White matter stimulation for the treatment of epilepsy

Girgis, Fady; Miller, Jonathan P.

doi:10.1016/j.seizure.2016.02.004

Cited by 16 publications

(15 citation statements)

References 53 publications

(52 reference statements)

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“…However, patients with long-standing refractory epilepsy have been shown to develop areas of secondary epileptogenesis, possibly through kindling. To better manage multiple epileptogenic loci in this population, stimulation of the affected circuitry (white matter) rather than the epileptogenic gray matter is being considered (Girgis and Miller, 2016). In these studies, it has been shown that microelectrode recording and modification of the area of stimulation can achieve differential, acute and chronic effects on the involved neurocircuitry.…”

Section: Dbs Innovationsmentioning

confidence: 99%

Proceedings of the Fourth Annual Deep Brain Stimulation Think Tank: A Review of Emerging Issues and Technologies

Deeb

Giordano

Rossi

et al. 2016

Front. Integr. Neurosci.

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This paper provides an overview of current progress in the technological advances and the use of deep brain stimulation (DBS) to treat neurological and neuropsychiatric disorders, as presented by participants of the Fourth Annual DBS Think Tank, which was convened in March 2016 in conjunction with the Center for Movement Disorders and Neurorestoration at the University of Florida, Gainesveille FL, USA. The Think Tank discussions first focused on policy and advocacy in DBS research and clinical practice, formation of registries, and issues involving the use of DBS in the treatment of Tourette Syndrome. Next, advances in the use of neuroimaging and electrochemical markers to enhance DBS specificity were addressed. Updates on ongoing use and developments of DBS for the treatment of Parkinson's disease, essential tremor, Alzheimer's disease, depression, post-traumatic stress disorder, obesity, addiction were presented, and progress toward innovation(s) in closed-loop applications were discussed. Each section of these proceedings provides updates and highlights of new information as presented at this year's international Think Tank, with a view toward current and near future advancement of the field.

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Section: Dbs Innovationsmentioning

confidence: 99%

Proceedings of the Fourth Annual Deep Brain Stimulation Think Tank: A Review of Emerging Issues and Technologies

Deeb

Giordano

Rossi

et al. 2016

Front. Integr. Neurosci.

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show abstract

“…Axons are more prone to be excited by extracellular pulses of HFS than other structure elements of neurons ( Ranck, 1975 ; Nowak and Bullier, 1998 ; Johnson and McIntyre, 2008 ). The outputs of axonal HFS can spread widely through projections of axonal fibers ( Nowak and Bullier, 1998 ), which may play important roles in DBS therapy ( Girgis and Miller, 2016 ; Herrington et al, 2016 ). Therefore, the present study of axonal stimulation could reveal important mechanisms of DBS and especially provide a new explanation for the demand of high frequency pulses in effective DBS.…”

Section: Introductionmentioning

confidence: 99%

Axonal Stimulations With a Higher Frequency Generate More Randomness in Neuronal Firing Rather Than Increase Firing Rates in Rat Hippocampus

2018

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Deep brain stimulation (DBS) has been used for treating many brain disorders. Clinical applications of DBS commonly require high-frequency stimulations (HFS, ∼100 Hz) of electrical pulses to obtain therapeutic efficacy. It is not clear whether the electrical energy of HFS functions other than generating firing of action potentials in neuronal elements. To address the question, we investigated the reactions of downstream neurons to pulse sequences with a frequency in the range 50–200 Hz at afferent axon fibers in the hippocampal CA1 region of anesthetized rats. The results show that the mean rates of neuronal firing induced by axonal HFS were similar even for an up to fourfold difference (200:50) in the number and thereby in the energy of electrical pulses delivered. However, HFS with a higher pulse frequency (100 or 200 Hz) generated more randomness in the firing pattern of neurons than a lower pulse frequency (50 Hz), which were quantitatively evaluated by the significant changes of two indexes, namely, the peak coefficients and the duty ratios of excitatory phase of neuronal firing, induced by different frequencies (50–200 Hz). The findings indicate that a large portion of the HFS energy might function to generate a desynchronization effect through a possible mechanism of intermittent depolarization block of neuronal membranes. The present study addresses the demand of high frequency for generating HFS-induced desynchronization in neuronal activity, which may play important roles in DBS therapy.

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“…Studies have shown that pulse stimulations can generate action potentials in efferent axons even though the firing of neuronal cell bodies is suppressed at stimulation sites [10]. The action potentials traveling along the efferent axons to the downstream neurons may play an important role in DBS therapy [30, 31]. The present study demonstrates the changes of dynamic balance between inhibition and excitation in the downstream neurons induced by axonal stimulations, thereby providing new insights into different effects of various stimulations.…”

Section: Discussionmentioning

confidence: 59%

Selective modulation of neuronal firing by pulse stimulations with different frequencies in rat hippocampus

et al. 2019

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Background Deep brain stimulation (DBS) has a good prospect for treating many brain diseases. Recent studies have shown that axonal activation induced by pulse stimulations may play an important role in DBS therapies through wide projections of axonal fibers. However, it is undetermined whether the downstream neurons are inhibited or excited by axonal stimulation. The present study addressed the question in rat hippocampus by in vivo experiments. Methods Pulse stimulations with different frequencies (10–400 Hz) were applied to the Schaffer collateral, the afferent fiber of hippocampal CA1 region in anaesthetized rats. Single-unit spikes of interneurons and pyramidal cells in the downstream region of stimulation were recorded and evaluated. Results Stimulations with a lower frequency (10 or 20 Hz) did not change the firing rates of interneurons but decreased the firing rates of pyramidal cells (the principal neurons) significantly. The phase-locked firing of interneurons during these stimulations might increase the efficacy of GABAergic inhibitions on the principal neurons. However, stimulations with a higher frequency (100–400 Hz) increased the firing rates of both types of the neurons significantly. In addition, the increases of interneurons’ firing were greater than the increases of pyramidal cells. Presumably, increase of direct excitation from afferent impulses together with failure of GABAergic inhibition might result in the increase of pyramidal cells’ firing by a higher stimulation frequency. Furthermore, silent periods appeared immediately following the cessation of stimulations, indicating a full control of the neuronal firing by the stimulation pulses during axonal stimulation. Furthermore longer silent periods were associated with higher stimulation frequencies. Conclusions Low-frequency (10–20 Hz) and high-frequency (100–400 Hz) stimulations of afferent axonal fibers exerted opposite effects on principal neurons in rat hippocampus CA1. These results provide new information for advancing deep brain stimulation to treat different brain disorders.

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White matter stimulation for the treatment of epilepsy

Cited by 16 publications

References 53 publications

Proceedings of the Fourth Annual Deep Brain Stimulation Think Tank: A Review of Emerging Issues and Technologies

Proceedings of the Fourth Annual Deep Brain Stimulation Think Tank: A Review of Emerging Issues and Technologies

Axonal Stimulations With a Higher Frequency Generate More Randomness in Neuronal Firing Rather Than Increase Firing Rates in Rat Hippocampus

Selective modulation of neuronal firing by pulse stimulations with different frequencies in rat hippocampus

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