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Meeker A, Van Gampelaere J, Zhu L, Luo H, Zhang J. Spike Analysis of the Neural Activities Across the Rats' Auditory Brain Structures. JOURNAL OF ENGINEERING AND SCIENCE IN MEDICAL DIAGNOSTICS AND THERAPY 2024; 7:041002. [PMID: 38617390 PMCID: PMC11009913 DOI: 10.1115/1.4064652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 01/26/2024] [Indexed: 04/16/2024]
Abstract
Tinnitus is a health condition that affects a large population. Clinical diagnosis and treatment have been developed for treating tinnitus for years. However, there are still limitations because researchers have yet to elucidate the mechanisms underlying how tinnitus neural signals develop in brain structures. Abnormal neural interactions among the brain areas are considered to play an important role in tinnitus generation. Researchers have been studying neural activities in the auditory brain structures, including the dorsal cochlear nucleus (DCN), inferior colliculus (IC), and auditory cortex (AC), to seek a better understanding of the information flow among these brain regions, especially in comparison with both health and tinnitus conditions. In this project, neural activities from the DCN, IC, and AC were collected and analyzed before and after the animals were noise-exposed and before and after their auditory cortices were electrically stimulated. These conditions in rats were used to estimate healthy animals, noise-trauma-induced tinnitus, and after auditory cortex electrical stimulation (ACES) treatment. The signal processing algorithms started with the raw measurement data and focused on the local field potentials (LFPs) and spikes in the time domain. The firing rate, shape of spikes, and time differences among channels were analyzed in the time domain, and phase-phase correlation was used to test the phase-frequency information. All the analysis results were summarized in plots and color-heat maps and also used to identify if any neural signal differs and cross-channel relation changes at various animal conditions and discussed.
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Affiliation(s)
- Alexis Meeker
- College of Innovation and Technology, University of Michigan - Flint,Flint, MI 48502
- University of Michigan–Flint
| | - Jensen Van Gampelaere
- College of Health Sciences, University of Michigan - Flint,Flint, MI 48502
- University of Michigan–Flint
| | - Linda Zhu
- College of Innovation and Technology, University of Michigan - Flint,Flint, MI 48502
| | - Hao Luo
- Henry Ford Health System, Detroit, MI 48202
- Henry Ford Health System
| | - Jinsheng Zhang
- School of Medicine, College of Liberal Arts and Sciences, Wayne State University, Detroit, MI 48202
- Wayne State University
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2
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Hasan NI, Dannhauer M, Wang D, Deng ZD, Gomez LJ. Real-Time Computation of Brain E-Field for Enhanced Transcranial Magnetic Stimulation Neuronavigation and Optimization. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.10.25.564044. [PMID: 37961454 PMCID: PMC10635016 DOI: 10.1101/2023.10.25.564044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
Transcranial Magnetic Stimulation (TMS) coil placement and pulse waveform current are often chosen to achieve a specified E-field dose on targeted brain regions. TMS neuronavigation could be improved by including real-time accurate distributions of the E-field dose on the cortex. We introduce a method and develop software for computing brain E-field distributions in real-time enabling easy integration into neuronavigation and with the same accuracy as 1st -order finite element method (FEM) solvers. Initially, a spanning basis set (< 400) of E-fields generated by white noise magnetic currents on a surface separating the head and permissible coil placements are orthogonalized to generate the modes. Subsequently, Reciprocity and Huygens' principles are utilized to compute fields induced by the modes on a surface separating the head and coil by FEM, which are used in conjunction with online (real-time) computed primary fields on the separating surface to evaluate the mode expansion. We conducted a comparative analysis of E-fields computed by FEM and in real-time for eight subjects, utilizing two head model types (SimNIBS's 'headreco' and 'mri2mesh' pipeline), three coil types (circular, double-cone, and Figure-8), and 1000 coil placements (48,000 simulations). The real-time computation for any coil placement is within 4 milliseconds (ms), for 400 modes, and requires less than 4 GB of memory on a GPU. Our solver is capable of computing E-fields within 4 ms, making it a practical approach for integrating E-field information into the neuronavigation systems without imposing a significant overhead on frame generation (20 and 50 frames per second within 50 and 20 ms, respectively).
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Affiliation(s)
- Nahian I. Hasan
- Elmore Family School of Electrical and Computer Engineering, Purdue University,, West Lafayette, 47907, Indiana, USA
| | - Moritz Dannhauer
- Computational Neurostimulation Research Program, Noninvasive Neuromodulation Unit, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health,, Bethesda, 20892, Maryland, USA
| | - Dezhi Wang
- Elmore Family School of Electrical and Computer Engineering, Purdue University,, West Lafayette, 47907, Indiana, USA
| | - Zhi-De Deng
- Computational Neurostimulation Research Program, Noninvasive Neuromodulation Unit, Experimental Therapeutics & Pathophysiology Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health,, Bethesda, 20892, Maryland, USA
| | - Luis J. Gomez
- Elmore Family School of Electrical and Computer Engineering, Purdue University,, West Lafayette, 47907, Indiana, USA
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Song S, Fallegger F, Trouillet A, Kim K, Lacour SP. Deployment of an electrocorticography system with a soft robotic actuator. Sci Robot 2023; 8:eadd1002. [PMID: 37163609 DOI: 10.1126/scirobotics.add1002] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
Electrocorticography (ECoG) is a minimally invasive approach frequently used clinically to map epileptogenic regions of the brain and facilitate lesion resection surgery and increasingly explored in brain-machine interface applications. Current devices display limitations that require trade-offs among cortical surface coverage, spatial electrode resolution, aesthetic, and risk consequences and often limit the use of the mapping technology to the operating room. In this work, we report on a scalable technique for the fabrication of large-area soft robotic electrode arrays and their deployment on the cortex through a square-centimeter burr hole using a pressure-driven actuation mechanism called eversion. The deployable system consists of up to six prefolded soft legs, and it is placed subdurally on the cortex using an aqueous pressurized solution and secured to the pedestal on the rim of the small craniotomy. Each leg contains soft, microfabricated electrodes and strain sensors for real-time deployment monitoring. In a proof-of-concept acute surgery, a soft robotic electrode array was successfully deployed on the cortex of a minipig to record sensory cortical activity. This soft robotic neurotechnology opens promising avenues for minimally invasive cortical surgery and applications related to neurological disorders such as motor and sensory deficits.
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Affiliation(s)
- Sukho Song
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
- Laboratory of Sustainability Robotics, Swiss Federal Laboratories for Materials Science and Technology (Empa), 8600 Dübendorf, Switzerland
| | - Florian Fallegger
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Alix Trouillet
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
| | - Kyungjin Kim
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
- Department of Mechanical Engineering, University of Connecticut, Storrs, CT 06269, USA
| | - Stéphanie P Lacour
- Laboratory for Soft Bioelectronic Interfaces, Neuro-X Institute, Ecole Polytechnique Fédérale de Lausanne (EPFL), 1202 Geneva, Switzerland
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4
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Fast computational E-field dosimetry for transcranial magnetic stimulation using adaptive cross approximation and auxiliary dipole method (ACA-ADM). Neuroimage 2023; 267:119850. [PMID: 36603745 DOI: 10.1016/j.neuroimage.2022.119850] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Revised: 12/14/2022] [Accepted: 12/31/2022] [Indexed: 01/04/2023] Open
Abstract
Transcranial Magnetic Stimulation (TMS) is a non-invasive brain stimulation technique that uses a coil to induce an electric field (E-field) in the brain and modulate its activity. Many applications of TMS call for the repeated execution of E-field solvers to determine the E-field induced in the brain for different coil placements. However, the usage of solvers for these applications remains impractical because each coil placement requires the solution of a large linear system of equations. We develop a fast E-field solver that enables the rapid evaluation of the E-field distribution for a brain region of interest (ROI) for a large number of coil placements, which is achieved in two stages. First, during the pre-processing stage, the mapping between coil placement and brain ROI E-field distribution is approximated from E-field results for a few coil placements. Specifically, we discretize the mapping into a matrix with each column having the ROI E-field samples for a fixed coil placement. This matrix is approximated from a few of its rows and columns using adaptive cross approximation (ACA). The accuracy, efficiency, and applicability of the new ACA approach are determined by comparing its E-field predictions with analytical and standard solvers in spherical and MRI-derived head models. During the second stage, the E-field distribution in the brain ROI from a specific coil placement is determined by the obtained rows and columns in milliseconds. For many applications, only the E-field distribution for a comparatively small ROI is required. For example, the solver can complete the pre-processing stage in approximately 4 hours and determine the ROI E-field in approximately 40 ms for a 100 mm diameter ROI with less than 2% error enabling its use for neuro-navigation and other applications. Highlight: We developed a fast solver for TMS computational E-field dosimetry, which can determine the ROI E-field in approximately 40 ms for a 100 mm diameter ROI with less than 2% error.
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De Ridder D, Vanneste S, Song JJ, Adhia D. Tinnitus and the triple network model: a perspective. Clin Exp Otorhinolaryngol 2022; 15:205-212. [PMID: 35835548 PMCID: PMC9441510 DOI: 10.21053/ceo.2022.00815] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2022] [Accepted: 07/06/2022] [Indexed: 11/24/2022] Open
Abstract
Tinnitus is defined as the conscious awareness of a sound without an identifiable external sound source, and tinnitus disorder as tinnitus with associated suffering. Chronic tinnitus has been anatomically and phenomenologically separated into three pathways: a lateral “sound” pathway, a medial “suffering” pathway, and a descending noise-canceling pathway. Here, the triple network model is proposed as a unifying framework common to neuropsychiatric disorders. It proposes that abnormal interactions among three cardinal networks—the self-representational default mode network, the behavioral relevance-encoding salience network and the goal-oriented central executive network—underlie brain disorders. Tinnitus commonly leads to negative cognitive, emotional, and autonomic responses, phenomenologically expressed as tinnitus-related suffering, processed by the medial pathway. This anatomically overlaps with the salience network, encoding the behavioral relevance of the sound stimulus. Chronic tinnitus can also become associated with the self-representing default mode network and becomes an intrinsic part of the self-percept. This is likely an energy-saving evolutionary adaptation, by detaching tinnitus from sympathetic energy-consuming activity. Eventually, this can lead to functional disability by interfering with the central executive network. In conclusion, these three pathways can be extended to a triple network model explaining all tinnitus-associated comorbidities. This model paves the way for the development of individualized treatment modalities.
