Lead-DBS v3.0: Mapping deep brain stimulation effects to local anatomy and global networks

NeuroImage, Год журнала: 2023, Номер 268, С. 119862 - 119862

Опубликована: Янв. 5, 2023

Following its introduction in 2014 and with support of a broad international community, the open-source toolbox Lead-DBS has evolved into comprehensive neuroimaging platform dedicated to localizing, reconstructing, visualizing electrodes implanted human brain, context deep brain stimulation (DBS) epilepsy monitoring. Expanding clinical indications for DBS, increasing availability related research tools, growing community clinician-scientist researchers, however, have led an ongoing need maintain, update, standardize codebase Lead-DBS. Major development efforts recent years now yielded end-to-end solution DBS-based analysis allowing image preprocessing, lead localization, volume modeling, statistical within single tool. The aim present manuscript is introduce fundamental additions pipeline including deformation warpfield editor novel algorithms electrode localization. Furthermore, we total three tools map DBS effects local, tract- network-levels. These updates are demonstrated using patient example (for subject-level analysis), as well retrospective cohort 51 Parkinson's disease patients who underwent subthalamic nucleus group-level analysis). Their applicability further by comparing various methodological choices amount explained variance outcomes across streams. Finally, based on folder file naming specifications groups neuroscience, imaging data structure (BIDS) derivative standard Thus, this multi-institutional collaborative effort represents important stage evolution comprehensive, connectomics.

Язык: Английский

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Connectomic Deep Brain Stimulation for Obsessive-Compulsive Disorder

Biological Psychiatry, Год журнала: 2021, Номер 90(10), С. 678 - 688

Опубликована: Июль 19, 2021

Obsessive-compulsive disorder is among the most disabling psychiatric disorders. Although deep brain stimulation considered an effective treatment, its use in clinical practice not fully established. This is, at least part, due to ambiguity about best suited target and insufficient knowledge underlying mechanisms. Recent advances suggest that changes broader networks are responsible for improvement of obsessions compulsions, rather than local impact site. These findings were fueled by innovative methodological approaches using connectivity analyses combination with neuromodulatory interventions. Such a connectomic approach neuromodulation constitutes integrative account aims characterize optimal networks. In this critical review, we integrate from studies interventions neural network presumably reducing compulsions. To end, scrutinize methodologies seemingly conflicting aim merge observations identify common diverse pathways treating obsessive-compulsive disorder. Ultimately, propose unified that—when modulated means cortical or subcortical interventions—alleviates symptoms.

Язык: Английский

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Probing responses to deep brain stimulation with functional magnetic resonance imaging

Brain stimulation, Год журнала: 2022, Номер 15(3), С. 683 - 694

Опубликована: Апрель 19, 2022

Deep brain stimulation (DBS) is an established treatment for certain movement disorders and has additionally shown promise various psychiatric, cognitive, seizure disorders. However, the mechanisms through which exerts therapeutic effects are incompletely understood. A technique that may help to address this knowledge gap functional magnetic resonance imaging (fMRI). This a non-invasive tool permits observation of DBS in vivo.The objective review was provide comprehensive overview studies fMRI during active performed, including studied disorders, stimulated regions, experimental designs, insights gleaned from stimulation-evoked responses.We conducted systematic published human performed patients. The search using PubMED MEDLINE.The rate increasing over time, with 37 identified overall. median number patients per study 10 (range = 1-67, interquartile range 11). Studies examined responses disease cohorts, Parkinson's (24 studies), essential tremor (3 epilepsy obsessive-compulsive disorder (2 pain Tourette syndrome (1 study), major depressive disorder, anorexia, bipolar dementia Lewy bodies study). most commonly region subthalamic nucleus studies). showed modulates large-scale networks, related site stimulation, parameters, patient characteristics, outcomes. Finally, proposed fMRI-based biomarkers treatment, highlighting ways could be used confirm circuit engagement refine therapy.A literature reflects exciting expanding field, showing combination represents uniquely powerful simultaneously manipulating observing neural circuitry. Future work should focus on relatively understudied cohorts while focusing prospective validation putative biomarkers.

