role during action inhibition, perhaps by acting like a fast brake on the motor system when inappropriate responses have to be rapidly suppressed. However, the mechanisms involving the STN during motor inhibition are still unclear, particularly because of a relative lack of single-cell responses reported in this structure in humans. In this study, we used extracellular microelectrode recordings during deep brain stimulation surgery in patients with Parkinson's disease (PD) to study STN neurophysiological correlates of inhibitory control during a stop signal task. We found two neuronal subpopulations responding either during motor execution (GO units) or during motor inhibition (STOP units). GO units fired selectively before patients' motor responses whereas STOP units fired selectively when patients successfully withheld their move at a latency preceding the duration of the inhibition process. These results provide electrophysiological evidence for the hypothesized role of the STN in current models of response inhibition.
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18
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Trenado C, Elben S, Petri D, Hirschmann J, Groiss SJ, Vesper J, Schnitzler A, Wojtecki L. Combined Invasive Subcortical and Non-invasive Surface Neurophysiological Recordings for the Assessment of Cognitive and Emotional Functions in Humans. J Vis Exp 2016. [PMID: 27286467 DOI: 10.3791/53466] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
In spite of the success in applying non-invasive electroencephalography (EEG), magneto-encephalography (MEG) and functional magnetic resonance imaging (fMRI) for extracting crucial information about the mechanism of the human brain, such methods remain insufficient to provide information about physiological processes reflecting cognitive and emotional functions at the subcortical level. In this respect, modern invasive clinical approaches in humans, such as deep brain stimulation (DBS), offer a tremendous possibility to record subcortical brain activity, namely local field potentials (LFPs) representing coherent activity of neural assemblies from localized basal ganglia or thalamic regions. Notwithstanding the fact that invasive approaches in humans are applied only after medical indication and thus recorded data correspond to altered brain circuits, valuable insight can be gained regarding the presence of intact brain functions in relation to brain oscillatory activity and the pathophysiology of disorders in response to experimental cognitive paradigms. In this direction, a growing number of DBS studies in patients with Parkinson's disease (PD) target not only motor functions but also higher level processes such as emotions, decision-making, attention, memory and sensory perception. Recent clinical trials also emphasize the role of DBS as an alternative treatment in neuropsychiatric disorders ranging from obsessive compulsive disorder (OCD) to chronic disorders of consciousness (DOC). Consequently, we focus on the use of combined invasive (LFP) and non-invasive (EEG) human brain recordings in assessing the role of cortical-subcortical structures in cognitive and emotional processing trough experimental paradigms (e.g. speech stimuli with emotional connotation or paradigms of cognitive control such as the Flanker task), for patients undergoing DBS treatment.
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Affiliation(s)
- Carlos Trenado
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University
| | - Saskia Elben
- Department of Neurology, Center for Movement Disorders and Neuromodulation, University Clinic Düsseldorf
| | - David Petri
- Department of Neurology, Center for Movement Disorders and Neuromodulation, University Clinic Düsseldorf
| | - Jan Hirschmann
- Department of Neurology, Center for Movement Disorders and Neuromodulation, University Clinic Düsseldorf
| | - Stefan J Groiss
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University; Department of Neurology, Center for Movement Disorders and Neuromodulation, University Clinic Düsseldorf
| | - Jan Vesper
- Department of Neurosurgery, Functional Neurosurgery and Stereotaxy, Center for Movement Disorders and Neuromodulation, University Clinic Düsseldorf
| | - Alfons Schnitzler
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University; Department of Neurology, Center for Movement Disorders and Neuromodulation, University Clinic Düsseldorf
| | - Lars Wojtecki
- Institute of Clinical Neuroscience and Medical Psychology, Medical Faculty, Heinrich-Heine-University; Department of Neurology, Center for Movement Disorders and Neuromodulation, University Clinic Düsseldorf;
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19
