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Gupta B, Saxena A, Perillo ML, Wade-Kleyn LC, Thompson CH, Purcell EK. Structural, Functional, and Genetic Changes Surrounding Electrodes Implanted in the Brain. Acc Chem Res 2024; 57:1346-1359. [PMID: 38630432 PMCID: PMC11079975 DOI: 10.1021/acs.accounts.4c00057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2024] [Revised: 04/09/2024] [Accepted: 04/09/2024] [Indexed: 05/08/2024]
Abstract
Implantable neurotechnology enables monitoring and stimulating of the brain signals responsible for performing cognitive, motor, and sensory tasks. Electrode arrays implanted in the brain are increasingly used in the clinic to treat a variety of sources of neurological diseases and injuries. However, the implantation of a foreign body typically initiates a tissue response characterized by physical disruption of vasculature and the neuropil as well as the initiation of inflammation and the induction of reactive glial states. Likewise, electrical stimulation can induce damage to the surrounding tissue depending on the intensity and waveform parameters of the applied stimulus. These phenomena, in turn, are likely influenced by the surface chemistry and characteristics of the materials employed, but further information is needed to effectively link the biological responses observed to specific aspects of device design. In order to inform improved design of implantable neurotechnology, we are investigating the basic science principles governing device-tissue integration. We are employing multiple techniques to characterize the structural, functional, and genetic changes that occur in the cells surrounding implanted electrodes. First, we have developed a new "device-in-slice" technique to capture chronically implanted electrodes within thick slices of live rat brain tissue for interrogation with single-cell electrophysiology and two-photon imaging techniques. Our data revealed several new observations of tissue remodeling surrounding devices: (a) there was significant disruption of dendritic arbors in neurons near implants, where losses were driven asymmetrically on the implant-facing side. (b) There was a significant loss of dendritic spine densities in neurons near implants, with a shift toward more immature (nonfunctional) morphologies. (c) There was a reduction in excitatory neurotransmission surrounding implants, as evidenced by a reduction in the frequency of excitatory postsynaptic currents (EPSCs). Lastly, (d) there were changes in the electrophysiological underpinnings of neuronal spiking regularity. In parallel, we initiated new studies to explore changes in gene expression surrounding devices through spatial transcriptomics, which we applied to both recording and stimulating arrays. We found that (a) device implantation is associated with the induction of hundreds of genes associated with neuroinflammation, glial reactivity, oligodendrocyte function, and cellular metabolism and (b) electrical stimulation induces gene expression associated with damage or plasticity in a manner dependent upon the intensity of the applied stimulus. We are currently developing computational analysis tools to distill biomarkers of device-tissue interactions from large transcriptomics data sets. These results improve the current understanding of the biological response to electrodes implanted in the brain while producing new biomarkers for benchmarking the effects of novel electrode designs on responses. As the next generation of neurotechnology is developed, it will be increasingly important to understand the influence of novel materials, surface chemistries, and implant architectures on device performance as well as the relationship with the induction of specific cellular signaling pathways.
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Affiliation(s)
- Bhavna Gupta
- Neuroscience
Program, Michigan State University, 775 Woodlot Dr., East Lansing, Michigan 48824, United States
- Institute
for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Dr., East Lansing, Michigan 48824, United States
| | - Akash Saxena
- Institute
for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Dr., East Lansing, Michigan 48824, United States
- Department
of Electrical and Computer Engineering, Michigan State University, 775 Woodlot Dr., East Lansing, Michigan 48824, United States
| | - Mason L. Perillo
- Department
of Biomedical Engineering, Michigan State
University, 775 Woodlot Dr., East Lansing, Michigan 48824, United States
- Institute
for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Dr., East Lansing, Michigan 48824, United States
| | - Lauren C. Wade-Kleyn
- Department
of Biomedical Engineering, Michigan State
University, 775 Woodlot Dr., East Lansing, Michigan 48824, United States
- Institute
for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Dr., East Lansing, Michigan 48824, United States
| | - Cort H. Thompson
- Department
of Biomedical Engineering, Michigan State
University, 775 Woodlot Dr., East Lansing, Michigan 48824, United States
- Institute
for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Dr., East Lansing, Michigan 48824, United States
| | - Erin K. Purcell
- Department
of Biomedical Engineering, Michigan State
University, 775 Woodlot Dr., East Lansing, Michigan 48824, United States
- Neuroscience
Program, Michigan State University, 775 Woodlot Dr., East Lansing, Michigan 48824, United States
