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Schutter DJ, Smits F, Klaus J. Mind matters: A narrative review on affective state-dependency in non-invasive brain stimulation. Int J Clin Health Psychol 2023; 23:100378. [PMID: 36866122 PMCID: PMC9971283 DOI: 10.1016/j.ijchp.2023.100378] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 02/03/2023] [Indexed: 02/18/2023] Open
Abstract
Variability in findings related to non-invasive brain stimulation (NIBS) have increasingly been described as a result of differences in neurophysiological state. Additionally, there is some evidence suggesting that individual differences in psychological states may correlate with the magnitude and directionality of effects of NIBS on the neural and behavioural level. In this narrative review, it is proposed that the assessment of baseline affective states can quantify non-reductive properties which are not readily accessible to neuroscientific methods. Particularly, affective-related states are theorized to correlate with physiological, behavioural and phenomenological effects of NIBS. While further systematic research is needed, baseline psychological states are suggested to provide a complementary cost-effective source of information for understanding variability in NIBS outcomes. Implementing measures of psychological state may potentially contribute to increasing the sensitivity and specificity of results in experimental and clinical NIBS studies.
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Affiliation(s)
- Dennis J.L.G. Schutter
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
| | - Fenne Smits
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
- Brain Research & Innovation Centre, Ministry of Defence, Utrecht, the Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, The Netherlands
| | - Jana Klaus
- Department of Experimental Psychology, Helmholtz Institute, Utrecht University, Utrecht, The Netherlands
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Chen M, Chen Z, Xiao X, Zhou L, Fu R, Jiang X, Pang M, Xia J. Corticospinal circuit neuroplasticity may involve silent synapses: Implications for functional recovery facilitated by neuromodulation after spinal cord injury. IBRO Neurosci Rep 2022; 14:185-194. [PMID: 36824667 PMCID: PMC9941655 DOI: 10.1016/j.ibneur.2022.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 08/15/2022] [Indexed: 10/15/2022] Open
Abstract
Spinal cord injury (SCI) leads to devastating physical consequences, such as severe sensorimotor dysfunction even lifetime disability, by damaging the corticospinal system. The conventional opinion that SCI is intractable due to the poor regeneration of neurons in the adult central nervous system (CNS) needs to be revisited as the CNS is capable of considerable plasticity, which underlie recovery from neural injury. Substantial spontaneous neuroplasticity has been demonstrated in the corticospinal motor circuitry following SCI. Some of these plastic changes appear to be beneficial while others are detrimental toward locomotor function recovery after SCI. The beneficial corticospinal plasticity in the spared corticospinal circuits can be harnessed therapeutically by multiple contemporary neuromodulatory approaches, especially the electrical stimulation-based modalities, in an activity-dependent manner to improve functional outcomes in post-SCI rehabilitation. Silent synapse generation and unsilencing contribute to profound neuroplasticity that is implicated in a variety of neurological disorders, thus they may be involved in the corticospinal motor circuit neuroplasticity following SCI. Exploring the underlying mechanisms of silent synapse-mediated neuroplasticity in the corticospinal motor circuitry that may be exploited by neuromodulation will inform a novel direction for optimizing therapeutic repair strategies and rehabilitative interventions in SCI patients.
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Key Words
- AMPARs, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptors
- BDNF, brain-derived neurotrophic factor
- BMIs, brain-machine interfaces
- CPG, central pattern generator
- CST, corticospinal tract
- Corticospinal motor circuitry
- DBS, deep brain stimulation
- ESS, epidural spinal stimulation
- MEPs, motor-evoked potentials
- NHPs, non-human primates
- NMDARs, N-methyl-d-aspartate receptors
- Neuromodulation
- Neuroplasticity
- PSNs, propriospinal neurons
- Rehabilitation
- SCI, spinal cord injury
- STDP, spike timing-dependent plasticity
- Silent synapses
- Spinal cord injury
- TBS, theta burst stimulation
- TMS, transcranial magnetic stimulation
- TrkB, tropomyosin-related kinase B
- cTBS, continuous TBS
- iTBS, intermittent TBS
- mTOR, mammalian target of rapamycin
- rTMS, repetitive TMS
- tDCS, transcranial direct current stimulation
- tcSCS, transcutaneous spinal cord stimulation
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Affiliation(s)
- Mingcong Chen
- Department of Orthopedics and Traumatology, Shenzhen University General Hospital, Shenzhen, Guangdong 518055, China
| | - Zuxin Chen
- Shenzhen Key Laboratory of Drug Addiction, Shenzhen Neher Neural Plasticity Laboratory, the Brain Cognition and Brain Disease Institute, Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences (CAS); Shenzhen-Hong Kong Institute of Brain Science-Shenzhen Fundamental Research Institutions, Shenzhen, Guangdong 518055, China
| | - Xiao Xiao
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Ministry of Education; Behavioral and Cognitive Neuroscience Center, Institute of Science and Technology for Brain-Inspired Intelligence; MOE Frontiers Center for Brain Science, Fudan University, Shanghai 200433, China
| | - Libing Zhou
- Guangdong-Hongkong-Macau CNS Regeneration Institute of Jinan University, Key Laboratory of CNS Regeneration (Jinan University)-Ministry of Education, Guangzhou, Guangdong 510632, China
| | - Rao Fu
- Department of Anatomy, School of Medicine, Sun Yat-sen University, Shenzhen, Guangdong 518100, China
| | - Xian Jiang
- Institute of Neurological and Psychiatric Disorder, Shenzhen Bay laboratory, Shenzhen, Guangdong 518000, China
| | - Mao Pang
- Department of Spine Surgery, the Third Affiliated Hospital of Sun Yat-sen University, Guangdong Provincial Center for Engineering and Technology Research of Minimally Invasive Spine Surgery, Guangzhou, Guangdong 510630, China
| | - Jianxun Xia
- Department of Basic Medical Sciences, Yunkang School of Medicine and Health, Nanfang College, Guangzhou, Guangdong 510970, China,Corresponding author.