Язык: Английский

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Proceedings of the 10th annual deep brain stimulation think tank: Advances in cutting edge technologies, artificial intelligence, neuromodulation, neuroethics, interventional psychiatry, and women in neuromodulation

Frontiers in Human Neuroscience, Год журнала: 2023, Номер 16

Опубликована: Янв. 27, 2023

The deep brain stimulation (DBS) Think Tank X was held on August 17–19, 2022 in Orlando FL. session organizers and moderators were all women with the theme neuromodulation . Dr. Helen Mayberg from Mt. Sinai, NY keynote speaker. She discussed milestones her experiences developing depression DBS. DBS founded 2012 provides an open platform where clinicians, engineers researchers (from industry academia) can freely discuss current emerging technologies as well logistical ethical issues facing field. consensus among speakers that has continued to expand scope however several indications have reached “trough of disillusionment.” for considered “re-emerging” approaching a slope enlightenment. will soon re-enter clinical trials. group estimated globally more than 244,000 devices been implanted neurological neuropsychiatric disorders. This year’s meeting focused advances following areas: Europe, Asia, Australia; cutting-edge technologies, closed loop DBS, tele-health, neuroethics, lesion therapy, interventional psychiatry, adaptive

Язык: Английский

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Left or right ear? A neuroimaging study using combined taVNS/fMRI to understand the interaction between ear stimulation target and lesion location in chronic stroke

Brain stimulation, Год журнала: 2023, Номер 16(4), С. 1144 - 1153

Опубликована: Июль 1, 2023

Implanted vagus nerve stimulation (VNS) and transcutaneous auricular VNS (taVNS) have been primarily administered clinically to the unilateral-left nerve. This left-only convention has proved beneficial in brain disorders. However, stroke survivors, presence of a lesion may complicate VNS-mediated signaling, it is important understand laterality effects survivors optimize intervention.To whether taVNS delivered different ear targets relative (ipsilesional vs contralesional bilateral sham) impacts blood oxygenation level dependent (BOLD) signal propagation survivors.We enrolled 20 adults with prior history stroke. Each participant underwent single visit, during which was concurrently functional magnetic resonance imaging (fMRI) acquisition. received three discrete active conditions (ipsilesional, contralesional, bilateral) one sham condition randomized order. Stimulation-related BOLD changes were compared interaction effects.All deactivated default mode network related regions sham, however only ipsilesional enhanced activations visuomotor secondary visual cortex. Furthermore, we reveal an task between cortical areas, where significantly increased activity decreased sham.Laterality critical factor optimizing population, providing largest direct activation should be explored further when designing studies neurorehabilitation.

Язык: Английский

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Deep Brain Stimulation Initiative: Toward Innovative Technology, New Disease Indications, and Approaches to Current and Future Clinical Challenges in Neuromodulation Therapy

Frontiers in Neurology, Год журнала: 2021, Номер 11

Опубликована: Янв. 28, 2021

Deep brain stimulation (DBS) is one of the most important clinical therapies for neurological disorders. DBS also has great potential to become a tool neuroscience research. Recently, National Engineering Laboratory Neuromodulation at Tsinghua University held an international Brain Stimulation Initiative workshop discuss cutting-edge technological achievements and applications DBS. We specifically addressed new approaches challenges in movement disorders (Parkinson's disease dystonia), application toward neurorehabilitation stroke, progress neuropsychiatric This review highlighted key developments (1) neuroimaging, with advancements 3-Tesla magnetic resonance imaging compatibility exploration network mechanisms; (2) novel recording capabilities uncovering pathophysiology; (3) overcoming global healthcare burdens online-based programming technology connecting patient communities. The successful event marks milestone collaborative opportunities development neuromodulation treat major

Язык: Английский

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Subthalamic stimulation modulates motor network in Parkinson’s disease: recover, relieve and remodel

Brain, Год журнала: 2023, Номер 146(7), С. 2780 - 2791

Опубликована: Янв. 10, 2023

Abstract Aberrant dynamic switches between internal brain states are believed to underlie motor dysfunction in Parkinson’s disease. Deep stimulation of the subthalamic nucleus is a well-established treatment for symptoms disease, yet it remains poorly understood how modulates whole-brain intrinsic network state dynamics. To investigate this, we acquired resting-state functional magnetic resonance imaging time-series data from 27 medication-free patients with disease (mean age: 64.8 years, standard deviation: 7.6) who had deep electrodes implanted nucleus, both on and off states. Sixteen matched healthy individuals were included as control group. We adopted powerful data-driven modelling approach, known hidden Markov model, disclose emergence recurring activation patterns interacting regions (whole-brain states) via blood oxygen level-dependent signal detected all participants. The estimated model disclosed dynamics distinct states, including frequency occurrence, duration, fractional coverage their transition probabilities. Notably, decoding revealed that reshaped expression stabilized transitions. Moreover, improved by modulating key trajectories within This modulation mechanism was manifested three significant effects: recovery, relieving remodelling effects. Significantly, recovery effects correlated improvements tremor posture induced (P < 0.05). Furthermore, found restore relatively low level fluctuation connectivity closer Also, changes associated gait These findings fill gap our knowledge role at neural activity, revealing regulatory inherent Our results provide mechanistic insight explanation

