Deep Brain Stimulation associated gliosis: A post-mortem study

Abstract

This study revealed that approximately three out of four post-mortem DBS cases exhibited pathological evidence of a glial collar or scar present at the ventral DBS lead tip. The amount of gliosis was not significantly associated with duration of DBS. Future studies should include serial sectioning across all DBS contacts with correlation to the volume of tissue activation and to the clinical outcome.

Frameless x-ray-based lead re-implantation after partial hardware removal of deep brain stimulation system with preservation of intracerebral trajectories

“…The presence of a gliotic scar surrounding the electrodes should prevent this complication. A development of a glial scar around the cerebral DBS-leads has been described before, which is assumed to be the result of microglial inflammatory response to the leads [ 22 ]. A fibrous sheath of 5 to 25 μm in diameter was found in the majority of postmortem histologically analyzed cases with implanted DBS-system.…”

“…Acute tissue reaction such as reactive astrogliosis was seen in 78% of cases, and chronic tissue reactions such as fibrillary gliosis were detected in 73% of the analyzed cases [ 7 ]. In a postmortem analysis of DBS-patients, the severity of gliotic response differed between the cases and did not correlate with the duration of DBS [ 22 ]. Another study with postmortem pathoanatomical evaluation of brain tissue alterations after DBS, however, described astrogliosis in all patients with long-term contact to DBS-electrode and an inflammatory and foreign-body reaction with CD3-immunoreactive T-lymphocytes in 93% of cases [ 13 ].…”

Suicidality Associated With Deep Brain Stimulation in Extrapyramidal Diseases: A Critical Review and Hypotheses on Neuroanatomical and Neuroimmune Mechanisms

“…Larger case series in PD patients also revealed extensive gliosis and macrophage accumulation in the majority of subjects undergoing DBS (Vedam-Mai et al, 2018). Notably, gliosis is associated with septicemia in deceased subjects (Kronenbuerger et al, 2015) but does not correlate with the duration of the DBS regimen (Vedam-Mai et al, 2018). Along with studies in animals, these findings suggest that neuroinflammation occurs during DBS and might represent a reaction against implanted neuroelectrodes, rather than against the DBS treatment itself (Amorim et al, 2015;Hadar et al, 2017;Lopez-Cuina et al, 2018).…”

“…In a pediatric status dystonicus case study, evidence of gliosis and multinucleated giant cells (macrophage aggregates) was observed along the trajectories of the implanted electrodes (Kronenbuerger et al, 2015). Larger case series in PD patients also revealed extensive gliosis and macrophage accumulation in the majority of subjects undergoing DBS (Vedam-Mai et al, 2018). Notably, gliosis is associated with septicemia in deceased subjects (Kronenbuerger et al, 2015) but does not correlate with the duration of the DBS regimen (Vedam-Mai et al, 2018).…”

Methodological Considerations for Neuroimaging in Deep Brain Stimulation of the Subthalamic Nucleus in Parkinson’s Disease Patients

“…For example, neurosurgery has been linked to brain deformation and shift, changes in cerebral spinal fluid volume, and intracranial pressure, which may induce spatial variability both during the surgery and cause a shift in the implanted lead location during recovery [ 27 , 234 ]. Similarly, DBS surgeries are associated with infection (mostly found in the chest and connector) [ 235 ]; reactive gliosis and gliotic scarring [ 236 ]; hemorrhage either during the surgery or delayed (in less than 5%) [ 237 ]; and, although rare, cerebral pneumocephalus [ 238 ]. In all these cases, the DBS system may require reimplantation, replacement, or removal.…”