Preventing morphine reinforcement with high‐frequency deep brain stimulation of the lateral hypothalamic area

2018 ◽  
Vol 24 (4) ◽  
pp. 685-695 ◽  
Author(s):  
Mojdeh Fattahi ◽  
Ghorbangol Ashabi ◽  
Seyed Morteza Karimian ◽  
Esmail Riahi
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
High Frequency ◽  
Lateral Hypothalamic Area ◽  
Hypothalamic Area ◽  
Lateral Hypothalamic ◽  
Deep Brain ◽  
Stimulation Of

scholarly journals Lateral hypothalamic area deep brain stimulation for refractory obesity: a pilot study with preliminary data on safety, body weight, and energy metabolism

2013 ◽  
Vol 119 (1) ◽  
pp. 56-63 ◽  
Author(s):  
Donald M. Whiting ◽  
Nestor D. Tomycz ◽  
Julian Bailes ◽  
Lilian de Jonge ◽  
Virgile Lecoultre ◽  
...  
Keyword(s):  
Weight Loss ◽  
Deep Brain Stimulation ◽  
Energy Metabolism ◽  
Pilot Study ◽  
Brain Stimulation ◽  
Lateral Hypothalamic Area ◽  
Hypothalamic Area ◽  
Lateral Hypothalamic ◽  
Deep Brain

Object Deep brain stimulation (DBS) of the lateral hypothalamic area (LHA) has been suggested as a potential treatment for intractable obesity. The authors present the 2-year safety results as well as early efficacy and metabolic effects in 3 patients undergoing bilateral LHA DBS in the first study of this approach in humans. Methods Three patients meeting strict criteria for intractable obesity, including failed bariatric surgery, underwent bilateral implantation of LHA DBS electrodes as part of an institutional review board– and FDA-approved pilot study. The primary focus of the study was safety; however, the authors also received approval to collect data on early efficacy including weight change and energy metabolism. Results No serious adverse effects, including detrimental psychological consequences, were observed with continuous LHA DBS after a mean follow-up of 35 months (range 30–39 months). Three-dimensional nonlinear transformation of postoperative imaging superimposed onto brain atlas anatomy was used to confirm and study DBS contact proximity to the LHA. No significant weight loss trends were seen when DBS was programmed using standard settings derived from movement disorder DBS surgery. However, promising weight loss trends have been observed when monopolar DBS stimulation has been applied via specific contacts found to increase the resting metabolic rate measured in a respiratory chamber. Conclusions Deep brain stimulation of the LHA may be applied safely to humans with intractable obesity. Early evidence for some weight loss under metabolically optimized settings provides the first “proof of principle” for this novel antiobesity strategy. A larger follow-up study focused on efficacy along with a more rigorous metabolic analysis is planned to further explore the benefits and therapeutic mechanism behind this investigational therapy.

scholarly journals Deep Brain Stimulation of the Posterior Insula in Chronic Pain: A Theoretical Framework

2021 ◽  
Vol 11 (5) ◽  
pp. 639
Author(s):  
David Bergeron ◽  
Sami Obaid ◽  
Marie-Pierre Fournier-Gosselin ◽  
Alain Bouthillier ◽  
Dang Khoa Nguyen
Keyword(s):  
Chronic Pain ◽  
Electrical Stimulation ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
High Frequency ◽  
Brain Lesion ◽  
Low Frequency ◽  
Posterior Insula ◽  
Deep Brain ◽  
Stimulation Of

Introduction: To date, clinical trials of deep brain stimulation (DBS) for refractory chronic pain have yielded unsatisfying results. Recent evidence suggests that the posterior insula may represent a promising DBS target for this indication. Methods: We present a narrative review highlighting the theoretical basis of posterior insula DBS in patients with chronic pain. Results: Neuroanatomical studies identified the posterior insula as an important cortical relay center for pain and interoception. Intracranial neuronal recordings showed that the earliest response to painful laser stimulation occurs in the posterior insula. The posterior insula is one of the only regions in the brain whose low-frequency electrical stimulation can elicit painful sensations. Most chronic pain syndromes, such as fibromyalgia, had abnormal functional connectivity of the posterior insula on functional imaging. Finally, preliminary results indicated that high-frequency electrical stimulation of the posterior insula can acutely increase pain thresholds. Conclusion: In light of the converging evidence from neuroanatomical, brain lesion, neuroimaging, and intracranial recording and stimulation as well as non-invasive stimulation studies, it appears that the insula is a critical hub for central integration and processing of painful stimuli, whose high-frequency electrical stimulation has the potential to relieve patients from the sensory and affective burden of chronic pain.