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Affiliation(s)
- Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand (Aotearoa)
| | - Sven Vanneste
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.,Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Jae-Jin Song
- Seoul National University Bundang Hospital, Seongnam, Korea.,Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Divya Adhia
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand (Aotearoa)
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Gloeckner CD, Nocon JC, Lim HH. Topographic and widespread auditory modulation of the somatosensory cortex: potential for bimodal sound and body stimulation for pain treatment. J Neural Eng 2022; 19. [PMID: 35671702 DOI: 10.1088/1741-2552/ac7665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 06/07/2022] [Indexed: 11/11/2022]
Abstract
OBJECTIVE There has been growing interest in understanding multisensory integration in the cortex through activation of multiple sensory and motor pathways to treat brain disorders, such as tinnitus or essential tremors. For tinnitus, previous studies show that combined sound and body stimulation can modulate the auditory pathway and lead to significant improvements in tinnitus symptoms. Considering that tinnitus is a type of chronic auditory pain, bimodal stimulation could potentially alter activity in the somatosensory pathway relevant for treating chronic pain. As an initial step towards that goal, we mapped and characterized neuromodulation effects in the somatosensory cortex (SC) in response to sound and/or electrical stimulation of the body. APPROACH We first mapped the topographic organization of activity across the SC of ketamine-anesthetized guinea pigs through electrical stimulation of different body locations using subcutaneous needle electrodes or with broadband acoustic stimulation. We then characterized how neural activity in different parts of the SC could be facilitated or suppressed with bimodal stimulation. MAIN RESULTS The topography in the SC of guinea pigs in response to electrical stimulation of the body aligns consistently to that shown in previous rodent studies. Interestingly, auditory broadband noise stimulation primarily excited SC areas that typically respond to stimulation of lower body locations. Although there was only a small subset of SC locations that were excited by acoustic stimulation alone, all SC recording sites could be altered (facilitated or suppressed) with bimodal stimulation. Furthermore, specific regions of the SC could be modulated by stimulating an appropriate body region combined with broadband noise. SIGNIFICANCE These findings show that bimodal stimulation can excite or modulate firing across a widespread yet targeted population of SC neurons. This approach may provide a non-invasive method for altering or disrupting abnormal firing patterns within certain parts of the SC for chronic pain treatment.
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Affiliation(s)
- Cory D Gloeckner
- University of Minnesota Duluth, 1305 Ordean Court, Duluth, Minnesota, 55812, UNITED STATES
| | - Jian C Nocon
- Biomedical Engineering, Boston University, 44 Cummington Mall, Boston, Massachusetts, 02215, UNITED STATES
| | - Hubert H Lim
- Department of Biomedical Engineering, University of Minnesota, 7-105 Hasselmo Hall, 312 Church Street SE, Minneapolis, MN 55455, USA, Minneapolis, Minnesota, 55455, UNITED STATES
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De Ridder D, Adhia D, Vanneste S. The anatomy of pain and suffering in the brain and its clinical implications. Neurosci Biobehav Rev 2021; 130:125-146. [PMID: 34411559 DOI: 10.1016/j.neubiorev.2021.08.013] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 08/09/2021] [Accepted: 08/13/2021] [Indexed: 02/08/2023]
Abstract
Pain is an unpleasant sensory and emotional experience associated with actual or potential tissue damage. Chronic pain, with a prevalence of 20-30 % is the major cause of human suffering worldwide, because effective, specific and safe therapies have yet to be developed. It is unevenly distributed among sexes, with women experiencing more pain and suffering. Chronic pain can be anatomically and phenomenologically dissected into three separable but interacting pathways, a lateral 'painfulness' pathway, a medial 'suffering' pathway and a descending pain inhibitory pathway. One may have pain(fullness) without suffering and suffering without pain(fullness). Pain sensation leads to suffering via a cognitive, emotional and autonomic processing, and is expressed as anger, fear, frustration, anxiety and depression. The medial pathway overlaps with the salience and stress networks, explaining that behavioural relevance or meaning determines the suffering associated with painfulness. Genetic and epigenetic influences trigger chronic neuroinflammatory changes which are involved in transitioning from acute to chronic pain. Based on the concept of the Bayesian brain, pain (and suffering) can be regarded as the consequence of an imbalance between the two ascending and the descending pain inhibitory pathways under control of the reward system. The therapeutic clinical implications of this simple pain model are obvious. After categorizing the working mechanisms of each of the available treatments (pain killers, psychopharmacology, psychotherapy, neuromodulation, psychosurgery, spinal cord stimulation) to 1 or more of the 3 pathways, a rational combination can be proposed of activating the descending pain inhibitory pathway in combination with inhibition of the medial and lateral pathway, so as to rebalance the pain (and suffering) pathways.
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Affiliation(s)
- Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
| | - Divya Adhia
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Sven Vanneste
- Global Brain Health Institute, Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
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Huang L, Jin J, Chen K, You S, Zhang H, Sideris A, Norcini M, Recio-Pinto E, Wang J, Gan WB, Yang G. BDNF produced by cerebral microglia promotes cortical plasticity and pain hypersensitivity after peripheral nerve injury. PLoS Biol 2021; 19:e3001337. [PMID: 34292944 PMCID: PMC8346290 DOI: 10.1371/journal.pbio.3001337] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Revised: 08/06/2021] [Accepted: 06/22/2021] [Indexed: 12/30/2022] Open
Abstract
Peripheral nerve injury–induced mechanical allodynia is often accompanied by abnormalities in the higher cortical regions, yet the mechanisms underlying such maladaptive cortical plasticity remain unclear. Here, we show that in male mice, structural and functional changes in the primary somatosensory cortex (S1) caused by peripheral nerve injury require neuron-microglial signaling within the local circuit. Following peripheral nerve injury, microglia in the S1 maintain ramified morphology and normal density but up-regulate the mRNA expression of brain-derived neurotrophic factor (BDNF). Using in vivo two-photon imaging and Cx3cr1CreER;Bdnfflox mice, we show that conditional knockout of BDNF from microglia prevents nerve injury–induced synaptic remodeling and pyramidal neuron hyperactivity in the S1, as well as pain hypersensitivity in mice. Importantly, S1-targeted removal of microglial BDNF largely recapitulates the beneficial effects of systemic BDNF depletion on cortical plasticity and allodynia. Together, these findings reveal a pivotal role of cerebral microglial BDNF in somatosensory cortical plasticity and pain hypersensitivity. This study reveals that brain-derived neurotrophic factor (BDNF) from cerebral microglia contributes to nerve injury-induced synaptic remodeling and neuronal hyperactivity, and ultimately contributes to pain sensitivity in mice; removal of microglial BDNF has beneficial effects on cortical plasticity and pain.
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Affiliation(s)
- Lianyan Huang
- Department of Anesthesiology, New York University School of Medicine, New York, New York, United States of America
- Neuroscience Program, Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China
- * E-mail: (LH); (GY)
| | - Jianhua Jin
- Neuroscience Program, Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Kai Chen
- Department of Anesthesiology, Columbia University Medical Center, New York, New York, United States of America
| | - Sikun You
- Neuroscience Program, Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Hongyang Zhang
- Neuroscience Program, Guangdong Provincial Key Laboratory of Brain Function and Disease, Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Alexandra Sideris
- Department of Anesthesiology, New York University School of Medicine, New York, New York, United States of America
| | - Monica Norcini
- Department of Anesthesiology, New York University School of Medicine, New York, New York, United States of America
| | - Esperanza Recio-Pinto
- Department of Anesthesiology, New York University School of Medicine, New York, New York, United States of America
| | - Jing Wang
- Department of Anesthesiology, New York University School of Medicine, New York, New York, United States of America
| | - Wen-Biao Gan
- Department of Anesthesiology, New York University School of Medicine, New York, New York, United States of America
- Skirball Institute, Department of Neuroscience and Physiology, New York University School of Medicine, New York, New York, United States of America
| | - Guang Yang
- Department of Anesthesiology, New York University School of Medicine, New York, New York, United States of America
- Department of Anesthesiology, Columbia University Medical Center, New York, New York, United States of America
- * E-mail: (LH); (GY)
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Invasive cortical stimulation. INTERNATIONAL REVIEW OF NEUROBIOLOGY 2021; 159:23-45. [PMID: 34446248 DOI: 10.1016/bs.irn.2021.03.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The field of neuromodulation, at its essence, aims to apply electrical stimulation to the brain to ameliorate various pathology. Many methods of applying this stimulation exist, including invasive and non-invasive means. In the realm of invasive stimulation, stimulation of the cortex remains one of the earliest techniques investigated, yet one of the most underutilized today. Evidence for the efficacy of direct invasive cortical stimulation continues to mount, especially in recent years. In this chapter we will review the evidence for the use of invasive cortical stimulation as it applies to neuropathic pain, epilepsy, psychiatric disease, movement disorders, tinnitus, and post-stroke recovery, as well explore some potential mechanisms and future directions of the technique.
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Fallegger F, Schiavone G, Pirondini E, Wagner FB, Vachicouras N, Serex L, Zegarek G, May A, Constanthin P, Palma M, Khoshnevis M, Van Roost D, Yvert B, Courtine G, Schaller K, Bloch J, Lacour SP. MRI-Compatible and Conformal Electrocorticography Grids for Translational Research. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2021; 8:2003761. [PMID: 33977054 PMCID: PMC8097365 DOI: 10.1002/advs.202003761] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 12/23/2020] [Indexed: 05/23/2023]
Abstract
Intraoperative electrocorticography (ECoG) captures neural information from the surface of the cerebral cortex during surgeries such as resections for intractable epilepsy and tumors. Current clinical ECoG grids come in evenly spaced, millimeter-sized electrodes embedded in silicone rubber. Their mechanical rigidity and fixed electrode spatial resolution are common shortcomings reported by the surgical teams. Here, advances in soft neurotechnology are leveraged to manufacture conformable subdural, thin-film ECoG grids, and evaluate their suitability for translational research. Soft grids with 0.2 to 10 mm electrode pitch and diameter are embedded in 150 µm silicone membranes. The soft grids are compatible with surgical handling and can be folded to safely interface hidden cerebral surface such as the Sylvian fold in human cadaveric models. It is found that the thin-film conductor grids do not generate diagnostic-impeding imaging artefacts (<1 mm) nor adverse local heating within a standard 3T clinical magnetic resonance imaging scanner. Next, the ability of the soft grids to record subdural neural activity in minipigs acutely and two weeks postimplantation is validated. Taken together, these results suggest a promising future alternative to current stiff electrodes and may enable the future adoption of soft ECoG grids in translational research and ultimately in clinical settings.
