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Papp M, Gruca P, Litwa E, Lason M, Willner P. Optogenetic stimulation of transmission from prelimbic cortex to nucleus accumbens core overcomes resistance to venlafaxine in an animal model of treatment-resistant depression. Prog Neuropsychopharmacol Biol Psychiatry 2023; 123:110715. [PMID: 36610613 DOI: 10.1016/j.pnpbp.2023.110715] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 12/28/2022] [Accepted: 01/03/2023] [Indexed: 01/06/2023]
Abstract
BACKGROUND Our earlier study demonstrated that repeated optogenetic stimulation of afferents from ventral hippocampus (vHIP) to the prelimbic region of medial prefrontal cortex (mPFC) overcame resistance to antidepressant treatment in Wistar-Kyoto (WKY) rats. These results suggested that antidepressant resistance may result from an insufficiency of transmission from vHIP to mPFC. Here we examined whether similar effects can be elicited from major output of mPFC; the pathway from to nucleus accumbens core (NAc). METHOD WKY rats were subjected to Chronic Mild Stress and were used in two sets of experiments: 1) they were treated acutely with optogenetic stimulation of afferents to NAc core originating from the mPFC, and 2) they were treated with chronic (5 weeks) venlafaxine (10 mg/kg) and/or repeated (once weekly) optogenetic stimulation of afferents to NAc originating from either mPFC or vHIP. RESULTS Chronic mild stress procedure decreased sucrose intake, open arm entries on elevated plus maze, and novel object recognition test. Acute optogenetic stimulation of the mPFC-NAc and vHIP-NAc pathways had no effect in sucrose or plus maze tests, but increased object recognition. Neither venlafaxine nor mPFC-NAc optogenetic stimulation alone was effective in reversing the effects of CMS, but the combination of chronic antidepressant and repeated optogenetic stimulation improved behaviour on all three measures. CONCLUSIONS The synergism between venlafaxine and mPFC-NAc optogenetic stimulation supports the hypothesis that the mechanisms of non-responsiveness of WKY rats involves a failure of antidepressant treatment to restore transmission in the mPFC-NAc pathway. Together with earlier results, this implicates insufficiency in a vHIP-mPFC-NAc circuit in non-responsiveness to antidepressant drugs.
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Affiliation(s)
- Mariusz Papp
- Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland.
| | - Piotr Gruca
- Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Ewa Litwa
- Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Magdalena Lason
- Maj Institute of Pharmacology, Polish Academy of Sciences, Krakow, Poland
| | - Paul Willner
- Department of Psychology, Swansea University, Swansea, UK
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Zhang Y, Xiao N, Zhang X, Zhang Z, Zhang J. Identifying Factors Associated with the Recurrence of Tic Disorders. Brain Sci 2022; 12:brainsci12060697. [PMID: 35741583 PMCID: PMC9221031 DOI: 10.3390/brainsci12060697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2022] [Revised: 05/24/2022] [Accepted: 05/24/2022] [Indexed: 11/16/2022] Open
Abstract
Tic disorders are neurological disorders that are prone to fluctuation and recurrence. It is important to study the factors related to disease recurrence and to subsequently provide suggestions for clinical treatment. A retrospective study was conducted to assess patients with recurrent and non-recurring tic disorders diagnosed in the Pediatric Tic Disorder Clinic of the First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, China, and to extract various factors—such as fetal status; medication, allergy, and family history; social and psychological factors; blood lead content; electroencephalogram (EEG); disease duration; type of tics; and disease severity—and identify factors associated with recurrence. The recurrence rate of tic disorders was approximately 45.10% in this study. The childbirth conditions, surgery/trauma, respiratory tract infection, allergy, stress, consumption of tiapride, and severity of tic disorders were factors related to and affected disease recurrence.