High-frequency deep brain stimulation of the putamen improves bradykinesia in Parkinson's disease

2011 ◽  
Vol 27 (1) ◽  
pp. 168-169
Author(s):  
Erwin B. Montgomery ◽  
He Huang ◽  
Harrison C. Walker ◽  
Barton L. Guthrie ◽  
Ray L. Watts
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
High Frequency ◽  
Deep Brain ◽  
Stimulation Of

scholarly journals Deep brain stimulation of posterior hypothalamic area for cluster headache

2018 ◽  
Vol 1 ◽  
pp. 251581631877133 ◽  
Author(s):  
Antti Huotarinen ◽  
Mikko Kallela ◽  
Ville Artto ◽  
Aki Laakso ◽  
Riku Kivisaari
Keyword(s):  
Deep Brain Stimulation ◽  
Cluster Headache ◽  
Brain Stimulation ◽  
Treatment Effect ◽  
Chronic Cluster Headache ◽  
University Hospital ◽  
Hypothalamic Area ◽  
Headache Patients ◽  
Deep Brain ◽  
Stimulation Of

Background: Deep brain stimulation of the posterior hypothalamic area is one of the neuromodulation treatments used for chronic cluster headache, but the number of published patients remains low. Aim: The aim of this article was to present the retrospective results of 12 consecutive chronic cluster headache patients treated with deep brain stimulation at Helsinki University Hospital. Materials and Methods: All chronic cluster headache patients treated with deep brain stimulation between 2004 and 2012 were included in the study. Patients were interviewed and their hospital files analyzed. Treatment effect was classified as good, partial, or no effect. Results: Of the 12 patients, four had a good treatment effect, five had partial, and three had no effect of deep brain stimulation. In contrast to previous studies, our patients reported an almost immediate benefit after the onset of stimulation. Conclusions: Deep brain stimulation provides clinically meaningful benefit to a subgroup of chronic cluster headache patients.

Stereotactic coordinates associated with facial musculature contraction during high-frequency stimulation of the subthalamic nucleus

2009 ◽  
Vol 110 (6) ◽  
pp. 1317-1321 ◽  
Author(s):  
Alessandra A. Gorgulho ◽  
Donald C. Shields ◽  
Dennis Malkasian ◽  
Eric Behnke ◽  
Antonio A. F. DeSalles
Keyword(s):  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
High Frequency ◽  
Electrical Current ◽  
High Frequency Stimulation ◽  
Facial Musculature ◽  
Frequency Stimulation ◽  
Deep Brain ◽  
Stimulation Of

Object High-frequency stimulation of the subthalamic nucleus (STN) in patients with parkinsonian symptoms is often used to ameliorate debilitating motor symptoms associated with this condition. However, individual variability in the shape and orientation of this relatively small nucleus results in multiple side effects related to the spread of electrical current to surrounding structures. Specifically, contraction of the muscles of facial expression is noted in a small percentage of patients, although the precise mechanism remains poorly understood. Methods Facial muscle contraction was triggered by high-frequency stimulation of 49 contacts in 18 patients undergoing deep brain stimulation of the STN. The mean coordinates of these individual contacts relative to the anterior commissure–posterior commissure midpoint (also called the midcommissural point) were calculated to determine the location or structure(s) most often associated with facial contraction during physiological macrostimulation. Results The x, y, and z coordinates associated with contraction of the facial musculature were found to be 11.52, 1.29, and 1.15 mm lateral, posterior, and inferior to the midcommissural point, respectively. This location, along the lateral-anterior-superior border of the STN, may allow for the spread of electrical current to the fields of Forel, zona incerta, and/or descending corticospinal/corticobulbar tracts. Because stimulation of corticobulbar tracts produces similar findings, these results are best explained by the spread of electrical current to nearby internal capsule axons coursing lateral to the STN. Conclusions Thus, if intraoperative deep brain stimulation lead testing results in facial musculature contraction, placement of the electrode in a more medial, posterior position may reduce the amount of current spread to corticobulbar fibers and resolve this side effect.

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