Technology of deep brain stimulation: current status and future directions

Nature Reviews Neurology, Год журнала: 2020, Номер 17(2), С. 75 - 87

Опубликована: Ноя. 26, 2020

Язык: Английский

---

A unified connectomic target for deep brain stimulation in obsessive-compulsive disorder

Nature Communications, Год журнала: 2020, Номер 11(1)

Опубликована: Июль 3, 2020

Abstract Multiple surgical targets for treating obsessive-compulsive disorder with deep brain stimulation (DBS) have been proposed. However, different may modulate the same neural network responsible clinical improvement. We analyzed data from four cohorts of patients ( N = 50) that underwent DBS to anterior limb internal capsule (ALIC), nucleus accumbens or subthalamic (STN). The fiber bundle was associated optimal response in targeting either structure. This connected frontal regions STN. When informing tract target based on first cohort, improvements second could be significantly predicted, and vice versa. To further confirm results, eight a third center six fourth were predicted their overlap this tract. Our results show connectivity-derived models inform across targets, surgeons centers. identified is openly available atlas form.

Язык: Английский

---

7 Tesla MRI of the ex vivo human brain at 100 micron resolution

Scientific Data, Год журнала: 2019, Номер 6(1)

Опубликована: Окт. 30, 2019

We present an ultra-high resolution MRI dataset of ex vivo human brain specimen. The specimen was donated by a 58-year-old woman who had no history neurological disease and died non-neurological causes. After fixation in 10% formalin, the imaged on 7 Tesla scanner at 100 µm isotropic using custom-built 31-channel receive array coil. Single-echo multi-flip Fast Low-Angle SHot (FLASH) data were acquired over hours scan time (25 per flip angle), allowing derivation synthesized FLASH volumes. This provides unprecedented view three-dimensional neuroanatomy brain. To optimize utility this resource, we warped into standard stereotactic space. now distribute both native space to academic community via multiple platforms. envision that will have broad range investigational, educational, clinical applications advance understanding anatomy health disease.

Язык: Английский

---

Dynamic coupling of whole-brain neuronal and neurotransmitter systems

Proceedings of the National Academy of Sciences, Год журнала: 2020, Номер 117(17), С. 9566 - 9576

Опубликована: Апрель 13, 2020

Significance In a technical tour de force, we have created framework demonstrating the underlying fundamental principles of bidirectional coupling neuronal and neurotransmitter dynamical systems. Specifically, in present study, combined multimodal neuroimaging data to causally explain functional effects specific serotoninergic receptor (5-HT 2A R) stimulation with psilocybin healthy humans. Longer term, this could provide better understanding why is showing considerable promise as therapeutic intervention for neuropsychiatric disorders including depression, anxiety, addiction.

Язык: Английский

---

Integrative and Network-Specific Connectivity of the Basal Ganglia and Thalamus Defined in Individuals

Neuron, Год журнала: 2019, Номер 105(4), С. 742 - 758.e6

Опубликована: Дек. 10, 2019

Язык: Английский

---

Deep Brain Stimulation in Movement Disorders: From Experimental Surgery to Evidence‐Based Therapy

Movement Disorders, Год журнала: 2019, Номер 34(12), С. 1795 - 1810

Опубликована: Окт. 3, 2019

ABSTRACT Deep brain stimulation (DBS) of 3 different targets is the most important therapeutic innovation past 30 years for patients with fluctuating Parkinson's disease (PD), disabling dystonia, tremors, and refractory Gilles de la Tourette syndrome. When compared medical treatment alone, controlled studies have shown better motor, nonmotor, particularly quality‐of‐life outcomes large effect sizes advanced complicated PD that cannot be improved medication, also only early fluctuations. Class 1 superiority over generalized, segmental, botulinum‐toxin focal cervical dystonia. Long‐term efficacy established all indications open studies. For DBS remarkably effective on essential tremor, but severe tremor cerebellar tremors limited by a tendency tolerance/habituation, including concerns about long‐term efficacy. Open syndrome show an improvement in tics. New developments hold promise further improvement. hardware directional new paradigms are areas research. The refined imaging processing will help to diversify surgical targets. being explored. Closed‐loop using or peripheral sensor signals favorable clinical short‐term results. data lacking, it hoped similar approaches other movement behavioral disorders may developed. Exciting carry hope more pathophysiology‐based approach various circuit disorders. © 2019 International Parkinson Movement Disorder Society

Язык: Английский

---

Probabilistic sweet spots predict motor outcome for deep brain stimulation in Parkinson disease