- Institute
for Quantitative Health Science and Engineering, Michigan State University, 775 Woodlot Dr., East Lansing, Michigan 48824, United States
- Department
of Electrical and Computer Engineering, Michigan State University, 775 Woodlot Dr., East Lansing, Michigan 48824, United States
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Stereotactic Surgery for Treating Intractable Tourette Syndrome: A Single-Center Pilot Study. Brain Sci 2022; 12:brainsci12070838. [PMID: 35884645 PMCID: PMC9313141 DOI: 10.3390/brainsci12070838] [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: 05/07/2022] [Revised: 06/14/2022] [Accepted: 06/14/2022] [Indexed: 11/27/2022] Open
Abstract
To evaluate the potential effect of radiofrequency ablation and deep brain stimulation in patients with treatment-refractory Tourette syndrome (TS), this study enrolled thirteen patients with TS who were admitted to our hospital between August 2002 and September 2018. Four patients received a single- or multi-target radiofrequency ablation after local, potentiated, or general anesthesia; eight patients underwent deep brain stimulation (DBS) surgery; and one patient underwent both ablation and DBS surgery. The severity of tics and obsessive compulsive disorder symptoms and the quality of life were evaluated using the Yale Global Tic Severity Scale (YGTSS), Yale−Brown Obsessive Compulsive Scale (YBOCS), and Gilles de la Tourette Syndrome Quality of Life scale (GTS-QOL), respectively, before surgery, one month after surgery, and at the final follow-up after surgery, which was conducted in December 2018. A paired-sample t test and a multiple linear regression analysis were performed to analyze the data. All patients underwent the operation successfully without any severe complications. Overall, the YGTSS total scores at one month post-surgery (44.1 ± 22.3) and at the final visit (35.1 ± 23.7) were significantly decreased compared with those at baseline (75.1 ± 6.2; both p < 0.05). Additionally, the YBOCS scores at one month post-surgery (16.5 ± 10.1) and at the final visit (12.0 ± 9.5) were significantly decreased compared with those at baseline (22.5 ± 13.1; both p < 0.05). Furthermore, the GTS-QOL scores at one month post-surgery (44.0 ± 12.8) and at the final visit (31.0 ± 17.8) were significantly decreased compared with those at baseline (58.4 ± 14.2; both p < 0.05). Results from a multiple linear regression analysis revealed that the improvement in the YGTSS total score was independently associated with the improvement in the GTS-QOL score at one month post-surgery (standardized β = 0.716, p = 0.023) and at the final visit (standardized β = 1.064, p = 0.000). Conversely, changes in YBOCS scores did not correlate with changes in GTS-QOL scores (p > 0.05). Our results demonstrate that tics, psychiatric symptoms, and the quality of life in patients with intractable TS may be relieved by stereotactic ablation surgery and deep brain stimulation. Furthermore, it appears that the improvement in tics contributes more to the post-operative quality of life of patients than does the improvement in obsessive compulsive symptoms.
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Lin L, Lan Y, Zhu H, Yu L, Wu S, Wan W, Shu Y, Xiang H, Hou T, Zhang H, Ma Y, Su W, Li M. Effects of Chemogenetic Inhibition of D1 or D2 Receptor-Containing Neurons of the Substantia Nigra and Striatum in Mice With Tourette Syndrome. Front Mol Neurosci 2021; 14:779436. [PMID: 34955745 PMCID: PMC8696039 DOI: 10.3389/fnmol.2021.779436] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2021] [Accepted: 11/09/2021] [Indexed: 01/02/2023] Open
Abstract
As tourette syndrome (TS) is a common neurobehavioral disorder, the primary symptoms of which include behavioral stereotypies. Dysfunction of the substantia nigra-striatum network could be the main pathogenesis of TS, which is closely associated with dopamine (DA) and its receptors. TS is often resistant to conventional treatments. Therefore, it is necessary to investigate the neurobiological mechanisms underlying its pathogenesis. In this study, we investigated whether chemogenetic activation or inhibition of dopaminergic D1 receptor (D1R)- or D2 receptor (D2R)-containing neurons in the substantia nigra pars compacta (SNpc) or dorsal striatum (dSTR) affected the stereotyped behavior and motor functions of TS mice. Intraperitoneal injection of 3,3'-iminodipropionitrile (IDPN) was used to induce TS in mice. Stereotyped behavior test and open-field, rotarod, and grip strength tests were performed to evaluate stereotyped behavior and motor functions, respectively. Immunofluorescence labeling was used to detect the co-labeling of virus fluorescence and D1R or D2R. We found that chemogenetic inhibition of D1R- or D2R-containing neurons in the SNpc and dSTR alleviated behavioral stereotypies and motor functions in TS mice. Chemogenetic activation of D1R-containing neurons in the dSTR aggravated behavioral stereotypies and motor functions in vehicle-treated mice, but neither was aggravated in TS mice. In conclusion, chemogenetic inhibition of D1R- or D2R-containing neurons in the SNpc and dSTR alleviated behavioral stereotypies of TS, providing a new treatment target for TS. Moreover, the activation of D1R-containing neurons in the dSTR may contribute to the pathogenesis of TS, which can be chosen as a more precise target for treatment.