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Affiliation(s)
- Yixin Zhang
- Department of Rehabilitation, Children’s Hospital of Chongqing Medical University, Chongqing 400010, China;
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400010, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400010, China
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing 400010, China
| | - Nong Xiao
- Department of Rehabilitation, Children’s Hospital of Chongqing Medical University, Chongqing 400010, China;
- National Clinical Research Center for Child Health and Disorders, Ministry of Education Key Laboratory of Child Development and Disorders, Chongqing 400010, China
- Chongqing Key Laboratory of Pediatrics, Chongqing 400010, China
- Chongqing Key Laboratory of Translational Medical Research in Cognitive Development and Learning and Memory Disorders, Chongqing 400010, China
- Correspondence: ; Tel.: +86-189-8366-5866
| | - Xilian Zhang
- Department of Pediatrics, The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300380, China; (X.Z.); (Z.Z.)
| | - Zhenhua Zhang
- Department of Pediatrics, The First Affiliated Hospital of Tianjin University of Traditional Chinese Medicine, Tianjin 300380, China; (X.Z.); (Z.Z.)
| | - Jiusi Zhang
- Acupuncture, Tianjin Rehabilitation Center, Tianjin 300110, China;
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Wehmeyer L, Schüller T, Kiess J, Heiden P, Visser-Vandewalle V, Baldermann JC, Andrade P. Target-Specific Effects of Deep Brain Stimulation for Tourette Syndrome: A Systematic Review and Meta-Analysis. Front Neurol 2021; 12:769275. [PMID: 34744993 PMCID: PMC8563609 DOI: 10.3389/fneur.2021.769275] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2021] [Accepted: 09/21/2021] [Indexed: 01/09/2023] Open
Abstract
Background: Extended research has pointed to the efficacy of deep brain stimulation (DBS) in treatment of patients with treatment-refractory Tourette syndrome (TS). The four most commonly used DBS targets for TS include the centromedian nucleus-nucleus ventrooralis internus (CM-Voi) and the centromedian nucleus-parafascicular (CM-Pf) complexes of the thalamus, and the posteroventrolateral (pvIGPi) and the anteromedial portion of the globus pallidus internus (amGPi). Differences and commonalities between those targets need to be compared systematically. Objective: Therefore, we evaluated whether DBS is effective in reducing TS symptoms and target-specific differences. Methods: A PubMed literature search was conducted according to the PRISMA guidelines. Eligible literature was used to conduct a systematic review and meta-analysis. Results: In total, 65 studies with 376 patients were included. Overall, Yale Global Tic Severity Scale (YGTSS) scores were reduced by more than 50 in 69% of the patients. DBS also resulted in significant reductions of secondary outcome measures, including the total YGTSS, modified Rush Video-Based Tic Rating Scale (mRVRS), Yale-Brown Obsessive Compulsive Scale (YBOCS), and Becks Depression Inventory (BDI). All targets resulted in significant reductions of YGTSS scores and, with the exception of the CM-Pf, also in reduced YBOCS scores. Interestingly, DBS of pallidal targets showed increased YGTSS and YBOCS reductions compared to thalamic targets. Also, the meta-analysis including six randomized controlled and double-blinded trials demonstrated clinical efficacy of DBS for TS, that remained significant for GPi but not thalamic stimulation in two separate meta-analyses. Conclusion: We conclude that DBS is a clinically effective treatment option for patients with treatment-refractory TS, with all targets showing comparable improvement rates. Future research might focus on personalized and symptom-specific target selection.