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Affiliation(s)
- Florian Fallegger
- Bertarelli Foundation Chair in Neuroprosthetic TechnologyLaboratory for Soft Bioelectronic InterfacesInstitute of MicroengineeringInstitute of BioengineeringCenter for NeuroprostheticsEcole Polytechnique Fédérale de Lausanne (EPFL)Geneva1202Switzerland
| | - Giuseppe Schiavone
- Bertarelli Foundation Chair in Neuroprosthetic TechnologyLaboratory for Soft Bioelectronic InterfacesInstitute of MicroengineeringInstitute of BioengineeringCenter for NeuroprostheticsEcole Polytechnique Fédérale de Lausanne (EPFL)Geneva1202Switzerland
| | - Elvira Pirondini
- Department of NeurosurgeryUniversity Hospital of Lausanne (CHUV) and University of Lausanne (UNIL)Lausanne1010Switzerland
- Defitech Center for Interventional Neurotherapies (NeuroRestore)Department of NeurosurgeryUniversity Hospital of Lausanne (CHUV)University of Lausanne (UNIL)Lausanne1015Switzerland
| | - Fabien B. Wagner
- Defitech Center for Interventional Neurotherapies (NeuroRestore)Department of NeurosurgeryUniversity Hospital of Lausanne (CHUV)University of Lausanne (UNIL)Lausanne1015Switzerland
- UPCourtineCenter for Neuroprosthetics and Brain Mind InstituteSchool of Life SciencesEcole Polytechnique Fédérale de Lausanne (EPFL)Geneva1202Switzerland
- Present address:
Institut des Maladies Neurodégénératives – CNRS UMR 5293Université de BordeauxCentre Broca Nouvelle‐Aquitaine146 rue Léo Saignat – CS 61292 – Case 28, Bordeaux cedexBordeaux33076France
| | - Nicolas Vachicouras
- Bertarelli Foundation Chair in Neuroprosthetic TechnologyLaboratory for Soft Bioelectronic InterfacesInstitute of MicroengineeringInstitute of BioengineeringCenter for NeuroprostheticsEcole Polytechnique Fédérale de Lausanne (EPFL)Geneva1202Switzerland
| | - Ludovic Serex
- Bertarelli Foundation Chair in Neuroprosthetic TechnologyLaboratory for Soft Bioelectronic InterfacesInstitute of MicroengineeringInstitute of BioengineeringCenter for NeuroprostheticsEcole Polytechnique Fédérale de Lausanne (EPFL)Geneva1202Switzerland
| | - Gregory Zegarek
- Department of NeurosurgeryHôpital Universitaire de Genève (HUG)Geneva1205Switzerland
| | - Adrien May
- Department of NeurosurgeryHôpital Universitaire de Genève (HUG)Geneva1205Switzerland
| | - Paul Constanthin
- Department of NeurosurgeryHôpital Universitaire de Genève (HUG)Geneva1205Switzerland
| | - Marie Palma
- BrainTech LaboratoryInsermUniv Grenoble AlpesGrenoble38400France
| | | | - Dirk Van Roost
- Department of NeurosurgeryHôpital Universitaire de Genève (HUG)Geneva1205Switzerland
- Department of NeurosurgeryGhent UniversityGhent9000Belgium
| | - Blaise Yvert
- BrainTech LaboratoryInsermUniv Grenoble AlpesGrenoble38400France
| | - Grégoire Courtine
- Defitech Center for Interventional Neurotherapies (NeuroRestore)Department of NeurosurgeryUniversity Hospital of Lausanne (CHUV)University of Lausanne (UNIL)Lausanne1015Switzerland
- UPCourtineCenter for Neuroprosthetics and Brain Mind InstituteSchool of Life SciencesEcole Polytechnique Fédérale de Lausanne (EPFL)Geneva1202Switzerland
| | - Karl Schaller
- Department of NeurosurgeryHôpital Universitaire de Genève (HUG)Geneva1205Switzerland
| | - Jocelyne Bloch
- Department of NeurosurgeryUniversity Hospital of Lausanne (CHUV) and University of Lausanne (UNIL)Lausanne1010Switzerland
- Defitech Center for Interventional Neurotherapies (NeuroRestore)Department of NeurosurgeryUniversity Hospital of Lausanne (CHUV)University of Lausanne (UNIL)Lausanne1015Switzerland
| | - Stéphanie P. Lacour
- Bertarelli Foundation Chair in Neuroprosthetic TechnologyLaboratory for Soft Bioelectronic InterfacesInstitute of MicroengineeringInstitute of BioengineeringCenter for NeuroprostheticsEcole Polytechnique Fédérale de Lausanne (EPFL)Geneva1202Switzerland
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Tinnitus and tinnitus disorder: Theoretical and operational definitions (an international multidisciplinary proposal). PROGRESS IN BRAIN RESEARCH 2021; 260:1-25. [PMID: 33637213 DOI: 10.1016/bs.pbr.2020.12.002] [Citation(s) in RCA: 108] [Impact Index Per Article: 36.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
As for hypertension, chronic pain, epilepsy and other disorders with particular symptoms, a commonly accepted and unambiguous definition provides a common ground for researchers and clinicians to study and treat the problem. The WHO's ICD11 definition only mentions tinnitus as a nonspecific symptom of a hearing disorder, but not as a clinical entity in its own right, and the American Psychiatric Association's DSM-V doesn't mention tinnitus at all. Here we propose that the tinnitus without and with associated suffering should be differentiated by distinct terms: "Tinnitus" for the former and "Tinnitus Disorder" for the latter. The proposed definition then becomes "Tinnitus is the conscious awareness of a tonal or composite noise for which there is no identifiable corresponding external acoustic source, which becomes Tinnitus Disorder "when associated with emotional distress, cognitive dysfunction, and/or autonomic arousal, leading to behavioural changes and functional disability.". In other words "Tinnitus" describes the auditory or sensory component, whereas "Tinnitus Disorder" reflects the auditory component and the associated suffering. Whereas acute tinnitus may be a symptom secondary to a trauma or disease, chronic tinnitus may be considered a primary disorder in its own right. If adopted, this will advance the recognition of tinnitus disorder as a primary health condition in its own right. The capacity to measure the incidence, prevalence, and impact will help in identification of human, financial, and educational needs required to address acute tinnitus as a symptom but chronic tinnitus as a disorder.
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Zhang J, Firestone E, Elattma A. Animal Models of Tinnitus Treatment: Cochlear and Brain Stimulation. Curr Top Behav Neurosci 2021; 51:83-129. [PMID: 34282563 DOI: 10.1007/7854_2021_227] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Neuromodulation, via stimulation of a variety of peripheral and central structures, is used to suppress tinnitus. However, investigative limitations in humans due to ethical reasons have made it difficult to decipher the mechanisms underlying treatment-induced tinnitus relief, so a number of animal models have arisen to address these unknowns. This chapter reviews animal models of cochlear and brain stimulation and assesses their modulatory effects on behavioral evidence of tinnitus and its related neural correlates. When a structure is stimulated, localized modulation, often presenting as downregulation of spontaneous neuronal spike firing rate, bursting and neurosynchrony, occurs within the brain area. Through anatomical projections and transmitter pathways, the interventions activate both auditory- and non-auditory structures by taking bottom-up ascending and top-down descending modes to influence their target brain structures. Furthermore, it is the brain oscillations that cochlear or brain stimulation evoke and connect the prefrontal cortex, striatal systems, and other limbic structures to refresh neural networks and relieve auditory, attentive, conscious, as well as emotional reactive aspects of tinnitus. This oscillatory neural network connectivity is achieved via the thalamocorticothalamic circuitry including the lemniscal and non-lemniscal auditory brain structures. Beyond existing technologies, the review also reveals opportunities for developing advanced animal models using new modalities to achieve precision neuromodulation and tinnitus abatement, such as optogenetic cochlear and/or brain stimulation.
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Affiliation(s)
- Jinsheng Zhang
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA. .,Department of Communication Sciences and Disorders, Wayne State University College of Liberal Arts and Sciences, Detroit, MI, USA.
| | - Ethan Firestone
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ahmed Elattma
- Department of Otolaryngology-Head and Neck Surgery, Wayne State University School of Medicine, Detroit, MI, USA
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Abstract
The pathophysiological mechanisms that underlie the generation and maintenance of tinnitus are being unraveled progressively. Based on this knowledge, a large variety of different neuromodulatory interventions have been developed and are still being designed, adapting to the progressive mechanistic insights in the pathophysiology of tinnitus. rTMS targeting the temporal, temporoparietal, and the frontal cortex has been the mainstay of non-invasive neuromodulation. Yet, the evidence is still unclear, and therefore systematic meta-analyses are needed for drawing conclusions on the effectiveness of rTMS in chronic tinnitus. Different forms of transcranial electrical stimulation (tDCS, tACS, tRNS), applied over the frontal and temporal cortex, have been investigated in tinnitus patients, also without robust evidence for universal efficacy. Cortex and deep brain stimulation with implanted electrodes have shown benefit, yet there is insufficient data to support their routine clinical use. Recently, bimodal stimulation approaches have revealed promising results and it appears that targeting different sensory modalities in temporally combined manners may be more promising than single target approaches.While most neuromodulatory approaches seem promising, further research is required to help translating the scientific outcomes into routine clinical practice.
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De Ridder D, Vanneste S. The Bayesian brain in imbalance: Medial, lateral and descending pathways in tinnitus and pain: A perspective. PROGRESS IN BRAIN RESEARCH 2020; 262:309-334. [PMID: 33931186 DOI: 10.1016/bs.pbr.2020.07.012] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Tinnitus and pain share similarities in their anatomy, pathophysiology, clinical picture and treatments. Based on what is known in the pain field, a heuristic model can be proposed for the pathophysiolgy of tinnitus. This heuristic pathophysiological model suggests that pain and tinnitus are the consequence of an imbalance between two pain/tinnitus evoking pathways, i.e., a lateral sensory pathway and a medial affective pathway, both of which are not balanced anymore by a pain/noise inhibitory pathway. Mechanistically, based on the Bayesian brain concept, it can be explained by a switch occuring under influence of the rostral to dorsal anterior cingulate cortex of its prior predictions, i.e., a reference resetting, in which the pain/tinnitus state is considered as the new reference state. This reference resetting is confirmed by the nucleus accumbens as part of the reward system and maintained by connectivity changes between the nucleus accumbens and the pregenual anterior cingulate cortex. As a consequence it can be suggested to treat pain/tinnitus via reconditioning, either surgically or non-surgically. The model can also be used to develop objective measures for tinnitus and pain via supervised machine learning.