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Affiliation(s)
- Lixue Lin
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.,Department of Rehabilitation, Wuhan No.1 Hospital, Wuhan, China
| | - Yuye Lan
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - He Zhu
- Institute of Clinical Medicine, Zhanjiang Central People's Hospital, Zhanjiang, China
| | - Lingling Yu
- Institute of Integrated Traditional Chinese and Western Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Shuang Wu
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wangyixuan Wan
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yang Shu
- Department of Central Laboratory, Affiliated Hospital of Jiangsu University, Zhenjiang, China
| | - Hongchun Xiang
- Department of Acupuncture and Moxibustion, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Tengfei Hou
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Hong Zhang
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Ma
- Department of Rehabilitation, Wuhan No.1 Hospital, Wuhan, China
| | - Wen Su
- Department of Pediatrics, Wuhan No.1 Hospital, Wuhan, China
| | - Man Li
- Department of Neurobiology, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Thompson CH, Riggins TE, Patel PR, Chestek CA, Li W, Purcell E. Toward guiding principles for the design of biologically-integrated electrodes for the central nervous system. J Neural Eng 2020; 17:021001. [PMID: 31986501 PMCID: PMC7523527 DOI: 10.1088/1741-2552/ab7030] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Innovation in electrode design has produced a myriad of new and creative strategies for interfacing the nervous system with softer, less invasive, more broadly distributed sites with high spatial resolution. However, despite rapid growth in the use of implanted electrode arrays in research and clinical applications, there are no broadly accepted guiding principles for the design of biocompatible chronic recording interfaces in the central nervous system (CNS). Studies suggest that the architecture and flexibility of devices play important roles in determining effective tissue integration: device feature dimensions (varying from 'sub'- to 'supra'-cellular scales, <10 µm to >100 µm), Young's modulus, and bending modulus have all been identified as key features of design. However, critical knowledge gaps remain in the field with respect to the underlying motivation for these designs: (1) a systematic study of the relationship between device design features (materials, architecture, flexibility), biointegration, and signal quality needs to be performed, including controls for interaction effects between design features, (2) benchmarks for success need to be determined (biological integration, recording performance, longevity, stability), and (3) user results, particularly those that champion a specific design or electrode modification, need to be replicated across laboratories. Finally, the ancillary effects of factors such as tethering, site impedance and insertion method need to be considered. Here, we briefly review observations to-date of device design effects on tissue integration and performance, and then highlight the need for comprehensive and systematic testing of these effects moving forward.
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Affiliation(s)
- Cort H Thompson
- Department of Biomedical Engineering, Michigan State University, East Lansing, MI, United States of America
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Deep brain stimulation in pediatric dystonia: a systematic review. Neurosurg Rev 2018; 43:873-880. [PMID: 30397842 DOI: 10.1007/s10143-018-1047-9] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/21/2018] [Accepted: 10/29/2018] [Indexed: 01/12/2023]
Abstract
While deep brain stimulation (DBS) treatment is relatively rare in children, it may have a role in dystonia to reduce motor symptoms and disability. Pediatric DBS studies are sparse and limited by small sample size, and thus, outcomes are poorly understood. Thus, we performed a systematic review of the literature including studies of DBS for pediatric (age < 21) dystonia. Patient demographics, disease causes and characteristics, motor scores, and disability scores were recorded at baseline and at last post-operative follow-up. We identified 19 studies reporting DBS outcomes in 76 children with dystonia. Age at surgery was 13.8 ± 3.9 (mean ± SD) years, and 58% of individuals were male. Post-operative follow-up duration was 2.8 ± 2.8 years. Sixty-eight percent of patients had primary dystonia (PD), of whom 56% had a pathological mutation in DYT1 (DYT1+). Across all patients, regardless of dystonia type, 43.8 ± 36% improvement was seen in Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) motor (-M) scores after DBS, while 43.7 ± 31% improvement was observed in BFMDRS disability (-D) scores. Patients with PD were more likely to experience ≥ 50% improvement (56%) in BFMDRS-M scores compared to patients with secondary causes of dystonia (21%, p = 0.004). DYT1+ patients were more likely to achieve ≥ 50% improvement (65%) in BFMDRS-D than DTY1- individuals (29%, p = 0.02), although there was no difference in BFMDRS-M ≥ 50% improvement rates between DYT1+ (66%) or DYT1- (43%) children (p = 0.11). While DBS is less common in pediatric patients, individuals with severe dystonia may receive worthwhile benefit with neuromodulation treatment.