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Affiliation(s)
- Laura Wehmeyer
- Faculty of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, University of Cologne, Cologne, Germany,*Correspondence: Laura Wehmeyer
| | - Thomas Schüller
- Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Jana Kiess
- Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Petra Heiden
- Faculty of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, University of Cologne, Cologne, Germany
| | - Veerle Visser-Vandewalle
- Faculty of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, University of Cologne, Cologne, Germany
| | - Juan Carlos Baldermann
- Faculty of Medicine and University Hospital Cologne, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany,Faculty of Medicine and University Hospital Cologne, Department of Neurology, University of Cologne, Cologne, Germany
| | - Pablo Andrade
- Faculty of Medicine and University Hospital Cologne, Department of Stereotactic and Functional Neurosurgery, University of Cologne, Cologne, Germany
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Billings C, Langley M, Warrington G, Mashali F, Johnson JA. Magnetic Particle Imaging: Current and Future Applications, Magnetic Nanoparticle Synthesis Methods and Safety Measures. Int J Mol Sci 2021; 22:ijms22147651. [PMID: 34299271 PMCID: PMC8306580 DOI: 10.3390/ijms22147651] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 07/10/2021] [Accepted: 07/14/2021] [Indexed: 02/07/2023] Open
Abstract
Magnetic nanoparticles (MNPs) have a wide range of applications; an area of particular interest is magnetic particle imaging (MPI). MPI is an imaging modality that utilizes superparamagnetic iron oxide particles (SPIONs) as tracer particles to produce highly sensitive and specific images in a broad range of applications, including cardiovascular, neuroimaging, tumor imaging, magnetic hyperthermia and cellular tracking. While there are hurdles to overcome, including accessibility of products, and an understanding of safety and toxicity profiles, MPI has the potential to revolutionize research and clinical biomedical imaging. This review will explore a brief history of MPI, MNP synthesis methods, current and future applications, and safety concerns associated with this newly emerging imaging modality.
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Affiliation(s)
- Caroline Billings
- College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA;
| | - Mitchell Langley
- Department of Mechanical, Aerospace and Biomedical Engineering, University of Tennessee, Knoxville, TN 37996, USA; (M.L.); (G.W.); (F.M.)
| | - Gavin Warrington
- Department of Mechanical, Aerospace and Biomedical Engineering, University of Tennessee, Knoxville, TN 37996, USA; (M.L.); (G.W.); (F.M.)
| | - Farzin Mashali
- Department of Mechanical, Aerospace and Biomedical Engineering, University of Tennessee, Knoxville, TN 37996, USA; (M.L.); (G.W.); (F.M.)
| | - Jacqueline Anne Johnson
- Department of Mechanical, Aerospace and Biomedical Engineering, University of Tennessee Space Institute, Tullahoma, TN 37388, USA
- Correspondence:
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GABAergic Neurons in the Dorsal-Intermediate Lateral Septum Regulate Sleep-Wakefulness and Anesthesia in Mice. Anesthesiology 2021; 135:463-481. [PMID: 34259824 DOI: 10.1097/aln.0000000000003868] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND The γ-aminobutyric acid-mediated (GABAergic) inhibitory system in the brain is critical for regulation of sleep-wake and general anesthesia. The lateral septum contains mainly GABAergic neurons, being cytoarchitectonically divided into the dorsal, intermediate, and ventral parts. This study hypothesized that GABAergic neurons of the lateral septum participate in the control of wakefulness and promote recovery from anesthesia. METHODS By employing fiber photometry, chemogenetic and optogenetic neuronal manipulations, anterograde