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Affiliation(s)
- Dirk De Ridder
- Department of Surgical Sciences, Section of Neurosurgery, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand.
| | - Sven Vanneste
- Global Brain Health Institute & Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
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Low inter-rater consistency in semantic profiles of tinnitus-like sounds rated by tinnitus patients. PROGRESS IN BRAIN RESEARCH 2020; 262:93-113. [PMID: 33931196 DOI: 10.1016/bs.pbr.2020.06.021] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
Characterizations of the tinnitus sound percept are always based on a subjective description by the person affected. Since the experimenter cannot have access to the tinnitus percept, it is not possible to verify whether individuals use the adjectives describing the sound in the expected way, i.e., whether a label given to the tinnitus percept corresponds to the label that the experimenter or another individual would give to the same sound percept. However, if it is assumed that tinnitus patients can reliably describe their own tinnitus, then they should also be able to reliably describe tinnitus-like sounds, presented acoustically. In this study, 26 tinnitus patients used a tablet computer to rate 18 pre-defined adjectives on their level of descriptiveness for their own tinnitus percept as well as 17 tinnitus-like sounds presented via headphones. The main interest of the current study was to calculate intraclass correlation (ICC) and Krippendorff's alpha coefficients for the rating profiles of the acoustically-presented sounds, in order to quantify how well the individuals agreed on the ratings of known sounds, i.e., whether the adjectives would receive similar ratings from all participants for a specific tinnitus-like sound. The results show that the level of agreement was low for all adjectives and sounds, meaning that the different individuals did not use the adjectives in a consistent manner. The conclusion is that subjective tinnitus descriptions should be interpreted with great caution, and that the inherent variability involved in the characterization of sounds by naïve listeners can contribute to the observed heterogeneity in tinnitus symptoms and treatment outcomes.
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Chen Q, Wang Z, Lv H, Zhao P, Yang Z, Gong S, Wang Z. Reorganization of Brain White Matter in Persistent Idiopathic Tinnitus Patients Without Hearing Loss: Evidence From Baseline Data. Front Neurosci 2020; 14:591. [PMID: 32612504 PMCID: PMC7308730 DOI: 10.3389/fnins.2020.00591] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Accepted: 05/13/2020] [Indexed: 12/19/2022] Open
Abstract
It remains unknown whether tinnitus or tinnitus-related hearing loss (HL) could indirectly impair or reshape the white matter (WM) of the human brain. We aim to explore the possible brain WM change in tinnitus patients without HL and further to investigate their associations with clinical variables. Structural and diffusion tensor imaging (DTI) of 20 idiopathic tinnitus patients without HL and 22 healthy controls (HCs) were obtained. Voxel-based morphometry (VBM) and tract-based spatial statistics (TBSS) analysis were conducted to investigate the differences in WM volume and integrity between patients and HCs, separately. We extracted WM parameters to determine a sensitive imaging index to differentiate the idiopathic tinnitus patients from the HCs in the early stage. Correlations between the clinical variables and WM indices were also performed in patients. Compared with the controls, the tinnitus patients without HL exhibited significant decreased fractional anisotropy (FA) in the body and genu of corpus callosum (CC), left cingulum (LC) and right cingulum (RC), and right superior longitudinal fasciculus (RSLF) and increase in mean diffusivity (MD) in the body of CC in WM. Moreover, the patients also showed decreases in WM axial diffusivity (AD) in LC, left superior longitudinal fasciculus (LSLF), and right interior cerebellar peduncle (ICP) and increases in radial diffusivity (RD) in the body and genu of CC and RSLF (p < 0.05, voxel-level FWE corrected). Furthermore, the increased RD value of the genu of CC is closely associated with the tinnitus handicap inventory (THI) subscale scores. No WMV changes were detected in tinnitus patients. We combined the altered WM integrity index of body and genu of CC and LC and RSLF as an index to differentiate the two groups and reached a sensitivity of 100% and a specificity of 77.3%. Our findings suggest that tinnitus without HL is associated with significant alterations of WM integrity. These changes may be irrespective of the duration and other clinical performance. The combination of diffusion indices of body and genu of CC and LC and RSLF might be used as the potential useful imaging index for the diagnosis of persistent idiopathic tinnitus without HL in the early stage.
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Affiliation(s)
- Qian Chen
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhaodi Wang
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Han Lv
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Pengfei Zhao
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenghan Yang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Shusheng Gong
- Department of Otolaryngology Head and Neck Surgery, Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - Zhenchang Wang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing, China
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Chai Z, Ma C, Jin X. Homeostatic activity regulation as a mechanism underlying the effect of brain stimulation. Bioelectron Med 2019; 5:16. [PMID: 32232105 PMCID: PMC7098242 DOI: 10.1186/s42234-019-0032-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 08/23/2019] [Indexed: 01/10/2023] Open
Abstract
Hyperexcitability of the neural network often occurs after brain injuries or degeneration and is a key pathophysiological feature in certain neurological diseases such as epilepsy, neuropathic pain, and tinnitus. Although the standard approach of pharmacological treatments is to directly suppress the hyperexcitability through reducing excitation or enhancing inhibition, different techniques for stimulating brain activity are often used to treat refractory neurological conditions. However, it is unclear why stimulating brain activity would be effective for controlling hyperexcitability. Recent studies suggest that the pathogenesis in these disorders exhibits a transition from an initial activity loss after acute injury or progressive neurodegeneration to subsequent development of hyperexcitability. This process mimics homeostatic activity regulation and may contribute to developing network hyperexcitability that underlies neurological symptoms. This hypothesis also predicts that stimulating brain activity should be effective in reducing hyperexcitability due to homeostatic activity regulation and in relieving symptoms. Here we review current evidence of homeostatic plasticity in the development of hyperexcitability in some neurological diseases and the effects of brain stimulation. The homeostatic plasticity hypothesis may provide new insights into the pathophysiology of neurological diseases and may guide the use of brain stimulation techniques for treating them.
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Affiliation(s)
- Zhi Chai
- Neurobiology Research Center, College of Basic Medicine, Shanxi University of Chinese Medicine, Taiyuan, 030619 China
| | - Cungen Ma
- Neurobiology Research Center, College of Basic Medicine, Shanxi University of Chinese Medicine, Taiyuan, 030619 China
| | - Xiaoming Jin
- Department of Anatomy, Cell Biology and Physiology, Department of Neurological Surgery, Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, Indiana University School of Medicine, 320 West 15th Street, NB 500C, Indianapolis, IN 46202 USA
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New Onset Tinnitus after High-Frequency Spinal Cord Stimulator Implantation. Case Rep Anesthesiol 2019; 2019:5039646. [PMID: 31186971 PMCID: PMC6521477 DOI: 10.1155/2019/5039646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2019] [Accepted: 04/11/2019] [Indexed: 11/17/2022] Open
Abstract
The most common complications of spinal cord stimulation (SCS) therapy are generally related to surgical site infection and hardware malfunction. Less well understood are the adverse neurological effects of this therapy. We present the case of a patient who underwent placement of a Senza HF10 high-frequency spinal cord stimulator with subsequent development of tinnitus, vertigo, intermittent involuntary left facial twitches, and perioral numbness. These symptoms resolved following deactivation of her device. To further explore these less common neurologic complications of SCS therapy, a review of literature and a review of the U.S. Food and Drug Administration Manufacturer and User Facility Device Experience database are included. Further research and investigation in this area are needed so that clinicians and patients may have more complete knowledge and understanding of the potential treatment-limiting complications of spinal cord stimulation.
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Adding Prefrontal Transcranial Direct Current Stimulation Before Occipital Nerve Stimulation in Fibromyalgia. Clin J Pain 2019; 34:421-427. [PMID: 28877142 DOI: 10.1097/ajp.0000000000000552] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Fibromyalgia (FM) is a type of chronic musculoskeletal pain without a clear peripheral origin of nociception, often associated with depression. The underlying pathophysiology involves changes in a functional network that is related to pain and emotional processing in the central nervous system. Transcranial direct current stimulation (tDCS) targeting the dorsolateral prefrontal cortex or the occipital nerve (ON) is a noninvasive neuromodulation technique capable of improving fibromyalgia symptoms. This study aims to test the effect of combining 2 targets of stimulation using tDCS. MATERIALS AND METHODS We applied ON-tDCS in isolation or coupled with pre-ONS right-anode bifrontal tDCS and assessed its effect on fibromyalgia using the Fibromyalgia Impact Questionnaire, the Beck Depression Inventory, and Numeric Rating Scale for pain scores. These measures were compared with a sham control group using repeated measures analysis of variance. RESULTS The interaction effect of stimulation trials and the protocols of sham versus ON-tDCS were significant for the impact, distress, and pain caused by fibromyalgia (P<0.05). The interaction effect of trials and protocols of sham versus ON-tDCS with bifrontal tDCS was significant for distress (P<0.01), and it showed a trend of improvement for impact and pain (P<0.1). On the basis of the nonsignificant interaction effect of ON-tDCS versus ON-tDCS with bifrontal tDCS (P>0.1), adding bifrontal tDCS was found not to improve the treatment effect of ON-tDCS in any of the tested clinical outcome measures. DISCUSSION This study suggests that adding right-anode bifrontal tDCS to ONS has no added benefit in improving fibromyalgia-related symptoms.
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Vanneste S, To WT, De Ridder D. Tinnitus and neuropathic pain share a common neural substrate in the form of specific brain connectivity and microstate profiles. Prog Neuropsychopharmacol Biol Psychiatry 2019; 88:388-400. [PMID: 30142355 DOI: 10.1016/j.pnpbp.2018.08.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2018] [Revised: 07/06/2018] [Accepted: 08/19/2018] [Indexed: 12/12/2022]
Abstract
Tinnitus and neuropathic pain share similar pathophysiological, clinical, and treatment characteristics. In this EEG study, a group of tinnitus (n = 100) and neuropathic pain (n = 100) patients are compared to each other and to a healthy control group (n = 100). Spectral analysis demonstrates gamma band activity within the primary auditory and somatosensory cortices in patients with tinnitus and neuropathic pain, respectively. A conjunction analysis further demonstrates an overlap of tinnitus and pain related activity in the anterior and posterior cingulate cortex as well as in the dorsolateral prefrontal cortex in comparison to healthy controls. Further analysis reveals that similar states characterize tinnitus and neuropathic pain patients, two of which differ from the healthy group and two of which are shared. Both pain and tinnitus patients spend half of the time in one specific microstate. Seed-based functional connectivity with the source within the predominant microstate shows delta, alpha1, and gamma lagged phase synchronization overlap with multiple brain areas between pain and tinnitus. These data suggest that auditory and somatosensory phantom perceptions share an overlapping brain network with common activation and connectivity patterns and are differentiated by specific sensory cortex gamma activation.
