Article

Network perspectives on the mechanisms of deep brain stimulation.

Department of Biomedical Engineering, Cleveland Clinic Foundation, 9500 Euclid Ave, ND20, Cleveland, OH 44195, USA. <>
Neurobiology of Disease (impact factor: 5.4). 10/2009; 38(3):329-37. DOI:10.1016/j.nbd.2009.09.022 pp.329-37
Source: PubMed

ABSTRACT Deep brain stimulation (DBS) is an established medical therapy for the treatment of movement disorders and shows great promise for several other neurological disorders. However, after decades of clinical utility the underlying therapeutic mechanisms remain undefined. Early attempts to explain the mechanisms of DBS focused on hypotheses that mimicked an ablative lesion to the stimulated brain region. More recent scientific efforts have explored the wide-spread changes in neural activity generated throughout the stimulated brain network. In turn, new theories on the mechanisms of DBS have taken a systems-level approach to begin to decipher the network activity. This review provides an introduction to some of the network based theories on the function and pathophysiology of the cortico-basal-ganglia-thalamo-cortical loops commonly targeted by DBS. We then analyze some recent results on the effects of DBS on these networks, with a focus on subthalamic DBS for the treatment of Parkinson's disease. Finally we attempt to summarize how DBS could be achieving its therapeutic effects by overriding pathological network activity.

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Keywords

brain stimulation
 
clinical utility
 
cortico-basal-ganglia-thalamo-cortical loops
 
DBS
 
decades
 
established medical therapy
 
great promise
 
mimicked
 
network activity
 
networks
 
overriding pathological network activity
 
Parkinson's disease
 
recent results
 
recent scientific efforts
 
stimulated brain network
 
stimulated brain region
 
subthalamic DBS
 
systems-level approach
 
underlying therapeutic mechanisms
 
wide-spread changes
 

Cameron C McIntyre