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Zhang XH, Li JY, Zhang YQ, Li YJ. Deep Brain Stimulation of the Globus Pallidus Internus in Patients with Intractable Tourette Syndrome: A 1-year Follow-up Study. Chin Med J (Engl) 2017; 129:1022-7. [PMID: 27098785 PMCID: PMC4852667 DOI: 10.4103/0366-6999.180512] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Background: Deep brain stimulation (DBS) has been a promising treatment for patients with refractory Tourette syndrome (TS) for more than a decade. Despite successful DBS treatment of TS in more than 100 patients worldwide, studies with a large patient sample and long-term follow-up assessments are still scarce. Accordingly, we investigated the clinical efficacy and safety of globus pallidus internus (GPi) DBS in the treatment of intractable TS in 24 patients with a 1-year follow-up assessment. Methods: Bilateral/unilateral GPi-DBS was performed in 24 patients with TS. We evaluated symptoms of tics and obsessive-compulsive disorder (OCD) through the Yale Global Tic Severity Scale (YGTSS) and Yale-Brown Obsessive-compulsive Scale (Y-BOCS). We used the Wechsler Adult Intelligence Scale-Revised in China (WAIS-RC) to evaluate the safety of the treatment. We conducted follow-up assessments of all patients for at least 12 months (12–99 months). Results: Symptoms of tics and OCD were significantly relieved at a 12-month follow-up assessment. The mean YGTSS score was 74.04 ± 11.52, 49.83 ± 10.91, 32.58 ± 7.97, and 31.21 ± 8.87 at baseline, 3, 6, and 12 months, respectively. The mean YGTSS scores obtained at the follow-up assessments were significantly different from the baseline (P < 0.05). The improvement in motor tics was superior to that in phonic tics. The mean Y-BOCS scores were 21.61 ± 4.97, 18 ± 4.58, 14.39 ± 3.99, and 13.78 ± 4.56 at baseline, 3, 6, and 12 months, respectively (P < 0.05). We observed a remarkable improvement in psychiatric comorbidities, such as OCD and attention-deficit hyperactivity disorder, after the procedure. WAIS-RC scores were comparable before and after the operation. There were no severe postoperative complications. Conclusion: GPi-DBS appears to comprehensively alleviate tic symptoms and psychiatric comorbidities in patients with TS, thus significantly improving patients’ quality of life.
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Affiliation(s)
| | | | | | - Yong-Jie Li
- Department of Functional Neurosurgery, Beijing Institute of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China
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Moustafa AA, McMullan RD, Rostron B, Hewedi DH, Haladjian HH. The thalamus as a relay station and gatekeeper: relevance to brain disorders. Rev Neurosci 2017; 28:203-218. [DOI: 10.1515/revneuro-2016-0067] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2016] [Accepted: 10/21/2016] [Indexed: 01/18/2023]
Abstract
AbstractHere, we provide a review of behavioural, cognitive, and neural studies of the thalamus, including its role in attention, consciousness, sleep, and motor processes. We further discuss neuropsychological and brain disorders associated with thalamus function, including Parkinson’s disease, Alzheimer’s disease, Korsakoff’s syndrome, and sleep disorders. Importantly, we highlight how thalamus-related processes and disorders can be explained by the role of the thalamus as a relay station.
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Affiliation(s)
- Ahmed A. Moustafa
- 1School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, Australia
- 2Marcs Institute for Brain and Behaviour, Western Sydney University, Sydney, New South Wales, NSW 2751, Australia
| | - Ryan D. McMullan
- 3School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, NSW 2751, Australia
| | - Bjorn Rostron
- 3School of Social Sciences and Psychology, Western Sydney University, Sydney, New South Wales, NSW 2751, Australia
| | - Doaa H. Hewedi
- 4Psychogeriatric Research Center, Department of Psychiatry, School of Medicine, Ain Shams University, 11566 Cairo, Egypt
| | - Harry H. Haladjian
- 5Laboratoire Psychologie de la Perception, Université Paris Descartes, CNRS, 75270 Paris Cedex 06, France
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The Relationship between Neurocircuitry Dysfunctions and Attention Deficit Hyperactivity Disorder: A Review. BIOMED RESEARCH INTERNATIONAL 2016; 2016:3821579. [PMID: 27689077 PMCID: PMC5023827 DOI: 10.1155/2016/3821579] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2016] [Accepted: 07/19/2016] [Indexed: 01/16/2023]
Abstract
The prefrontal cortex is the superlative structure of brain that needs the longest developmental and maturational duration that highlights the region of attention deficit hyperactivity disorder (ADHD) in neuroimaging studies. Prefrontal cortex functions generate enormously complex and its abundant feedback neurocircuitries with subcortical structures such as striatum and thalamus established through dual neural fibers. These microneurocircuitries are called corticostriatothalamocortical (CSTC) circuits. The CSTC circuits paly an essential role in flexible behaviors. The impaired circuits increase the risk of behavioral and psychological symptoms. ADHD is an especial developmental stage of paediatric disease. It has been reported that the CSTC circuits dysfunctions in ADHD are related to homologous symptoms. This study aimed to review the symptoms of ADHD and discuss the recent advances on the effects of the disease as well as the new progress of treatments with each circuit.