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Affiliation(s)
- Sven Vanneste
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, USA.
| | - Wing Ting To
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, USA
| | - Dirk De Ridder
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand
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Chai Z, Ma C, Jin X. Cortical stimulation for treatment of neurological disorders of hyperexcitability: a role of homeostatic plasticity. Neural Regen Res 2019; 14:34-38. [PMID: 30531066 PMCID: PMC6262991 DOI: 10.4103/1673-5374.243696] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
Hyperexcitability of neural network is a key neurophysiological mechanism in several neurological disorders including epilepsy, neuropathic pain, and tinnitus. Although standard paradigm of pharmacological management of them is to suppress this hyperexcitability, such as having been exemplified by the use of certain antiepileptic drugs, their frequent refractoriness to drug treatment suggests likely different pathophysiological mechanism. Because the pathogenesis in these disorders exhibits a transition from an initial activity loss after injury or sensory deprivation to subsequent hyperexcitability and paroxysmal discharges, this process can be regarded as a process of functional compensation similar to homeostatic plasticity regulation, in which a set level of activity in neural network is maintained after injury-induced activity loss through enhanced network excitability. Enhancing brain activity, such as cortical stimulation that is found to be effective in relieving symptoms of these disorders, may reduce such hyperexcitability through homeostatic plasticity mechanism. Here we review current evidence of homeostatic plasticity in the mechanism of acquired epilepsy, neuropathic pain, and tinnitus and the effects and mechanism of cortical stimulation. Establishing a role of homeostatic plasticity in these disorders may provide a theoretical basis on their pathogenesis as well as guide the development and application of therapeutic approaches through electrically or pharmacologically stimulating brain activity for treating these disorders.
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Affiliation(s)
- Zhi Chai
- Basic Medical College, Shanxi Key Laboratory of Innovative Drugs for Serious Illness Based on Inflammatory Reactions, Neurobiology Research Center, Shanxi University of Chinese Medicine, Jinzhong, Shanxi Province, China
| | - Cungen Ma
- Basic Medical College, Shanxi Key Laboratory of Innovative Drugs for Serious Illness Based on Inflammatory Reactions, Neurobiology Research Center, Shanxi University of Chinese Medicine, Jinzhong; Institute of Brain Science, Shanxi Datong University, Datong, Shanxi Province, China
| | - Xiaoming Jin
- Department of Anatomy and Cell Biology, Department of Neurological Surgery, Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
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Landgrebe M, Hajak G, Wolf S, Padberg F, Klupp P, Fallgatter AJ, Polak T, Höppner J, Haker R, Cordes J, Klenzner T, Schönfeldt-Lecuona C, Kammer T, Graf E, Koller M, Kleinjung T, Lehner A, Schecklmann M, Pöppl TB, Kreuzer P, Frank E, Langguth B. 1-Hz rTMS in the treatment of tinnitus: A sham-controlled, randomized multicenter trial. Brain Stimul 2017; 10:1112-1120. [DOI: 10.1016/j.brs.2017.08.001] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2017] [Revised: 07/20/2017] [Accepted: 08/02/2017] [Indexed: 01/01/2023] Open
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Xiong W, Ping X, Ripsch MS, Chavez GSC, Hannon HE, Jiang K, Bao C, Jadhav V, Chen L, Chai Z, Ma C, Wu H, Feng J, Blesch A, White FA, Jin X. Enhancing excitatory activity of somatosensory cortex alleviates neuropathic pain through regulating homeostatic plasticity. Sci Rep 2017; 7:12743. [PMID: 28986567 PMCID: PMC5630599 DOI: 10.1038/s41598-017-12972-6] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2017] [Accepted: 09/18/2017] [Indexed: 01/06/2023] Open
Abstract
Central sensitization and network hyperexcitability of the nociceptive system is a basic mechanism of neuropathic pain. We hypothesize that development of cortical hyperexcitability underlying neuropathic pain may involve homeostatic plasticity in response to lesion-induced somatosensory deprivation and activity loss, and can be controlled by enhancing cortical activity. In a mouse model of neuropathic pain, in vivo two-photon imaging and patch clamp recording showed initial loss and subsequent recovery and enhancement of spontaneous firings of somatosensory cortical pyramidal neurons. Unilateral optogenetic stimulation of cortical pyramidal neurons both prevented and reduced pain-like behavior as detected by bilateral mechanical hypersensitivity of hindlimbs, but corpus callosotomy eliminated the analgesic effect that was ipsilateral, but not contralateral, to optogenetic stimulation, suggesting involvement of inter-hemispheric excitatory drive in this effect. Enhancing activity by focally blocking cortical GABAergic inhibition had a similar relieving effect on the pain-like behavior. Patch clamp recordings from layer V pyramidal neurons showed that optogenetic stimulation normalized cortical hyperexcitability through changing neuronal membrane properties and reducing frequency of excitatory postsynaptic events. We conclude that development of neuropathic pain involves abnormal homeostatic activity regulation of somatosensory cortex, and that enhancing cortical excitatory activity may be a novel strategy for preventing and controlling neuropathic pain.
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Affiliation(s)
- Wenhui Xiong
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute. Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Xingjie Ping
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute. Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Matthew S Ripsch
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Grace Santa Cruz Chavez
- Department of Biomedical Engineering, Purdue School of Engineering and Technology. IUPUI, Indianapolis, USA
| | - Heidi Elise Hannon
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute. Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Kewen Jiang
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Neurology, Children's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Chunhui Bao
- Shanghai Research Institute of Acupuncture-Moxibustion and Meridian, Shanghai, China
| | - Vaishnavi Jadhav
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Lifang Chen
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Department of Acupuncture, Zhejiang Traditional Chinese Medical University and the Third Affiliated Hospital, Hangzhou, Zhejiang, China
| | - Zhi Chai
- Research Center of Neurobiology, Shanxi University of Traditional Chinese Medicine, Taiyuan, China
| | - Cungen Ma
- Research Center of Neurobiology, Shanxi University of Traditional Chinese Medicine, Taiyuan, China
| | - Huangan Wu
- Shanghai Research Institute of Acupuncture-Moxibustion and Meridian, Shanghai, China
| | - Jianqiao Feng
- Department of Acupuncture, Zhejiang Traditional Chinese Medical University and the Third Affiliated Hospital, Hangzhou, Zhejiang, China
| | - Armin Blesch
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, USA
- Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute. Indiana University School of Medicine, Indianapolis, IN, 46202, USA
| | - Fletcher A White
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
- Department of Anesthesia, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
- Research and Development Services, Richard L. Roudebush VA Medical Center, Indianapolis, IN 46202, USA.
| | - Xiaoming Jin
- Department of Anatomy and Cell Biology, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
- Department of Neurological Surgery, Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
- Spinal Cord and Brain Injury Research Group, Stark Neurosciences Research Institute. Indiana University School of Medicine, Indianapolis, IN, 46202, USA.
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Lan L, Zhang X, Li X, Rong X, Peng Y. The efficacy of transcranial magnetic stimulation on migraine: a meta-analysis of randomized controlled trails. J Headache Pain 2017; 18:86. [PMID: 28831756 PMCID: PMC5567575 DOI: 10.1186/s10194-017-0792-4] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 08/02/2017] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES As a non-invasive therapy, whether transcranial magnetic stimulation (TMS) is effective on migraine. This article was aimed to assess the efficacy of TMS on migraine based on randomized controlled trails (RCTs). METHODS We searched PubMed, Embase and Cochrane Library electronic databases for published studies which compared TMS group with sham group, conducted a meta-analysis of all RCTs. RESULTS Five studies, consisting of 313 migraine patients, were identified. Single-pulse transcranial magnetic stimulation is effective for the acute treatment of migraine with aura after the first attack (p = 0.02). And, the efficacy of TMS on chronic migraine was not significant (OR 2.93; 95% CI 0.71-12.15; p = 0.14). CONCLUSIONS TMS is effective for migraine based on the studies included in the article.
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Affiliation(s)
- Lihuan Lan
- Sun Yat-Sen University, Guangzhou, 510288, China
| | - Xiaoni Zhang
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Number 33, Yingfeng Road, Haizhu District, Guangzhou, 510288, China
| | - Xiangpen Li
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Number 33, Yingfeng Road, Haizhu District, Guangzhou, 510288, China
| | - Xiaoming Rong
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Number 33, Yingfeng Road, Haizhu District, Guangzhou, 510288, China
| | - Ying Peng
- Department of Neurology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Number 33, Yingfeng Road, Haizhu District, Guangzhou, 510288, China.
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Activation of cortical somatostatin interneurons prevents the development of neuropathic pain. Nat Neurosci 2017; 20:1122-1132. [PMID: 28671692 PMCID: PMC5559271 DOI: 10.1038/nn.4595] [Citation(s) in RCA: 89] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2016] [Accepted: 05/20/2017] [Indexed: 12/13/2022]
Abstract
Neuropathic pain involves long-lasting modifications of pain pathways that result in abnormal cortical activity. How cortical circuits are altered and contribute to the intense sensation associated with allodynia is unclear. Here we report a persistent elevation of layer V pyramidal neuron activity in the somatosensory cortex of a mouse model of neuropathic pain. This enhanced pyramidal neuron activity was caused in part by increases of synaptic activity and NMDA-receptor-dependent calcium spikes in apical tuft dendrites. Furthermore, local inhibitory interneuron networks shifted their activity in favor of pyramidal neuron hyperactivity: somatostatin-expressing and parvalbumin-expressing inhibitory neurons reduced their activity, whereas vasoactive intestinal polypeptide–expressing interneurons increased their activity. Pharmacogenetic activation of somatostatin-expressing cells reduced pyramidal neuron hyperactivity and reversed mechanical allodynia. These findings reveal cortical circuit changes that arise during the development of neuropathic pain and identify the activation of specific cortical interneurons as therapeutic targets for chronic pain treatment.
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Deer TR, Campos LW, Pope JE. Evaluation of Abbott’s BurstDR stimulation device for the treatment of chronic pain. Expert Rev Med Devices 2017; 14:417-422. [DOI: 10.1080/17434440.2017.1330147] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
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Kim W, Kim SK, Nabekura J. Functional and structural plasticity in the primary somatosensory cortex associated with chronic pain. J Neurochem 2017; 141:499-506. [PMID: 28278355 DOI: 10.1111/jnc.14012] [Citation(s) in RCA: 75] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2017] [Revised: 02/28/2017] [Accepted: 03/02/2017] [Indexed: 02/03/2023]
Abstract
Tissue or nerve injury induces widespread plastic changes from the periphery and spinal cord up to the cortex, resulting in chronic pain. Although many clinicians and researchers have extensively studied altered nociceptive signaling and neural circuit plasticity at the spinal cord level, effective treatments to ameliorate chronic pain are still insufficient. For about the last two decades, the rapid development in macroscopic brain imaging studies on humans and animal models have revealed maladaptive plastic changes in the 'pain matrix' brain regions, which may subsequently contribute to chronic pain. Among these brain regions, our group has concentrated for many years on the primary somatosensory (S1) cortex with a help of advanced imaging techniques and has found the functional and structural changes in neurons/glia as well as individual synapses in the S1 cortex during chronic pain. Taken together, it is now believed that such S1 plasticity is one of the causes for chronic pain, not a simple and passive epiphenomenon following tissue/nerve injury as previously thought. In this small review, we discuss the relation of plasticity in the S1 cortex with chronic pain, based on clinical trials and experimental studies conducted on this field. This article is part of the special article series "Pain".