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Kallioniemi E, Awiszus F, Pitkänen M, Julkunen P. Fast acquisition of resting motor threshold with a stimulus-response curve - Possibility or hazard for transcranial magnetic stimulation applications? Clin Neurophysiol Pract 2022; 7:7-15. [PMID: 35024510 PMCID: PMC8733273 DOI: 10.1016/j.cnp.2021.10.005] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 09/15/2021] [Accepted: 10/05/2021] [Indexed: 11/24/2022] Open
Abstract
Objective Previous research has suggested that transcranial magnetic stimulation (TMS) related cortical excitability measures could be estimated quickly using stimulus-response curves with short interstimulus intervals (ISIs). Here we evaluated the resting motor threshold (rMT) estimated with these curves. Methods Stimulus-response curves were measured with three ISIs: 1.2-2 s, 2-3 s, and 3-4 s. Each curve was formed with 108 stimuli using stimulation intensities ranging from 0.75 to 1.25 times the rMTguess, which was estimated based on motor evoked potential (MEP) amplitudes of three scout responses. Results The ISI did not affect the rMT estimated from the curves (F = 0.235, p = 0.683) or single-trial MEP amplitudes at the group level (F = 0.90, p = 0.405), but a significant subject by ISI interaction (F = 3.64; p < 0.001) was detected in MEP amplitudes. No trend was observed which ISI was most excitable, as it varied between subjects. Conclusions At the group level, the stimulus-response curves are unaffected by the short ISI. At the individual level, these curves are highly affected by the ISI. Significance Estimating rMT using stimulus-response curves with short ISIs impacts the rMT estimate and should be avoided in clinical and research TMS applications.
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Key Words
- APB, abductor pollicis brevis
- EMG, electromyography
- ISI, interstimulus interval
- Interstimulus interval
- MEP, motor evoked potential
- MRI, magnetic resonance imaging
- MSO, maximum stimulator output
- Motor evoked potential
- Motor threshold
- SI, stimulation intensity
- Stimulus-response curve
- TMS, transcranial magnetic stimulation
- rMT, resting motor threshold
- rMTRR, resting motor threshold estimated with the Rossini-Rothwell method
- rMTestimate, resting motor threshold estimated with stimulus–response curves
- rMTguess, resting motor threshold estimated with prior information and three scout pulses
- rMTthreshold, resting motor threshold estimated with the threshold-hunting method
- rMTtrue, true resting motor threshold in simulations
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Affiliation(s)
- Elisa Kallioniemi
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States
| | - Friedemann Awiszus
- Neuromuscular Research Group at the Department of Orthopaedics, Otto-von-Guericke University, Magdeburg, Germany
| | - Minna Pitkänen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland
| | - Petro Julkunen
- Department of Applied Physics, University of Eastern Finland, Kuopio, Finland.,Department of Clinical Neurophysiology, Kuopio University Hospital, Kuopio, Finland
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Forman-Hoffman VL, Nelson BW, Ranta K, Nazander A, Hilgert O, de Quevedo J. Significant reduction in depressive symptoms among patients with moderately-severe to severe depressive symptoms after participation in a therapist-supported, evidence-based mobile health program delivered via a smartphone app. Internet Interv 2021; 25:100408. [PMID: 34401367 PMCID: PMC8350582 DOI: 10.1016/j.invent.2021.100408] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 05/20/2021] [Accepted: 06/02/2021] [Indexed: 01/04/2023] Open
Abstract
Depression is a debilitating disorder associated with poor health outcomes, including increased comorbidity and early mortality. Despite the advent of new digital health interventions, few have been tested among patients with more severe forms of depression. As such, in an intent-to-treat study we examined whether 218 patients with at least moderately severe depressive symptoms (PHQ-9 ≥ 15) experienced significant reductions in depressive symptoms after participation in a therapist-supported, evidence-based mobile health (mHealth) program, Meru Health Program (MHP). Patients with moderately severe and severe depressive symptoms at pre-program assessment experienced significant decreases in depressive symptoms at end-of treatment (mean [standard deviation] PHQ-9 reduction = 8.30 [5.03], Hedges' g = 1.64, 95% CI [1.44, 1.85]). Also, 34% of patients with at least moderately severe depressive symptoms at baseline and 29.9% of patients with severe depressive symptoms (PHQ-9 ≥ 20) at baseline responded to the intervention at end-of-treatment, defined as experiencing ≥50% reduction in PHQ-9 score and a post-program PHQ-9 score lower than 10. Limitations include use lack of a control group and no clinical diagnostic information. Future randomized trials are warranted to test the MHP as a scalable solution for patients with more severe depressive symptoms.
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Affiliation(s)
| | - Benjamin W. Nelson
- Meru Health Inc., San Mateo, CA, USA
- University of North Carolina at Chapel Hill, Department of Psychology and Neuroscience, Chapel Hill, NC, USA
| | | | | | | | - Joao de Quevedo
- Translational Psychiatry Program, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
- Center of Excellence on Mood Disorders, Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, USA
- Neuroscience Graduate Program, The University of Texas MD Anderson Cancer Center UTHealth Graduate School of Biomedical Sciences, Houston, TX, USA
- Translational Psychiatry Laboratory, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
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Sharma H, Vishnu V, Kumar N, Sreenivas V, Rajeswari M, Bhatia R, Sharma R, Srivastava MP. Efficacy of Low-Frequency Repetitive Transcranial Magnetic Stimulation in Ischemic Stroke: A Double-Blind Randomized Controlled Trial. Arch Rehabil Res Clin Transl 2021; 2:100039. [PMID: 33543068 PMCID: PMC7853333 DOI: 10.1016/j.arrct.2020.100039] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Objective To investigate the role of low-frequency repetitive transcranial magnetic stimulation (rTMS) along with conventional physiotherapy in the functional recovery of patients with subacute ischemic stroke. Design Double-blind, parallel group, randomized controlled trial. Setting The outpatient department of a tertiary hospital participants: first ever ischemic stroke patients (N=96) in the previous 15 days were recruited and were randomized after a run-in period of 75±7 days into real rTMS (n=47) and sham rTMS (n=49) groups. Intervention Conventional physical therapy was given to both the groups for 90±7 days postrecruitment. Total 10 sessions of low-frequency rTMS on contralesional premotor cortex was administered to real rTMS group (n=47) over a period of 2 weeks followed by physiotherapy regime for 45-50 minutes. Main Outcome Measures The primary efficacy outcomes were change in modified Barthel Index (mBI) score (pre- to postscore) and proportion of participants with mBI score more than 90, measured at 90±7 days postrecruitment. The secondary outcomes were change in Fugl-Meyer Assessment–upper extremity, Fugl-Meyer Assessment–lower extremity, Hamilton Depression Scale, modified Rankin Scale, and National Institute of Health and Stroke Scale (pre- to post-rTMS) scores at 90±7 days post recruitment. Results Modified intention to treat analysis showed a significant increase in the mBI score from pre- to post-rTMS in real rTMS group (4.96±4.06) versus sham rTMS group (2.65±3.25). There was no significant difference in proportion of patients with mBI>90 (55% vs 59%; P=.86) at 3 months between the groups. Conclusion In patients with subacute ischemic stroke, 1-Hz low-frequency rTMS on contralesional premotor cortex along with conventional physical therapy resulted in significant change in mBI score.