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Deeb W, Rossi PJ, Porta M, Visser-Vandewalle V, Servello D, Silburn P, Coyne T, Leckman JF, Foltynie T, Hariz M, Joyce EM, Zrinzo L, Kefalopoulou Z, Welter ML, Karachi C, Mallet L, Houeto JL, Shahed-Jimenez J, Meng FG, Klassen BT, Mogilner AY, Pourfar MH, Kuhn J, Ackermans L, Kaido T, Temel Y, Gross RE, Walker HC, Lozano AM, Khandhar SM, Walter BL, Walter E, Mari Z, Changizi BK, Moro E, Baldermann JC, Huys D, Zauber SE, Schrock LE, Zhang JG, Hu W, Foote KD, Rizer K, Mink JW, Woods DW, Gunduz A, Okun MS. The International Deep Brain Stimulation Registry and Database for Gilles de la Tourette Syndrome: How Does It Work? Front Neurosci 2016; 10:170. [PMID: 27199634 PMCID: PMC4842757 DOI: 10.3389/fnins.2016.00170] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2016] [Accepted: 04/04/2016] [Indexed: 12/24/2022] Open
Abstract
Tourette Syndrome (TS) is a neuropsychiatric disease characterized by a combination of motor and vocal tics. Deep brain stimulation (DBS), already widely utilized for Parkinson's disease and other movement disorders, is an emerging therapy for select and severe cases of TS that are resistant to medication and behavioral therapy. Over the last two decades, DBS has been used experimentally to manage severe TS cases. The results of case reports and small case series have been variable but in general positive. The reported interventions have, however, been variable, and there remain non-standardized selection criteria, various brain targets, differences in hardware, as well as variability in the programming parameters utilized. DBS centers perform only a handful of TS DBS cases each year, making large-scale outcomes difficult to study and to interpret. These limitations, coupled with the variable effect of surgery, and the overall small numbers of TS patients with DBS worldwide, have delayed regulatory agency approval (e.g., FDA and equivalent agencies around the world). The Tourette Association of America, in response to the worldwide need for a more organized and collaborative effort, launched an international TS DBS registry and database. The main goal of the project has been to share data, uncover best practices, improve outcomes, and to provide critical information to regulatory agencies. The international registry and database has improved the communication and collaboration among TS DBS centers worldwide. In this paper we will review some of the key operation details for the international TS DBS database and registry.
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Affiliation(s)
- Wissam Deeb
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Peter J Rossi
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Mauro Porta
- Tourette's Syndrome and Movement Disorders Center, Galeazzi Hospital Milan, Italy
| | | | | | - Peter Silburn
- Asia-Pacific Centre for Neuromodulation, Queensland Brain InstituteBrisbane, Queensland, Australia; University of Queensland Centre for Clinical Research, The University of QueenslandBrisbane, Queensland, Australia
| | - Terry Coyne
- University of Queensland Centre for Clinical Research, The University of QueenslandBrisbane, Queensland, Australia; BrizBrain&SpineBrisbane, QLD, Australia
| | - James F Leckman
- Departments of Psychiatry, Pediatrics and Psychology, Child Study Center, Yale University New Haven, CT, USA
| | - Thomas Foltynie
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Marwan Hariz
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Eileen M Joyce
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Ludvic Zrinzo
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Zinovia Kefalopoulou
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Marie-Laure Welter
- Assistance publique - Hôpitaux de Paris, Institut du Cerveau et de la Moelle Epiniere, Institut National de la Santé et de la Recherche Médicale 1127, Pitié-Salpêtrière Hospital, Sorbonne Universités, UPMC Univ Paris 06, Unité Mixte de Recherche 1127, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7225 Paris, France
| | - Carine Karachi
- Institut National de la Santé et de la Recherche Médicale U 1127, Centre National de la Recherche Scientifique UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinièreParis, France; Department of Neurosurgery, Assistance Publique - Hôpitaux de Paris, Hôpital de la Pitié-SalpêtrièreParis, France
| | - Luc Mallet
- Institut National de la Santé et de la Recherche Médicale U 1127, Centre National de la Recherche Scientifique UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinièreParis, France; Assistance publique - Hôpitaux de Paris, DHU Pe-PSY, Pôle de Psychiatrie et d'addictologie des Hôpitaux Universitaires H Mondor, Université Paris Est CréteilCréteil, France; Department of Mental Health and Psychiatry, Geneva University HospitalGeneva, Switzerland
| | - Jean-Luc Houeto
- Service de Neurologie, Institut National de la Santé et de la Recherche Médicale-Centres d'Investigation Clinique 1402, Centre Hospitalier Universitaire de Grenoble de Poitiers, Université de Poitiers Poitiers, France
| | - Joohi Shahed-Jimenez
- Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine Houston, TX, USA
| | - Fan-Gang Meng
- Beijing Neurosurgical Institute, Capital Medical University Beijing, China
| | - Bryan T Klassen
- Department of Neurology, Mayo Clinic College of Medicine Rochester, MN, USA
| | - Alon Y Mogilner
- Department of Neurosurgery, Center for Neuromodulation, NYU Langone Medical Center New York, NY, USA
| | - Michael H Pourfar
