scholarly journals Does Belief in Dualism Protect against Maladaptive Psycho- Social Responses to Deep Brain Stimulation? An Empirical Exploration

2019 ◽  
Author(s):  
Jason Shepard ◽  
Joshua May
Keyword(s):  
Deep Brain Stimulation ◽  
Empirical Evidence ◽  
Brain Stimulation ◽  
Theoretical Perspective ◽  
Social Responses ◽  
Target Article ◽  
The Mind ◽  
The Brain ◽  
Deep Brain

We provide empirical evidence that people who believe in dualism are more likely to be uncomfortable with Deep Brain Stimulation (DBS) and to view it as threatening to their identity, humanity, or self. It is (neurocentric) materialists—who think the mind just is the brain—that are less inclined to fear DBS or to see it as threatening. We suggest various possible reasons for this connection. The inspiration for this brief report is a target article that addresses this issue from a theoretical perspective.

Brain shift: an error factor during implantation of deep brain stimulation electrodes

2007 ◽  
Vol 107 (5) ◽  
pp. 989-997 ◽  
Author(s):  
Yasushi Miyagi ◽  
Fumio Shima ◽  
Tomio Sasaki
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Brain Shift ◽  
Mr Images ◽  
Implanted Electrodes ◽  
Error Factor ◽  
Bilateral Surgery ◽  
Second Procedure ◽  
The Brain ◽  
Deep Brain

Object The goal of this study was to focus on the tendency of brain shift during stereotactic neurosurgery and the shift's impact on the unilateral and bilateral implantation of electrodes for deep brain stimulation (DBS). Methods Eight unilateral and 10 bilateral DBS electrodes at 10 nuclei ventrales intermedii and 18 subthalamic nuclei were implanted in patients at Kaizuka Hospital with the aid of magnetic resonance (MR) imaging–guided and microelectrode-guided methods. Brain shift was assessed as changes in the 3D coordinates of the anterior and posterior commissures (AC and PC) with MR images before and immediately after the implantation surgery. The positions of the implanted electrodes, based on the midcommissural point and AC–PC line, were measured both on x-ray films (virtual position) during surgery and the postoperative MR images (actual position) obtained on the 7th day postoperatively. Results Contralateral and posterior shift of the AC and PC were the characteristics of unilateral and bilateral procedures, respectively. The authors suggest the following. 1) The first unilateral procedure elicits a unilateral air invasion, resulting in a contralateral brain shift. 2) During the second procedure in the bilateral surgery, the contralateral shift is reset to the midline and, at the same time, the anteroposterior support by the contralateral hemisphere against gravity is lost due to a bilateral air invasion, resulting in a significant posterior (caudal) shift. Conclusions To note the tendency of the brain to shift is very important for accurate implantation of a DBS electrode or high frequency thermocoagulation, as well as for the prediction of therapeutic and adverse effects of stereotactic surgery.

Accuracy of Magnetic Resonance Imaging–Directed Frame-Based Stereotaxis

2011 ◽  
Vol 70 (suppl_1) ◽  
pp. ons114-ons124 ◽  
Author(s):  
Nova B. Thani ◽  
Arul Bala ◽  
Christopher R. P. Lind
Keyword(s):  
Deep Brain Stimulation ◽  
Magnetic Resonance ◽  
Brain Stimulation ◽  
Entry Point ◽  
Mean Deviation ◽  
Guide Tube ◽  
3 Dimensional ◽  
The Mean ◽  
The Brain ◽  
Deep Brain

Abstract BACKGROUND: Accurate placement of a probe to the deep regions of the brain is an important part of neurosurgery. In the modern era, magnetic resonance image (MRI)-based target planning with frame-based stereotaxis is the most common technique. OBJECTIVE: To quantify the inaccuracy in MRI-guided frame-based stereotaxis and to assess the relative contributions of frame movements and MRI distortion. METHODS: The MRI-directed implantable guide-tube technique was used to place carbothane stylettes before implantation of the deep brain stimulation electrodes. The coordinates of target, dural entry point, and other brain landmarks were compared between preoperative and intraoperative MRIs to determine the inaccuracy. RESULTS: The mean 3-dimensional inaccuracy of the stylette at the target was 1.8 mm (95% confidence interval [CI], 1.5-2.1. In deep brain stimulation surgery, the accuracy in the x and y (axial) planes is important; the mean axial inaccuracy was 1.4 mm (95% CI, 1.1-1.8). The maximal mean deviation of the head frame compared with brain over 24.1 ± 1.8 hours was 0.9 mm (95% CI, 0.5-1.1). The mean 3-dimensional inaccuracy of the dural entry point of the stylette was 1.8 mm (95% CI, 1.5-2.1), which is identical to that of the target. CONCLUSION: Stylette positions did deviate from the plan, albeit by 1.4 mm in the axial plane and 1.8 mm in 3-dimensional space. There was no difference between the accuracies at the dura and the target approximately 70 mm deep in the brain, suggesting potential feasibility for accurate planning along the whole trajectory.

