A Review of Brain Stimulation Treatments for Late-Life Depression

Blumberger, Daniel M.; Hsu, Jonathan H.; Daskalakis, Zafiris J.

doi:10.1007/s40501-015-0059-0

Cited by 61 publications

(23 citation statements)

References 76 publications

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“…tDCS is another non-invasive brain stimulation technique that uses scalp electrodes to deliver mild (1–2 mA) electrical currents to target brain regions, thereby modulating ongoing brain activity (Blumberger et al, 2015). The mechanisms of tDCS and related techniques such as transcranial alternating current stimulation (tACS) are still under investigation and debate (for reviews, see Nitsche et al, 2008; Tortella et al, 2015).…”

Section: Targeting the Sn-cstc With Therapeutic Brain Stimulationmentioning

confidence: 99%

Cortico-Striatal-Thalamic Loop Circuits of the Salience Network: A Central Pathway in Psychiatric Disease and Treatment

Peters

Dunlop

Downar³

2016

Front. Syst. Neurosci.

437

298

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The salience network (SN) plays a central role in cognitive control by integrating sensory input to guide attention, attend to motivationally salient stimuli and recruit appropriate functional brain-behavior networks to modulate behavior. Mounting evidence suggests that disturbances in SN function underlie abnormalities in cognitive control and may be a common etiology underlying many psychiatric disorders. Such functional and anatomical abnormalities have been recently apparent in studies and meta-analyses of psychiatric illness using functional magnetic resonance imaging (fMRI) and voxel-based morphometry (VBM). Of particular importance, abnormal structure and function in major cortical nodes of the SN, the dorsal anterior cingulate cortex (dACC) and anterior insula (AI), have been observed as a common neurobiological substrate across a broad spectrum of psychiatric disorders. In addition to cortical nodes of the SN, the network’s associated subcortical structures, including the dorsal striatum, mediodorsal thalamus and dopaminergic brainstem nuclei, comprise a discrete regulatory loop circuit. The SN’s cortico-striato-thalamo-cortical loop increasingly appears to be central to mechanisms of cognitive control, as well as to a broad spectrum of psychiatric illnesses and their available treatments. Functional imbalances within the SN loop appear to impair cognitive control, and specifically may impair self-regulation of cognition, behavior and emotion, thereby leading to symptoms of psychiatric illness. Furthermore, treating such psychiatric illnesses using invasive or non-invasive brain stimulation techniques appears to modulate SN cortical-subcortical loop integrity, and these effects may be central to the therapeutic mechanisms of brain stimulation treatments in many psychiatric illnesses. Here, we review clinical and experimental evidence for abnormalities in SN cortico-striatal-thalamic loop circuits in major depression, substance use disorders (SUD), anxiety disorders, schizophrenia and eating disorders (ED). We also review emergent therapeutic evidence that novel invasive and non-invasive brain stimulation treatments may exert therapeutic effects by normalizing abnormalities in the SN loop, thereby restoring the capacity for cognitive control. Finally, we consider a series of promising directions for future investigations on the role of SN cortico-striatal-thalamic loop circuits in the pathophysiology and treatment of psychiatric disorders.

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Section: Targeting the Sn-cstc With Therapeutic Brain Stimulationmentioning

confidence: 99%

Cortico-Striatal-Thalamic Loop Circuits of the Salience Network: A Central Pathway in Psychiatric Disease and Treatment

Peters

Dunlop

Downar³

2016

Front. Syst. Neurosci.

437

298

View full text Add to dashboard Cite

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“…Positive results have been reported in stroke (Gomez Palacio Schjetnan et al, 2013; Peters et al, 2016), Alzheimer's disease (Boggio et al, 2009), movement disorders (Benninger et al, 2010), depression (Blumberger et al, 2015), schizophrenia (Brunelin et al, 2012), and addiction (Dunlop et al, 2016). Growing use of tDCS creates pressure to understand the underlying mechanisms and, thus, to enable optimal application (Dubljević et al, 2014).…”

Section: Introductionmentioning

confidence: 97%

Impact of Transcranial Direct Current Stimulation (tDCS) on Neuronal Functions

et al. 2016

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Transcranial direct current stimulation (tDCS), a non-invasive brain stimulation technique, modulates neuronal excitability by the application of a small electrical current. The low cost and ease of the technique has driven interest in potential clinical applications. However, outcomes are highly sensitive to stimulation parameters, leading to difficulty maximizing the technique's effectiveness. Although reversing the polarity of stimulation often causes opposite effects, this is not always the case. Effective clinical application will require an understanding of how tDCS works; how it modulates a neuron; how it affects the local network; and how it alters inter-network signaling. We have summarized what is known regarding the mechanisms of tDCS from sub-cellular processing to circuit level communication with a particular focus on what can be learned from the polarity specificity of the effects.

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“…This ability to increase surface area without sacrificing spatial resolution also has advantages for cortical stimulation applications such as stroke rehabilitation 29 , seizure disruption 30 , chronic pain 31 , and psychiatric disorders 32,33 . When stimulating, the amount of current that can safely be delivered is limited by electrode surface area because the current density has to be maintained within the electrode’s safe limits to prevent degradation of the metal and tissue damage.…”

Section: Discussionmentioning

confidence: 99%

A testbed for optimizing electrodes embedded in the skull or in artificial skull replacement pieces used after injury

Jiang

Marathe

Keene

et al. 2017

Journal of Neuroscience Methods

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Background Custom-fitted skull replacement pieces are often used after a head injury or surgery to replace damaged bone. Chronic brain recordings are beneficial after injury/surgery for monitoring brain health and seizure development. Embedding electrodes directly in these artificial skull replacement pieces would be a novel, low-risk way to perform chronic brain monitoring in these patients. Similarly, embedding electrodes directly in healthy skull would be a viable minimally-invasive option for many other neuroscience and neurotechnology applications requiring chronic brain recordings. New Method We demonstrate a preclinical testbed that can be used for refining electrode designs embedded in artificial skull replacement pieces or for embedding directly into the skull itself. Options are explored to increase the surface area of the contacts without increasing recording contact diameter to maximize recording resolution. Results Embedding electrodes in real or artificial skull allows one to lower electrode impedance without increasing the recording contact diameter by making use of conductive channels that extend into the skull. The higher density of small contacts embedded in the artificial skull in this testbed enables one to optimize electrode spacing for use in real bone. Comparison with Existing Methods For brain monitoring applications, skull-embedded electrodes fill a gap between electroencephalograms recorded on the scalp surface and the more invasive epidural or subdural electrode sheets. Conclusions Embedding electrodes into the skull or in skull replacement pieces may provide a safe, convenient, minimally-invasive alternative for chronic brain monitoring. The manufacturing methods described here will facilitate further testing of skull-embedded electrodes in animal models.

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A Review of Brain Stimulation Treatments for Late-Life Depression

Cited by 61 publications

References 76 publications

Cortico-Striatal-Thalamic Loop Circuits of the Salience Network: A Central Pathway in Psychiatric Disease and Treatment

Cortico-Striatal-Thalamic Loop Circuits of the Salience Network: A Central Pathway in Psychiatric Disease and Treatment

Impact of Transcranial Direct Current Stimulation (tDCS) on Neuronal Functions

A testbed for optimizing electrodes embedded in the skull or in artificial skull replacement pieces used after injury

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