- Department of Neurosurgery, Center for Neuromodulation, NYU Langone Medical Center New York, NY, USA
| | - Jens Kuhn
- Department of Psychiatry and Psychotherapy, University of Cologne Cologne, Germany
| | - L Ackermans
- Department of Neurosurgery, Maastricht University Medical Centre Maastricht, Netherlands
| | - Takanobu Kaido
- Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry Kodaira, Japan
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical CenterMaastricht, Netherlands; Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht UniversityMaastricht, Netherlands
| | - Robert E Gross
- Department of Neurosurgery, Emory University Atlanta, GA, USA
| | - Harrison C Walker
- Department of Neurology, Department of Biomedical Engineering, University of Alabama at Birmingham Birmingham, AL, USA
| | - Andres M Lozano
- Division of Neurosurgery, University of Toronto Toronto, Canada
| | - Suketu M Khandhar
- Department of Neurology, The Permanente Medical Group (Tidewater Physicians Multispecialty Group), Movement Disorders Program Sacramento, CA, USA
| | - Benjamin L Walter
- University Hospitals, Case Western Reserve University School of Medicine Cleveland, OH, USA
| | - Ellen Walter
- Department of Neurology, University Hospitals Case Medical Center, Neurological Institute Cleveland, OH, USA
| | - Zoltan Mari
- Parkinson's & Movement Disorder Center/Division, Johns Hopkins University, School of Medicine Baltimore, MD, USA
| | - Barbara K Changizi
- Department of Neurology, The Ohio State University Wexner Medical Center Columbus, OH, USA
| | - Elena Moro
- Division of Neurology, Centre Hospitalier Universitaire de Grenoble Grenoble, Grenoble Alpes University Grenoble, France
| | - Juan C Baldermann
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Köln Köln, Germany
| | - Daniel Huys
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Köln Köln, Germany
| | - S Elizabeth Zauber
- Department of Neurology, Indiana University School of Medicine Indianapolis, IN, USA
| | - Lauren E Schrock
- Department of Neurology, University of Utah Salt Lake City, UT, USA
| | - Jian-Guo Zhang
- Department of Functional Neurosurgery, Beijing Tiantan Hospital, Capital Medical University Beijing, China
| | - Wei Hu
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Kelly D Foote
- Department of Neurology, University of Florida and Center for Movement Disorders and NeurorestorationGainesville, FL, USA; Department of Neurological Surgery, University of FloridaGainesville, FL, USA
| | - Kyle Rizer
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Jonathan W Mink
- Department of Neurology, University of Rochester Medical Center Rochester, NY, USA
| | - Douglas W Woods
- Department of Psychology, Marquette University Milwaukee, WI, USA
| | - Aysegul Gunduz
- Department of Neurology, University of Florida and Center for Movement Disorders and NeurorestorationGainesville, FL, USA; J. Crayton Pruitt Family Department of Biomedical Engineering, University of FloridaGainesville, FL, USA
| | - Michael S Okun
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
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10
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Deeb W, Rossi PJ, Porta M, Visser-Vandewalle V, Servello D, Silburn P, Coyne T, Leckman JF, Foltynie T, Hariz M, Joyce EM, Zrinzo L, Kefalopoulou Z, Welter ML, Karachi C, Mallet L, Houeto JL, Shahed-Jimenez J, Meng FG, Klassen BT, Mogilner AY, Pourfar MH, Kuhn J, Ackermans L, Kaido T, Temel Y, Gross RE, Walker HC, Lozano AM, Khandhar SM, Walter BL, Walter E, Mari Z, Changizi BK, Moro E, Baldermann JC, Huys D, Zauber SE, Schrock LE, Zhang JG, Hu W, Foote KD, Rizer K, Mink JW, Woods DW, Gunduz A, Okun MS. The International Deep Brain Stimulation Registry and Database for Gilles de la Tourette Syndrome: How Does It Work? Front Neurosci 2016. [PMID: 27199634 DOI: 10.3389/fnins.2016.00170/abstract] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/23/2023] Open
Abstract
Tourette Syndrome (TS) is a neuropsychiatric disease characterized by a combination of motor and vocal tics. Deep brain stimulation (DBS), already widely utilized for Parkinson's disease and other movement disorders, is an emerging therapy for select and severe cases of TS that are resistant to medication and behavioral therapy. Over the last two decades, DBS has been used experimentally to manage severe TS cases. The results of case reports and small case series have been variable but in general positive. The reported interventions have, however, been variable, and there remain non-standardized selection criteria, various brain targets, differences in hardware, as well as variability in the programming parameters utilized. DBS centers perform only a handful of TS DBS cases each year, making large-scale outcomes difficult to study and to interpret. These limitations, coupled with the variable effect of surgery, and the overall small numbers of TS patients with DBS worldwide, have delayed regulatory agency approval (e.g., FDA and equivalent agencies around the world). The Tourette Association of America, in response to the worldwide need for a more organized and collaborative effort, launched an international TS DBS registry and database. The main goal of the project has been to share data, uncover best practices, improve outcomes, and to provide critical information to regulatory agencies. The international registry and database has improved the communication and collaboration among TS DBS centers worldwide. In this paper we will review some of the key operation details for the international TS DBS database and registry.
