State of the Art: Novel Applications for Cortical Stimulation

Ridder, Dirk De; Perera, Sanjaya; Vanneste, Sven

doi:10.1111/ner.12593

Cited by 27 publications

(18 citation statements)

References 120 publications

(170 reference statements)

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“…The most important finding in our study is that the cortical gain control mechanism provides the basis for a novel approach to neuromodulation. Traditional designs of neuromodulation rely on high-frequency, supraphysiologic stimulation to either activate or inhibit neurons in a specific brain region ( Ashkan et al, 2017 ; De Ridder et al, 2017 ; Levy et al, 1987 ). Applications of this method to the PFC have been effective in pain relief in animal models ( Lee et al, 2015 ; Martinez et al, 2017 ; Wang et al, 2015 ).…”

Section: Discussionmentioning

confidence: 99%

Scaling Up Cortical Control Inhibits Pain

Dale

Zhou²,

Zhang

et al. 2018

Cell Reports

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SUMMARY Acute pain evokes protective neural and behavioral responses. Chronic pain, however, disrupts normal nociceptive processing. The prefrontal cortex (PFC) is known to exert top-down regulation of sensory inputs; unfortunately, how individual PFC neurons respond to an acute pain signal is not well characterized. We found that neurons in the prelimbic region of the PFC increased firing rates of the neurons after noxious stimulations in free-moving rats. Chronic pain, however, suppressed both basal spontaneous and pain-evoked firing rates. Furthermore, we identified a linear correlation between basal and evoked firing rates of PFC neurons, whereby a decrease in basal firing leads to a nearly 2-fold reduction in pain-evoked response in chronic pain states. In contrast, enhancing basal PFC activity with low-frequency optogenetic stimulation scaled up prefrontal outputs to inhibit pain. These results demonstrate a cortical gain control system for nociceptive regulation and establish scaling up prefrontal outputs as an effective neuromodulation strategy to inhibit pain.

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Section: Discussionmentioning

confidence: 99%

Scaling Up Cortical Control Inhibits Pain

Dale

Zhou²,

Zhang

et al. 2018

Cell Reports

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“…The relevance of the homologous areas balance in different neurological and psychiatric disorders (Fregni et al, 2006a ; Ferrucci et al, 2009 ; Nitsche et al, 2009 ), and the indication that equal bilateral stimulation impinge positively counteracting pathological imbalances (Pahor and Jaušovec, 2018 ; Tseng et al, 2018 ), suggests that developing electrodes to target such bilateral representations will be more frequent in future. Conceivably, to build electrodes that take into account the specific individual cortical folding is an advantage in focusing the stimulation of high-definition tES (Edwards et al, 2013 ; Moreno-Duarte et al, 2014 ; Malavera et al, 2015 ; De Ridder et al, 2017 ). In fact, we devoted this work to develop an easy applicable tool to stimulate a specific cortical region in individual patients, without the need of neuronavigation, and we underlined that other RePE to target other cortical folding can be shaped and positioned via the procedure offered in the present work.…”

Section: Discussionmentioning

confidence: 99%

MRI-Guided Regional Personalized Electrical Stimulation in Multisession and Home Treatments