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Key Words
- BI, Barthel Index
- EEG, electroencephalogram
- HAMD, Hamilton Depression Scale
- MCID, minimal clinically important difference
- MEP, motor evoked potential
- NIHSS, National Institutes of Health and Stroke Scale
- RCT, randomized controlled trial
- Rehabilitation
- Stroke
- TMS, transcranial magnetic stimulation
- Transcranial magnetic stimulation
- mBI, modified Barthel Index
- mRS, modified Rankin Scale
- rTMS, repetitive transcranial magnetic stimulation
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Affiliation(s)
- H. Sharma
- Department of Neurology, All India Institutes of Medical Sciences, New Delhi
| | - V.Y. Vishnu
- Department of Neurology, All India Institutes of Medical Sciences, New Delhi
| | - N. Kumar
- Department of Psychiatry, All India Institutes of Medical Sciences, New Delhi
| | - V. Sreenivas
- Department of Biostatistics, All India Institutes of Medical Sciences, New Delhi
| | - M.R. Rajeswari
- Department of Biochemistry, All India Institutes of Medical Sciences, New Delhi, India
| | - R. Bhatia
- Department of Neurology, All India Institutes of Medical Sciences, New Delhi
| | - R. Sharma
- Department of Neurology, All India Institutes of Medical Sciences, New Delhi
| | - M.V. Padma Srivastava
- Department of Neurology, All India Institutes of Medical Sciences, New Delhi
- Corresponding author M.V. Padma Srivastava, MD, DM, Department of Neurology, RN 708, CN Centre, All India Institute of Medical Sciences, New Delhi, Delhi, India.
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Powell ES, Westgate PM, Goldstein LB, Sawaki L. Absence of Motor-Evoked Potentials Does Not Predict Poor Recovery in Patients With Severe-Moderate Stroke: An Exploratory Analysis. Arch Rehabil Res Clin Transl 2019; 1:100023. [PMID: 33543054 PMCID: PMC7853378 DOI: 10.1016/j.arrct.2019.100023] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023] Open
Abstract
Objective To better understand the role of the presence or absence of motor-evoked potentials (MEPs) in predicting functional outcomes following a severe-moderate stroke. Design Retrospective exploratory analysis. We compared the effects of the stimulation condition (active or sham), MEP status (+ or −), and a combination of stimulation condition and MEP status on outcome. Within-group and between-group changes were assessed with longitudinal repeated measures analysis of variance and longitudinal repeated measures analysis of covariance, respectively. The proportions of participants who achieved minimal clinically important differences (MCIDs) for the main outcome measures were calculated. Setting University research laboratory within a rehabilitation hospital. Participants A total of 129 subjects with severe-moderate stroke-related motor impairments who participated in previous studies combining neuromodulation and motor training Interventions Neuromodulation (active or sham) and motor training. Main Outcome Measures Fugl-Meyer Assessment (FMA) and Action Research Arm Test (ARAT). Results When participants were grouped by stimulation condition or MEP status, all groups improved from baseline to immediate postintervention and follow-up evaluations (all P<.05). Analysis by stimulation condition and MEP status found that the MEP−/active group improved by 4.2 points on FMA (P<.0001) and 1.8 on ARAT (P=.003) post intervention. The MEP+/active group improved by 5.7 points on FMA (P<.0001) and 3.9 points on ARAT (P<.0001) post intervention. There were no between-group differences (P>.05). Regarding MCIDs, in the MEP−/active group, 14.5% of individuals reached MCID on FMA and 8.3% on ARAT post intervention. In the MEP+/active group, 33.3% of individuals reached MCID on FMA and 27.3% on ARAT post intervention. Conclusion As expected, the MEP+ group had the greatest improvement in motor function. However, it was shown that individuals without MEPs can also achieve meaningful changes, as reflected by MCID, when neuromodulation is paired with motor training. To our knowledge, this is the first study to differentiate the effects of neuromodulation by MEP status.
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Affiliation(s)
- Elizabeth S Powell
- Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, Kentucky
| | - Philip M Westgate
- Department of Biostatistics, College of Public Health, University of Kentucky, Lexington, Kentucky
| | - Larry B Goldstein
- Department of Neurology, University of Kentucky, Lexington, Kentucky
| | - Lumy Sawaki
- Department of Physical Medicine and Rehabilitation, University of Kentucky, Lexington, Kentucky
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Ye H, Kaszuba S. Neuromodulation with electromagnetic stimulation for seizure suppression: From electrode to magnetic coil. IBRO Rep 2019; 7:26-33. [PMID: 31360792 PMCID: PMC6639724 DOI: 10.1016/j.ibror.2019.06.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2019] [Accepted: 06/25/2019] [Indexed: 12/31/2022] Open
Abstract
Non-invasive brain tissue stimulation with a magnetic coil provides several irreplaceable advantages over that with an implanted electrode, in altering neural activities under pathological situations. We reviewed clinical cases that utilized time-varying magnetic fields for the treatment of epilepsy, and the safety issues related to this practice. Animal models have been developed to foster understanding of the cellular/molecular mechanisms underlying magnetic control of epileptic activity. These mechanisms include (but are not limited to) (1) direct membrane polarization by the magnetic field, (2) depolarization blockade by the deactivation of ion channels, (3) alteration in synaptic transmission, and (4) interruption of ephaptic interaction and cellular synchronization. Clinical translation of this technology could be improved through the advancement of magnetic design, optimization of stimulation protocols, and evaluation of the long-term safety. Cellular and molecular studies focusing on the mechanisms of magnetic stimulation are of great value in facilitating this translation.