Annals of Neurology, Год журнала: 2019, Номер 86(4), С. 527 - 538

Опубликована: Авг. 3, 2019

Objective To investigate whether functional sweet spots of deep brain stimulation (DBS) in the subthalamic nucleus (STN) can predict motor improvement Parkinson disease (PD) patients. Methods Stimulation effects 449 DBS settings 21 PD patients were clinically and quantitatively assessed through standardized monopolar reviews mapped into standard space. A spot for best outcome was determined using voxelwise nonparametric permutation statistics. Two independent cohorts used to overlap with could acute (10 patients, 163 settings) long‐term overall Unified Parkinson's Disease Rating Scale Part III (UPDRS‐III) (63 patients). Results Significant clusters suppression rigidity akinesia, as well improvement, resided around dorsolateral border STN. Overlap volume tissue activated explained R 2 = 37% variance more than triple what by STN ( 9%) its sensorimotor subpart 10%). In second cohort, 20% UPDRS‐III which equivalent 21%) 19%). Interpretation This study is first clinical parkinsonian symptoms across based on local only. The new approach revealed a distinct PD. short‐ may be guide programming. ANN NEUROL 2019;86:527–538

Язык: Английский

---

Opportunities of connectomic neuromodulation

NeuroImage, Год журнала: 2020, Номер 221, С. 117180 - 117180

Опубликована: Июль 20, 2020

The process of altering neural activity – neuromodulation has long been used to treat patients with brain disorders and answer scientific questions. Deep stimulation in particular provided clinical benefit over 150,000 patients. However, our understanding how impacts the is evolving. Instead focusing on local impact at site itself, we are considering remote regions connected site. Brain connectivity information derived from advanced magnetic resonance imaging data can be identify these connections better understand behavioral effects neuromodulation. In this article, review studies combining connectomics, highlighting opportunities where approach may prove particularly valuable. We focus deep stimulation, but show that same principles applied other forms neuromodulation, such as transcranial MRI-guided focused ultrasound. outline future perspectives provide testable hypotheses for work.

Язык: Английский

---

Towards network-guided neuromodulation for epilepsy

Brain, Год журнала: 2022, Номер 145(10), С. 3347 - 3362

Опубликована: Июнь 30, 2022

Abstract Epilepsy is well-recognized as a disorder of brain networks. There growing body research to identify critical nodes within dynamic epileptic networks with the aim target therapies that halt onset and propagation seizures. In parallel, intracranial neuromodulation, including deep stimulation responsive neurostimulation, are well-established expanding reduce seizures in adults focal-onset epilepsy; there emerging evidence for their efficacy children generalized-onset seizure disorders. The convergence these advancing fields driving an era ‘network-guided neuromodulation’ epilepsy. this review, we distil current literature on network mechanisms underlying neurostimulation We discuss modulation key ‘propagation points’ epileptogenic network, focusing primarily thalamic nuclei targeted clinical practice. These include (i) anterior nucleus thalamus, now clinically approved site open loop stimulation, increasingly neurostimulation; (ii) centromedian both epilepsies. briefly associated other neuromodulation targets, such pulvinar piriform cortex, septal area, subthalamic nucleus, cerebellum others. report synergistic findings garnered from multiple modalities investigation have revealed structural functional points — scalp invasive EEG, diffusion MRI. also recordings implanted devices which provide us data aiming modulate. Finally, review continuing evolution network-guided epilepsy accelerate progress towards two translational goals: use pre-surgical analyses determine patient candidacy by providing biomarkers predict efficacy; deliver precise, personalized effective antiepileptic prevent arrest through mapping each patients’ individual

Язык: Английский

---

Neural signatures of hyperdirect pathway activity in Parkinson’s disease

Nature Communications, Год журнала: 2021, Номер 12(1)

Опубликована: Авг. 31, 2021

Abstract Parkinson’s disease (PD) is characterised by the emergence of beta frequency oscillatory synchronisation across cortico-basal-ganglia circuit. The relationship between anatomy this circuit and within it remains unclear. We address combining recordings from human subthalamic nucleus (STN) internal globus pallidus (GPi) with magnetoencephalography, tractography computational modelling. Coherence supplementary motor area STN high (21–30 Hz) but not low (13-21 range correlated ‘hyperdirect pathway’ fibre densities these structures. Furthermore, activity drove selectively at frequencies suggesting that propagate cortex to basal ganglia via hyperdirect pathway. Computational modelling revealed exaggerated pathway can provoke generation widespread pathological synchrony lower frequencies. These findings suggest a spectral signature pathophysiological role for in PD.

Язык: Английский

---