tracing, in vivo electrophysiology, and electroencephalogram/electromyography recordings in adult male mice, the authors measured the role of lateral septum GABAergic neurons to the control of sleep-wake transition and anesthesia emergence and the corresponding neuron circuits in arousal and emergence control. RESULTS The GABAergic neurons of the lateral septum exhibited high activities during the awake state by in vivo fiber photometry recordings (awake vs. non-rapid eye movement sleep: 3.3 ± 1.4% vs. -1.3 ± 1.2%, P < 0.001, n = 7 mice/group; awake vs. anesthesia: 2.6 ± 1.2% vs. -1.3 ± 0.8%, P < 0.001, n = 7 mice/group). Using chemogenetic stimulation of lateral septum GABAergic neurons resulted in a 100.5% increase in wakefulness and a 51.2% reduction in non-rapid eye movement sleep. Optogenetic activation of these GABAergic neurons promoted wakefulness from sleep (median [25th, 75th percentiles]: 153.0 [115.9, 179.7] s to 4.0 [3.4, 4.6] s, P = 0.009, n = 5 mice/group) and accelerated emergence from isoflurane anesthesia (514.4 ± 122.2 s vs. 226.5 ± 53.3 s, P < 0.001, n = 8 mice/group). Furthermore, the authors demonstrated that the lateral septum GABAergic neurons send 70.7% (228 of 323 cells) of monosynaptic projections to the ventral tegmental area GABAergic neurons, preferentially inhibiting their activities and thus regulating wakefulness and isoflurane anesthesia depth. CONCLUSIONS The results uncover a fundamental role of the lateral septum GABAergic neurons and their circuit in maintaining awake state and promoting general anesthesia emergence time. EDITOR’S PERSPECTIVE
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Zhang X, Liu B, Li N, Li Y, Hou J, Duan G, Wu D. Transcranial Direct Current Stimulation Over Prefrontal Areas Improves Psychomotor Inhibition State in Patients With Traumatic Brain Injury: A Pilot Study. Front Neurosci 2020; 14:386. [PMID: 32508560 PMCID: PMC7251071 DOI: 10.3389/fnins.2020.00386] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 03/30/2020] [Indexed: 01/10/2023] Open
Abstract
Objectives Many post-traumatic patients with minimally conscious state are complicated by psychomotor inhibition state (PIS), which impedes further rehabilitation. The treatment of PIS is not satisfactory. This pilot study aimed to investigate effects of anodal transcranial direct current stimulation (A-tDCS) on PIS in post-traumatic patients and examine the altered cortical activation after tDCS using non-linear electroencephalogram (EEG). Methods The study included 10 patients with post-traumatic PIS. An A–B design was used. The patients received 4 weeks of sham tDCS during Phase A, and they received A-tDCS over the prefrontal area and left dorsolateral prefrontal cortex (DLPFC) for 4 weeks (40 sessions) during Phase B. Conventional treatments were administered throughout both phases. JFK Coma Recovery Scale-Revised (CRS-R), apathy evaluation scale (AES), and the EEG non-linear indices of approximate entropy (ApEn) and cross approximate entropy (C-ApEn) were measured before Phase A, before Phase B, and after Phase B. Results After A-tDCS treatment, CRS-R and AES were improved significantly. ApEn and C-ApEn results showed that the local cortical connection of bilateral sensorimotor areas with their peripheral areas could be activated by affected painful stimuli, while bilateral cerebral hemispheres could be activated by the unaffected painful-stimuli condition. Linear regression analysis revealed that the affected sensorimotor cortex excitability and unaffected local and distant cortical networks connecting the sensorimotor area to the prefrontal area play a major role in AES improvement. Conclusion A-tDCS over the prefrontal area and left DLPFC improves PIS. The recovery might be related to increased excitability in local and distant cortical networks connecting the sensorimotor area to the prefrontal area. Thus, tDCS may be an alternative treatment for post-traumatic PIS.