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Key Words
- 4-AP, 4-aminopyridine
- Animal models
- CD50, convulsant dose
- Cellular mechanisms
- DBS, deep brain stimulation
- EEG, electroencephalography
- ELF-MF, extremely low frequency magnetic fields
- EcoG, electrocorticography
- Epilepsy
- GABA, gamma-aminobutyric acid
- HFS, high frequency stimulation
- KA, kainic acid
- LD50, lethal dose
- LTD, long-term depression
- LTP, long-term potential
- MEG, magnetoencephalography
- MRI, magnetic resonance imaging
- Magnetic stimulation
- NMDAR, N-methyl-d-aspartate receptor
- PTZ, pentylenetetrazol
- REM, rapid eye movement
- SMF, static magnetic field
- TES, transcranial electrical stimulation
- TLE, temporal lobe epilepsy
- TMS, transcranial magnetic stimulation
- rTMS, repetitive transcranial magnetic stimulation
- tDCS, transcranial direct-current stimulation
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Affiliation(s)
- Hui Ye
- Department of Biology, Loyola University Chicago, Chicago, 1032 W. Sheridan Rd., IL, 60660, United States
| | - Stephanie Kaszuba
- Chicago Medical School, Rosalind Franklin University of Medicine and Science, 3333 Green Bay Rd., North Chicago, IL, 60064, United States
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Nakagawa K, Nakazawa K. Static magnetic field stimulation applied over the cervical spinal cord can decrease corticospinal excitability in finger muscle. Clin Neurophysiol Pract 2018; 3:49-53. [PMID: 30215008 DOI: 10.1016/j.cnp.2018.02.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 01/19/2018] [Accepted: 02/11/2018] [Indexed: 12/23/2022] Open
Abstract
Static magnetic field stimulation was delivered on cervical spinal cord. Trans-spinal static magnetic field stimulation (tsSMS) decreased MEP amplitudes. The suppressive effect of tsSMS was not maintained after the intervention ceased.
Objective Transcranial static magnetic field stimulation has recently been demonstrated to modulate cortical excitability. In the present study, we investigated the effect of transspinal static magnetic field stimulation (tsSMS) on excitability of the corticospinal tract. Methods A compact magnet for tsSMS (0.45 Tesla) or a stainless steel cylinder for sham stimulation was positioned over the neck (C8 level) of 24 able-bodied subjects for 15 min. Using 120% of the resting motor threshold transcranial magnetic stimulation intensity, motor evoked potentials (MEPs) were measured from the first digital interosseous muscle before, during, and after the tsSMS or sham intervention. Results Compared with baseline MEP amplitudes were decreased during tsSMS, but not during sham stimulation. Additionally, during the intervention, MEP amplitudes were lower with tsSMS than sham stimulation, although these effects did not last after the intervention ceased. Conclusions The results suggest that static magnetic field stimulation of the spinal cord by a compact magnet can reduce the excitability of the corticospinal tract. Significance Transspinal static magnetic field stimulation may be a new non-invasive neuromodulatory tool for spinal cord stimulation. Its suppressive effect may be applied to patients who have pathological hyperexcitability of the spinal neural network.
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Akram H, Dayal V, Mahlknecht P, Georgiev D, Hyam J, Foltynie T, Limousin P, De Vita E, Jahanshahi M, Ashburner J, Behrens T, Hariz M, Zrinzo L. Connectivity derived thalamic segmentation in deep brain stimulation for tremor. Neuroimage Clin 2018; 18:130-142. [PMID: 29387530 PMCID: PMC5790021 DOI: 10.1016/j.nicl.2018.01.008] [Citation(s) in RCA: 113] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2017] [Revised: 12/23/2017] [Accepted: 01/13/2018] [Indexed: 02/02/2023]
Abstract
The ventral intermediate nucleus (VIM) of the thalamus is an established surgical target for stereotactic ablation and deep brain stimulation (DBS) in the treatment of tremor in Parkinson's disease (PD) and essential tremor (ET). It is centrally placed on a cerebello-thalamo-cortical network connecting the primary motor cortex, to the dentate nucleus of the contralateral cerebellum through the dentato-rubro-thalamic tract (DRT). The VIM is not readily visible on conventional MR imaging, so identifying the surgical target traditionally involved indirect targeting that relies on atlas-defined coordinates. Unfortunately, this approach does not fully account for individual variability and requires surgery to be performed with the patient awake to allow for intraoperative targeting confirmation. The aim of this study is to identify the VIM and the DRT using probabilistic tractography in patients that will undergo thalamic DBS for tremor. Four male patients with tremor dominant PD and five patients (three female) with ET underwent high angular resolution diffusion imaging (HARDI) (128 diffusion directions, 1.5 mm isotropic voxels and b value = 1500) preoperatively. Patients received VIM-DBS using an MR image guided and MR image verified approach with indirect targeting. Postoperatively, using parallel Graphical Processing Unit (GPU) processing, thalamic areas with the highest diffusion connectivity to the primary motor area (M1), supplementary motor area (SMA), primary sensory area (S1) and contralateral dentate nucleus were identified. Additionally, volume of tissue activation (VTA) corresponding to active DBS contacts were modelled. Response to treatment was defined as 40% reduction in the total Fahn-Tolosa-Martin Tremor Rating Score (FTMTRS) with DBS-ON, one year from surgery. Three out of nine patients had a suboptimal, long-term response to treatment. The segmented thalamic areas corresponded well to anatomically known counterparts in the ventrolateral (VL) and ventroposterior (VP) thalamus. The dentate-thalamic area, lay within the M1-thalamic area in a ventral and lateral location. Streamlines corresponding to the DRT connected M1 to the contralateral dentate nucleus via the dentate-thalamic area, clearly crossing the midline in the mesencephalon. Good response was seen when the active contact VTA was in the thalamic area with highest connectivity to the contralateral dentate nucleus. Non-responders had active contact VTAs outside the dentate-thalamic area. We conclude that probabilistic tractography techniques can be used to segment the VL and VP thalamus based on cortical and cerebellar connectivity. The thalamic area, best representing the VIM, is connected to the contralateral dentate cerebellar nucleus. Connectivity based segmentation of the VIM can be achieved in individual patients in a clinically feasible timescale, using HARDI and high performance computing with parallel GPU processing. This same technique can map out the DRT tract with clear mesencephalic crossing.
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Key Words
- AC, anterior commissure
- BEDPOSTX, Bayesian estimation of diffusion parameters obtained using sampling techniques X
- BET, brain extraction tool
- CI, confidence interval
- CON, connectivity
- Connectivity
- DBS
- DBS, deep brain stimulation
- DF, degrees of freedom
- DICOM, digital imaging and communications in medicine
- DRT
- DWI
- DWI, diffusion weighted imaging
- Deep brain stimulation
- Dentate nucleus
- Dentato-rubro-thalamic tract
- Diffusion weighted imaging
- EV, explanatory variable
- FLIRT, FMRIB's linear image registration tool
- FMRIB, Oxford centre for functional MRI of the brain
- FNIRT, FMRIB's non-linear image registration tool
- FSL, FMRIB's software library
- FoV, field of view
- GLM, general linear model
- HARDI, high angular resolution diffusion imaging
- HFS, high frequency stimulation
- IPG, implantable pulse generator
- LC, Levodopa challenge
- LEDD, l-DOPA equivalent daily dose
- M1, primary motor cortex
- MMS, mini-mental score
- MNI, Montreal neurological institute
- MPRAGE, magnetization-prepared rapid gradient-echo
- MPTP, 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine
- NHNN, National Hospital for Neurology and Neurosurgery
- NIfTI, neuroimaging informatics technology initiative
- PC, posterior commissure
- PD
- PFC, prefrontal cortex
- PMC, premotor cortex
- Parkinson's disease
- S1, primary sensory cortex
- SAR, specific absorption rate
- SD, standard deviation
- SE, standard error
- SMA, supplementary motor area
- SNR, signal-to-noise ratio
- SSEPI, single-shot echo planar imaging
- STN, subthalamic nucleus
- TFCE, threshold-free cluster enhancement
- TMS, transcranial magnetic stimulation
- Tremor
- UPDRS, unified Parkinson's disease rating scale
- VBM, voxel based morphometry
- VIM
- VL
- VL, ventral lateral
- VP, ventral posterior
- VTA, volume of tissue activated
- Ventrointermedialis
- Ventrolateral nucleus
- cZI, caudal zona incerta
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Affiliation(s)
- Harith Akram
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK.