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Barahona-Corrêa JB, Camacho M, Castro-Rodrigues P, Costa R, Oliveira-Maia AJ. From Thought to Action: How the Interplay Between Neuroscience and Phenomenology Changed Our Understanding of Obsessive-Compulsive Disorder. Front Psychol 2015; 6:1798. [PMID: 26635696 PMCID: PMC4655583 DOI: 10.3389/fpsyg.2015.01798] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 11/07/2015] [Indexed: 01/25/2023] Open
Abstract
The understanding of obsessive-compulsive disorder (OCD) has evolved with the knowledge of behavior, the brain, and their relationship. Modern views of OCD as a neuropsychiatric disorder originated from early lesion studies, with more recent models incorporating detailed neuropsychological findings, such as perseveration in set-shifting tasks, and findings of altered brain structure and function, namely of orbitofrontal corticostriatal circuits and their limbic connections. Interestingly, as neurobiological models of OCD evolved from cortical and cognitive to sub-cortical and behavioral, the focus of OCD phenomenology also moved from thought control and contents to new concepts rooted in animal models of action control. Most recently, the proposed analogy between habitual action control and compulsive behavior has led to the hypothesis that individuals suffering from OCD may be predisposed to rely excessively on habitual rather than on goal-directed behavioral strategies. Alternatively, compulsions have been proposed to result either from hyper-valuation of certain actions and/or their outcomes, or from excessive uncertainty in the monitoring of action performance, both leading to perseveration in prepotent actions such as washing or checking. In short, the last decades have witnessed a formidable renovation in the pathophysiology, phenomenology, and even semantics, of OCD. Nevertheless, such progress is challenged by several caveats, not least psychopathological oversimplification and overgeneralization of animal to human extrapolations. Here we present an historical overview of the understanding of OCD, highlighting converging studies and trends in neuroscience, psychiatry and neuropsychology, and how they influenced current perspectives on the nosology and phenomenology of this disorder.
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Affiliation(s)
- J Bernardo Barahona-Corrêa
- Department of Psychiatry and Mental Health, Faculdade de Ciências Médicas, Nova Medical School , Lisbon, Portugal ; Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental , Lisbon, Portugal ; Champalimaud Clinical Centre, Champalimaud Centre for the Unknown , Lisbon, Portugal ; Centro de Apoio ao Desenvolvimento Infantil , Cascais, Portugal
| | - Marta Camacho
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown , Lisbon, Portugal
| | - Pedro Castro-Rodrigues
- Champalimaud Clinical Centre, Champalimaud Centre for the Unknown , Lisbon, Portugal ; Centro Hospitalar Psiquiátrico de Lisboa , Lisbon, Portugal
| | - Rui Costa
- Champalimaud Research, Champalimaud Centre for the Unknown , Lisbon, Portugal
| | - Albino J Oliveira-Maia
- Department of Psychiatry and Mental Health, Centro Hospitalar de Lisboa Ocidental , Lisbon, Portugal ; Champalimaud Clinical Centre, Champalimaud Centre for the Unknown , Lisbon, Portugal ; Champalimaud Research, Champalimaud Centre for the Unknown , Lisbon, Portugal
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20
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Rossi PJ, Gunduz A, Okun MS. The Subthalamic Nucleus, Limbic Function, and Impulse Control. Neuropsychol Rev 2015; 25:398-410. [PMID: 26577509 DOI: 10.1007/s11065-015-9306-9] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2015] [Accepted: 11/08/2015] [Indexed: 12/16/2022]
Abstract
It has been well documented that deep brain stimulation (DBS) of the subthalamic nucleus (STN) to address some of the disabling motor symptoms of Parkinson's disease (PD) can evoke unintended effects, especially on non-motor behavior. This observation has catalyzed more than a decade of research concentrated on establishing trends and identifying potential mechanisms for these non-motor effects. While many issues remain unresolved, the collective result of many research studies and clinical observations has been a general recognition of the role of the STN in mediating limbic function. In particular, the STN has been implicated in impulse control and the related construct of valence processing. A better understanding of STN involvement in these phenomena could have important implications for treating impulse control disorders (ICDs). ICDs affect up to 40% of PD patients on dopamine agonist therapy and approximately 15% of PD patients overall. ICDs have been reported to be associated with STN DBS. In this paper we will focus on impulse control and review pre-clinical, clinical, behavioral, imaging, and electrophysiological studies pertaining to the limbic function of the STN.
