Transient Acute Depression Induced by High-Frequency Deep-Brain Stimulation

Bejjani, Boulos‐Paul; Damier, Philippe; Arnulf, Isabelle; Thivard, Lionel; Bonnet, Anne‐Marie; Dormont, Didier; Cornu, Philippe; Pidoux, B.; Samson, Yves; Agid, Yves

doi:10.1056/nejm199905133401905

Cited by 601 publications

(345 citation statements)

References 19 publications

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“…Worsening of dyskinesia or dystonia can appear during initial DBS programming sessions, but these symptoms decline after several hours of continuous stimulation. 160 Deep brain stimulation can generate cognitive side effects as well, including mood changes, 161 depression, 162 decreased working memory performance, 163,164 impulsivity, 165 and hallucinations. 166 One explanation for the emergence of such cognitive side effects is that suprathreshold currents spread into nonmotor regions within the basal ganglia and thalamocortical networks.…”

Section: What To Avoid: Targets That Lead To Undesirable Side Effectsmentioning

confidence: 99%

Mechanisms and Targets of Deep Brain Stimulation in Movement Disorders

et al. 2008

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Summary:Chronic electrical stimulation of the brain, known as deep brain stimulation (DBS), has become a preferred surgical treatment for medication-refractory movement disorders. Despite its remarkable clinical success, the therapeutic mechanisms of DBS are still not completely understood, limiting opportunities to improve treatment efficacy and simplify selection of stimulation parameters. This review addresses three questions essential to understanding the mechanisms of DBS. 1) How does DBS affect neuronal tissue in the vicinity of the active electrode or electrodes? 2) How do these changes translate into therapeutic benefit on motor symptoms? 3) How do these effects depend on the particular site of stimulation? Early hypotheses proposed that stimulation inhibited neuronal activity at the site of stimulation, mimicking the outcome of ablative surgeries. Recent studies have challenged that view, suggesting that although somatic activity near the DBS electrode may exhibit substantial inhibition or complex modulation patterns, the output from the stimulated nucleus follows the DBS pulse train by direct axonal excitation. The intrinsic activity is thus replaced by high-frequency activity that is time-locked to the stimulus and more regular in pattern. These changes in firing pattern are thought to prevent transmission of pathologic bursting and oscillatory activity, resulting in the reduction of disease symptoms through compensatory processing of sensorimotor information. Although promising, this theory does not entirely explain why DBS improves motor symptoms at different latencies. Understanding these processes on a physiological level will be critically important if we are to reach the full potential of this powerful tool.

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Section: What To Avoid: Targets That Lead To Undesirable Side Effectsmentioning

confidence: 99%

Mechanisms and Targets of Deep Brain Stimulation in Movement Disorders

et al. 2008

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“…Furthermore, STN DBS can contribute to certain impulsive behaviours during high-conflict decisions [57]. Functional imaging has revealed that the STN is involved in inhibition of an ongoing action [55].…”

Section: The Stn and Impulsivitymentioning

confidence: 99%

“…The STN and mood Depression, apathy and anxiety can arise as complications after surgery [60][61][62][63] and rare cases of acute stimulationinduced depressed mood have been reported [57,58]. However, the vast majority of cases with an acute emotional response to STN DBS exhibit hypomania [50] or mania [25,52].…”

Section: The Stn and Impulsivitymentioning

confidence: 99%

Deep brain stimulation in Parkinson disease—what went wrong?

Krack

Hariz

2010

Nat Rev Neurol

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“…fMRI offers several advantages: it is noninvasive, has superior spatial/temporal resolution, and is widely available. Recently, researchers have found that during DBS, patients experienced emotional changes (3,4). Using DBS may become another treatment option for psychiatric disorders such as depression, mood disorders, and bipolar disorder, and fMRI may be suitable to monitor treatment results.…”

Section: Deep Brain Stimulation (Dbs) Is An Establishedmentioning

confidence: 99%

“…A few previous studies have tried to explore and localize related neuronal pathways during DBS using fMRI on patients with implanted thalamic and subthalamic electrodes (2)(3)(4). Also, two studies proposed safety recommendations for combining DBS treatment with fMRI examination (1,5).…”

Section: Disscussionmentioning

confidence: 99%

False‐positive analysis of functional MRI during simulated deep brain stimulation: A phantom study

Liu

Chen

et al. 2008

Magnetic Resonance Imaging

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Purpose:To investigate the false-positive activations/deactivations in functional MRI (fMRI) of deep brain stimulation (DBS) using a phantom. Materials and Methods: fMRI experiments were performed on a 1.5T scanner using a single-shot gradientecho echo-planar imaging (GE-EPI) sequence (TR/TE/ FA ϭ 6000 msec/60 msec/90°) on an agar-gel phantom inserted with DBS electrodes. During the experimental blocks, two-second stimuli were delivered during the interscan waiting time (ISWT), which was adjusted by changing the number of slices acquired within the TR (3500 msec with 30 slices and 5160 msec with 10 slices). Data were analyzed using SPM2 software, and the falsepositive voxels were detected with five different P-value thresholds.Results: The number of false-positive voxels in experimental conditions had no significant differences from those in control conditions with either long or short ISWT, which increased with the P-value threshold from zero at P Ͻ 0.0001 to approximately 40 at P Ͻ 0.05. The pattern of increasing number of false-positive reactions along with P-value was similar between all conditions. Conclusion:False-positive findings from fMRI with similar experimental design can be well controlled with a statistical threshold of P Ͻ 0.001 or tighter. The short ISWT of 3500 msec did not increase false-positive reactions compared to the long ISWT of 5160 msec.

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Transient Acute Depression Induced by High-Frequency Deep-Brain Stimulation

Cited by 601 publications

References 19 publications

Mechanisms and Targets of Deep Brain Stimulation in Movement Disorders

Mechanisms and Targets of Deep Brain Stimulation in Movement Disorders

Deep brain stimulation in Parkinson disease—what went wrong?

False‐positive analysis of functional MRI during simulated deep brain stimulation: A phantom study

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