| | - Viswas Dayal
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Philipp Mahlknecht
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Department of Neurology, Innsbruck Medical University, Innsbruck, Austria
| | - Dejan Georgiev
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Jonathan Hyam
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
| | - Thomas Foltynie
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Patricia Limousin
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Enrico De Vita
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Lysholm Department of Neuroradiology, National Hospital for Neurology and Neurosurgery, University College London NHS Foundation Trust, London, UK
| | - Marjan Jahanshahi
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - John Ashburner
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK
| | - Tim Behrens
- Wellcome Trust Centre for Neuroimaging, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Centre for Functional MRI of the Brain (FMRIB), John Radcliffe Hospital, Oxford OX3 9DU, UK
| | - Marwan Hariz
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Department of Clinical Neuroscience, Umeå University, Umeå, Sweden
| | - Ludvic Zrinzo
- Unit of Functional Neurosurgery, Sobell Department of Motor Neuroscience and Movement Disorders, UCL Institute of Neurology, Queen Square, London WC1N 3BG, UK; Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK
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Zhang Y, Yang Y, Si J, Xia X, He J, Jiang T. Influence of inter-stimulus interval of spinal cord stimulation in patients with disorders of consciousness: A preliminary functional near-infrared spectroscopy study. Neuroimage Clin 2017; 17:1-9. [PMID: 29619317 PMCID: PMC5883216 DOI: 10.1016/j.nicl.2017.09.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/12/2017] [Accepted: 09/23/2017] [Indexed: 11/30/2022]
Abstract
Spinal cord stimulation (SCS) is a promising treatment for disorders of consciousness (DOC), but the underlying mechanism and most effective procedures remain uncertain. To optimize the protocol, previous studies evaluated the frequency-specific effects of SCS on neurophysiological activities. However, whether and how the inter-stimulus interval (ISI) parameter affects the SCS neuromodulation in DOC remains unknown. We enrolled nine DOC patients who had implanted SCS devices and conducted three different durations of ISIs. Using functional near-infrared spectroscopy (fNIRS), we monitored the blood volume fluctuations in the prefrontal and occipital cortices during the SCS. The results showed that short stimuli (30 s) induced significant cerebral blood volume changes, especially in the prefrontal cortex, an important area in the consciousness system. By comparing the mean value of the responses from the first and the last block in each session, a shorter ISI was found to improve the blood volume in the prefrontal cortex. This phenomenon was more significant for the subgroup of patients with a favorable prognosis. These preliminary results imply that the ISI may be an important factor for SCS. The research paradigm proposed here also provides insights for further quantitative evaluations of the therapeutic effects of neuromodulation. Spinal cord stimulation rapidly evokes activity in consciousness-related brain areas. Inter-stimulus interval of neuromodulation is important for treating disorders of consciousness. Shorter inter-stimulus interval can better improve the blood volume in frontal area. Near-infrared spectroscopy is feasible for evaluating neuromodulation effects.
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Key Words
- ARAS, ascending reticular activating system
- CBF, cerebral blood flow
- DBS, deep brain stimulation
- DOC, disorders of consciousness
- Disorders of consciousness
- EEG, electroencephalography
- FWHM, full-width-at-half-maximum
- Functional near-infrared spectroscopy
- GOS, Glasgow Outcome Scale
- HbO, oxygenated hemoglobin
- HbR, deoxygenated hemoglobin
- HbT, total hemoglobin
- ISI, inter-stimulus interval
- Inter-stimulus interval
- JFKCRS-R, JFK Coma Recovery Scale
- LTP, long-term potentiation
- MBLL, modified Beer-Lambert law
- MCS, minimally conscious state
- MSN, medium spiny neuron
- Prefrontal cortex
- SCS, spinal cord stimulation
- Spinal cord stimulation
- TMS, transcranial magnetic stimulation
- VS, vegetative state
- fMRI, functional magnetic resonance imaging
- fNIRS, functional near-infrared spectroscopy
- rCBV, regional cerebral blood volume
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Affiliation(s)
- Yujin Zhang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China; National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Yi Yang
- Department of Neurosurgery, PLA Army General Hospital, Beijing 100700, China
| | - Juanning Si
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China; National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Xiaoyu Xia
- Department of Neurosurgery, PLA Army General Hospital, Beijing 100700, China
| | - Jianghong He
- Department of Neurosurgery, PLA Army General Hospital, Beijing 100700, China.
| | - Tianzi Jiang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China; National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China; Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China; CAS Center for Excellence in Brain Science, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China; Queensland Brain Institute, University of Queensland, St. Lucia, Queensland 4072, Australia.
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11
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Wandschneider B, Koepp MJ. Pharmaco fMRI: Determining the functional anatomy of the effects of medication. Neuroimage Clin 2016; 12:691-697. [PMID: 27766202 PMCID: PMC5067101 DOI: 10.1016/j.nicl.2016.10.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2016] [Accepted: 10/03/2016] [Indexed: 01/15/2023]
Abstract
Functional MRI studies have helped to elucidate underlying mechanisms in complex neurological and neuropsychiatric disorders. Disease processes often involve complex large-scale network interactions, extending beyond the presumed main disease focus. Given both the complexity of the clinical phenotype and the underlying dysfunctional brain circuits, so called pharmaco-fMRI (ph-MRI) studies probe pharmacological effects on functional neuro-anatomy, and can help to determine early treatment response, mechanisms of drug efficacy and side effects, and potentially advance CNS drug development. In this review, we discuss recent ph-MRI research in three major neuropsychiatric and neurological disorders and associated network alterations, namely selective serotonin and noradrenergic reuptake inhibitors in affective disorders and emotional processing circuits; antiepileptic drugs in epilepsy and cognitive networks; and stimulants in attention-deficit/hyperactivity disorder and networks of attention control. We conclude that ph-MRI studies show consistent and reproducible changes on disease relevant networks, and prove sensitive to early pharmacological effects on functional anatomy associated with disease. Further CNS drug research and development would benefit greatly from improved disease phenotyping, or biomarkers, using advanced imaging techniques.
