Thalamic Deep Brain Stimulation for Parkinson’s Disease

Morigaki, Ryoma; Saijo, Nagahiro; Kaji, Ryuji; Goto, Satoshi

doi:10.5772/18320

Cited by 6 publications

(9 citation statements)

References 135 publications

(158 reference statements)

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“…While these circuits are engaged in motor learning (Hardwick et al, 2013; Tzvi et al, 2014), they also comprise the network involved in tremor (Fang et al, 2016; Nahab et al, 2007). Imaging and deep brain stimulation (DBS) studies document a role in tremor for the ventral intermediate thalamic nucleus (VIM) in particular (Haslinger et al, 2003; Morigaki et al, 2011), and VIM‐DBS, a well‐established essential tremor treatment, targets this circuit (Benabid et al, 1991; Chopra et al, 2013; Cury et al, 2017).…”

Section: Introductionmentioning

confidence: 99%

“…While anatomical, imaging, and DBS studies indicate cerebellum–VIM and VIM–motor cortex connectivity (Haslinger et al, 2003; Morigaki et al, 2011), a role for the VIM in motor sequence learning has not been established. Studies examining the effects of VIM‐DBS on motor learning in essential tremor patients have shown improvement (Kronenbuerger et al, 2008), and also impairment (Chen et al, 2006; Luo et al, 2016), independent of tremor severity (Luo et al, 2016).…”

Section: Introductionmentioning

confidence: 99%

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Deep brain stimulation of the ventrointermediate nucleus of the thalamus to treat essential tremor improves motor sequence learning

Terzic

Voegtle

Farahat

et al. 2022

Human Brain Mapping

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The network of brain structures engaged in motor sequence learning comprises the same structures as those involved in tremor, including basal ganglia, cerebellum, thalamus, and motor cortex. Deep brain stimulation (DBS) of the ventrointermediate nucleus of the thalamus (VIM) reduces tremor, but the effects on motor sequence learning are unknown. We investigated whether VIM stimulation has an impact on motor sequence learning and hypothesized that stimulation effects depend on the laterality of electrode location. Twenty patients (age: 38–81 years; 12 female) with VIM electrodes implanted to treat essential tremor (ET) successfully performed a serial reaction time task, varying whether the stimuli followed a repeating pattern or were selected at random, during which VIM‐DBS was either on or off. Analyses of variance were applied to evaluate motor sequence learning performance according to reaction times (RTs) and accuracy. An interaction was observed between whether the sequence was repeated or random and whether VIM‐DBS was on or off (F[1,18] = 7.89, p = .012). Motor sequence learning, reflected by reduced RTs for repeated sequences, was greater with DBS on than off (T[19] = 2.34, p = .031). Stimulation location correlated with the degree of motor learning, with greater motor learning when stimulation targeted the lateral VIM (n = 23, ρ = 0.46; p = .027). These results demonstrate the beneficial effects of VIM‐DBS on motor sequence learning in ET patients, particularly with lateral VIM electrode location, and provide evidence for a role for the VIM in motor sequence learning.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Deep brain stimulation of the ventrointermediate nucleus of the thalamus to treat essential tremor improves motor sequence learning

Terzic

Voegtle

Farahat

et al. 2022

Human Brain Mapping

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“…The target of stimulation is either the subthalamic nucleus (STN) or internal globus pallidus (GPi) ( Sako et al, 2014 ). The ventral intermediate nucleus of the thalamus (VIM) is also used to improve tremors ( Morigaki et al, 2011a , b ). Recently, advanced imaging sequences have enabled direct visualization of anatomical targets, and patient-specific DBS has been performed ( Neudorfer et al, 2022 ).…”

Section: Resultsmentioning

confidence: 99%

“…Recently, advanced imaging sequences have enabled direct visualization of anatomical targets, and patient-specific DBS has been performed ( Neudorfer et al, 2022 ). DBS has been demonstrated to improve motor function including FOG ( Krack et al, 2003 ; Huang et al, 2018 ), camptocormia ( Sako et al, 2009 ; Chan et al, 2018 ), tremor ( Morigaki et al, 2011a , b ), and cognitive dysfunction. Although DBS has a lower complication rate than stereotactic thalamotomy ( Tasker, 1998 ; Pahwa et al, 2001 ), intracranial hemorrhage and infection still occur in 3.9 and 1.6% of the patients, respectively ( Kleiner-Fisman et al, 2006 ).…”