scholarly journals Low frequency deep brain stimulation in the inferior colliculus ameliorates haloperidol-induced catalepsy and reduces anxiety in rats

PLoS ONE ◽  
2020 ◽  
Vol 15 (12) ◽  
pp. e0243438
Author(s):  
Hannah Ihme ◽  
Rainer K. W. Schwarting ◽  
Liana Melo-Thomas
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Low Frequency ◽  
Anxiolytic Effect ◽  
Motor Deficits ◽  
Sham Treatment ◽  
Plus Maze ◽  
Aversive Behavior ◽  
The Brain ◽  
Deep Brain

Deep brain stimulation (DBS) of the colliculus inferior (IC) improves haloperidol-induced catalepsy and induces paradoxal kinesia in rats. Since the IC is part of the brain aversive system, DBS of this structure has long been related to aversive behavior in rats limiting its clinical use. This study aimed to improve intracollicular DBS parameters in order to avoid anxiogenic side effects while preserving motor improvements in rats. Catalepsy was induced by systemic haloperidol (0.5mg/kg) and after 60 min the bar test was performed during which a given rat received continuous (5 min, with or without pre-stimulation) or intermittent (5 x 1 min) DBS (30Hz, 200–600μA, pulse width 100μs). Only continuous DBS with pre-stimulation reduced catalepsy time. The rats were also submitted to the elevated plus maze (EPM) test and received either continuous stimulation with or without pre-stimulation, or sham treatment. Only rats receiving continuous DBS with pre-stimulation increased the time spent and the number of entries into the open arms of the EPM suggesting an anxiolytic effect. The present intracollicular DBS parameters induced motor improvements without any evidence of aversive behavior, pointing to the IC as an alternative DBS target to induce paradoxical kinesia improving motor deficits in parkinsonian patients.

Neuroethics

2021 ◽  
pp. 405-420
Author(s):  
Georg Northoff
Keyword(s):  
Deep Brain Stimulation ◽  
Psychiatric Disorders ◽  
Brain Stimulation ◽  
Empirical Data ◽  
Moral Agency ◽  
Ethical Issues ◽  
Spatio Temporal ◽  
The Brain ◽  
Deep Brain

Neuroethics, located at the interface of conceptual and empirical dimensions, carries major implications for psychiatry, such as the neuroscientific basis of ethical concepts as moral agency. Drawing on data in neuroscience, this chapter highlights issues central to psychiatric ethics. First, it addresses a reductionistic model of the brain, often conceived as purely neuronal, and then it discusses empirical data suggesting that the brain’s activity is strongly aligned to its respective social (e.g., relation to others) and ecological (e.g., relation to the environment and nature) contexts; this implies a relational rather than reductionist model. Second, it suggests that self (e.g., the experience or sense of a self) and personhood (e.g., the person as existent independent of experience) must also be understood in such a social and ecological and, therefore, relational and spatio-temporal sense. Ethical concepts like agency, therefore, cannot be limited solely to the person and brain, but must rather be understood in a relational and neuro-ecological/social way. Third, it discusses deep brain stimulation as a treatment that promotes enhancement. In sum, this chapter presents findings in neuroscience that carry major implications for our view of brain, mental features, psychiatric disorders, and ethical issues like agency, responsibility, and enhancement.