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Key Words
- ACC, anterior cingulate cortex
- ADHD, attention-deficit/hyperactivity disorder
- AED, antiepileptic drugs
- BOLD, blood oxygen level-dependent signal
- Biomarker
- CBZ, carbamazepine
- CNS drug research
- CNS, central nervous system
- DAT, dopamine transporter
- Functional MRI
- JME, juvenile myoclonic epilepsy
- LEV, levetiracetam
- LTG, lamotrigine
- NaRI, noradrenergic reuptake inhibitors
- Neuroimaging
- OXC, oxcarbazepine
- Ph-MRI, pharmacological functional MRI
- Pharmacological
- SSRI, selective serotonin reuptake inhibitors
- TLE, temporal lobe epilepsy
- TMS, transcranial magnetic stimulation
- TPM, topiramate
- VPA, valproate
- ZNS, zonisamide
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Affiliation(s)
- Britta Wandschneider
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK; MRI Unit, Epilepsy Society, Chalfont St Peter, UK
| | - Matthias J Koepp
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK; MRI Unit, Epilepsy Society, Chalfont St Peter, UK
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Gersner R, Oberman L, Sanchez MJ, Chiriboga N, Kaye HL, Pascual-Leone A, Libenson M, Roth Y, Zangen A, Rotenberg A. H-coil repetitive transcranial magnetic stimulation for treatment of temporal lobe epilepsy: A case report. Epilepsy Behav Case Rep 2016; 5:52-6. [PMID: 27114902 PMCID: PMC4832041 DOI: 10.1016/j.ebcr.2016.03.001] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 02/29/2016] [Accepted: 03/04/2016] [Indexed: 01/02/2023]
Abstract
Low frequency repetitive TMS (rTMS) of a cortical seizure focus is emerging as an antiepileptic treatment. While conventional rTMS stimulators activate only superficial cortical areas, reaching deep epileptic foci, for example in temporal lobe epilepsy (TLE), is possible using specially designed H-coils. We report the results of rTMS in a young adult with pharmacoresistant bilateral TLE who underwent three courses (of 10, 15, and 30 daily sessions) of unilateral rTMS over the hemisphere from which seizures originated most often. Seizure frequency was assessed before and after each block of rTMS sessions, as was the tolerability of the procedure. Seizure frequency declined significantly, by 50 to 70% following each rTMS course. All sessions were well-tolerated.
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Affiliation(s)
- R Gersner
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States; Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - L Oberman
- Department of Psychiatry and Human Behavior, Warren Alpert Medical School of Brown University, Providence, RI, United States
| | - M J Sanchez
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - N Chiriboga
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - H L Kaye
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - A Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
| | - M Libenson
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States
| | - Y Roth
- Department of Life Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - A Zangen
- Department of Life Sciences, Ben-Gurion University, Beer-Sheva, Israel
| | - A Rotenberg
- Neuromodulation Program, Division of Epilepsy and Clinical Neurophysiology, Department of Neurology, Boston Children's Hospital, Harvard Medical School, Boston, MA, United States; Berenson-Allen Center for Noninvasive Brain Stimulation, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States
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13
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Val-Laillet D, Aarts E, Weber B, Ferrari M, Quaresima V, Stoeckel L, Alonso-Alonso M, Audette M, Malbert C, Stice E. Neuroimaging and neuromodulation approaches to study eating behavior and prevent and treat eating disorders and obesity. Neuroimage Clin 2015; 8:1-31. [PMID: 26110109 PMCID: PMC4473270 DOI: 10.1016/j.nicl.2015.03.016] [Citation(s) in RCA: 275] [Impact Index Per Article: 30.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Revised: 03/18/2015] [Accepted: 03/19/2015] [Indexed: 12/11/2022]
Abstract
Functional, molecular and genetic neuroimaging has highlighted the existence of brain anomalies and neural vulnerability factors related to obesity and eating disorders such as binge eating or anorexia nervosa. In particular, decreased basal metabolism in the prefrontal cortex and striatum as well as dopaminergic alterations have been described in obese subjects, in parallel with increased activation of reward brain areas in response to palatable food cues. Elevated reward region responsivity may trigger food craving and predict future weight gain. This opens the way to prevention studies using functional and molecular neuroimaging to perform early diagnostics and to phenotype subjects at risk by exploring different neurobehavioral dimensions of the food choices and motivation processes. In the first part of this review, advantages and limitations of neuroimaging techniques, such as functional magnetic resonance imaging (fMRI), positron emission tomography (PET), single photon emission computed tomography (SPECT), pharmacogenetic fMRI and functional near-infrared spectroscopy (fNIRS) will be discussed in the context of recent work dealing with eating behavior, with a particular focus on obesity. In the second part of the review, non-invasive strategies to modulate food-related brain processes and functions will be presented. At the leading edge of non-invasive brain-based technologies is real-time fMRI (rtfMRI) neurofeedback, which is a powerful tool to better understand the complexity of human brain-behavior relationships. rtfMRI, alone or when combined with other techniques and tools such as EEG and cognitive therapy, could be used to alter neural plasticity and learned behavior to optimize and/or restore healthy cognition and eating behavior. Other promising non-invasive neuromodulation approaches being explored are repetitive transcranial magnetic stimulation (rTMS) and transcranial direct-current stimulation (tDCS). Converging evidence points at the value of these non-invasive neuromodulation strategies to study basic mechanisms underlying eating behavior and to treat its disorders. Both of these approaches will be compared in light of recent work in this field, while addressing technical and practical questions. The third part of this review will be dedicated to invasive neuromodulation strategies, such as vagus nerve stimulation (VNS) and deep brain stimulation (DBS). In combination with neuroimaging approaches, these techniques are promising experimental tools to unravel the intricate relationships between homeostatic and hedonic brain circuits. Their potential as additional therapeutic tools to combat pharmacorefractory morbid obesity or acute eating disorders will be discussed, in terms of technical challenges, applicability and ethics. In a general discussion, we will put the brain at the core of fundamental research, prevention and therapy in the context of obesity and eating disorders. First, we will discuss the possibility to identify new biological markers of brain functions. Second, we will highlight the potential of neuroimaging and neuromodulation in individualized medicine. Third, we will introduce the ethical questions that are concomitant to the emergence of new neuromodulation therapies.
