Probing responses to deep brain stimulation with functional magnetic resonance imaging

Loh, Aaron; Gwun, David; Chow, Chung‐Wai; Boutet, Alexandre; Tasserie, Jordy; Germann, Jürgen; Santyr, Brendan; Elias, Gavin J B; Yamamoto, Kazuaki; Sarica, Can; Vetkas, Artur; Zemmar, Ajmal; Madhavan, Radhika; Fasano, Alfonso; Lozano, Andrés M.

doi:10.1016/j.brs.2022.03.009

Cited by 33 publications

(23 citation statements)

References 75 publications

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“…Investigations of the new brain targets mentioned above, and maybe of other brain areas, will continue aiming to further improving outcome [110]. This will be facilitated by improved imaging of the brain, including functional MRI [118] and connectivity imaging [119,120]. Additionally, from DBS having been initially the exclusivity of one company, there are now at least three major DBS companies, resulting in several technical DBS innovations that are already being implemented or investigated [121][122][123], such as MRI-compatible DBS hardware; neuropacemakers with rechargeable batteries and extended life up to 25 years; neuropacemakers with sensing technology allowing to record the depth electroencephalogram, especially beta activity, and adapt the stimulation accordingly, so called closed loop stimulation, with the potential to decrease side effects and battery drain; directional DBS electrodes allowing the electric current to be focused precisely on the region of interest, again to decrease side effects such as dysarthria and improve outcome; remote web-based follow-up programming and troubleshooting of the stimulation to help patients who live far away from the DBS centre; and new modes of stimulation based on judicious use of more flexible electric parameters (such as pulse width, pulse shape, frequency, amplitude, etc.…”

Section: Future Prospects Of Dbs In Pdmentioning

confidence: 99%

Deep brain stimulation for Parkinson's disease

Hariz

Blomstedt

2022

J Intern Med

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Parkinson's disease (PD) is a progressive neurodegenerative illness with both motor and nonmotor symptoms. Deep brain stimulation (DBS) is an established safe neurosurgical symptomatic therapy for eligible patients with advanced disease in whom medical treatment fails to provide adequate symptom control and good quality of life, or in whom dopaminergic medications induce severe side effects such as dyskinesias. DBS can be tailored to the patient's symptoms and targeted to various nodes along the basal ganglia–thalamus circuitry, which mediates the various symptoms of the illness; DBS in the thalamus is most efficient for tremors, and DBS in the pallidum most efficient for rigidity and dyskinesias, whereas DBS in the subthalamic nucleus (STN) can treat both tremors, akinesia, rigidity and dyskinesias, and allows for decrease in doses of medications even in patients with advanced stages of the disease, which makes it the preferred target for DBS. However, DBS in the STN assumes that the patient is not too old, with no cognitive decline or relevant depression, and does not exhibit severe and medically resistant axial symptoms such as balance and gait disturbances, and falls. Dysarthria is the most common side effect of DBS, regardless of the brain target. DBS has a long‐lasting effect on appendicular symptoms, but with progression of disease, nondopaminergic axial features become less responsive to DBS. DBS for PD is highly specialised; to enable adequate selection and follow‐up of patients, DBS requires dedicated multidisciplinary teams of movement disorder neurologists, functional neurosurgeons, specialised DBS nurses and neuropsychologists.

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Section: Future Prospects Of Dbs In Pdmentioning

confidence: 99%

Deep brain stimulation for Parkinson's disease

Hariz

Blomstedt

2022

J Intern Med

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“…However, the safety of DBS still needs attention, including visual disturbances, dysarthria, paresthesia, intracranial hemorrhage, and infection ( Schrock et al, 2015 ; Martinez-Ramirez et al, 2018 ; Smeets et al, 2018 ). The mechanisms by which DBS works are not fully understood, but functional magnetic resonance imaging (fMRI) may help to fill this knowledge gap ( Loh et al, 2022 ). According to an analysis of fMRI, the subthalamic nucleus was the area of the brain that was most frequently stimulated ( Loh et al, 2022 ).…”