Psychiatric neurosurgery

2018 ◽  
pp. 135-184
Author(s):  
Walter Glannon
Keyword(s):  
Clinical Trials ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Neural Circuits ◽  
Therapeutic Potential ◽  
Genetic Material ◽  
Research Subjects ◽  
Ethical Justification ◽  
The Brain ◽  
Deep Brain

This chapter discusses functional neurosurgery designed to modulate dysfunctional neural circuits mediating sensorimotor, cognitive, emotional, and volitional capacities. The chapter assesses the comparative benefits and risks of neural ablation and deep brain stimulation as the two most invasive forms of neuromodulation. It discusses the question of whether individuals with a severe or moderately severe psychiatric disorder have enough cognitive and emotional capacity to weigh reasons for and against ablation or deep brain stimulation and give informed consent to undergo it. The chapter also discusses the obligations of investigators conducting these trials to research subjects. In addition, it examines the medical and ethical justification for a sham control arm in psychiatric neurosurgery clinical trials. It considers the therapeutic potential of optogenetics as a novel form of neuromodulation. The fact that this technique manipulates both genetic material and neural circuits and has been tested only in animal models makes it unclear what its benefit–risk ratio would be. The chapter concludes with a brief discussion of the potential of neuromodulation to stimulate endogenous repair and growth mechanisms in the brain.

Deep Brain Stimulation Programming

2016 ◽  
Author(s):  
Erwin B Montgomery, Jr
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Exact Nature ◽  
Basic Premise ◽  
Electrical Device ◽  
Regional Anatomy ◽  
Magnetic Forces ◽  
Electrical Devices ◽  
The Brain ◽  
Deep Brain

This second edition of the book continues the basic premise that a thorough knowledge of the mechanisms by which neurons respond to electrical stimulation, how to control the stimulation and the regional anatomy allows the Deep Brain Stimulation (DBS) programmer to effectively and efficiently help patients reach optimal control of their disorder. There are a great many variables that influence the patient’s response to DBS, such as the exact nature of the patient’s individual symptoms and disabilities and the variability of the surgical placement of stimulating leads. The complexity has expanded because rapid increases in technology, both current and anticipated. The book makes no assumptions as to the prior knowledge or expertise. As the brain fundamentally is an electrical device, the book begins explaining the relevant electronics, building a nearly intuitive knowledge of how electrons are affected by electrical and magnetic forces and how the actions of the programmer controls electrical charges that ultimately activate neurons, which themselves are electrical devices.

A systems approach to the brain basis of emotion also needs developmental and locationist views – the case of Tourette's Syndrome

2012 ◽  
Vol 35 (3) ◽  
pp. 160-160 ◽  
Author(s):  
Aribert Rothenberger
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Systems Approach ◽  
Tourette's Syndrome ◽  
Tourette’S Syndrome ◽  
Emotional States ◽  
Clinical Perspective ◽  
Realistic Picture ◽  
The Brain ◽  
Deep Brain

AbstractThe closeness of somatosensory phenomena and emotional states can be critically extended into a clinical perspective by referring to Tourette's Syndrome (TS). Two examples are discussed in this commentary: (1) the neurodevelopmental approach to the pre- and post-tic sensorimotor urges, and (2) the TS treatment with deep brain stimulation. It is shown that in TS, both views (locationist and constructionist) need to be combined along the lifespan in order to get a more realistic picture of the brain basis of emotion.

Deep brain stimulation and anterior capsulotomy: The question of autonomy

2017 ◽  
Vol 41 (S1) ◽  
pp. S323-S323
Author(s):  
S. Raymaekers ◽  
Z. Van Duppen ◽  
K. Demyttenaere ◽  
L. Luyten ◽  
L. Gabriels ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Well Being ◽  
Structured Interviews ◽  
Obsessive Compulsive ◽  
Research Education ◽  
Compulsive Disorder ◽  
The Brain ◽  
Anterior Capsulotomy ◽  
Deep Brain