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Key Words
- 5-HT, serotonin
- ADHD, attention deficit hyperactivity disorder
- AN, anorexia nervosa
- ANT, anterior nucleus of the thalamus
- B N, bulimia nervosa
- BAT, brown adipose tissue
- BED, binge eating disorder
- BMI, body mass index
- BOLD, blood oxygenation level dependent
- BS, bariatric surgery
- Brain
- CBF, cerebral blood flow
- CCK, cholecystokinin
- Cg25, subgenual cingulate cortex
- DA, dopamine
- DAT, dopamine transporter
- DBS, deep brain stimulation
- DBT, deep brain therapy
- DTI, diffusion tensor imaging
- ED, eating disorders
- EEG, electroencephalography
- Eating disorders
- GP, globus pallidus
- HD-tDCS, high-definition transcranial direct current stimulation
- HFD, high-fat diet
- HHb, deoxygenated-hemoglobin
- Human
- LHA, lateral hypothalamus
- MER, microelectrode recording
- MRS, magnetic resonance spectroscopy
- Nac, nucleus accumbens
- Neuroimaging
- Neuromodulation
- O2Hb, oxygenated-hemoglobin
- OCD, obsessive–compulsive disorder
- OFC, orbitofrontal cortex
- Obesity
- PD, Parkinson's disease
- PET, positron emission tomography
- PFC, prefrontal cortex
- PYY, peptide tyrosine tyrosine
- SPECT, single photon emission computed tomography
- STN, subthalamic nucleus
- TMS, transcranial magnetic stimulation
- TRD, treatment-resistant depression
- VBM, voxel-based morphometry
- VN, vagus nerve
- VNS, vagus nerve stimulation
- VS, ventral striatum
- VTA, ventral tegmental area
- aCC, anterior cingulate cortex
- dTMS, deep transcranial magnetic stimulation
- daCC, dorsal anterior cingulate cortex
- dlPFC, dorsolateral prefrontal cortex
- fMRI, functional magnetic resonance imaging
- fNIRS, functional near-infrared spectroscopy
- lPFC, lateral prefrontal cortex
- pCC, posterior cingulate cortex
- rCBF, regional cerebral blood flow
- rTMS, repetitive transcranial magnetic stimulation
- rtfMRI, real-time functional magnetic resonance imaging
- tACS, transcranial alternate current stimulation
- tDCS, transcranial direct current stimulation
- tRNS, transcranial random noise stimulation
- vlPFC, ventrolateral prefrontal cortex
- vmH, ventromedial hypothalamus
- vmPFC, ventromedial prefrontal cortex
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Affiliation(s)
| | - E. Aarts
- Radboud University, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - B. Weber
- Department of Epileptology, University Hospital Bonn, Germany
| | - M. Ferrari
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - V. Quaresima
- Department of Life, Health and Environmental Sciences, University of L'Aquila, Italy
| | - L.E. Stoeckel
- Massachusetts General Hospital, Harvard Medical School, USA
| | - M. Alonso-Alonso
- Beth Israel Deaconess Medical Center, Harvard Medical School, USA
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Riwkes S, Goldstein A, Gilboa-Schechtman E. The temporal unfolding of face processing in social anxiety disorder--a MEG study. Neuroimage Clin 2014; 7:678-87. [PMID: 25844308 PMCID: PMC4377840 DOI: 10.1016/j.nicl.2014.11.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/06/2014] [Revised: 10/10/2014] [Accepted: 11/01/2014] [Indexed: 11/04/2022]
Abstract
The current study is the first to use magnetoencephalography (MEG) to examine how individuals with social anxiety disorder (SAD) process emotional facial expressions (EFEs). We expected that, compared to healthy controls (HCs), participants with SAD will show an early (<200 ms post-stimulus) over-activation in the insula and the fusiform gyrus (FG, associated with the N170/M170 component), and later (>200 ms post-stimulus) over-activation in the dorsolateral prefrontal cortex (DLPFC). Individuals with SAD (n = 12) and healthy controls (HCs, n = 12) were presented with photographs of facial displays during MEG recording. As compared to the HC group, the SAD group showed a reduced M170 (right FG under-activation around 130–200 ms); early reduced activation in the right insula, and lower insular sensitivity to the type of EFE displayed. In addition, the SAD group showed a late over-activation in the right DLPFC. This unique EFE processing pattern in SAD suggests an early under-activation of cortical areas, possibly related to reduced emphasis on high spatial frequency information and greater early emphasis on low spatial frequency information. The late DLPFC over-activation in the SAD group may correlate to failures of cognitive control in this disorder. The importance of a temporal perspective for the understanding of facial processing in psychopathology is underlined. This study is the first to use MEG to study social anxiety disorder (SAD). SADs and controls viewed emotional facial expressions during MEG. Compared to controls, SADs showed reduced M170 (early fusiform gyrus activity). SADs presented a late over-activation in the right dorsolateral prefrontal cortex. The late frontal over-activity may correlate to failures of cognitive control in SAD.
