Introduction to Brain Stimulation

Reti, Irving M.; Chang, Andrew

doi:10.1002/9781118568323.ch1

Cited by 4 publications

(3 citation statements)

References 48 publications

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“…It is unclear how STN-HFS triggers both acute suppression at stimulation onset, and suppression of SIB that persists beyond the stimulus, although longlasting neuronal plasticity is a key feature of all brain stimulation interventions (Baraban, 2015). Noting also that we found HFS restimulation to be effective, our data raise the possibility that if STN-DBS were used for ASD patients with intractable SIB, one could consider on-demand stimulation and real-time feedback to slow the development of tolerance if an electrophysiological signal for the stereotyped selfinjury could be identified (Reti and Chang, 2015). Habituation to the therapeutic effects of DBS has been described for both essential tremor and Parkinson's disease, the cause of which is unknown, but on-demand stimulation in response to local field potentials appears to lengthen the time DBS is effective and increase battery life (Kronenbuerger et al, 2006;Little et al, 2013).…”

Section: Discussionmentioning

confidence: 62%

“…However, focal brain stimulation engages neural elements that form part of distinct, parallel-organized, functional basal ganglia-thalamocortical circuits (Reti and Chang, 2015). Accordingly, in future studies it will be important to evaluate the efficacy of HFS at other sites, including cortical regions that project to the STN and GPi such as the orbitofrontal cortex and supplementary motor area, which have also been implicated in mediating intractable SIB seen in ASD patients (Muehlmann and Lewis, 2012).…”

Section: Discussionmentioning

confidence: 99%

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High-Frequency Stimulation at the Subthalamic Nucleus Suppresses Excessive Self-Grooming in Autism-Like Mouse Models

Chang

Berges

Chung

et al. 2015

Neuropsychopharmacol

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Approximately one quarter of individuals with an autism spectrum disorder (ASD) display self-injurious behavior (SIB) ranging from head banging to self-directed biting and punching. Sometimes, these behaviors are extreme and unresponsive to pharmacological and behavioral therapies. We have found electroconvulsive therapy (ECT) can produce life-changing results, with more than 90% suppression of SIB frequency. However, these patients typically require frequent maintenance ECT (mECT), as often as every 5 days, to sustain the improvement gained during the acute course. Long-term consequences of such frequent mECT started as early as childhood in some cases are unknown. Accordingly, there is a need for alternative forms of chronic stimulation for these patients. To explore the feasibility of deep brain stimulation (DBS) for intractable SIB seen in some patients with an ASD, we utilized two genetically distinct mouse models demonstrating excessive self-grooming, namely the Viaat-Mecp2 − /y and Shank3B −/− lines, and administered high-frequency stimulation (HFS) via implanted electrodes at the subthalamic nucleus (STN-HFS). We found that STN-HFS significantly suppressed excessive selfgrooming in both genetic lines. Suppression occurs both acutely when stimulation is switched on, and persists for several days after HFS is stopped. This effect was not explained by a change in locomotor activity, which was unaffected by STN-HFS. Likewise, social interaction deficits were not corrected by STN-HFS. Our data show STN-HFS suppresses excessive self-grooming in two autism-like mouse models, raising the possibility DBS might be used to treat intractable SIB associated with ASDs. Further studies are required to explore the circuitry engaged by STN-HFS, as well as other potential stimulation sites. Such studies might also yield clues about pathways, which could be modulated by non-invasive stimulatory techniques.

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Section: Discussionmentioning

confidence: 62%

Section: Discussionmentioning

confidence: 99%

High-Frequency Stimulation at the Subthalamic Nucleus Suppresses Excessive Self-Grooming in Autism-Like Mouse Models

Chang

Berges

Chung

et al. 2015

Neuropsychopharmacol

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“…Other ethical questions are more specific to the therapeutic goals of particular prosthetics and the conditions for which they are indicated. DBS can restore motor control in movement disorders (Benabid 2003, Krack et al 2010, Benabid and Torres 2012, Okun 2012, Reti 2015 and improve cognition, mood and motivation in psychiatric disorders (Mayberg et al 2005, Lozano et al 2008, Mallet et al 2008, Greenberg et al 2010, Holtzheimer and Mayberg 2011. But neurostimulation can also cause adverse effects, which requires careful weighing of potential benefits and risks of the technique (Frank et al 2007, Mallet et al 2008, Rabins et al 2009, Muller and Christen 2011, Christen et al 2012, Castrioto et al 2014.…”

Section: Introductionmentioning

confidence: 99%

Ethical issues in neuroprosthetics

Glannon

2016

J. Neural Eng.

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Provided that adequate protections are in place for research subjects and patients, the probable benefit of research into and therapeutic applications of neuroprosthetics outweighs the risk and therefore can be ethically justified. Depending on their neurogenerative potential, there may be an ethical obligation to conduct this research. Advances in neuroscience will generate new ethical and philosophical questions about people and their brains. These questions should shape the evolution and application of novel techniques to better understand and treat brain disorders.

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Advances in the Application of Electroconvulsive Therapy

D’Agati

Reti

2016

Curr Behav Neurosci Rep

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Introduction to Brain Stimulation

Cited by 4 publications

References 48 publications

High-Frequency Stimulation at the Subthalamic Nucleus Suppresses Excessive Self-Grooming in Autism-Like Mouse Models

High-Frequency Stimulation at the Subthalamic Nucleus Suppresses Excessive Self-Grooming in Autism-Like Mouse Models

Ethical issues in neuroprosthetics

Advances in the Application of Electroconvulsive Therapy

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