Section: Discussionmentioning

confidence: 99%

“…The mechanisms by which DBS works are not fully understood, but functional magnetic resonance imaging (fMRI) may help to fill this knowledge gap ( Loh et al, 2022 ). According to an analysis of fMRI, the subthalamic nucleus was the area of the brain that was most frequently stimulated ( Loh et al, 2022 ). Considering the higher risk of complications after DBS, we figure the sensible thing to do is to better understand the feasibility, safety, and clinical effectiveness of DBS in the treatment of severe-refractory TS.…”

Section: Discussionmentioning

confidence: 99%

Trends of Tourette Syndrome in children from 2011 to 2021: A bibliometric analysis

Yang

Zhang

Zhao

et al. 2022

Front. Behav. Neurosci.

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ObjectiveAnalyze the research status of Tourette Syndrome (TS) in children by CiteSpace and determine the current research hotspots and frontiers.Materials and methodsWe chose publications indexed in the Web of Science Core Collection (WoSCC) database for studies related to TS in children from 2011 to 2021. We built online cooperation maps of countries/regions, institutions, authors, journals, references, and keywords by CiteSpace, and identified hotspots and frontiers of study for children’s TS.ResultsA total of 1,232 publications about TS in children were downloaded from the WoSCC. The USA (414) was the country with the highest rate of production, and University College London (87) was the institution that had the highest publication rate. Andrea Eugenio Cavanna was the most prolific author (39 papers). There was inactive cooperation between institutions, countries/regions, and authors. The Journal of European Child & Adolescent Psychiatry was the most active journal. Hot topics focused on epidemiology, comorbidities, deep brain stimulation, behavioral therapy, basal ganglia, pharmacological treatment, and risk factors of TS in children.ConclusionAccording to the CiteSpace results, this study found that authors, countries/regions, and institutions were not actively working together. Current research hotspots mainly consist of epidemiology, comorbidities, deep brain stimulation, behavior therapy, and basal ganglia. The main research trends include comorbidities, pharmacological treatment, and risk factors. Therefore, international cooperation should be strengthened in the future, and it should be mindful of the psychiatric comorbidities of TS, the choice of intervention measures, and early warning of risk factors.

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“…A critical feature of these interventions is that even though their delivery is highly focal -especially true for invasive techniques -their influence is quite broad. Neuroimaging and scalp EEG studies during therapeutic DBS in psychiatric indications, for example, have demonstrated its widespread effects across frontotemporal networks, despite the focal nature of its delivery [12][13][14][15] . Alterations in functional connectivity have been observed between nodes of these frontotemporal subnetworks following stimulation and have been linked to symptom improvement in mood disorders 13,16 .…”

Section: Introductionmentioning

confidence: 99%

Prefrontal network engagement by deep brain stimulation in limbic hubs

Allawala

Bijanki

Oswalt

et al. 2022

Preprint

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Frontotemporal circuits in the human brain play an important role in cognitive and affective processing. Neuromodulation therapies delivered to certain key hubs within these circuits are being used with increasing frequency to treat a host of neuropsychiatric disorders, but the detailed neurophysiological effects of stimulation are largely unknown. Here, we performed intracranial recordings across frontotemporal networks while delivering electrical stimulation to two well-established white matter hubs involved in cognitive regulation. We demonstrate a frontotemporal circuit consisting of the amygdala, lateral orbitofrontal cortex, and ventromedial prefrontal cortex in which gamma oscillations are differentially modulated depending on the target stimulated. We additionally highlight the heterogeneity in neural responses to stimulation across human subjects in other corticolimbic regions and demonstrate the capacity for further tuning of neural activity using current-steered stimulation. Our findings indicate a potential neurophysiological mechanism for the dissociable therapeutic effects seen across targets for neuromodulation and implications for future efforts in personalized, network-guided neurostimulation.

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Probing responses to deep brain stimulation with functional magnetic resonance imaging

Cited by 33 publications

References 75 publications

Deep brain stimulation for Parkinson's disease

Deep brain stimulation for Parkinson's disease

Trends of Tourette Syndrome in children from 2011 to 2021: A bibliometric analysis

Prefrontal network engagement by deep brain stimulation in limbic hubs

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