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Key Words
- AFNI, analysis of functional neuroimages
- BDI, Beck Depression Inventory
- Cognitive control
- DLPFC, dorsolateral prefrontal cortex
- EEG, electroencephalography
- EFE, emotional facial expressions
- FG, fusiform gyrus
- FMRI, functional magnetic resonance imaging
- FNE, fear of negative evaluation
- Facial processing
- HC, healthy control
- HSF, high spatial frequency
- LSAS, Liebowitz Social Anxiety Scale
- LSF, low spatial frequency
- MEG, magnetoencephalography
- Magnetoenchephalography
- Regulation
- SA, social anxiety
- SAD, social anxiety disorder
- SAM, synthetic aperture modeling
- Social anxiety
- TMS, transcranial magnetic stimulation
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Affiliation(s)
- Sharon Riwkes
- Department of Psychology, Bar Ilan University, Ramat Gan 52900, Israel
| | - Abraham Goldstein
- Department of Psychology, Bar Ilan University, Ramat Gan 52900, Israel
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Schmidt-Wilcke T, Ichesco E, Hampson JP, Kairys A, Peltier S, Harte S, Clauw DJ, Harris RE. Resting state connectivity correlates with drug and placebo response in fibromyalgia patients. Neuroimage Clin 2014; 6:252-61. [PMID: 25379438 DOI: 10.1016/j.nicl.2014.09.007] [Citation(s) in RCA: 86] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/13/2014] [Revised: 07/08/2014] [Accepted: 09/11/2014] [Indexed: 11/21/2022]
Abstract
Fibromyalgia is a chronic pain syndrome characterized by widespread pain, fatigue, and memory and mood disturbances. Despite advances in our understanding of the underlying pathophysiology, treatment is often challenging. New research indicates that changes in functional connectivity between brain regions, as can be measured by magnetic resonance imaging (fcMRI) of the resting state, may underlie the pathogenesis of this and other chronic pain states. As such, this parameter may be able to be used to monitor changes in brain function associated with pharmacological treatment, and might also be able to predict treatment response. We performed a resting state fcMRI trial using a randomized, placebo-controlled, cross-over design to investigate mechanisms of action of milnacipran (MLN), a selective serotonin and norepinephrine reuptake inhibitor (SNRI), in fibromyalgia patients. Our aim was to identify functional connectivity patterns at baseline that would differentially predict treatment response to MLN as compared to placebo. Since preclinical studies of MLN suggest that this medication works by augmenting antinociceptive processes, we specifically investigated brain regions known to be involved in pain inhibition. 15 fibromyalgia patients completed the study, consisting of 6 weeks of drug and placebo intake (order counterbalanced) with an interspersed 2 week wash out period. As a main finding we report that reductions in clinical pain scores during MLN were associated with decreased functional connectivity between pro-nociceptive regions and antinociceptive pain regions at baseline, specifically between the rostral part of the anterior cingulate cortex (ACC) and the insular cortex (IC), as well as between the periaqueductal gray (PAG) and the IC: patients with lower preexisting functional connectivity had the greatest reduction in clinical pain. This pattern was not observed for the placebo period. However a more robust placebo response was associated with lower baseline functional connectivity between the ACC and the dorsolateral prefrontal cortex. This study indicates that ACC–IC connectivity might play a role in the mechanism of action of MLN, and perhaps more importantly fcMRI might be a useful tool to predict pharmacological treatment response. Resting brain connectivity predicts clinical pain response to milnacipran. Different brain connectivity patterns predicted response to placebo treatment. Personalized analgesic therapy may be facilitated by brain imaging.
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Key Words
- 5-HT, serotonin
- ACC, anterior cingulate cortex
- BPI, brief pain inventory
- CNS, central nervous system
- Chronic pain
- DLPFC, dorsolateral prefrontal cortex
- DMN, default mode network
- FEW, family wise error
- Fibromyalgia
- Functional connectivity
- IC, insular cortex
- IPL, inferior parietal lobule
- MCC, mid-cingulate cortex
- MLN, milnacipran
- NE, norepinephrine
- PAG, periaqueductal gray
- PCC, posterior cingulate cortex
- QST, quantitative sensory testing
- SNRI
- SNRI, selective serotonin and norepinephrine reuptake inhibitor
- SPM, statistical parametric mapping
- TMS, transcranial magnetic stimulation
- fMRI
- fMRI, functional magnetic resonance imaging
- fcMRI, functional connectivity magnetic resonance imaging
- rs-fc, resting state functional connectivity
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Bede P, Hardiman O. Lessons of ALS imaging: Pitfalls and future directions - A critical review. Neuroimage Clin 2014; 4:436-43. [PMID: 24624329 DOI: 10.1016/j.nicl.2014.02.011] [Citation(s) in RCA: 90] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/22/2013] [Revised: 02/23/2014] [Accepted: 02/23/2014] [Indexed: 12/19/2022]
Abstract
Background While neuroimaging in ALS has gained unprecedented momentum in recent years, little progress has been made in the development of viable diagnostic, prognostic and monitoring markers. Objectives To identify and discuss the common pitfalls in ALS imaging studies and to reflect on optimal study designs based on pioneering studies. Methods A “PubMed”-based literature search on ALS was performed based on neuroimaging-related keywords. Study limitations were systematically reviewed and classified so that stereotypical trends could be identified. Results Common shortcomings, such as relatively small sample sizes, statistically underpowered study designs, lack of disease controls, poorly characterised patient cohorts and a large number of conflicting studies, remain a significant challenge to the field. Imaging data of ALS continue to be interpreted at a group-level, as opposed to meaningful individual-patient inferences. Conclusions A systematic, critical review of ALS imaging has identified stereotypical shortcomings, the lessons of which should be considered in the design of future prospective MRI studies. At a time when large multicentre studies are underway a candid discussion of these factors is particularly timely. Stereotypical shortcomings can be identified in ALS neuroimaging studies. A systematic discussion of ALS study limitations is particularly timely. Individual patient data meta-analyses and multicentre studies are urgently required. The gaps identified in ALS imaging indicate exciting research opportunities.
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Key Words
- AD, axial diffusivity
- Amyotrophic lateral sclerosis
- Biomarker
- C9orf72, chromosome 9 open reading frame 72
- DTI, diffusion tensor imaging
- FA, fractional anisotropy
- MD, mean diffusivity
- MEG, magnetoencephalography
- MRI
- MRS, magnetic resonance spectroscopy
- MUNE, motor unit number estimation
- PET
- PET, positron emission tomography
- PNS, peripheral nervous system
- RD, radial diffusivity
- ROI, region of interest
- SPECT, single photon emission computed tomography
- Spectroscopy
- TMS, transcranial magnetic stimulation
- VBM, voxel-based morphometry
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Rossiter HE, Eaves C, Davis E, Boudrias MH, Park CH, Farmer S, Barnes G, Litvak V, Ward NS. Changes in the location of cortico-muscular coherence following stroke. Neuroimage Clin 2012; 2:50-5. [PMID: 24179758 DOI: 10.1016/j.nicl.2012.11.002] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Revised: 10/10/2012] [Accepted: 11/05/2012] [Indexed: 12/04/2022]
Abstract
Stroke results in reorganization of residual brain networks. The functional role of brain regions within these networks remains unclear, particularly those in the contralesional hemisphere. We studied 25 stroke patients with a range of motor impairment and 23 healthy age-matched controls using magnetoencephalography (MEG) and electromyography (EMG) to measure oscillatory signals from the brain and affected muscles simultaneously during a simple isometric hand grip, from which cortico-muscular coherence (CMC) was calculated. Peaks of cortico-muscular coherence in both the beta and gamma bands were found in the contralateral sensorimotor cortex in all healthy controls, but were more widespread in stroke patients, including some peaks found in the contralesional hemisphere (7 patients for beta coherence and 5 for gamma coherence). Neither the coherence value nor the distance of the coherence peak from the mean of controls correlated with impairment. Peak CMC in the contralesional hemisphere was found not only in some highly impaired patients, but also in some patients with good functional recovery. Our results provide evidence that a wide range of cortical brain regions, including some in the contralesional hemisphere, may have influence over EMG activity in the affected muscles after stroke thereby supporting functional recovery.
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