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Affiliation(s)
- Xu Zhang
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Baohu Liu
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Nan Li
- Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing, China
| | - Yuanyuan Li
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Jun Hou
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Guoping Duan
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
| | - Dongyu Wu
- Department of Rehabilitation, Wangjing Hospital of China Academy of Chinese Medical Sciences, Beijing, China
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Reconfigurable MRI technology for low-SAR imaging of deep brain stimulation at 3T: Application in bilateral leads, fully-implanted systems, and surgically modified lead trajectories. Neuroimage 2019; 199:18-29. [PMID: 31096058 DOI: 10.1016/j.neuroimage.2019.05.015] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2019] [Revised: 04/24/2019] [Accepted: 05/06/2019] [Indexed: 11/22/2022] Open
Abstract
Patients with deep brain stimulation devices highly benefit from postoperative MRI exams, however MRI is not readily accessible to these patients due to safety risks associated with RF heating of the implants. Recently we introduced a patient-adjustable reconfigurable coil technology that substantially reduced local SAR at tips of single isolated DBS leads during MRI at 1.5 T in 9 realistic patient models. This contribution extends our work to higher fields by demonstrating the feasibility of scaling the technology to 3T and assessing its performance in patients with bilateral leads as well as fully implanted systems. We developed patient-derived models of bilateral DBS leads and fully implanted DBS systems from postoperative CT images of 13 patients and performed finite element simulations to calculate SAR amplification at electrode contacts during MRI with a reconfigurable rotating coil at 3T. Compared to a conventional quadrature body coil, the reconfigurable coil system reduced the SAR on average by 83% for unilateral leads and by 59% for bilateral leads. A simple surgical modification in trajectory of implanted leads was demonstrated to increase the SAR reduction efficiency of the rotating coil to >90% in a patient with a fully implanted bilateral DBS system. Thermal analysis of temperature-rise around electrode contacts during typical brain exams showed a 15-fold heating reduction using the rotating coil, generating <1°C temperature rise during ∼4-min imaging with high-SAR sequences where a conventional CP coil generated >10°C temperature rise in the tissue for the same flip angle.
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How Deep Brain Stimulation of the Nucleus Accumbens Affects the Cingulate Gyrus and Vice Versa. Brain Sci 2019; 9:brainsci9010005. [PMID: 30621216 PMCID: PMC6356752 DOI: 10.3390/brainsci9010005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 12/30/2018] [Indexed: 12/20/2022] Open
Abstract
The nucleus accumbens (NA) and the cingulate gyrus (CG) are two vital limbic brain structures. They have attracted attention as deep brain stimulation (DBS) targets in the treatment of common refractory psychiatric illness. The primary purpose of this article was to review the current knowledge regarding the way that NA DBS affects the CG and vice versa. Methodologically, a thorough literature review was performed. According to the current literature, NA DBS modulates the function of several brain areas including the CG cortex. It specifically causes activation in the ipsilateral CG cortex and voltage-dependent reduction of its blood oxygenation. It also reverses anterior mid-CG cortex dysfunction and decreases metabolism in the subgenual CG. Moreover, NA DBS that induces mirth inhibits the function of the anterior CG cortex and enhances effective connectivity from anterior CG to the ventral striatum. On the other hand, although it is highly probable that CG DBS affects the NA, the exact nature of its effects remains unclear. Despite the increasing interest in psychiatric DBS, the available data on how NA DBS affects the CG and vice versa are restricted. This conclusion probably reflects the high complexity of the limbic circuits and necessitates further research.
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Cassimjee N, van Coller R, Slabbert P, Fletcher L, Vaidyanathan J. Longitudinal neuropsychological outcomes in treatment-resistant depression following bed nucleus of the stria terminalis-area deep brain stimulation: a case review. Neurocase 2018; 24:231-237. [PMID: 30507338 DOI: 10.1080/13554794.2018.1549680] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Studies have demonstrated the effectiveness of deep brain stimulation (DBS) as a treatment modality for psychiatric conditions. We present a case reviewing the longitudinal neuropsychological performance outcomes following bed nucleus of the stria terminalis-area (BNST) DBS in a patient with treatment-resistant depression (TRD). The cognitive safety of DBS is well documented for various targets, however cognitive outcomes of BNST-area DBS have not been extensively reported for patients with TRD. Neuropsychological assessment was conducted pre- and post-DBS. Twelve months following DBS, augmented general cognitive performance was observed with significant changes in specific domains.
