scholarly journals Neuroimaging evaluation of deep brain stimulation in the treatment of representative neurodegenerative and neuropsychiatric disorders

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Shichun Peng ◽  
Vijay Dhawan ◽  
David Eidelberg ◽  
Yilong Ma
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Targeted Delivery ◽  
Target Identification ◽  
Brain Dysfunction ◽  
Bioelectronic Medicine ◽  
Neurosurgical Planning ◽  
Brain Circuitry ◽  
Pre Treatment ◽  
Deep Brain

AbstractBrain stimulation technology has become a viable modality of reversible interventions in the effective treatment of many neurological and psychiatric disorders. It is aimed to restore brain dysfunction by the targeted delivery of specific electronic signal within or outside the brain to modulate neural activity on local and circuit levels. Development of therapeutic approaches with brain stimulation goes in tandem with the use of neuroimaging methodology in every step of the way. Indeed, multimodality neuroimaging tools have played important roles in target identification, neurosurgical planning, placement of stimulators and post-operative confirmation. They have also been indispensable in pre-treatment screen to identify potential responders and in post-treatment to assess the modulation of brain circuitry in relation to clinical outcome measures. Studies in patients to date have elucidated novel neurobiological mechanisms underlying the neuropathogenesis, action of stimulations, brain responses and therapeutic efficacy. In this article, we review some applications of deep brain stimulation for the treatment of several diseases in the field of neurology and psychiatry. We highlight how the synergistic combination of brain stimulation and neuroimaging technology is posed to accelerate the development of symptomatic therapies and bring revolutionary advances in the domain of bioelectronic medicine.

scholarly journals Stereotactic neurosurgical planning, recording, and visualization for deep brain stimulation in non-human primates

2007 ◽  
Vol 162 (1-2) ◽  
pp. 32-41 ◽  
Author(s):  
Svjetlana Miocinovic ◽  
Jianyu Zhang ◽  
Weidong Xu ◽  
Gary S. Russo ◽  
Jerrold L. Vitek ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Neurosurgical Planning ◽  
Deep Brain

scholarly journals Probabilistic versus deterministic tractography for delineation of the cortico-subthalamic hyperdirect pathway in patients with Parkinson disease selected for deep brain stimulation

2017 ◽  
Vol 126 (5) ◽  
pp. 1657-1668 ◽  
Author(s):  
Mikkel V. Petersen ◽  
Torben E. Lund ◽  
Niels Sunde ◽  
Jesper Frandsen ◽  
Frederikke Rosendal ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Motor Cortex ◽  
Parkinson Disease ◽  
Brain Stimulation ◽  
Probabilistic Method ◽  
Clinical Settings ◽  
Constrained Spherical Deconvolution ◽  
Spherical Deconvolution ◽  
Neurosurgical Planning ◽  
Deep Brain

OBJECTIVEDiffusion-weighted MRI (DWI) and tractography allows noninvasive mapping of the structural connections of the brain, and may provide important information for neurosurgical planning. The hyperdirect pathway, connecting the subthalamic nucleus (STN) with the motor cortex, is assumed to play a key role in mediating the effects of deep brain stimulation (DBS), which is an effective but poorly understood treatment for Parkinson disease. This study aimed to apply recent methodological advances in DWI acquisition and analysis to the delineation of the hyperdirect pathway in patients with Parkinson disease selected for surgery.METHODSHigh spatial and angular resolution DWI data were acquired preoperatively from 5 patients with Parkinson disease undergoing DBS. The authors compared the delineated hyperdirect pathways and associated STN target maps generated by 2 different tractography methods: a tensor-based deterministic method, typically available in clinical settings, and an advanced probabilistic method based on constrained spherical deconvolution. In addition, 10 high-resolution data sets with the same scanning parameters were acquired from a healthy control participant to assess the robustness of the tractography results.RESULTSBoth tractography approaches identified connections between the ipsilateral motor cortex and the STN. However, the 2 methods provided substantially different target regions in the STN, with the target center of gravity differing by > 1.4 mm on average. The probabilistic method (based on constrained spherical deconvolution) plausibly reconstructed a continuous set of connections from the motor cortex, terminating in the dorsolateral region of the STN. In contrast, the tensor-based method reconstructed a comparatively sparser and more variable subset of connections. Furthermore, across the control scans, the probabilistic method identified considerably more consistent targeting regions within the STN compared with the deterministic tensor-based method, which demonstrated a 1.9–2.4 times higher variation.CONCLUSIONSThese data provide a strong impetus for the use of a robust probabilistic tractography framework based on constrained spherical deconvolution, or similar advanced DWI models, in clinical settings. The inherent limitations and demonstrated inaccuracy of the tensor-based method leave it questionable for use in high-precision stereotactic DBS surgery. The authors have also described a straightforward method for importing tractography-derived information into any clinical neuronavigation system, based on the generation of track-density images.