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Affiliation(s)
- P Justin Rossi
- Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA. .,Department of Neurology, University of Florida College of Medicine, HSC Box 100236, Gainesville, FL, 32610-0236, USA.
| | - Aysegul Gunduz
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, FL, USA
| | - Michael S Okun
- Center for Movement Disorders and Neurorestoration, University of Florida, Gainesville, FL, USA
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21
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A fronto–striato–subthalamic–pallidal network for goal-directed and habitual inhibition. Nat Rev Neurosci 2015; 16:719-32. [DOI: 10.1038/nrn4038] [Citation(s) in RCA: 352] [Impact Index Per Article: 39.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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22
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Kim SG, Jung WH, Kim SN, Jang JH, Kwon JS. Alterations of Gray and White Matter Networks in Patients with Obsessive-Compulsive Disorder: A Multimodal Fusion Analysis of Structural MRI and DTI Using mCCA+jICA. PLoS One 2015; 10:e0127118. [PMID: 26038825 PMCID: PMC4454537 DOI: 10.1371/journal.pone.0127118] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Accepted: 04/10/2015] [Indexed: 02/06/2023] Open
Abstract
Many of previous neuroimaging studies on neuronal structures in patients with obsessive-compulsive disorder (OCD) used univariate statistical tests on unimodal imaging measurements. Although the univariate methods revealed important aberrance of local morphometry in OCD patients, the covariance structure of the anatomical alterations remains unclear. Motivated by recent developments of multivariate techniques in the neuroimaging field, we applied a fusion method called "mCCA+jICA" on multimodal structural data of T1-weighted magnetic resonance imaging (MRI) and diffusion tensor imaging (DTI) of 30 unmedicated patients with OCD and 34 healthy controls. Amongst six highly correlated multimodal networks (p < 0.0001), we found significant alterations of the interrelated gray and white matter networks over occipital and parietal cortices, frontal interhemispheric connections and cerebella (False Discovery Rate q ≤ 0.05). In addition, we found white matter networks around basal ganglia that correlated with a subdimension of OC symptoms, namely 'harm/checking' (q ≤ 0.05). The present study not only agrees with the previous unimodal findings of OCD, but also quantifies the association of the altered networks across imaging modalities.
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Affiliation(s)
- Seung-Goo Kim
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul National University Hospital, Seoul, South Korea
- Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Wi Hoon Jung
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul National University Hospital, Seoul, South Korea
| | - Sung Nyun Kim
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea
| | - Joon Hwan Jang
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea
| | - Jun Soo Kwon
- Institute of Human Behavioral Medicine, SNU-MRC, Seoul National University Hospital, Seoul, South Korea
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea
- Department of Brain and Cognitive Sciences, College of Natural Sciences, Seoul National University, Seoul, South Korea
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23
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Burguière E, Monteiro P, Mallet L, Feng G, Graybiel AM. Striatal circuits, habits, and implications for obsessive-compulsive disorder. Curr Opin Neurobiol 2014; 30:59-65. [PMID: 25241072 DOI: 10.1016/j.conb.2014.08.008] [Citation(s) in RCA: 169] [Impact Index Per Article: 16.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2014] [Accepted: 08/22/2014] [Indexed: 02/06/2023]
Abstract
Increasing evidence implicates abnormalities in corticostriatal circuits in the pathophysiology of obsessive-compulsive disorder (OCD) and OC-spectrum disorders. Parallels between the emergence of repetitive, compulsive behaviors and the acquisition of automated behaviors suggest that the expression of compulsions could in part involve loss of control of such habitual behaviors. The view that striatal circuit dysfunction is involved in OC-spectrum disorders is strengthened by imaging and other evidence in humans, by discovery of genes related to OCD syndromes, and by functional studies in animal models of these disorders. We highlight this growing concordance of work in genetics and neurobiology suggesting that frontostriatal circuits, and their links with basal ganglia, thalamus and brainstem, are promising candidates for therapeutic intervention in OCD.