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Affiliation(s)
- Nafisa Cassimjee
- a Department of Psychology , University of Pretoria , Pretoria , South Africa
| | - Riaan van Coller
- b Department of Neurology , University of Pretoria , South Africa
| | - Pieter Slabbert
- c Neurosurgeon , Pretoria East Hospital , Pretoria , South Africa
| | - Lizelle Fletcher
- d Department of Statistics , University of Pretoria , Pretoria , South Africa
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Targeted neural network interventions for auditory hallucinations: Can TMS inform DBS? Schizophr Res 2018; 195:455-462. [PMID: 28969932 PMCID: PMC8141945 DOI: 10.1016/j.schres.2017.09.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Revised: 08/30/2017] [Accepted: 09/14/2017] [Indexed: 12/30/2022]
Abstract
The debilitating and refractory nature of auditory hallucinations (AH) in schizophrenia and other psychiatric disorders has stimulated investigations into neuromodulatory interventions that target the aberrant neural networks associated with them. Internal or invasive forms of brain stimulation such as deep brain stimulation (DBS) are currently being explored for treatment-refractory schizophrenia. The process of developing and implementing DBS is limited by symptom clustering within psychiatric constructs as well as a scarcity of causal tools with which to predict response, refine targeting or guide clinical decisions. Transcranial magnetic stimulation (TMS), an external or non-invasive form of brain stimulation, has shown some promise as a therapeutic intervention for AH but remains relatively underutilized as an investigational probe of clinically relevant neural networks. In this editorial, we propose that TMS has the potential to inform DBS by adding individualized causal evidence to an evaluation processes otherwise devoid of it in patients. Although there are significant limitations and safety concerns regarding DBS, the combination of TMS with computational modeling of neuroimaging and neurophysiological data could provide critical insights into more robust and adaptable network modulation.
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Bentzley BS, Pannu J, Badran BW, Halpern CH, Williams NR. It takes time to tune. ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:171. [PMID: 28480207 PMCID: PMC5401673 DOI: 10.21037/atm.2017.03.49] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/25/2017] [Accepted: 02/06/2017] [Indexed: 11/06/2022]
Affiliation(s)
- Brandon S. Bentzley
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Jaspreet Pannu
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Bashar W. Badran
- Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston, SC, USA
| | - Casey H. Halpern
- Department of Neurosurgery, Stanford University, Stanford, CA, USA
| | - Nolan R. Williams
- Department of Psychiatry & Behavioral Sciences, Stanford University, Stanford, CA, USA
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A Neurophysiological Perspective on a Preventive Treatment against Schizophrenia Using Transcranial Electric Stimulation of the Corticothalamic Pathway. Brain Sci 2017; 7:brainsci7040034. [PMID: 28350371 PMCID: PMC5406691 DOI: 10.3390/brainsci7040034] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 03/11/2017] [Accepted: 03/24/2017] [Indexed: 12/16/2022] Open
Abstract
Schizophrenia patients are waiting for a treatment free of detrimental effects. Psychotic disorders are devastating mental illnesses associated with dysfunctional brain networks. Ongoing brain network gamma frequency (30–80 Hz) oscillations, naturally implicated in integrative function, are excessively amplified during hallucinations, in at-risk mental states for psychosis and first-episode psychosis. So, gamma oscillations represent a bioelectrical marker for cerebral network disorders with prognostic and therapeutic potential. They accompany sensorimotor and cognitive deficits already present in prodromal schizophrenia. Abnormally amplified gamma oscillations are reproduced in the corticothalamic systems of healthy humans and rodents after a single systemic administration, at a psychotomimetic dose, of the glutamate N-methyl-d-aspartate receptor antagonist ketamine. These translational ketamine models of prodromal schizophrenia are thus promising to work out a preventive noninvasive treatment against first-episode psychosis and chronic schizophrenia. In the present essay, transcranial electric stimulation (TES) is considered an appropriate preventive therapeutic modality because it can influence cognitive performance and neural oscillations. Here, I highlight clinical and experimental findings showing that, together, the corticothalamic pathway, the thalamus, and the glutamatergic synaptic transmission form an etiopathophysiological backbone for schizophrenia and represent a potential therapeutic target for preventive TES of dysfunctional brain networks in at-risk mental state patients against psychotic disorders.
