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Directional stimulation of subthalamic nucleus sweet spot predicts clinical efficacy: Proof of concept
Directional deep brain stimulation (dDBS) of the subthalamic nucleus for Parkinson's disease (PD) increases the therapeutic window. However, empirical programming of the neurostimulator becomes more complex given the increasing number of stimulation parameters. A better understanding of dDBS is needed to improve therapy and help guide postoperative programming.Is awake physiological confirmation necessary for DBS treatment of Parkinson's disease today? A comparison of intraoperative imaging, physiology, and physiology imaging-guided DBS in the past decade
Deep brain stimulation (DBS) is a well-established surgical therapy for Parkinson's disease (PD). Intraoperative imaging (IMG), intraoperative physiology (PHY) and their combination (COMB) are the three mainstream DBS guidance methods.Dual threshold neural closed loop deep brain stimulation in Parkinson disease patients
Closed loop deep brain stimulation (clDBS) in Parkinson's disease (PD) using subthalamic (STN) neural feedback has been shown to be efficacious only in the acute post-operative setting, using externalized leads and stimulators.Individual white matter bundle trajectories are associated with deep brain stimulation response in obsessive-compulsive disorder
The ventral anterior limb of the internal capsule (vALIC) is a target for deep brain stimulation (DBS) in obsessive-compulsive disorder (OCD). Conventional surgical planning is based on anatomical landmarks. Objective/hypothesis: We hypothesized that treatment response depends on the location of the active DBS contacts with respect to individual white matter bundle trajectories. This study thus aimed to elucidate whether vALIC DBS can benefit from bundle-specific targeting.Deep brain stimulation electrode insertion and depression: Patterns of activity and modulation by analgesics
An initial antidepressant effect when using deep brain stimulation (DBS) of the subcallosal area of the cingulate cortex (Cg25) to treat resistant depression that could be the result of electrode insertion has been described. We previously showed that electrode insertion into the infralimbic cortex (ILC; the Cg25 rodent correlate) provokes a temporally limited antidepressant-like effect that is counteracted by non-steroidal anti-inflammatory drugs, such as those routinely used for pain relief.Histopathology after microelectrode recording and twelve years of deep brain stimulation
Despite the widespread use of deep brain stimulation (DBS), studies on the histological alterations induced by the DBS electrode remain relatively scarce. Typical findings include fibrous sheaths of 5–25 μm surrounding the electrode track, a chronic inflammation with reactive astrocytes, multinucleated giant cells, macrophages, mononuclear leucocytes and T-lymphocytes, fibrillary gliosis and Rosenthal fibers [1,2].Novel application of virtual reality in patient engagement for deep brain stimulation: A pilot study
Deep brain stimulation (DBS) is an efficacious intervention for neurological and other disorders such as Parkinson's disease, essential tremor, and dystonia [1]. While the scope of DBS is broadening, standardized content for patient engagement is less established. Without identifiable structural pathology and small surgical targets, patients often supplement with personal research. Additionally, there is growing emphasis on patient satisfaction as an indicator of quality, with perception of therapy and overall experience serving a key component in surgical outcome [2,3].Chronic deep brain stimulation in an Alzheimer's disease mouse model enhances memory and reduces pathological hallmarks
Alzheimer's disease (AD) is a progressive degenerative disorder that currently remains extremely disabling. Recent work has shown that deep brain stimulation (DBS) has promising effects in AD patients. In parallel to the clinical trials, we investigated the impact of chronic DBS in 3xTg mice, a well-established animal model of AD.Differential release of dopamine in the nucleus accumbens evoked by low-versus high-frequency medial prefrontal cortex stimulation
The medial prefrontal cortex (mPFC) coordinates goal-directed behaviors, which may be mediated through mPFC regulation of dopamine release in the nucleus accumbens (NAc). Furthermore, frequency-specific oscillatory activity between the frontal cortex and downstream structures may facilitate inter-region communication. Although high-frequency (e.g., 60 Hz) mPFC stimulation is known to increase basal dopamine levels in the NAc, little is known about how phasic dopamine release is affected by mPFC stimulation.Effect of Deep Brain Stimulation of the ventromedial prefrontal cortex on the noradrenergic system in rats
Deep Brain Stimulation (DBS) of the subgenual cingulate cortex (SCC) is a promising therapeutic alternative to treat resistant major depressive disorder. In preclinical studies, DBS of the ventromedial prefrontal cortex (vmPFC, the rodent SCC correlate) provokes an antidepressant-like effect, along with changes in noradrenaline levels at the site of stimulation. Hence, DBS appears to activate the noradrenergic-locus coeruleus (LC) system.Two indications, one target: Concomitant epilepsy and Tourettism treated with Centromedian/parafascicular thalamic stimulation
The Centromedian/parafascicular (CM/Pf) thalamic nuclear complex is a deep brain stimulation (DBS) target for medically refractory Tourette syndrome (TS) as well as for patients affected by resistant generalized tonic-clonic (GTC) seizures [1–3].Beneficial Effects of Bilateral Subthalamic Stimulation on Non-Motor Symptoms in Parkinson's Disease
Subthalamic nucleus (STN) deep brain stimulation (DBS) is well established for the symptomatic treatment of Parkinson's disease (PD) improving motor symptoms, activities of daily living (ADL), and quality of life (QoL) [1–3]. Non-motor symptoms (NMS) play a crucial role for QoL in patients with PD [4,5]. Long-term effects of DBS on neuropsychological [6,7] and neuropsychiatric symptoms [8,9] have been studied. However, these symptoms contribute only to a part of NMS in patients with PD. Previously published studies on a wider range of NMS have methodological limitations due to a lack of objective clinician-based [10], patient-based [11,12] or any validated assessment at all [12], and small cohort sizes of only 10 [13,14] or 11 subjects followed up on 6 month [12].Effect of Subthalamic Nucleus Stimulation on Penicillin Induced Focal Motor Seizures in Primate
Drug-resistant motor epilepsies are particularly incapacitating for the patients. In a primate model of focal motor seizures induced by intracortical injection of penicillin, we recently showed that seizures propagated from the motor cortex towards the basal ganglia.