Язык: Английский

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Subthalamic and Pallidal Stimulations in Patients with Parkinson's Disease: Common and Dissociable Connections

Annals of Neurology, Год журнала: 2021, Номер 90(4), С. 670 - 682

Опубликована: Авг. 14, 2021

Objective The subthalamic nucleus (STN) and internal globus pallidus (GPi) are the most effective targets in deep brain stimulation (DBS) for Parkinson's disease (PD). However, common specific effects on connectivity of stimulating 2 nuclei remain unclear. Methods Patients with PD receiving STN‐DBS (n = 27, 6 women, mean age 64.8 years) or GPi‐DBS 28, 13 64.6 were recruited resting‐state functional magnetic resonance imaging to assess dynamics. Results both between somatosensory‐motor cortices thalamus, cerebellum decreased DBS‐on state compared off ( p < 0.05). changes thalamocortical correlated DBS‐induced motor improvement 0.05) negatively normalized intersection volume tissues activated at DBS modulated among a wider range areas than 0.009). Notably, only affected postcentral gyrus cerebellar vermis 0.001) somatomotor visual networks 0.001). Interpretation Our findings highlight alterations pathway its relationship induced by STN‐ GPi‐DBS. cortico‐cerebellar somatomotor‐visual differed groups, suggesting differentiated neural modulation target sites. results provide mechanistic insight yield potential refine selection strategies focal PD. ANN NEUROL 2021;90:670–682

Язык: Английский

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Recent developments in representations of the connectome

NeuroImage, Год журнала: 2021, Номер 243, С. 118533 - 118533

Опубликована: Авг. 29, 2021

Research into the human connectome (i.e., all connections in brain) with use of resting state functional MRI has rapidly increased popularity recent years, especially growing availability large-scale neuroimaging datasets. The goal this review article is to describe innovations representations that have come about past 8 since 2013 NeuroImage special issue on 'Mapping Connectome'. In period, research shifted from group-level brain parcellations towards characterization individualized and relationships between individual connectomic differences behavioral/clinical variation. Achieving subject-specific accuracy parcel boundaries while retaining cross-subject correspondence challenging, a variety different approaches are being developed meet challenge, including improved alignment, noise reduction, robust group-to-subject mapping approaches. Beyond interest connectome, new data studied complement traditional parcellated representation pairwise distinct regions), such as methods capture overlapping smoothly varying patterns connectivity ('gradients'). These offer complimentary insights inherent organization brain, but challenges for remain. Interpretability will be by future gaining neural mechanisms underlying observations obtained MRI. Validation studies comparing also needed build consensus confidence proceed clinical trials may produce meaningful translation insights.

Язык: Английский

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3T MRI of rapid brain activity changes driven by subcallosal cingulate deep brain stimulation

Brain, Год журнала: 2021, Номер 145(6), С. 2214 - 2226

Опубликована: Дек. 13, 2021

Abstract Deep brain stimulation targeting the subcallosal cingulate area, a hub with multiple axonal projections, has shown therapeutic potential for treatment-resistant mood disorders. While deep drives long-term metabolic changes in corticolimbic circuits, areas that are directly modulated by electrical of this region not known. We used 3.0 T functional MRI to map topography acute produced an initial cohort 12 patients fully implanted devices area. Four additional were also scanned and employed as validation cohort. Participants underwent resting state scans (n = 78 acquisitions overall) during (i) inactive stimulation; (ii) clinically optimal active (iii) suboptimal stimulation. All acquired within single session, each separated 5-min washout period. Analysis amplitude low-frequency fluctuations sequence indicated reduced spontaneous activity several areas, including bilateral dorsal anterior cortex, posterior precuneus left inferior parietal lobule (PBonferroni &lt; 0.0001). Stimulation-induced cortex signal reduction correlated immediate within-session fluctuations, was greater at versus settings related local cingulum bundle engagement. Moreover, linear modelling showed could predict individual antidepressant improvement. A model derived from primary incorporated these three (along preoperative symptom severity) explained 55% variance clinical improvement The same 93% out-of-sample Additionally, all exhibited significant connectivity between states 0.01). These results provide insight into network-level mechanisms point towards biomarkers response help optimize personalize therapy.

Язык: Английский

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