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Langevin JP, Koek RJ, Schwartz HN, Chen JWY, Sultzer DL, Mandelkern MA, Kulick AD, Krahl SE. Neuromodulation for Treatment-Refractory PTSD. Fed Pract 2017; 34:20S-33S. [PMID: 30766304 PMCID: PMC6375501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Deep brain stimulation has been successful in treating Parkinson disease and essential tremor and is now reducing PTSD symptoms in the first patient enrolled in an early-phase safety trial.
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Affiliation(s)
- Jean-Philippe Langevin
- is a neurosurgeon, is a neurologist, is a radiologist, and is a neurophysiologist in the research and development service; and are mental/behavioral health physicians, is a psychologist, and is a mental/behavioral health physician in the psychiatry and mental health service; all at the VA Greater Los Angeles Healthcare System in California. Dr. Langevin, Dr. Koek, Dr. Chen, Dr. Sultzer, Dr. Mandelkern, and Dr. Krahl are professors at David Geffen School of Medicine at the University of California Los Angeles
| | - Ralph J Koek
- is a neurosurgeon, is a neurologist, is a radiologist, and is a neurophysiologist in the research and development service; and are mental/behavioral health physicians, is a psychologist, and is a mental/behavioral health physician in the psychiatry and mental health service; all at the VA Greater Los Angeles Healthcare System in California. Dr. Langevin, Dr. Koek, Dr. Chen, Dr. Sultzer, Dr. Mandelkern, and Dr. Krahl are professors at David Geffen School of Medicine at the University of California Los Angeles
| | - Holly N Schwartz
- is a neurosurgeon, is a neurologist, is a radiologist, and is a neurophysiologist in the research and development service; and are mental/behavioral health physicians, is a psychologist, and is a mental/behavioral health physician in the psychiatry and mental health service; all at the VA Greater Los Angeles Healthcare System in California. Dr. Langevin, Dr. Koek, Dr. Chen, Dr. Sultzer, Dr. Mandelkern, and Dr. Krahl are professors at David Geffen School of Medicine at the University of California Los Angeles
| | - James W Y Chen
- is a neurosurgeon, is a neurologist, is a radiologist, and is a neurophysiologist in the research and development service; and are mental/behavioral health physicians, is a psychologist, and is a mental/behavioral health physician in the psychiatry and mental health service; all at the VA Greater Los Angeles Healthcare System in California. Dr. Langevin, Dr. Koek, Dr. Chen, Dr. Sultzer, Dr. Mandelkern, and Dr. Krahl are professors at David Geffen School of Medicine at the University of California Los Angeles
| | - David L Sultzer
- is a neurosurgeon, is a neurologist, is a radiologist, and is a neurophysiologist in the research and development service; and are mental/behavioral health physicians, is a psychologist, and is a mental/behavioral health physician in the psychiatry and mental health service; all at the VA Greater Los Angeles Healthcare System in California. Dr. Langevin, Dr. Koek, Dr. Chen, Dr. Sultzer, Dr. Mandelkern, and Dr. Krahl are professors at David Geffen School of Medicine at the University of California Los Angeles
| | - Mark A Mandelkern
- is a neurosurgeon, is a neurologist, is a radiologist, and is a neurophysiologist in the research and development service; and are mental/behavioral health physicians, is a psychologist, and is a mental/behavioral health physician in the psychiatry and mental health service; all at the VA Greater Los Angeles Healthcare System in California. Dr. Langevin, Dr. Koek, Dr. Chen, Dr. Sultzer, Dr. Mandelkern, and Dr. Krahl are professors at David Geffen School of Medicine at the University of California Los Angeles
| | - Alexis D Kulick
- is a neurosurgeon, is a neurologist, is a radiologist, and is a neurophysiologist in the research and development service; and are mental/behavioral health physicians, is a psychologist, and is a mental/behavioral health physician in the psychiatry and mental health service; all at the VA Greater Los Angeles Healthcare System in California. Dr. Langevin, Dr. Koek, Dr. Chen, Dr. Sultzer, Dr. Mandelkern, and Dr. Krahl are professors at David Geffen School of Medicine at the University of California Los Angeles