Section: Resultsmentioning

confidence: 99%

“…These devices also measure tremor characteristics using a gyroscope, accelerometer, and electromyogram. Peripheral nerve stimulation has been reported to be useful in reducing tremors—especially in patients with ET ( Kim et al, 2020 ; Yu et al, 2020 ; Reis et al, 2021 )—and is thought to evoke central activity via VIM, a thalamic target widely accepted to improve tremor with DBS ( Morigaki et al, 2011a , b ; Morigaki and Goto, 2015 ). Lin et al (2018) reported the effect of median and radial nerve stimulation using a wrist band in patients with PD.…”

Section: Resultsmentioning

confidence: 99%

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Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

Fujikawa

Morigaki

Yamamoto

et al. 2022

Front. Aging Neurosci.

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BackgroundPharmacotherapy is the first-line treatment option for Parkinson’s disease, and levodopa is considered the most effective drug for managing motor symptoms. However, side effects such as motor fluctuation and dyskinesia have been associated with levodopa treatment. For these conditions, alternative therapies, including invasive and non-invasive medical devices, may be helpful. This review sheds light on current progress in the development of devices to alleviate motor symptoms in Parkinson’s disease.MethodsWe first conducted a narrative literature review to obtain an overview of current invasive and non-invasive medical devices and thereafter performed a systematic review of recent randomized controlled trials (RCTs) of these devices.ResultsOur review revealed different characteristics of each device and their effectiveness for motor symptoms. Although invasive medical devices are usually highly effective, surgical procedures can be burdensome for patients and have serious side effects. In contrast, non-pharmacological/non-surgical devices have fewer complications. RCTs of non-invasive devices, especially non-invasive brain stimulation and mechanical peripheral stimulation devices, have proven effectiveness on motor symptoms. Nearly no non-invasive devices have yet received Food and Drug Administration certification or a CE mark.ConclusionInvasive and non-invasive medical devices have unique characteristics, and several RCTs have been conducted for each device. Invasive devices are more effective, while non-invasive devices are less effective and have lower hurdles and risks. It is important to understand the characteristics of each device and capitalize on these.

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Suppression of Motor Sequence Learning and Execution Through Anodal Cerebellar Transcranial Electrical Stimulation

et al. 2022

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Cerebellum (CB) and primary motor cortex (M1) have been associated with motor learning, with different putative roles. Modulation of task performance through application of transcranial direct current stimulation (TDCS) to brain structures provides causal evidence for their engagement in the task. Studies evaluating and comparing TDCS to these structures have provided conflicting results, however, likely due to varying paradigms and stimulation parameters. Here we applied TDCS to CB and M1 within the same experimental design, to enable direct comparison of their roles in motor sequence learning. We examined the effects of anodal TDCS during motor sequence learning in 60 healthy participants, randomly allocated to CB-TDCS, M1-TDCS, or Sham stimulation groups during a serial reaction time task. Key to the design was an equal number of repeated and random sequences. Reaction times (RTs) to implicitly learned and random sequences were compared between groups using ANOVAs and post hoc t-tests. A speed–accuracy trade-off was excluded by analogous analysis of accuracy scores. An interaction was observed between whether responses were to learned or random sequences and the stimulation group. Post hoc analyses revealed a preferential slowing of RTs to implicitly learned sequences in the group receiving CB-TDCS. Our findings provide evidence that CB function can be modulated through transcranial application of a weak electrical current, that the CB and M1 cortex perform separable functions in the task, and that the CB plays a specific role in motor sequence learning during implicit motor sequence learning.

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Thalamic Deep Brain Stimulation for Parkinson’s Disease

Cited by 6 publications

References 135 publications

Deep brain stimulation of the ventrointermediate nucleus of the thalamus to treat essential tremor improves motor sequence learning

Deep brain stimulation of the ventrointermediate nucleus of the thalamus to treat essential tremor improves motor sequence learning

Therapeutic Devices for Motor Symptoms in Parkinson’s Disease: Current Progress and a Systematic Review of Recent Randomized Controlled Trials

Suppression of Motor Sequence Learning and Execution Through Anodal Cerebellar Transcranial Electrical Stimulation

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