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Affiliation(s)
- Eric Burguière
- Brain and Spine Institute (ICM), CNRS UMR 7225, Inserm U 1127, UPMC-P6 UMR S 1127, Hôpital de la Pitié-Salpêtrière, 47 boulevard de l'Hôpital, 75013 Paris, France
| | - Patricia Monteiro
- McGovern Institute for Brain Research and Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Luc Mallet
- Brain and Spine Institute (ICM), CNRS UMR 7225, Inserm U 1127, UPMC-P6 UMR S 1127, Hôpital de la Pitié-Salpêtrière, 47 boulevard de l'Hôpital, 75013 Paris, France
| | - Guoping Feng
- McGovern Institute for Brain Research and Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA
| | - Ann M Graybiel
- McGovern Institute for Brain Research and Department of Brain and Cognitive Sciences, Massachusetts Institute of Technology, Cambridge, MA, USA.
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24
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Castrioto A, Lhommée E, Moro E, Krack P. Mood and behavioural effects of subthalamic stimulation in Parkinson's disease. Lancet Neurol 2014; 13:287-305. [PMID: 24556007 DOI: 10.1016/s1474-4422(13)70294-1] [Citation(s) in RCA: 202] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Deep-brain stimulation (DBS) of the subthalamic nucleus (STN) is an established treatment for motor complications in Parkinson's disease. 20 years of experience with this procedure have contributed to improved understanding of the role of the STN in motor, cognitive, and emotional control. In Parkinson's disease, the pathological STN neuronal activity leads to motor, cognitive, and emotional inhibition. Deafferentation of the STN by DBS can reverse such behavioural inhibition. The release of this brake allows both motor and non-motor improvement, but can also be associated with excessive motor, cognitive, and emotional behavioural disinhibition. Conversely, the notable reduction in anti-parkinsonian drug dose allowed by motor improvement can unveil mesolimbic hypodopaminergic behaviours such as apathy, anxiety, or depression. Fine-tuning of stimulation parameters with dopaminergic drugs is necessary to prevent or improve pathological behaviours.
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Affiliation(s)
- Anna Castrioto
- Movement Disorder Unit, Department of Psychiatry and Neurology, Centre Hospitalier Universitaire de Grenoble, Joseph Fourier University, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 836, Grenoble Institut des Neurosciences, Grenoble, France; Clinica Neurologica, Università di Perugia, Ospedale Santa Maria della Misericordia, Perugia, Italy
| | - Eugénie Lhommée
- Movement Disorder Unit, Department of Psychiatry and Neurology, Centre Hospitalier Universitaire de Grenoble, Joseph Fourier University, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 836, Grenoble Institut des Neurosciences, Grenoble, France
| | - Elena Moro
- Movement Disorder Unit, Department of Psychiatry and Neurology, Centre Hospitalier Universitaire de Grenoble, Joseph Fourier University, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 836, Grenoble Institut des Neurosciences, Grenoble, France
| | - Paul Krack
- Movement Disorder Unit, Department of Psychiatry and Neurology, Centre Hospitalier Universitaire de Grenoble, Joseph Fourier University, Grenoble, France; Institut National de la Santé et de la Recherche Médicale (INSERM), Unit 836, Grenoble Institut des Neurosciences, Grenoble, France.
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25
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Feng L, Liu TT, Ye DW, Qiu Q, Xiang HB, Cheung CW. Stimulation of the dorsal portion of subthalamic nucleus may be a viable therapeutic approach in pharmacoresistant epilepsy: a virally mediated transsynaptic tracing study in transgenic mouse model. Epilepsy Behav 2014; 31:114-6. [PMID: 24394606 DOI: 10.1016/j.yebeh.2013.11.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/16/2013] [Accepted: 11/27/2013] [Indexed: 12/31/2022]
Affiliation(s)
- Li Feng
- Department of Anesthesiology and Pain Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China
| | - Tao-Tao Liu
- Department of Anesthesiology and Pain Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China
| | - Da-Wei Ye
- Cancer Center, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China
| | - Qiu Qiu
- Department of Anesthesiology and Pain Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China; Department of Anaesthesiology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Hong-Bing Xiang
- Department of Anesthesiology and Pain Medicine, Tongji Hospital of Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430030, PR China.