| | - Scott E Krahl
- is a neurosurgeon, is a neurologist, is a radiologist, and is a neurophysiologist in the research and development service; and are mental/behavioral health physicians, is a psychologist, and is a mental/behavioral health physician in the psychiatry and mental health service; all at the VA Greater Los Angeles Healthcare System in California. Dr. Langevin, Dr. Koek, Dr. Chen, Dr. Sultzer, Dr. Mandelkern, and Dr. Krahl are professors at David Geffen School of Medicine at the University of California Los Angeles
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Casquero-Veiga M, Hadar R, Pascau J, Winter C, Desco M, Soto-Montenegro ML. Response to Deep Brain Stimulation in Three Brain Targets with Implications in Mental Disorders: A PET Study in Rats. PLoS One 2016; 11:e0168689. [PMID: 28033356 PMCID: PMC5199108 DOI: 10.1371/journal.pone.0168689] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2016] [Accepted: 12/05/2016] [Indexed: 12/11/2022] Open
Abstract
Objective To investigate metabolic changes in brain networks by deep brain stimulation (DBS) of the medial prefrontal cortex (mPFC), nucleus accumbens (NAcc) and dorsomedial thalamus (DM) using positron emission tomography (PET) in naïve rats. Methods 43 male Wistar rats underwent stereotactic surgery and concentric bipolar platinum-iridium electrodes were bilaterally implanted into one of the three brain sites. [18F]-fluoro-2-deoxy-glucose-PET (18FDG-PET) and computed tomography (CT) scans were performed at the 7th (without DBS) and 9th day (with DBS) after surgery. Stimulation period matched tracer uptake period. Images were acquired with a small-animal PET-CT scanner. Differences in glucose uptake between groups were assessed with Statistical Parametric Mapping. Results DBS induced site-specific metabolic changes, although a common increased metabolic activity in the piriform cortex was found for the three brain targets. mPFC-DBS increased metabolic activity in the striatum, temporal and amygdala, and reduced it in the cerebellum, brainstem (BS) and periaqueductal gray matter (PAG). NAcc-DBS increased metabolic activity in the subiculum and olfactory bulb, and decreased it in the BS, PAG, septum and hypothalamus. DM-DBS increased metabolic activity in the striatum, NAcc and thalamus and decreased it in the temporal and cingulate cortex. Conclusions DBS induced significant changes in 18FDG uptake in brain regions associated with the basal ganglia-thalamo-cortical circuitry. Stimulation of mPFC, NAcc and DM induced different patterns of 18FDG uptake despite interacting with the same circuitries. This may have important implications to DBS research suggesting individualized target selection according to specific neural modulatory requirements.
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Affiliation(s)
- Marta Casquero-Veiga
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
| | - Ravit Hadar
- Department of Psychiatry and Psychotherapy, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Javier Pascau
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Spain
| | - Christine Winter
- Department of Psychiatry and Psychotherapy, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Manuel Desco
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
- Departamento de Bioingeniería e Ingeniería Aeroespacial, Universidad Carlos III de Madrid, Spain
- * E-mail:
| | - María Luisa Soto-Montenegro
- CIBER de Salud Mental (CIBERSAM), Madrid, Spain
- Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain
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Five-Year Follow-Up of Bilateral Epidural Prefrontal Cortical Stimulation for Treatment-Resistant Depression. Brain Stimul 2016; 9:897-904. [PMID: 27443912 DOI: 10.1016/j.brs.2016.06.054] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 06/22/2016] [Accepted: 06/25/2016] [Indexed: 12/23/2022] Open
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De Jesus S, Almeida L, Peng-Chen Z, Okun MS, Hess CW. Novel targets and stimulation paradigms for deep brain stimulation. Expert Rev Neurother 2015; 15:1067-80. [DOI: 10.1586/14737175.2015.1083421] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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