et al. 2018

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The shape and position of the electrodes is a key factor for the efficacy of transcranial electrical stimulations (tES). We have recently introduced the Regional Personalized Electrode (RePE), a tES electrode fitting the personal cortical folding, that has been able to differentiate the stimulation of close by regions, in particular the primary sensory (S1) and motor (M1) cortices, and to personalize tES onto such an extended cortical district. However, neuronavigation on individual brain was compulsory for the correct montage. Here, we aimed at developing and testing a neuronavigation-free procedure for easy and quick positioning RePE, enabling multisession RePE-tES at home. We used off-line individual MRI to shape RePE via an ad-hoc computerized procedure, while an ad-hoc developed Adjustable Helmet Frame (AHF) was used to properly position it in multisession treatments, even at home. We used neuronavigation to test the RePE shape and position obtained by the new computerized procedure and the re-positioning obtained via the AHF. Using Finite Element Method (FEM) model, we also estimated the intra-cerebral current distribution induced by transcranial direct current stimulation (tDCS) comparing RePE vs. non-RePE with fixed reference. Additionally, we tested, using FEM, various shapes, and positions of the reference electrode taking into account possible small displacements of RePE, to test feasibility of RePE-tES sessions at home. The new RePE neuronavigation-free positioning relies on brain MRI space distances, and produced a mean displacement of 3.5 ± 0.8 mm, and the re-positioning of 4.8 ± 1.1 mm. Higher electric field in S1 than in M1 was best obtained with the occipital reference electrode, a montage that proved to feature low sensitivity to typical RePE millimetric displacements. Additionally, a new tES accessory was developed to enable repositioning the electrodes over the scalp also at home, with a precision which is acceptable according to the modeling-estimated intracerebral currents. Altogether, we provide here a procedure to simplify and make easily applicable RePE-tDCS, which enables efficacious personalized treatments.

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“…There is growing interest in the use of neuromodulation to treat chronic tinnitus; defined as the perception of sound in the absence of overt acoustic stimulation. Neuromodulation paradigms used for tinnitus suppression include but are not limited to repetitive transcranial magnetic stimulation ( r TMS), transcranial direct current stimulation ( t DCS), transcutaneous electrical nerve stimulation (TENs), cortical neurofeedback, electrical stimulation of auditory cortex, magnetic or electrical stimulation of the dorsolateral prefrontal cortex, deep‐brain stimulation (DBS), direct electrical stimulation of the vagus‐nerve paired with tones (paired‐VNS t ) 1‐13 and, other less invasive approaches like transcutaneous stimulation of the auricular branch of the vagus nerve (VN) located on the surface of the outer ear 14‐20 . These novel experimental approaches can modify the physiology and neurochemistry of the underlying tinnitus substrate and have positive impact on the psychological, social, emotional, and/or psychiatric reactions to this abnormal phantom percept.…”

Section: Introductionmentioning

confidence: 99%

Vagus nerve stimulation paired with tones for tinnitus suppression: Effects on voice and hearing

Kochilas

Cacace

Arnold

et al. 2020

Laryngoscope Investig Oto

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Objective: In individuals with chronic tinnitus, our interest was to determine whether daily low-level electrical stimulation of the vagus nerve paired with tones (paired-VNSt) for tinnitus suppression had any adverse effects on motor-speech production and physiological acoustics of sustained vowels. Similarly, we were also interested in evaluating for changes in pure-tone thresholds, word-recognition performance, and minimum-masking levels.Both voice and hearing functions were measured repeatedly over a period of 1 year. Study design: Longitudinal with repeated-measures.Methods: Digitized samples of sustained frontal, midline, and back vowels (/e/, /o/, /ah/) were analyzed with computer software to quantify the degree of jitter, shimmer, and harmonic-to-noise ratio contained in these waveforms. Pure-tone thresholds, monosyllabic word-recognition performance, and MMLs were also evaluated for VNS alterations. Linear-regression analysis was the benchmark statistic used to document change over time in voice and hearing status from a baseline condition.Results: Most of the regression functions for the vocal samples and audiometric variables had slope values that were not significantly different from zero. Four of the nine vocal functions showed a significant improvement over time, whereas three of the pure tone regression functions at 2-4 kHz showed some degree of decline; all changes observed were for the left ear, all were at adjacent frequencies, and all were ipsilateral to the side of VNS. However, mean pure-tone threshold changes did not exceed 4.29 dB from baseline and therefore, would not be considered clinically significant. In some individuals, larger threshold shifts were observed. No significant regression/slope effects were observed for word-recognition or MMLs.Meeting information: Portions of this study were presented at

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State of the Art: Novel Applications for Cortical Stimulation

Cited by 27 publications

References 120 publications

Scaling Up Cortical Control Inhibits Pain

Scaling Up Cortical Control Inhibits Pain

MRI-Guided Regional Personalized Electrical Stimulation in Multisession and Home Treatments

Vagus nerve stimulation paired with tones for tinnitus suppression: Effects on voice and hearing

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