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Affiliation(s)
- Woojin Kim
- Department of Physiology, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Sun Kwang Kim
- Department of Physiology, College of Korean Medicine, Kyung Hee University, Seoul, Korea
| | - Junichi Nabekura
- Division of Homeostatic Development, National Institute for Physiological Sciences, Okazaki, Aichi, Japan.,Department of Physiological Sciences, The Graduate School for Advanced Study, Hayama, Kanagawa, Japan.,Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Tokyo, Japan
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De Ridder D, Perera S, Vanneste S. State of the Art: Novel Applications for Cortical Stimulation. Neuromodulation 2017; 20:206-214. [PMID: 28371170 DOI: 10.1111/ner.12593] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2016] [Revised: 01/13/2017] [Accepted: 01/30/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVE Electrical stimulation via implanted electrodes that overlie the cortex of the brain is an upcoming neurosurgical technique that was hindered for a long time by insufficient knowledge of how the brain functions in a dynamic, physiological, and pathological way, as well as by technological limitations of the implantable stimulation devices. METHODS This paper provides an overview of cortex stimulation via implantable devices and introduces future possibilities to improve cortex stimulation. RESULTS Cortex stimulation was initially used preoperatively as a technique to localize functions in the brain and only later evolved into a treatment technique. It was first used for pain, but more recently a multitude of pathologies are being targeted by cortex stimulation. These disorders are being treated by stimulating different cortical areas of the brain. Risks and complications are essentially similar to those related to deep brain stimulation and predominantly include haemorrhage, seizures, infection, and hardware failures. For cortex stimulation to fully mature, further technological development is required to predict its outcomes and improve stimulation designs. This includes the development of network science-based functional connectivity approaches, genetic analyses, development of navigated high definition transcranial alternating current stimulation, and development of pseudorandom stimulation designs for preventing habituation. CONCLUSION In conclusion, cortex stimulation is a nascent but very promising approach to treating a variety of diseases, but requires further technological development for predicting outcomes, such as network science based functional connectivity approaches, genetic analyses, development of navigated transcranial electrical stimulation, and development of pseudorandom stimulation designs for preventing habituation.
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Affiliation(s)
- Dirk De Ridder
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand
| | | | - Sven Vanneste
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand.,The University of Texas at Dallas, Richardson, TX, USA
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Anterior Cingulate Implant for Obsessive-Compulsive Disorder. World Neurosurg 2016; 97:754.e7-754.e16. [PMID: 27756670 DOI: 10.1016/j.wneu.2016.10.046] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2016] [Revised: 10/04/2016] [Accepted: 10/06/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is a brain disorder with a lifetime prevalence of 2.3%, causing severe functional impairment as a result of anxiety and distress, persistent and repetitive, unwanted, intrusive thoughts (obsessions), and repetitive ritualized behavior (compulsions). Approximately 40%-60% of patients with OCD fail to satisfactorily respond to standard treatments. Intractable OCD has been treated by anterior capsulotomy and cingulotomy, but more recently, neurostimulation approaches have become more popular because of their reversibility. OBJECTIVE Implants for OCD are commonly being used, targeting the anterior limb of the internal capsula or the nucleus accumbens, but an implant on the anterior cingulate cortex has never been reported. METHODS We describe a patient who was primarily treated for alcohol addiction, first with transcranial magnetic stimulation, then by implantation of 2 electrodes overlying the rostrodorsal part of the anterior cingulate cortex bilaterally. RESULTS Her alcohol addiction developed as she was relief drinking to self-treat her OCD, anxiety, and depression. After the surgical implant, she underwent placebo stimulation followed by real stimulation of the dorsal anterior cingulate cortex, which dramatically improved her OCD symptoms (decrease of 65.5% on the Yale-Brown Obsessive Compulsive Drinking Scale) as well as her alcohol craving (decrease of 87.5%) after 36 weeks of treatment. Although there were improvements in all the scores, there was only a modest reduction in the patient's weekly alcohol consumption (from 50 units to 32 units). CONCLUSIONS Based on these preliminary positive results we propose to further study the possible beneficial effect of anterior cingulate cortex stimulation for intractable OCD.
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Beebe Palumbo D, Joos K, De Ridder D, Vanneste S. The Management and Outcomes of Pharmacological Treatments for Tinnitus. Curr Neuropharmacol 2016; 13:692-700. [PMID: 26467416 PMCID: PMC4761638 DOI: 10.2174/1570159x13666150415002743] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2015] [Revised: 03/12/2015] [Accepted: 04/09/2015] [Indexed: 01/28/2023] Open
Abstract
Tinnitus, a phantom sensation experienced by people around the world, currently is endured
without a known cure. Some find the condition tolerable, while others are tortured on a daily basis
from the incessant phantom noises. For those who seek treatment, oftentimes, they have a comorbid
condition (e.g., depression, anxiety, insomnia), which is treated pharmaceutically. These products aim
to reduce the comorbities associated with tinnitus thereby minimizing the overall burden present.
Because of the phantom nature of tinnitus, it is often compared to neurologic pain. Since pain can be managed with
pharmaceutical options, it is reasonable to assume that similar agents might work to alleviate tinnitus. The effects of
antidepressants, benzodiazepines, anticonvulsants, and glutamate antagonists are reviewed in this paper. Table 1 summarizes
the pharmaceutical products discussed. Due to the variety of comorbid factors and potential causes of tinnitus, there may
not be one pharmaceutical treatment that will combat every type of tinnitus. Nevertheless, a product that finally addresses
the true cause of tinnitus, and not just its comorbidities, will benefit millions of people worldwide.
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Affiliation(s)
| | | | | | - Sven Vanneste
- Lab for Auditory & Integrative Neuroscience, School of Behavioral & Brain Science, University of Texas at Dallas, W 1966 Inwood Rd, Dallas, Texas 75235, USA
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Kim SK, Hayashi H, Ishikawa T, Shibata K, Shigetomi E, Shinozaki Y, Inada H, Roh SE, Kim SJ, Lee G, Bae H, Moorhouse AJ, Mikoshiba K, Fukazawa Y, Koizumi S, Nabekura J. Cortical astrocytes rewire somatosensory cortical circuits for peripheral neuropathic pain. J Clin Invest 2016; 126:1983-97. [PMID: 27064281 PMCID: PMC4855913 DOI: 10.1172/jci82859] [Citation(s) in RCA: 118] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2015] [Accepted: 02/25/2016] [Indexed: 01/09/2023] Open
Abstract
Long-term treatments to ameliorate peripheral neuropathic pain that includes mechanical allodynia are limited. While glial activation and altered nociceptive transmission within the spinal cord are associated with the pathogenesis of mechanical allodynia, changes in cortical circuits also accompany peripheral nerve injury and may represent additional therapeutic targets. Dendritic spine plasticity in the S1 cortex appears within days following nerve injury; however, the underlying cellular mechanisms of this plasticity and whether it has a causal relationship to allodynia remain unsolved. Furthermore, it is not known whether glial activation occurs within the S1 cortex following injury or whether it contributes to this S1 synaptic plasticity. Using in vivo 2-photon imaging with genetic and pharmacological manipulations of murine models, we have shown that sciatic nerve ligation induces a re-emergence of immature metabotropic glutamate receptor 5 (mGluR5) signaling in S1 astroglia, which elicits spontaneous somatic Ca2+ transients, synaptogenic thrombospondin 1 (TSP-1) release, and synapse formation. This S1 astrocyte reactivation was evident only during the first week after injury and correlated with the temporal changes in S1 extracellular glutamate levels and dendritic spine turnover. Blocking the astrocytic mGluR5-signaling pathway suppressed mechanical allodynia, while activating this pathway in the absence of any peripheral injury induced long-lasting (>1 month) allodynia. We conclude that reawakened astrocytes are a key trigger for S1 circuit rewiring and that this contributes to neuropathic mechanical allodynia.
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Affiliation(s)
- Sun Kwang Kim
- Department of Physiology, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
- Division of Homeostatic Development, National Institute for Physiological Sciences, Okazaki, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Saitama, Japan
| | - Hideaki Hayashi
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Saitama, Japan
- Department of Neuropharmacology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Tatsuya Ishikawa
- Division of Homeostatic Development, National Institute for Physiological Sciences, Okazaki, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Saitama, Japan
- Department of Physiological Sciences, The Graduate School for Advanced Study, Hayama, Japan
| | - Keisuke Shibata
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Saitama, Japan
- Department of Neuropharmacology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Eiji Shigetomi
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Saitama, Japan
- Department of Neuropharmacology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Youichi Shinozaki
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Saitama, Japan
- Department of Neuropharmacology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Hiroyuki Inada
- Division of Homeostatic Development, National Institute for Physiological Sciences, Okazaki, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Saitama, Japan
| | - Seung Eon Roh
- Department of Physiology, College of Medicine, Seoul National University, Seoul, South Korea
| | - Sang Jeong Kim
- Department of Physiology, College of Medicine, Seoul National University, Seoul, South Korea
| | - Gihyun Lee
- Department of Physiology, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Hyunsu Bae
- Department of Physiology, College of Korean Medicine, Kyung Hee University, Seoul, South Korea
| | - Andrew J. Moorhouse
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Katsuhiko Mikoshiba
- Laboratory for Developmental Neurobiology, Brain Science Institute, RIKEN, Saitama, Japan
| | - Yugo Fukazawa
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Saitama, Japan
- Division of Cell Biology and Neuroscience, Department of Histological and Physiological Sciences, Faculty of Medical Science, University of Fukui, Fukui, Japan
| | - Schuichi Koizumi
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Saitama, Japan
- Department of Neuropharmacology, Interdisciplinary Graduate School of Medicine, University of Yamanashi, Yamanashi, Japan
| | - Junichi Nabekura
- Division of Homeostatic Development, National Institute for Physiological Sciences, Okazaki, Japan
- Core Research for Evolutional Science and Technology, Japan Science and Technology Agency, Saitama, Japan
- Department of Physiological Sciences, The Graduate School for Advanced Study, Hayama, Japan
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De Ridder D, Manning P, Glue P, Cape G, Langguth B, Vanneste S. Anterior Cingulate Implant for Alcohol Dependence. Neurosurgery 2016; 78:E883-93. [DOI: 10.1227/neu.0000000000001248] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Abstract
BACKGROUND AND IMPORTANCE:
Alcohol dependence is related to dysfunctional brain processes, in which a genetic background and environmental factors shape brain mechanisms involved with alcohol consumption. Craving, a major component determining relapses in alcohol abuse, has been linked to abnormal brain activity.