| | - Chi-Wai Cheung
- Department of Anaesthesiology, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
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26
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Bastin J, Polosan M, Piallat B, Krack P, Bougerol T, Chabardès S, David O. Changes of oscillatory activity in the subthalamic nucleus during obsessive-compulsive disorder symptoms: two case reports. Cortex 2014; 60:145-50. [PMID: 24552693 DOI: 10.1016/j.cortex.2013.12.007] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2013] [Revised: 08/26/2013] [Accepted: 12/13/2013] [Indexed: 11/20/2022]
Abstract
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has positive and negative effects on mood and cognition, as shown in patients suffering from Parkinson's disease (PD) and severe obsessive-compulsive disorders (OCD). Such behavioural and clinical effects suggest that the STN has an important function in limbic circuitry, which still needs to be clarified from electrophysiological recordings. Here we report two exceptional cases of OCD patients in whom local field potentials (LFP) of the anterior STN were directly recorded during acute obsessive-compulsive symptoms. We found significant symptom-related changes in different frequency bands, with no clear preferential oscillatory pattern. The overall modified STN activity during OCD symptoms suggests a mixture of both pathological and compensatory mechanisms that would reflect the maintenance of an over stable motor/cognitive/emotional set. Whether this activity propagates throughout the entire cognitive-limbic loops that are impaired in OCD is an interesting question for future research in larger series of patients.
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Affiliation(s)
- Julien Bastin
- Fonctions Cérébrales et Neuromodulation, Université Joseph Fourier, Grenoble, France; Grenoble Institut des Neurosciences, INSERM, U836, Grenoble, France.
| | - Mircea Polosan
- Fonctions Cérébrales et Neuromodulation, Université Joseph Fourier, Grenoble, France; Grenoble Institut des Neurosciences, INSERM, U836, Grenoble, France; Clinique de Psychiatrie, Pôle Neurologie Psychiatrie, Centre Hospitalier Universitaire, Grenoble, France
| | - Brigitte Piallat
- Fonctions Cérébrales et Neuromodulation, Université Joseph Fourier, Grenoble, France; Grenoble Institut des Neurosciences, INSERM, U836, Grenoble, France
| | - Paul Krack
- Fonctions Cérébrales et Neuromodulation, Université Joseph Fourier, Grenoble, France; Grenoble Institut des Neurosciences, INSERM, U836, Grenoble, France; Clinique de Neurologie, Pôle Neurologie Psychiatrie, Centre Hospitalier Universitaire, Grenoble, France
| | - Thierry Bougerol
- Clinique de Psychiatrie, Pôle Neurologie Psychiatrie, Centre Hospitalier Universitaire, Grenoble, France
| | - Stéphan Chabardès
- Fonctions Cérébrales et Neuromodulation, Université Joseph Fourier, Grenoble, France; Grenoble Institut des Neurosciences, INSERM, U836, Grenoble, France; Clinique de Neurochirurgie, Pôle Tête et Cou, Centre Hospitalier Universitaire, Grenoble, France
| | - Olivier David
- Fonctions Cérébrales et Neuromodulation, Université Joseph Fourier, Grenoble, France; Grenoble Institut des Neurosciences, INSERM, U836, Grenoble, France
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27
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Jahanshahi M. Effects of deep brain stimulation of the subthalamic nucleus on inhibitory and executive control over prepotent responses in Parkinson's disease. Front Syst Neurosci 2013; 7:118. [PMID: 24399941 PMCID: PMC3872293 DOI: 10.3389/fnsys.2013.00118] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2013] [Accepted: 12/06/2013] [Indexed: 12/19/2022] Open
Abstract
Inhibition of inappropriate, habitual or prepotent responses is an essential component of executive control and a cornerstone of self-control. Via the hyperdirect pathway, the subthalamic nucleus (STN) receives inputs from frontal areas involved in inhibition and executive control. Evidence is reviewed from our own work and the literature suggesting that in Parkinson's disease (PD), deep brain stimulation (DBS) of the STN has an impact on executive control during attention-demanding tasks or in situations of conflict when habitual or prepotent responses have to be inhibited. These results support a role for the STN in an inter-related set of processes: switching from automatic to controlled processing, inhibitory and executive control, adjusting response thresholds and influencing speed-accuracy trade-offs. Such STN DBS-induced deficits in inhibitory and executive control may contribute to some of the psychiatric problems experienced by a proportion of operated cases after STN DBS surgery in PD. However, as no direct evidence for such a link is currently available, there is a need to provide direct evidence for such a link between STN DBS-induced deficits in inhibitory and executive control and post-surgical psychiatric complications experienced by operated patients.
