scholarly journals PET Functional Imaging of Deep Brain Stimulation in Movement Disorders and Psychiatry

2009 ◽  
Vol 29 (11) ◽  
pp. 1743-1754 ◽  
Author(s):  
Benedicte Ballanger ◽  
Marjan Jahanshahi ◽  
Emmanuel Broussolle ◽  
Stéphane Thobois
Keyword(s):  
Deep Brain Stimulation ◽  
Functional Imaging ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Major Advance ◽  
Imaging Studies ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Neuropsychiatric Diseases ◽  
Deep Brain

Deep brain stimulation (DBS) represents a major advance in the treatment of various severe movement disorders or neuropsychiatric diseases. Our understanding of the mechanism of action of this surgical treatment has greatly benefited from functional imaging studies. Most of these studies have been conducted in patients with Parkinson's disease (PD) treated by bilateral subthalamic nucleus (STN) stimulation. These studies have notably underlined the fact that STN stimulation influences motor, limbic, or associative cortical-subcortical loops in various (sometimes contradictory) ways. We present an up-to-date review of the information provided by functional imaging studies in surgery for PD, dystonia, tremor, as well as in psychiatric disorders such as depression or obsessive-compulsive disorder. On the basis of this information, proposed mechanisms of action of DBS are discussed, as well as the need for additional approaches such as improved anatomical localization of the contact used for stimulation or a better understanding of the electrical distribution around the electrode.

scholarly journals Mechanisms of deep brain stimulation

2016 ◽  
Vol 115 (1) ◽  
pp. 19-38 ◽  
Author(s):  
Todd M. Herrington ◽  
Jennifer J. Cheng ◽  
Emad N. Eskandar
Keyword(s):  
Synaptic Plasticity ◽  
Deep Brain Stimulation ◽  
Essential Tremor ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Oscillatory Activity ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain

Deep brain stimulation (DBS) is widely used for the treatment of movement disorders including Parkinson's disease, essential tremor, and dystonia and, to a lesser extent, certain treatment-resistant neuropsychiatric disorders including obsessive-compulsive disorder. Rather than a single unifying mechanism, DBS likely acts via several, nonexclusive mechanisms including local and network-wide electrical and neurochemical effects of stimulation, modulation of oscillatory activity, synaptic plasticity, and, potentially, neuroprotection and neurogenesis. These different mechanisms vary in importance depending on the condition being treated and the target being stimulated. Here we review each of these in turn and illustrate how an understanding of these mechanisms is inspiring next-generation approaches to DBS.

scholarly journals A randomised, double-blind, sham-controlled trial of deep brain stimulation of the bed nucleus of the stria terminalis for treatment-resistant obsessive-compulsive disorder

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Philip E. Mosley ◽  
François Windels ◽  
John Morris ◽  
Terry Coyne ◽  
Rodney Marsh ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Adverse Events ◽  
Brain Stimulation ◽  
Stria Terminalis ◽  
Treatment Resistant ◽  
Obsessive Compulsive ◽  
Double Blind ◽  
Bed Nucleus ◽  
Compulsive Disorder ◽  
Deep Brain

AbstractDeep brain stimulation (DBS) is a promising treatment for severe, treatment-resistant obsessive-compulsive disorder (OCD). Here, nine participants (four females, mean age 47.9 ± 10.7 years) were implanted with DBS electrodes bilaterally in the bed nucleus of the stria terminalis (BNST). Following a one-month postoperative recovery phase, participants entered a three-month randomised, double-blind, sham-controlled phase before a twelve-month period of open-label stimulation incorporating a course of cognitive behavioural therapy (CBT). The primary outcome measure was OCD symptoms as rated with the Yale-Brown Obsessive-Compulsive Scale (YBOCS). In the blinded phase, there was a significant benefit of active stimulation over sham (p = 0.025, mean difference 4.9 points). After the open phase, the mean reduction in YBOCS was 16.6 ± 1.9 points (χ2 (11) = 39.8, p = 3.8 × 10−5), with seven participants classified as responders. CBT resulted in an additive YBOCS reduction of 4.8 ± 3.9 points (p = 0.011). There were two serious adverse events related to the DBS device, the most severe of which was an infection during the open phase necessitating device explantation. There were no serious psychiatric adverse events related to stimulation. An analysis of the structural connectivity of each participant’s individualised stimulation field isolated right-hemispheric fibres associated with YBOCS reduction. These included subcortical tracts incorporating the amygdala, hippocampus and stria terminalis, in addition to cortical regions in the ventrolateral and ventromedial prefrontal cortex, parahippocampal, parietal and extrastriate visual cortex. In conclusion, this study provides further evidence supporting the efficacy and tolerability of DBS in the region of the BNST for individuals with otherwise treatment-refractory OCD and identifies a connectivity fingerprint associated with clinical benefit.

scholarly journals Elucidating neural network changes induced by deep brain stimulation for OCD

Brain ◽  
2020 ◽  
Vol 143 (5) ◽  
pp. 1293-1296
Author(s):  
Jens Kuhn ◽  
Juan Carlos Baldermann
Keyword(s):  
Neural Network ◽  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain

This scientific commentary refers to ‘Deep brain stimulation modulates directional limbic connectivity in obsessive-compulsive disorder’, by Fridgeirsson etal. (doi:10.1093/brain/awaa100).

Improvements in Anorexia Symptoms After Deep Brain Stimulation for Intractable Obsessive-Compulsive Disorder

2013 ◽  
Vol 73 (9) ◽  
pp. e29-e31 ◽  
Author(s):  
Nicole C.R. McLaughlin ◽  
Elizabeth R. Didie ◽  
Andre G. Machado ◽  
Suzanne N. Haber ◽  
Emad N. Eskandar ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain

scholarly journals Connectomic deep brain stimulation for obsessive-compulsive disorder

2021 ◽  
Author(s):  
Juan Carlos Baldermann ◽  
Thomas Schüller ◽  
Sina Kohl ◽  
Valerie Voon ◽  
Ningfei Li ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Brain Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain
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