scholarly journals Personalizing Dual-Target Cortical Stimulation with Bayesian Parameter Optimization Successfully Treats Central Post-Stroke Pain: A Case Report

2021 ◽  
Vol 12 (1) ◽  
pp. 25
Author(s):  
Evan M. Dastin-van Rijn ◽  
Seth D. König ◽  
Danielle Carlson ◽  
Vasudha Goel ◽  
Andrew Grande ◽  
...  
Keyword(s):  
Case Report ◽  
Memory Task ◽  
Cortical Stimulation ◽  
Bayesian Optimization ◽  
Systematic Evaluation ◽  
Central Pain ◽  
Post Stroke ◽  
Stimulation Parameters ◽  
Dorsolateral Prefrontal ◽  
Personalized Approach

Central pain disorders, such as central post-stroke pain, remain clinically challenging to treat, despite many decades of pharmacological advances and the evolution of neuromodulation. For treatment refractory cases, previous studies have highlighted some benefits of cortical stimulation. Recent advances in new targets for pain and the optimization of neuromodulation encouraged our group to develop a dual cortical target approach paired with Bayesian optimization to provide a personalized treatment. Here, we present a case report of a woman who developed left-sided facial pain after multiple thalamic strokes. All previous pharmacologic and interventional treatments failed to mitigate the pain, leaving her incapacitated due to pain and medication side effects. She subsequently underwent a single burr hole for placement of motor cortex (M1) and dorsolateral prefrontal cortex (dlPFC) paddles for stimulation with externalization. By using Bayesian optimization to find optimal stimulation parameters and stimulation sites, we were able to reduce pain from an 8.5/10 to a 0/10 during a 5-day inpatient stay, with pain staying at or below a 2/10 one-month post-procedure. We found optimal treatment to be simultaneous stimulation of M1 and dlPFC without any evidence of seizure induction. In addition, we found no worsening in cognitive performance during a working memory task with dlPFC stimulation. This personalized approach using Bayesian optimization may provide a new foundation for treating central pain and other functional disorders through systematic evaluation of stimulation parameters.

Repetitive Transcranial Magnetic Stimulation Improves Depersonalization: A Case Report

CNS Spectrums ◽  
2004 ◽  
Vol 9 (5) ◽  
pp. 375-376 ◽  
Author(s):  
Alejandro M. Jiménez-Genchi
Keyword(s):  
Prefrontal Cortex ◽  
Case Report ◽  
Transcranial Magnetic Stimulation ◽  
Magnetic Stimulation ◽  
Dorsolateral Prefrontal Cortex ◽  
Repetitive Transcranial Magnetic Stimulation ◽  
Treatment Resistant ◽  
Depersonalization Disorder ◽  
Dorsolateral Prefrontal

AbstractDepersonalization disorder is a poorly understood and treatment-resistant condition. This report describes a patient with depersonalization disorder who underwent six sessions of repetitive transcranial magnetic stimulation on the left dorsolateral prefrontal cortex. Repetitive transcranial magnetic stimulation produced a 28% reduction on depersonalization scores.

scholarly journals Effects of Transcranial Direct Current Stimulation on effort during a working-memory task

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
David Framorando ◽  
Tianlan Cai ◽  
Yi Wang ◽  
Alan J. Pegna
Keyword(s):  
Working Memory ◽  
Direct Current ◽  
Transcranial Direct Current Stimulation ◽  
Memory Task ◽  
Time Interval ◽  
Direct Current Stimulation ◽  
Anodal Stimulation ◽  
Dorsolateral Prefrontal ◽  
Systolic Time ◽  
Task Mastery

AbstractTranscranial Direct Current Stimulation (tDCS) has shown that stimulation of Dorsolateral Prefrontal Cortex (DLPFC) facilitates task performance in working-memory tasks. However, little is known about its potential effects on effort. This study examined whether tDCS affects effort during a working-memory task. Participants received anodal, cathodal and sham stimulation over DLPFC across three sessions before carrying out a 2-back task. During the task, effort-related cardiovascular measures were recorded—especially the Initial Systolic Time Interval (ISTI). Results showed that anodal stimulation produced a shorter ISTI, indicating a greater effort compared to cathodal and sham conditions, where effort was lower. These findings demonstrate that anodal stimulation helps participants to maintain engagement in a highly demanding task (by increasing task mastery), without which they would otherwise disengage. This study is the first to show that tDCS impacts the extent of effort engaged by individuals during a difficult task.

scholarly journals Interesting finding of hyperpyrexia relieving post-stroke spasticity: A case report

2014 ◽  
Vol 9 (13) ◽  
pp. 625-627
Author(s):  
Cui Bao-Juan ◽  
Qiu Jian-Qing ◽  
Huang Lai-Gang ◽  
Zeng Fan-Shuo ◽  
Liu Ben-Ling ◽  
...  
Keyword(s):  
Case Report ◽  
Post Stroke

scholarly journals Prefrontal and Parietal Attractor Networks Mediate Working Memory Judgments

2020 ◽  
Author(s):  
Sihai Li ◽  
Christos Constantinidis ◽  
Xue-Lian Qi
Keyword(s):  
Working Memory ◽  
Prefrontal Cortex ◽  
Dorsolateral Prefrontal Cortex ◽  
Critical Role ◽  
Memory Task ◽  
Delayed Response ◽  
Persistent Activity ◽  
Neural Basis ◽  
Brain Areas ◽  
Dorsolateral Prefrontal

ABSTRACTThe dorsolateral prefrontal cortex plays a critical role in spatial working memory and its activity predicts behavioral responses in delayed response tasks. Here we addressed whether this predictive ability extends to categorical judgments based on information retained in working memory, and is present in other brain areas. We trained monkeys in a novel, Match-Stay, Nonmatch-Go task, which required them to observe two stimuli presented in sequence with an intervening delay period between them. If the two stimuli were different, the monkeys had to saccade to the location of the second stimulus; if they were the same, they held fixation. Neurophysiological recordings were performed in areas 8a and 46 of the dlPFC and 7a and lateral intraparietal cortex (LIP) of the PPC. We hypothesized that random drifts causing the peak activity of the network to move away from the first stimulus location and towards the location of the second stimulus would result in categorical errors. Indeed, for both areas, when the first stimulus appeared in a neuron’s preferred location, the neuron showed significantly higher firing rates in correct than in error trials. When the first stimulus appeared at a nonpreferred location and the second stimulus at a preferred, activity in error trials was higher than in correct. The results indicate that the activity of both dlPFC and PPC neurons is predictive of categorical judgments of information maintained in working memory, and the magnitude of neuronal firing rate deviations is revealing of the contents of working memory as it determines performance.SIGNIFICANCE STATEMENTThe neural basis of working memory and the areas mediating this function is a topic of controversy. Persistent activity in the prefrontal cortex has traditionally been thought to be the neural correlate of working memory, however recent studies have proposed alternative mechanisms and brain areas. Here we show that persistent activity in both the dorsolateral prefrontal cortex and posterior parietal cortex predicts behavior in a working memory task that requires a categorical judgement. Our results offer support to the idea that a network of neurons in both areas act as an attractor network that maintains information in working memory, which informs behavior.

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