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Affiliation(s)
- Marjan Jahanshahi
- Cognitive Motor Neuroscience Group and Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, The National Hospital for Neurology and Neurosurgery London, UK
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Espinosa-Parrilla JF, Baunez C, Apicella P. Linking reward processing to behavioral output: motor and motivational integration in the primate subthalamic nucleus. Front Comput Neurosci 2013; 7:175. [PMID: 24381555 PMCID: PMC3865598 DOI: 10.3389/fncom.2013.00175] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2013] [Accepted: 11/16/2013] [Indexed: 12/15/2022] Open
Abstract
The expectation and detection of motivationally relevant events is a major determinant of goal-directed behavior and there is a strong interest in the contribution of basal ganglia in the integration of motivational processes into behavioral output. Recent research has focused on the role of the subthalamic nucleus (STN) in the motivational control of action, but it remains to be determined how information about reward is encoded in this nucleus. We recorded the activity of single neurons in the STN of two behaving monkeys to examine whether activity was influenced by the delivery of reward in an instrumental task, a Pavlovian stimulus-reward association, or outside of a task context. We confirmed preliminary findings indicating that STN neurons were sensitive not only to rewards obtained during task performance, but also to the expectation of reward when its delivery was delayed in time. Most of the modulations at the onset of reaching movement were combined with modulations following reward delivery, suggesting the convergence of signals related to the animal's movement and its outcome in the same neurons. Some neurons were also influenced by the visuomotor contingencies of the task, i.e., target location and/or movement direction. In addition, modulations were observed under conditions where reward delivery was not contingent on an instrumental response, even in the absence of a reward predictive cue. Taken as a whole, these results demonstrate a potential contribution of the STN to motivational control of behavior in the non-human primate, although problems in distinguishing neuronal signals related to reward from those related to motor behavior should be considered. Characterizing the specificity of reward processing in the STN remains challenging and could have important implications for understanding the influence of this key component of basal ganglia circuitry on emotional and motivated behaviors under normal and pathological conditions.
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Affiliation(s)
| | - Christelle Baunez
- Institut de Neurosciences de la Timone, CNRS-Aix-Marseille Université Marseille, France
| | - Paul Apicella
- Institut de Neurosciences de la Timone, CNRS-Aix-Marseille Université Marseille, France
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Karas PJ, Mikell CB, Christian E, Liker MA, Sheth SA. Deep brain stimulation: a mechanistic and clinical update. Neurosurg Focus 2013; 35:E1. [DOI: 10.3171/2013.9.focus13383] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Deep brain stimulation (DBS), the practice of placing electrodes deep into the brain to stimulate subcortical structures with electrical current, has been increasing as a neurosurgical procedure over the past 15 years. Originally a treatment for essential tremor, DBS is now used and under investigation across a wide spectrum of neurological and psychiatric disorders. In addition to applying electrical stimulation for clinical symptomatic relief, the electrodes implanted can also be used to record local electrical activity in the brain, making DBS a useful research tool. Human single-neuron recordings and local field potentials are now often recorded intraoperatively as electrodes are implanted. Thus, the increasing scope of DBS clinical applications is being matched by an increase in investigational use, leading to a rapidly evolving understanding of cortical and subcortical neurocircuitry. In this review, the authors discuss recent innovations in the clinical use of DBS, both in approved indications as well as in indications under investigation. Deep brain stimulation as an investigational tool is also reviewed, paying special attention to evolving models of basal ganglia and cortical function in health and disease. Finally, the authors look to the future across several indications, highlighting gaps in knowledge and possible future directions of DBS treatment.
