Deep brain stimulation

Department of Neurology, Washington University School of Medicine, Washington University, St. Louis, Missouri 63110, USA.
Annual Review of Neuroscience (Impact Factor: 19.32). 02/2006; 29(1):229-57. DOI: 10.1146/annurev.neuro.29.051605.112824
Source: PubMed


Deep brain stimulation (DBS) has provided remarkable benefits for people with a variety of neurologic conditions. Stimulation of the ventral intermediate nucleus of the thalamus can dramatically relieve tremor associated with essential tremor or Parkinson disease (PD). Similarly, stimulation of the subthalamic nucleus or the internal segment of the globus pallidus can substantially reduce bradykinesia, rigidity, tremor, and gait difficulties in people with PD. Multiple groups are attempting to extend this mode of treatment to other conditions. Yet, the precise mechanism of action of DBS remains uncertain. Such studies have importance that extends beyond clinical therapeutics. Investigations of the mechanisms of action of DBS have the potential to clarify fundamental issues such as the functional anatomy of selected brain circuits and the relationship between activity in those circuits and behavior. Although we review relevant clinical issues, we emphasize the importance of current and future investigations on these topics.

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    • "For dozens of years, neural electrodes that enabled the selective stimulation and recording of multiple independent neurons of the central neural system (CNS) or the peripheral neural system (PNS) have been expected to provide enhanced functioning of neural prosthetic devices. Some good examples of this are the treatment of spinal cord injuries and the subsequent rehabilitation [1] [2] [3], urinary incontinence [4] [5] [6], cochlear implants [7] [8] [9] [10], and deep brain stimulation (DBS) [11]. Furthermore, neurophysiologists use neural electrodes to investigate the physiological functions of the brain, such as brain-computer interfaces and brain-machine interfaces, by the practice of stimulating neurons and recording their responses [12] [13] [14]. "
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    ABSTRACT: This paper demonstrates a polyimide nerve cuff electrode with a controllable drug loading/release function for stable recording of peripheral nerve signals and stimulation and minimizing inflammation. For control of anti-inflammatory drug loading/release, dexamethasone (DEX)-loaded poly L-lactic acid (PLLA) and/or poly lactic-co-glycol acid (PLGA) nanofibers were deposited on a functional nerve cuff electrode by the electro-spinning method, which can control the weight of DEX loading on the functional nerve cuff electrode. Then, UV patternable polyethylene glycol (PEG) was coated on the functional nerve cuff with DEX-loaded nanofibers for the acceleration of the release rate of the drug. Through high performance liquid chromatography (HPLC), DEX release rates were increased from 16 to 28% (PLLA-loaded nanofibers) and from 68 to 87% (PLGA-loaded nanofibers) due to the increased diffusion rate of DEX after 28 days, respectively. In addition, the functional nerve cuff electrode was electro-polymerized with poly(3,4-ethylenedioxythiophene)-poly(styrenesulfonate) (PEDOT:PSS) as a conductive polymer in order to recover the decreased electrical properties caused by PEG patterning. The impedance measured at 1 kHz was 342 Ω mm2, which was extremely lower than the value of 1046 Ω mm2 of PEG-patterned cuff electrodes. Through the acute ex-vivo test of SD rat's sciatic nerve, the functional nerve cuff electrode with PEDOT:PSS exhibited stable and effective recording of the nerve's signals despite PEG patterning.
    Sensors and Actuators B Chemical 08/2015; 215. DOI:10.1016/j.snb.2015.03.036 · 4.10 Impact Factor
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    • "Deep brain stimulation (DBS) has been shown to be effective in the treatment of movement disorders, such as Parkinson's disease and tremor (Kleiner-Fisman et al. 2006; Perlmutter & Mink, 2006). It has also been used in conditions as diverse as chronic pain and Tourette's syndrome (Bittar et al. 2005; Steeves et al. 2012). "

    American Psychiatric Association 168th annual conference, Toronto, Canada; 05/2015
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    • "The increasing adoption of DBS as a clinical tool for the treatment of a diverse range of pathological conditions has intensified interest in answering this question. The emerging consensus is that DBS primarily activates afferent and efferent axonal elements within the vicinity of the electrode tip in both the orthodromic and antidromic directions (Perlmutter & Mink 2006, Kringelbach et al. 2007, Deniau et al. 2010). Glial cell activation resulting in the release of adenosine, which could inhibit synaptic transmission in nearby neurones, may be another contributory factor (Bekar et al. 2008, Tawfik et al. 2010, Vedam-Mai et al. 2012, Fenoy et al. 2014). "
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    ABSTRACT: To understand how deep brain stimulation of the midbrain influences control of the urinary bladder. In urethane-anaesthetized male rats saline was infused continuously into the bladder to evoke cycles of filling and voiding. The effect of electrical (0.1-2.0ms pulses, 5-180Hz, 0.5-2.5V) compared to chemical stimulation (microinjection of D,L-homocysteic acid, 50nl 0.lM solution) at the same midbrain sites was tested. Electrical stimulation of the periaqueductal grey matter and surrounding midbrain disrupted normal co-ordinated voiding activity in detrusor and sphincters muscles and suppressed urine output. The effect occurred within seconds, was reversible and not secondary to cardiorespiratory changes. Bladder compliance remained unchanged. Chemical stimulation over the same area using microinjection of DLH to preferentially activate somatodendritic receptors decreased the frequency of micturition but did not disrupt the co-ordinated pattern of voiding. In contrast, chemical stimulation within the caudal ventrolateral periaqueductal grey, in the area where critical synapses in the micturition reflex pathway are located, increased the frequency of micturition. Electrical deep brain stimulation within the midbrain can inhibit reflex micturition. We suggest that the applied stimulus entrained activity in the neural circuitry locally, thereby imposing an unphysiological pattern of activity. In a way similar to the use of electrical signals to 'jam' radio transmission, this may prevent a synchronised pattern of efferent activity being transmitted to the spinal outflows to orchestrate a co-ordinated voiding response. Further experiments to record neuronal firing in the midbrain during the deep brain stimulation will be necessary to test this hypothesis. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.
    Acta Physiologica 03/2015; 214(1). DOI:10.1111/apha.12491 · 4.38 Impact Factor
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