CLINICAL PRESENTATION:
We report the results of a treatment-intractable, alcohol-addicted patient with associated agoraphobia and anxiety. Functional imaging studies consisting of functional magnetic resonance imaging and resting-state electroencephalogram were performed as a means to localize craving-related brain activation and for identification of a target for repetitive transcranial magnetic stimulation and implant insertion. Repetitive transcranial magnetic stimulation of the dorsal anterior cingulate cortex with a double-cone coil transiently suppressed his very severe alcohol craving for up to 6 weeks. For ongoing stimulation, 2 “back-to-back” paddle electrodes were implanted with functional magnetic resonance imaging neuronavigation guidance for bilateral dorsal anterior cingulate cortex stimulation. Using a recently developed novel stimulation design, burst stimulation, a quick improvement was obtained on craving, agoraphobia, and associated anxiety without the expected withdrawal symptoms. The patient has remained free of alcohol intake and relieved of agoraphobia and anxiety for over 18 months, associated with normalization of his alpha and beta activity on electroencephalogram in the stimulated area. He perceives a mental freedom by not being constantly focused on alcohol.
CONCLUSION:
This case report proposes a new pathophysiology-based target for the surgical treatment of alcohol dependence and suggests that larger studies are warranted to explore this potentially promising avenue for the treatment of intractable alcohol dependence with or without anxiety and agoraphobia.
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Affiliation(s)
- Dirk De Ridder
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Patrick Manning
- Section of Endocrinology, Department of Internal Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Paul Glue
- Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Gavin Cape
- Department of Psychological Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University Regensburg, Regensburg, Germany
| | - Sven Vanneste
- School of Behavioral and Brain Sciences, The University of Texas, Dallas, Texas
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Vanneste S, Faber M, Langguth B, De Ridder D. The neural correlates of cognitive dysfunction in phantom sounds. Brain Res 2016; 1642:170-179. [PMID: 27016059 DOI: 10.1016/j.brainres.2016.03.016] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2015] [Revised: 03/15/2016] [Accepted: 03/17/2016] [Indexed: 10/22/2022]
Abstract
Tinnitus is an auditory phantom percept with a tone, hissing or buzzing sound in the absence of an objective physical sound source. It has been shown that tinnitus can lead to emotional and cognitive impairment and people with tinnitus perform worse than a control group on different cognitive tasks. The hippocampus is known to play an important role in cognitive performance, and also in the pathophysiology of tinnitus. Hippocampal deficits have been described in animal models of tinnitus and in tinnitus patients a decrease in grey matter in the hippocampus has been demonstrated. Nineteen patients with tinnitus and fifteen healthy controls performed different cognitive processing tasks and underwent an EEG with source analysis to investigate the relationship between tinnitus loudness, tinnitus distress and tinnitus duration, cognitive impairment and neurophysiological changes in the hippocampus. Results show that both tinnitus loudness, tinnitus distress and tinnitus duration correlated positively with different cognitive measures (trail making test, Montreal cognitive assessment, mini mental state examination). It was also shown that these cognitive measures correlate with beta activity in the hippocampus, the pregenual and subgenual anterior cingulate cortex extending into the right insula. A region of interest analysis further confirms that beta activity in the left and right hippocampal area correlated with the trail making performance. In conclusion, these results support for the first time the notion that cognitive changes in tinnitus patients are associated with changes in hippocampal activity as well as the anterior cingulate and insula.
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Affiliation(s)
- Sven Vanneste
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, USA.
| | - Margriet Faber
- Department of Translational Neuroscience, Faculty of Medicine, University of Antwerp, Belgium
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University Regensburg, Germany
| | - Dirk De Ridder
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand
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Vanneste S, De Ridder D. Deafferentation-based pathophysiological differences in phantom sound: Tinnitus with and without hearing loss. Neuroimage 2015; 129:80-94. [PMID: 26708013 DOI: 10.1016/j.neuroimage.2015.12.002] [Citation(s) in RCA: 66] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2015] [Revised: 12/02/2015] [Accepted: 12/04/2015] [Indexed: 12/23/2022] Open
Abstract
Tinnitus has been considered an auditory phantom percept. Recently a theoretical multiphase compensation mechanism at a cortical level has been hypothesized linking auditory deafferentation to tinnitus. This Bayesian brain model predicts that two very different kinds of tinnitus should exist, depending on the amount of hearing loss: an auditory cortex related form of tinnitus not associated with hearing loss, and a (para)hippocampal form associated with hearing loss, in which the auditory cortex might be of little relevance. In order to verify this model, resting state source analyzed EEG recordings were made in 129 tinnitus patients, and correlated to the mean hearing loss, the range of the hearing loss and the hearing loss at the tinnitus frequency. Results demonstrate that tinnitus can be linked to 2 very different mechanisms. In patients with little or no hearing loss, the tinnitus seems to be more related to auditory cortex activity, but not to (para)hippocampal memory related activity, whereas in tinnitus patients with more severe hearing loss, tinnitus seems to be related to (para)hippocampal mechanisms. Furthermore hearing loss seems to drive the communication between the auditory cortex and the parahippocampus, as measured by functional and effective connectivity.
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Affiliation(s)
- Sven Vanneste
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, USA.
| | - Dirk De Ridder
- Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, New Zealand
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Elgoyhen AB, Langguth B, De Ridder D, Vanneste S. Tinnitus: perspectives from human neuroimaging. Nat Rev Neurosci 2015; 16:632-42. [DOI: 10.1038/nrn4003] [Citation(s) in RCA: 195] [Impact Index Per Article: 21.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Vanneste S, De Ridder D. Stress-Related Functional Connectivity Changes Between Auditory Cortex and Cingulate in Tinnitus. Brain Connect 2015; 5:371-83. [DOI: 10.1089/brain.2014.0255] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Affiliation(s)
- Sven Vanneste
- Lab for Clinical and Integrative Neuroscience, School of Behavioral and Brain Sciences, The University of Texas at Dallas, Dallas, Texas
- Department of Translational Neuroscience, Faculty of Medicine, University of Antwerp, Antwerp, Belgium
| | - Dirk De Ridder
- Brain & Department of Neurosurgery, Sint Augustinus Hospital, Antwerp, Belgium
- Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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De Ridder D, Vanneste S, Langguth B, Llinas R. Thalamocortical Dysrhythmia: A Theoretical Update in Tinnitus. Front Neurol 2015; 6:124. [PMID: 26106362 PMCID: PMC4460809 DOI: 10.3389/fneur.2015.00124] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 05/14/2015] [Indexed: 01/06/2023] Open
Abstract
Tinnitus is the perception of a sound in the absence of a corresponding external sound source. Pathophysiologically it has been attributed to bottom-up deafferentation and/or top-down noise-cancelling deficit. Both mechanisms are proposed to alter auditory thalamocortical signal transmission, resulting in thalamocortical dysrhythmia (TCD). In deafferentation, TCD is characterized by a slowing down of resting state alpha to theta activity associated with an increase in surrounding gamma activity, resulting in persisting cross-frequency coupling between theta and gamma activity. Theta burst-firing increases network synchrony and recruitment, a mechanism, which might enable long-range synchrony, which in turn could represent a means for finding the missing thalamocortical information and for gaining access to consciousness. Theta oscillations could function as a carrier wave to integrate the tinnitus-related focal auditory gamma activity in a consciousness enabling network, as envisioned by the global workspace model. This model suggests that focal activity in the brain does not reach consciousness, except if the focal activity becomes functionally coupled to a consciousness enabling network, aka the global workspace. In limited deafferentation, the missing information can be retrieved from the auditory cortical neighborhood, decreasing surround inhibition, resulting in TCD. When the deafferentation is too wide in bandwidth, it is hypothesized that the missing information is retrieved from theta-mediated parahippocampal auditory memory. This suggests that based on the amount of deafferentation TCD might change to parahippocampocortical persisting and thus pathological theta–gamma rhythm. From a Bayesian point of view, in which the brain is conceived as a prediction machine that updates its memory-based predictions through sensory updating, tinnitus is the result of a prediction error between the predicted and sensed auditory input. The decrease in sensory updating is reflected by decreased alpha activity and the prediction error results in theta–gamma and beta–gamma coupling. Thus, TCD can be considered as an adaptive mechanism to retrieve missing auditory input in tinnitus.
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Affiliation(s)
- Dirk De Ridder
- BRAI2N, Section of Neurosurgery, Department of Surgical Sciences, Dunedin School of Medicine, University of Otago , Dunedin , New Zealand
| | - Sven Vanneste
- School of Behavioral and Brain Sciences, University of Texas at Dallas , Richardson, TX , USA
| | - Berthold Langguth
- Department of Psychiatry and Psychotherapy, University of Regensburg , Regensburg , Germany
| | - Rodolfo Llinas
- Department of Neuroscience and Physiology, New York University School of Medicine , New York, NY , USA
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Han L, Zhaohui L, Fei Y, Pengfei Z, Ting L, Cheng D, Zhenchang W. Disrupted neural activity in unilateral vascular pulsatile tinnitus patients in the early stage of disease: evidence from resting-state fMRI. Prog Neuropsychopharmacol Biol Psychiatry 2015; 59:91-99. [PMID: 25645870 DOI: 10.1016/j.pnpbp.2015.01.013] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/28/2014] [Revised: 01/20/2015] [Accepted: 01/23/2015] [Indexed: 02/07/2023]
Abstract
Numerous studies have shown that neurological changes are important findings of tinnitus patients. Previous studies on tinnitus have indicated that patients with pulsatile tinnitus (PT) often show altered baseline brain activity in the resting state. This study used resting-state functional magnetic resonance imaging (rs-fMRI) to investigate changes in spontaneous brain activity among patients with unilateral pulsatile tinnitus in the early stage of disease (less than forty-eight months) and determined the relationship of these changes with clinical data. The PT patients (n=34) and matched normal control subjects (n=34) were enrolled in this study. Spontaneous brain activity was revealed by the regional homogeneity (ReHo) and amplitude of low-frequency fluctuation (ALFF) values. Compared with normal controls, the patients with PT had significantly increased ReHo and ALFF in the posterior cingulate cortex, right inferior parietal lobule (IPL) and right cerebellum posterior lobe. The PT group showed increased ReHo in the posterior cingulate cortex (PCC), precuneus, right IPL, right superior frontal gyrus, some occipital areas and part of the right cerebellum posterior lobe. For ALFF, the increased clusters were in the PCC and precuneus and in some areas of the cerebellum posterior lobe, bilateral IPL and inferior frontal gyrus (IFG). Increased PT duration was correlated with increased ALFF in the bilateral inferior frontal gyrus (IFG) and precuneus. An increased THI score was correlated with ReHo and ALFF values in the precuneus. Taken together, the combined study of ReHo and ALFF measurements may yield a more comprehensive neurological pathophysiology framework for PT patients in the early stage of the disease.
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Affiliation(s)
- Lv Han
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Liu Zhaohui
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Yan Fei
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Zhao Pengfei
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Li Ting
- Department of Radiology, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China
| | - Dong Cheng
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China
| | - Wang Zhenchang
- Department of Radiology, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China.