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Affiliation(s)
- Patrick J. Karas
- 1Department of Neurosurgery, The Neurological Institute, Columbia University Medical Center, New York, New York; and
| | - Charles B. Mikell
- 1Department of Neurosurgery, The Neurological Institute, Columbia University Medical Center, New York, New York; and
| | - Eisha Christian
- 2Department of Neurosurgery, Keck Hospital of the University of Southern California, Los Angeles, California
| | - Mark A. Liker
- 2Department of Neurosurgery, Keck Hospital of the University of Southern California, Los Angeles, California
| | - Sameer A. Sheth
- 1Department of Neurosurgery, The Neurological Institute, Columbia University Medical Center, New York, New York; and
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Williams NR, Okun MS. Deep brain stimulation (DBS) at the interface of neurology and psychiatry. J Clin Invest 2013; 123:4546-56. [PMID: 24177464 DOI: 10.1172/jci68341] [Citation(s) in RCA: 75] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
Deep brain stimulation (DBS) is an emerging interventional therapy for well-screened patients with specific treatment-resistant neuropsychiatric diseases. Some neuropsychiatric conditions, such as Parkinson disease, have available and reasonable guideline and efficacy data, while other conditions, such as major depressive disorder and Tourette syndrome, have more limited, but promising results. This review summarizes both the efficacy and the neuroanatomical targets for DBS in four common neuropsychiatric conditions: Parkinson disease, Tourette syndrome, major depressive disorder, and obsessive-compulsive disorder. Based on emerging new research, we summarize novel approaches to optimization of stimulation for each neuropsychiatric disease and we review the potential positive and negative effects that may be observed following DBS. Finally, we summarize the likely future innovations in the field of electrical neural-network modulation.
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31
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Eitan R, Shamir RR, Linetsky E, Rosenbluh O, Moshel S, Ben-Hur T, Bergman H, Israel Z. Asymmetric right/left encoding of emotions in the human subthalamic nucleus. Front Syst Neurosci 2013; 7:69. [PMID: 24194703 PMCID: PMC3810611 DOI: 10.3389/fnsys.2013.00069] [Citation(s) in RCA: 51] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 10/04/2013] [Indexed: 01/13/2023] Open
Abstract
Emotional processing is lateralized to the non-dominant brain hemisphere. However, there is no clear spatial model for lateralization of emotional domains in the basal ganglia. The subthalamic nucleus (STN), an input structure in the basal ganglia network, plays a major role in the pathophysiology of Parkinson's disease (PD). This role is probably not limited only to the motor deficits of PD, but may also span the emotional and cognitive deficits commonly observed in PD patients. Beta oscillations (12–30 Hz), the electrophysiological signature of PD, are restricted to the dorsolateral part of the STN that corresponds to the anatomically defined sensorimotor STN. The more medial, more anterior and more ventral parts of the STN are thought to correspond to the anatomically defined limbic and associative territories of the STN. Surprisingly, little is known about the electrophysiological properties of the non-motor domains of the STN, nor about electrophysiological differences between right and left STNs. In this study, microelectrodes were utilized to record the STN spontaneous spiking activity and responses to vocal non-verbal emotional stimuli during deep brain stimulation (DBS) surgeries in human PD patients. The oscillation properties of the STN neurons were used to map the dorsal oscillatory and the ventral non-oscillatory regions of the STN. Emotive auditory stimulation evoked activity in the ventral non-oscillatory region of the right STN. These responses were not observed in the left ventral STN or in the dorsal regions of either the right or left STN. Therefore, our results suggest that the ventral non-oscillatory regions are asymmetrically associated with non-motor functions, with the right ventral STN associated with emotional processing. These results suggest that DBS of the right ventral STN may be associated with beneficial or adverse emotional effects observed in PD patients and may relieve mental symptoms in other neurological and psychiatric diseases.
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Affiliation(s)
- Renana Eitan
- Department of Psychiatry, Hadassah-Hebrew University Medical Center Jerusalem, Israel
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