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Affiliation(s)
- Wissam Deeb
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Peter J Rossi
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Mauro Porta
- Tourette's Syndrome and Movement Disorders Center, Galeazzi Hospital Milan, Italy
| | | | | | - Peter Silburn
- Asia-Pacific Centre for Neuromodulation, Queensland Brain InstituteBrisbane, Queensland, Australia; University of Queensland Centre for Clinical Research, The University of QueenslandBrisbane, Queensland, Australia
| | - Terry Coyne
- University of Queensland Centre for Clinical Research, The University of QueenslandBrisbane, Queensland, Australia; BrizBrain&SpineBrisbane, QLD, Australia
| | - James F Leckman
- Departments of Psychiatry, Pediatrics and Psychology, Child Study Center, Yale University New Haven, CT, USA
| | - Thomas Foltynie
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Marwan Hariz
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Eileen M Joyce
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Ludvic Zrinzo
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Zinovia Kefalopoulou
- Sobell Department of Motor Neuroscience, University College London Institute of Neurology London, UK
| | - Marie-Laure Welter
- Assistance publique - Hôpitaux de Paris, Institut du Cerveau et de la Moelle Epiniere, Institut National de la Santé et de la Recherche Médicale 1127, Pitié-Salpêtrière Hospital, Sorbonne Universités, UPMC Univ Paris 06, Unité Mixte de Recherche 1127, Centre National de la Recherche Scientifique, Unité Mixte de Recherche 7225 Paris, France
| | - Carine Karachi
- Institut National de la Santé et de la Recherche Médicale U 1127, Centre National de la Recherche Scientifique UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinièreParis, France; Department of Neurosurgery, Assistance Publique - Hôpitaux de Paris, Hôpital de la Pitié-SalpêtrièreParis, France
| | - Luc Mallet
- Institut National de la Santé et de la Recherche Médicale U 1127, Centre National de la Recherche Scientifique UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Institut du Cerveau et de la Moelle épinièreParis, France; Assistance publique - Hôpitaux de Paris, DHU Pe-PSY, Pôle de Psychiatrie et d'addictologie des Hôpitaux Universitaires H Mondor, Université Paris Est CréteilCréteil, France; Department of Mental Health and Psychiatry, Geneva University HospitalGeneva, Switzerland
| | - Jean-Luc Houeto
- Service de Neurologie, Institut National de la Santé et de la Recherche Médicale-Centres d'Investigation Clinique 1402, Centre Hospitalier Universitaire de Grenoble de Poitiers, Université de Poitiers Poitiers, France
| | - Joohi Shahed-Jimenez
- Parkinson's Disease Center and Movement Disorders Clinic, Baylor College of Medicine Houston, TX, USA
| | - Fan-Gang Meng
- Beijing Neurosurgical Institute, Capital Medical University Beijing, China
| | - Bryan T Klassen
- Department of Neurology, Mayo Clinic College of Medicine Rochester, MN, USA
| | - Alon Y Mogilner
- Department of Neurosurgery, Center for Neuromodulation, NYU Langone Medical Center New York, NY, USA
| | - Michael H Pourfar
- Department of Neurosurgery, Center for Neuromodulation, NYU Langone Medical Center New York, NY, USA
| | - Jens Kuhn
- Department of Psychiatry and Psychotherapy, University of Cologne Cologne, Germany
| | - L Ackermans
- Department of Neurosurgery, Maastricht University Medical Centre Maastricht, Netherlands
| | - Takanobu Kaido
- Department of Neurosurgery, National Center Hospital, National Center of Neurology and Psychiatry Kodaira, Japan
| | - Yasin Temel
- Department of Neurosurgery, Maastricht University Medical CenterMaastricht, Netherlands; Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Maastricht UniversityMaastricht, Netherlands
| | - Robert E Gross
- Department of Neurosurgery, Emory University Atlanta, GA, USA
| | - Harrison C Walker
- Department of Neurology, Department of Biomedical Engineering, University of Alabama at Birmingham Birmingham, AL, USA
| | - Andres M Lozano
- Division of Neurosurgery, University of Toronto Toronto, Canada
| | - Suketu M Khandhar
- Department of Neurology, The Permanente Medical Group (Tidewater Physicians Multispecialty Group), Movement Disorders Program Sacramento, CA, USA
| | - Benjamin L Walter
- University Hospitals, Case Western Reserve University School of Medicine Cleveland, OH, USA
| | - Ellen Walter
- Department of Neurology, University Hospitals Case Medical Center, Neurological Institute Cleveland, OH, USA
| | - Zoltan Mari
- Parkinson's & Movement Disorder Center/Division, Johns Hopkins University, School of Medicine Baltimore, MD, USA
| | - Barbara K Changizi
- Department of Neurology, The Ohio State University Wexner Medical Center Columbus, OH, USA
| | - Elena Moro
