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Prefrontal delta oscillations during deep brain stimulation predict treatment success in patients with obsessive-compulsive disorder
Deep brain stimulation (DBS) of the ventral capsule/ventral striatum (VC/VS) is a promising neurotherapeutic approach for severe and refractory cases of obsessive-compulsive disorder (OCD). Successful VC/VS-DBS treatment alters function in frontostriatal pathways important for the etiopathogenesis of OCD [1–3]. Monitoring changes in frontostriatal functioning resulting from active DBS can reveal signatures of DBS engagement with disease-relevant pathways [1,4]. In particular, modulation of the dorsal-medial prefrontal cortex (dmPFC) seems to be crucial for therapeutic success: symptomatic OCD patients demonstrate hyperconnectivity between the VC/VS and dmPFC, which is normalized following successful VC/VS-DBS [1,5,6].MR imaging central thalamic deep brain stimulation restored autistic-like social deficits in the rat
Social deficit is a core symptom in autism spectrum disorder (ASD). Although deep brain stimulation (DBS) has been proposed as a potential treatment for ASD, an ideal target nucleus is yet to be identified. DBS at the central thalamic nucleus (CTN) is known to alter corticostriatal and limbic circuits, and subsequently increase the exploratory motor behaviors, cognitive performance, and skill learning in neuropsychiatric and neurodegenerative disorders.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.Adverse events associated with deep brain stimulation in patients with childhood-onset dystonia
Data on pediatric DBS is still limited because of small numbers in single center series and lack of systematic multi-center trials.Long-term effects of subthalamic stimulation in Obsessive-Compulsive Disorder: Follow-up of a randomized controlled trial
Obsessive-Compulsive Disorder (OCD) is characterized by intrusive, anxious thoughts with repetitive, ritualized behaviors, and has negative impacts on family relationships and social life. Its lifetime prevalence is estimated to be 2–3% [1]. Cognitive and behavioral therapy and selective serotonin reuptake inhibitors are the standard treatments for OCD; nevertheless, despite these treatments, between 25 and 40% of patients display persistent symptoms leading to severe functional disability [2]. Neurosurgical treatment targeting different parts of the orbito-fronto-striato-thalamo-cortical circuit has been proposed for the most severe and refractory forms, including both gamma knife non-invasive stereotactic lesions and invasive deep brain stimulation (DBS) [3] (Supplementary Information).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.Letter to the editor: Thalamic deep brain stimulation may relieve breathlessness in COPD
The cerebral mechanisms of dyspnoea (breathlessness) are not well understood. Neuroimaging studies of experimentally induced dyspnoea in healthy individuals have identified several cortical areas that might form a neural network for perception of dyspnoea [1], much like those identified for pain perception [2]. However, functional imaging studies alone do not reveal neurophysiological pathways and may miss putative targets for dyspnoea relief. The objective of this study was to assess the effects of Deep Brain Stimulation (DBS) of four different brain nuclei on the sensation of dyspnoea in an individual with Chronic Obstructive Pulmonary Disease (COPD) using an established multidimensional dyspnoea tool [3].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.Decreasing battery life in subthalamic deep brain stimulation for Parkinson's disease with repeated replacements: Just a matter of energy delivered?