IntroductionIn carefully selected treatment-refractory patients with obsessive compulsive disorder (OCD), deep brain stimulation (DBS) or anterior capsulotomy (AC) might be considered as a possible treatment. However, the direct intervention in the brain can raise questions about autonomy. Do patients still feel like they are in control of their actions when their behavior is changed by a surgical intervention?Objective/aimsTo examine in both AC and DBS patients whether these intervention influenced perception of autonomy. We aimed to discover any differences in these perceptions when comparing AC and DBS patients.MethodsWe conducted semi-structured interviews with AC and DBS patients. Interviews were recorded digitally and transcribed verbatim. We analyzed interviews in an iterative process based on grounded theory principles.ResultsWe interviewed 10 DBS patients and 6 AC patients. Sense of agency (the awareness that one is the author of his/her own actions) did not seem to be diminished by AC or DBS. However, especially DBS patients are aware of their dependency on a device for their well-being. Another important theme is authenticity (in how far patients perceive their actions and thoughts as matching their self-concept). Feelings of authenticity can be disturbed especially in cases of induced hypomania (for DBS) or apathy (for AC). OCD itself also has an impact on autonomy as patients describe a lack of freedom due to their disorder.ConclusionDespite extensive changes in emotions, behavior and even personal identity after DBS or AC surgery, perceived autonomy was not greatly altered in these OCD patients.Disclosure of interestMedtronic provided grants for research, education, and traveling to B. Nuttin and L. Gabriëls, who hold the Medtronic Chair for Stereotactic Neurosurgery in Psychiatric Disorders at KU Leuven. S. Raymaekers is supported by this Chair. B. Nuttin co-owns a patent on DBS in OCD.

Mechanisms and the Current State of Deep Brain Stimulation in Neuropsychiatry

CNS Spectrums ◽  
2003 ◽  
Vol 8 (7) ◽  
pp. 522-526 ◽  
Author(s):  
Benjamin D. Greenberg ◽  
Ali R. Rezai
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Mechanisms Of Action ◽  
Therapeutic Effects ◽  
Current State ◽  
Investigational Treatment ◽  
Preclinical And Clinical Studies ◽  
The Brain ◽  
Deep Brain

ABSTRACTDeep brain stimulation (DBS) is established as a therapy for movement disorders, and it is an investigational treatment in other neurologic conditions. DBS precisely targets neuroanatomical targets deep within the brain that are proposed to be centrally involved in the pathophysiology of some neuropsychiatric illnesses. DBS is nonablative, offering the advantages of reversibility and adjustability. This might permit therapeutic effectiveness to be enhanced or side effects to be minimized. Preclinical and clinical studies have shown effects of DBS locally, at the stimulation target, and at a distance, via actions on fibers of passage or across synapses. Although its mechanisms of action are not fully elucidated, several effects have been proposed to underlie the therapeutic effects of DBS in movement disorders, and potentially in other conditions as well. The mechanisms of action of DBS are the focus of active investigation in a number of clinical and preclinical laboratories. As in severe movement disorders, DBS may offer a degree of hope for patients with intractable neuropsychiatric illness. It is already clear that research intended to realize this potential will require a very considerable commitment of resources, energy, and time across disciplines including psychiatry, neurosurgery, neurology, neuropsychology, bioengineering, and bioethics. These investigations should proceed cautiously.

scholarly journals Deep brain stimulation for psychiatric disorders: where we are now

2015 ◽  
Vol 38 (6) ◽  
pp. E2 ◽  
Author(s):  
Daniel R. Cleary ◽  
Alp Ozpinar ◽  
Ahmed M. Raslan ◽  
Andrew L. Ko
Keyword(s):  
Deep Brain Stimulation ◽  
Psychiatric Disorders ◽  
Brain Stimulation ◽  
Historical Record ◽  
Psychiatric Disease ◽  
Current Application ◽  
Organic Brain Disease ◽  
Fossil Records ◽  
The Mind ◽  
Deep Brain

Fossil records showing trephination in the Stone Age provide evidence that humans have sought to influence the mind through physical means since before the historical record. Attempts to treat psychiatric disease via neurosurgical means in the 20th century provided some intriguing initial results. However, the indiscriminate application of these treatments, lack of rigorous evaluation of the results, and the side effects of ablative, irreversible procedures resulted in a backlash against brain surgery for psychiatric disorders that continues to this day. With the advent of psychotropic medications, interest in invasive procedures for organic brain disease waned. Diagnosis and classification of psychiatric diseases has improved, due to a better understanding of psychiatric patho-physiology and the development of disease and treatment biomarkers. Meanwhile, a significant percentage of patients remain refractory to multiple modes of treatment, and psychiatric disease remains the number one cause of disability in the world. These data, along with the safe and efficacious application of deep brain stimulation (DBS) for movement disorders, in principle a reversible process, is rekindling interest in the surgical treatment of psychiatric disorders with stimulation of deep brain sites involved in emotional and behavioral circuitry. This review presents a brief history of psychosurgery and summarizes the development of DBS for psychiatric disease, reviewing the available evidence for the current application of DBS for disorders of the mind.

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