- Division of Neurology, Centre Hospitalier Universitaire de Grenoble Grenoble, Grenoble Alpes University Grenoble, France
| | - Juan C Baldermann
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Köln Köln, Germany
| | - Daniel Huys
- Department of Psychiatry and Psychotherapy, Universitätsklinikum Köln Köln, Germany
| | - S Elizabeth Zauber
- Department of Neurology, Indiana University School of Medicine Indianapolis, IN, USA
| | - Lauren E Schrock
- Department of Neurology, University of Utah Salt Lake City, UT, USA
| | - Jian-Guo Zhang
- Department of Functional Neurosurgery, Beijing Tiantan Hospital, Capital Medical University Beijing, China
| | - Wei Hu
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Kelly D Foote
- Department of Neurology, University of Florida and Center for Movement Disorders and NeurorestorationGainesville, FL, USA; Department of Neurological Surgery, University of FloridaGainesville, FL, USA
| | - Kyle Rizer
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
| | - Jonathan W Mink
- Department of Neurology, University of Rochester Medical Center Rochester, NY, USA
| | - Douglas W Woods
- Department of Psychology, Marquette University Milwaukee, WI, USA
| | - Aysegul Gunduz
- Department of Neurology, University of Florida and Center for Movement Disorders and NeurorestorationGainesville, FL, USA; J. Crayton Pruitt Family Department of Biomedical Engineering, University of FloridaGainesville, FL, USA
| | - Michael S Okun
- Department of Neurology, University of Florida and Center for Movement Disorders and Neurorestoration Gainesville, FL, USA
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11
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Arsenault D, Drouin-Ouellet J, Saint-Pierre M, Petrou P, Dubois M, Kriz J, Barker RA, Cicchetti A, Cicchetti F. A novel combinational approach of microstimulation and bioluminescence imaging to study the mechanisms of action of cerebral electrical stimulation in mice. J Physiol 2015; 593:2257-78. [PMID: 25653107 DOI: 10.1113/jphysiol.2014.287243] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2014] [Accepted: 01/30/2015] [Indexed: 12/12/2022] Open
Abstract
Deep brain stimulation (DBS) is used to treat a number of neurological conditions and is currently being tested to intervene in neuropsychiatric conditions. However, a better understanding of how it works would ensure that side effects could be minimized and benefits optimized. We have thus developed a unique device to perform brain stimulation (BS) in mice and to address fundamental issues related to this methodology in the pre-clinical setting. This new microstimulator prototype was specifically designed to allow simultaneous live bioluminescence imaging of the mouse brain, allowing real time assessment of the impact of stimulation on cerebral tissue. We validated the authenticity of this tool in vivo by analysing the expression of toll-like receptor 2 (TLR2), corresponding to the microglial response, in the stimulated brain regions of TLR2-fluc-GFP transgenic mice, which we further corroborated with post-mortem analyses in these animals as well as in human brains of patients who underwent DBS to treat their Parkinson's disease. In the present study, we report on the development of the first BS device that allows for simultaneous live in vivo imaging in mice. This tool opens up a whole new range of possibilities that allow a better understanding of BS and how to optimize its effects through its use in murine models of disease.
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Affiliation(s)
- Dany Arsenault
- Centre de Recherche du CHU de Québec (CHUQ), Axe Neurosciences, Québec, QC, Canada
| | - Janelle Drouin-Ouellet
- John van Geest Centre for Brain Repair, Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK
| | - Martine Saint-Pierre
- Centre de Recherche du CHU de Québec (CHUQ), Axe Neurosciences, Québec, QC, Canada
| | - Petros Petrou
- Centre de Recherche du CHU de Québec (CHUQ), Axe Neurosciences, Québec, QC, Canada
| | - Marilyn Dubois
- Centre de Recherche du CHU de Québec (CHUQ), Axe Neurosciences, Québec, QC, Canada
| | - Jasna Kriz
- Département de Psychiatrie et Neurosciences, Université Laval, Québec, QC, Canada.,Institut Universitaire en Santé Mentale de Québec, Québec, QC, Canada
| | - Roger A Barker
- John van Geest Centre for Brain Repair, Department of Clinical Neuroscience, University of Cambridge, Cambridge, UK
| | - Antonio Cicchetti
- Centre de Recherche du CHU de Québec (CHUQ), Axe Neurosciences, Québec, QC, Canada
| | - Francesca Cicchetti
- Centre de Recherche du CHU de Québec (CHUQ), Axe Neurosciences, Québec, QC, Canada.,Département de Psychiatrie et Neurosciences, Université Laval, Québec, QC, Canada
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