People with Parkinson's disease (PD) treated with deep brain stimulation (DBS) with non-rechargeable implantable pulse generators (IPGs) require elective IPG replacement operations involving surgical and anesthesiologic risk. Life expectancy and the number of replacements per patient with DBS are increasing.Decoding voluntary movements and postural tremor based on thalamic LFPs as a basis for closed-loop stimulation for essential tremor
High frequency Deep brain stimulation (DBS) targeting motor thalamus is an effective therapy for essential tremor (ET). However, conventional continuous stimulation may deliver unnecessary current to the brain since tremor mainly affects voluntary movements and sustained postures in ET.Medial septal stimulation increases seizure threshold and improves cognition in epileptic rats
Temporal lobe epilepsy is most prevalent among focal epilepsies, and nearly one-third of patients are refractory to pharmacological intervention. Persistent cognitive and neurobehavioral comorbidities also occur due to the recurrent nature of seizures and medication-related side effects.Personalized striatal targets for deep brain stimulation in obsessive-compulsive disorder
Psychiatric conditions currently treated with deep brain stimulation (DBS), such as obsessive-compulsive disorder (OCD), are heterogeneous diseases with different symptomatic dimensions, indicating that fixed neuroanatomical DBS targets for all OCD cases may not be efficacious.Inferior thalamic peduncle deep brain stimulation for treatment-refractory obsessive-compulsive disorder: A phase 1 pilot trial
Several different surgical procedures targeting the limbic circuit have been utilized for severe, treatment resistant obsessive-compulsive disorder; however, there has only been limited exploration of the inferior thalamic peduncle (ITP). The aim of this study was to determine the safety and initial efficacy of ITP deep brain stimulation (DBS) in patients with severe obsessive-compulsive disorder.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.Long-term results after deep brain stimulation of nucleus accumbens and the anterior limb of the internal capsule for preventing heroin relapse: An open-label pilot study
Deep brain stimulation (DBS) is currently used to treat addiction, with the nucleus accumbens (NAc) as one promising target. The anterior limb of the internal capsule (ALIC) is also a potential target, as it carries fiber tracts connecting the mesocorticolimbic circuits that are crucially involved in several psychiatric disorders, including addiction. Stimulating the NAc and ALIC simultaneously may have a synergistic effect against addiction.Neurostimulation in tardive dystonia/dyskinesia: A delayed start, sham stimulation-controlled randomized trial
Growing evidence suggests that pallidal deep brain stimulation represents a potential new therapeutic avenue in tardive dystonia/dyskinesia, but controlled and blinded randomized studies (RCT) are missing. The present RCT compares dystonia/dyskinesia severity of pallidal neurostimulation in patients with tardive dystonia using a delayed-start design paradigm.Subthalamic nucleus deep brain stimulation reduces freezing of gait subtypes and patterns in Parkinson's disease
Freezing of gait (FOG) is a specific gait disorder in Parkinson's Disease (PD). FOG occurs mainly in the medication-off state and usually improves with dopaminergic medication. FOG episodes can be clinically grouped into three patterns (small steps forward, trembling in place, complete akinesia) and five provoking subtypes (starting to walk hesitation, moving in tight quarters hesitation, reaching destination hesitation, turning hesitation, and walking in open space hesitation) [1]. FOG is a debilitating symptom, limiting activities of daily living, leading to falls or fall-related injuries, and diminishing quality of life [2].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].Directional Deep Brain Stimulation: First experiences in centers across the globe
Deep Brain Stimulation (DBS) of the subthalamic nucleus (STN) has been an established treatment of motor symptoms in Parkinson's disease (PD) since the early nineties [1]. The effectiveness of DBS can be limited by bothersome side-effects, which can be caused by the spillover of current into adjacent structures [2,3]. A recent technological advancement in the field of DBS is the ability to steer current in a certain direction with ‘directional’ electrodes instead of the traditional ring-shaped electrodes.Non-motor outcomes of subthalamic stimulation in Parkinson's disease depend on location of active contacts
Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and non-motor symptoms (NMS) in Parkinson's disease (PD). Few studies have investigated the influence of the location of neurostimulation on NMS.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].Evidence of transcranial direct current stimulation-generated electric fields at subthalamic level in human brain in vivo
Transcranial direct current stimulation (tDCS) is a promising brain modulation technique for several disease conditions. With this technique, some portion of the current penetrates through the scalp to the cortex and modulates cortical excitability, but a recent human cadaver study questions the amount. This insufficient intracerebral penetration of currents may partially explain the inconsistent and mixed results in tDCS studies to date. Experimental validation of a transcranial alternating current stimulation-generated electric field (EF) in vivo has been performed on the cortical (using electrocorticography, ECoG, electrodes), subcortical (using stereo electroencephalography, SEEG, electrodes) and deeper thalamic/subthalamic levels (using DBS electrodes).Short-term quality of life after subthalamic stimulation depends on non-motor symptoms in Parkinson's disease
Subthalamic nucleus (STN) deep brain stimulation (DBS) improves quality of life (QoL), motor, and non-motor symptoms (NMS) in advanced Parkinson's disease (PD). However, considerable inter-individual variability has been observed for QoL outcome.Post-operative deep brain stimulation assessment: Automatic data integration and report generation
The gold standard for post-operative deep brain stimulation (DBS) parameter tuning is a monopolar review of all stimulation contacts, a strategy being challenged by recent developments of more complex electrode leads.