scholarly journals Robust modulation of arousal regulation, performance, and frontostriatal activity through central thalamic deep brain stimulation in healthy nonhuman primates

2016 ◽  
Vol 116 (5) ◽  
pp. 2383-2404 ◽  
Author(s):  
Jonathan L. Baker ◽  
Jae-Wook Ryou ◽  
Xuefeng F. Wei ◽  
Christopher R. Butson ◽  
Nicholas D. Schiff ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Nonhuman Primates ◽  
Brain Dysfunction ◽  
Mammalian Brain ◽  
Optimal Method ◽  
Novel Method ◽  
Central Thalamus ◽  
Lateral Nucleus ◽  
Deep Brain

The central thalamus (CT) is a key component of the brain-wide network underlying arousal regulation and sensory-motor integration during wakefulness in the mammalian brain. Dysfunction of the CT, typically a result of severe brain injury (SBI), leads to long-lasting impairments in arousal regulation and subsequent deficits in cognition. Central thalamic deep brain stimulation (CT-DBS) is proposed as a therapy to reestablish and maintain arousal regulation to improve cognition in select SBI patients. However, a mechanistic understanding of CT-DBS and an optimal method of implementing this promising therapy are unknown. Here we demonstrate in two healthy nonhuman primates (NHPs), Macaca mulatta, that location-specific CT-DBS improves performance in visuomotor tasks and is associated with physiological effects consistent with enhancement of endogenous arousal. Specifically, CT-DBS within the lateral wing of the central lateral nucleus and the surrounding medial dorsal thalamic tegmental tract (DTTm) produces a rapid and robust modulation of performance and arousal, as measured by neuronal activity in the frontal cortex and striatum. Notably, the most robust and reliable behavioral and physiological responses resulted when we implemented a novel method of CT-DBS that orients and shapes the electric field within the DTTm using spatially separated DBS leads. Collectively, our results demonstrate that selective activation within the DTTm of the CT robustly regulates endogenous arousal and enhances cognitive performance in the intact NHP; these findings provide insights into the mechanism of CT-DBS and further support the development of CT-DBS as a therapy for reestablishing arousal regulation to support cognition in SBI patients.

Nicht-medikamentöse Optionen zur Behandlung pharmakoresistenter Epilepsien

2018 ◽  
Vol 75 (7) ◽  
pp. 448-454
Author(s):  
Thomas Grunwald ◽  
Judith Kröll
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Tiefe Hirnstimulation ◽  
Ketogene Diät ◽  
Deep Brain

Zusammenfassung. Wenn mit den ersten beiden anfallspräventiven Medikamenten keine Anfallsfreiheit erzielt werden konnte, so ist die Wahrscheinlichkeit, dies mit anderen Medikamenten zu erreichen, nur noch ca. 10 %. Es sollte dann geprüft werden, warum eine Pharmakoresistenz besteht und ob ein epilepsiechirurgischer Eingriff zur Anfallsfreiheit führen kann. Ist eine solche Operation nicht möglich, so können palliative Verfahren wie die Vagus-Nerv-Stimulation (VNS) und die tiefe Hirnstimulation (Deep Brain Stimulation) in eine bessere Anfallskontrolle ermöglichen. Insbesondere bei schweren kindlichen Epilepsien stellt auch die ketogene Diät eine zu erwägende Option dar.

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