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De Ridder D, Vanneste S. Multitarget surgical neuromodulation: Combined C2 and auditory cortex implantation for tinnitus. Neurosci Lett 2015; 591:202-206. [DOI: 10.1016/j.neulet.2015.02.034] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 01/31/2015] [Accepted: 02/16/2015] [Indexed: 01/05/2023]
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The enigma of the tinnitus-free dream state in a Bayesian world. Neural Plast 2014; 2014:612147. [PMID: 25097788 PMCID: PMC4109081 DOI: 10.1155/2014/612147] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2014] [Accepted: 04/16/2014] [Indexed: 11/22/2022] Open
Abstract
There are pathophysiological, clinical, and treatment analogies between phantom limb pain and phantom sound (i.e., tinnitus). Phantom limb pain commonly is absent in dreams, and the question arises whether this is also the case for tinnitus. A questionnaire was given to 78 consecutive tinnitus patients seen at a specialized tinnitus clinic. Seventy-six patients remembered their dreams and of these 74 claim not to perceive tinnitus during their dreams (97%). This can be most easily explained by a predictive Bayesian brain model. That is, during the awake state the brain constantly makes predictions about the environment. Tinnitus is hypothesized to be the result of a prediction error due to deafferentation, and missing input is filled in by the brain. The heuristic explanation then is that in the dream state there is no interaction with the environment and therefore no updating of the prediction error, resulting in the absence of tinnitus.
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Lithwick A, Lev S, Binshtok AM. Chronic pain-related remodeling of cerebral cortex - 'pain memory': a possible target for treatment of chronic pain. Pain Manag 2014; 3:35-45. [PMID: 24645930 DOI: 10.2217/pmt.12.74] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
SUMMARY Chronic pain is a major health problem worldwide, yet its management is nonspecific and often insufficient. In order to be able to alleviate chronic pain, it is crucial to understand the profound and comprehensive mechanisms by which chronic pain is triggered and processed in higher brain areas. Painful stimuli are processed by an intricate axis of peripheral and central components. Adding to the inherent complexity, the system is highly dynamic, undergoing constant plastic changes that often lead to perpetuation of pain. Given the key role that the cerebral cortex plays in sensory perception, understanding pain-related changes in cortical areas allocated to pain sensation is crucial. This review aims to summarize present research on pain-related plastic changes in the cerebral cortex.
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Affiliation(s)
- Avigail Lithwick
- Department of Medical Neurobiology, Institute for Medical Research Israel-Canada, The Hebrew University Faculty of Medicine, Jerusalem, Israel
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De Ridder D, Vanneste S. Targeting the parahippocampal area by auditory cortex stimulation in tinnitus. Brain Stimul 2014; 7:709-17. [PMID: 25129400 DOI: 10.1016/j.brs.2014.04.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2013] [Revised: 04/09/2014] [Accepted: 04/09/2014] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND The final common pathway in tinnitus generation is considered to be synchronized auditory oscillatory hyperactivity. Intracranial auditory cortex stimulation (iACS) via implanted electrodes has been developed to treat severe cases of intractable tinnitus targeting this final common pathway, in the hope of being a panacea for tinnitus. However, not everybody responds to this treatment. OBJECTIVE The electrical brain activity and functional connectivity at rest might determine who is going to respond or not to iACS and might shed light on the pathophysiology of auditory phantom sound generation. METHOD The resting state electrical brain activity of 5 patients who responded and 5 patients who did not respond to auditory cortex implantation are compared using source localized spectral activity (Z-score of log transformed current density) and lagged phase synchronization. RESULTS sLORETA source localization reveals significant differences between responders vs non-responders for beta3 in left posterior parahippocampal, hippocampal and amygdala area extending into left insula. Gamma band differences exist in the posterior parahippocampal areas and BA10. Functional connectivity between the auditory cortex and the hippocampal area is increased for beta2, delta and theta2 in responders, as well as between the parahippocampal area and auditory cortex for beta3. CONCLUSION The resting state functional connectivity and activity between the auditory cortex and parahippocampus might determine whether a tinnitus patient will respond to a cortical implant. The auditory cortex may only be a functional entrance into a larger parahippocampal based tinnitus network.
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Affiliation(s)
- Dirk De Ridder
- Brai²n, Sint Augustinus Hospital, Antwerp, Belgium; Department of Surgical Sciences, Section of Neurosurgery, Dunedin School of Medicine, University of Otago, New Zealand.
| | - Sven Vanneste
- School for Behavioral & Brain Sciences, University of Texas at Dallas, Dallas, USA; Department of Translational Neuroscience, Faculty of Medicine, University of Antwerp, Belgium
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Polarity specific suppression effects of transcranial direct current stimulation for tinnitus. Neural Plast 2014; 2014:930860. [PMID: 24812586 PMCID: PMC4000666 DOI: 10.1155/2014/930860] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2014] [Accepted: 02/22/2014] [Indexed: 02/03/2023] Open
Abstract
Tinnitus is the perception of a sound in the absence of an external auditory stimulus and affects 10-15% of the Western population. Previous studies have demonstrated the therapeutic effect of anodal transcranial direct current stimulation (tDCS) over the left auditory cortex on tinnitus loudness, but the effect of this presumed excitatory stimulation contradicts with the underlying pathophysiological model of tinnitus. Therefore, we included 175 patients with chronic tinnitus to study polarity specific effects of a single tDCS session over the auditory cortex (39 anodal, 136 cathodal). To assess the effect of treatment, we used the numeric rating scale for tinnitus loudness and annoyance. Statistical analysis demonstrated a significant main effect for tinnitus loudness and annoyance, but for tinnitus annoyance anodal stimulation has a significantly more pronounced effect than cathodal stimulation. We hypothesize that the suppressive effect of tDCS on tinnitus loudness may be attributed to a disrupting effect of ongoing neural hyperactivity, independent of the inhibitory or excitatory effects and that the reduction of annoyance may be induced by influencing adjacent or functionally connected brain areas involved in the tinnitus related distress network. Further research is required to explain why only anodal stimulation has a suppressive effect on tinnitus annoyance.
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De Ridder D, Vanneste S, Van Laere K, Menovsky T. Chasing Map Plasticity in Neuropathic Pain. World Neurosurg 2013; 80:901.e1-5. [DOI: 10.1016/j.wneu.2012.12.009] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2012] [Revised: 11/26/2012] [Accepted: 12/07/2012] [Indexed: 10/27/2022]
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De Ridder D, Vanneste S, Engineer ND, Kilgard MP. Safety and Efficacy of Vagus Nerve Stimulation Paired With Tones for the Treatment of Tinnitus: A Case Series. Neuromodulation 2013; 17:170-9. [DOI: 10.1111/ner.12127] [Citation(s) in RCA: 118] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2012] [Revised: 08/15/2013] [Accepted: 09/06/2013] [Indexed: 11/29/2022]
Affiliation(s)
- Dirk De Ridder
- Brai n, Tinnitus Research Initiative Clinic Antwerp & Department of Neurosurgery; University Hospital Antwerp; Belgium
- Department of Surgical Sciences, Dunedin School of Medicine; University of Otago; New Zealand
| | - Sven Vanneste
- Brai n, Tinnitus Research Initiative Clinic Antwerp & Department of Neurosurgery; University Hospital Antwerp; Belgium
- Department of Translational Neuroscience, Faculty of Medicine; University of Antwerp; Belgium
| | | | - Michael P. Kilgard
- School of Behavioral and Brain Sciences; University of Texas at Dallas; Richardson TX USA
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A Short History of Neurosurgical Localization. World Neurosurg 2013; 80:479-81. [DOI: 10.1016/j.wneu.2012.06.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2012] [Accepted: 06/12/2012] [Indexed: 11/22/2022]
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Adamchic I, Toth T, Hauptmann C, Tass PA. Reversing pathologically increased EEG power by acoustic coordinated reset neuromodulation. Hum Brain Mapp 2013; 35:2099-118. [PMID: 23907785 PMCID: PMC4216412 DOI: 10.1002/hbm.22314] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 02/24/2013] [Accepted: 04/08/2013] [Indexed: 01/19/2023] Open
Abstract
Acoustic Coordinated Reset (CR) neuromodulation is a patterned stimulation with tones adjusted to the patient's dominant tinnitus frequency, which aims at desynchronizing pathological neuronal synchronization. In a recent proof-of-concept study, CR therapy, delivered 4-6 h/day more than 12 weeks, induced a significant clinical improvement along with a significant long-lasting decrease of pathological oscillatory power in the low frequency as well as γ band and an increase of the α power in a network of tinnitus-related brain areas. As yet, it remains unclear whether CR shifts the brain activity toward physiological levels or whether it induces clinically beneficial, but nonetheless abnormal electroencephalographic (EEG) patterns, for example excessively decreased δ and/or γ. Here, we compared the patients' spontaneous EEG data at baseline as well as after 12 weeks of CR therapy with the spontaneous EEG of healthy controls by means of Brain Electrical Source Analysis source montage and standardized low-resolution brain electromagnetic tomography techniques. The relationship between changes in EEG power and clinical scores was investigated using a partial least squares approach. In this way, we show that acoustic CR neuromodulation leads to a normalization of the oscillatory power in the tinnitus-related network of brain areas, most prominently in temporal regions. A positive association was found between the changes in tinnitus severity and the normalization of δ and γ power in the temporal, parietal, and cingulate cortical regions. Our findings demonstrate a widespread CR-induced normalization of EEG power, significantly associated with a reduction of tinnitus severity.
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Affiliation(s)
- Ilya Adamchic
- Institute of Neuroscience and Medicine-Neuromodulation (INM-7), Jülich Research Center, Jülich, Germany
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Noise exposure enhances auditory cortex responses related to hyperacusis behavior. Brain Res 2012; 1485:108-16. [DOI: 10.1016/j.brainres.2012.02.008] [Citation(s) in RCA: 84] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2011] [Revised: 02/01/2012] [Accepted: 02/02/2012] [Indexed: 11/21/2022]
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Disentangling depression and distress networks in the tinnitus brain. PLoS One 2012; 7:e40544. [PMID: 22808188 PMCID: PMC3395649 DOI: 10.1371/journal.pone.0040544] [Citation(s) in RCA: 62] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2011] [Accepted: 06/11/2012] [Indexed: 11/19/2022] Open
Abstract
Tinnitus is the continuous perception of an internal auditory stimulus. This permanent sound often affects a person's emotional state inducing distress and depressive feelings changes in 6–25% of the affected population. Distress and depression are two distinct emotional states. Whereas distress describes a transient aversive state, interfering with a person's ability to adequately adapt to stressors, depressive feelings should rather be considered as a more constant emotional state. Based on previous observations in chronic pain, posttraumatic stress disorder and depression, we assume that both states are related to separate neural circuits. We used the Dutch version of the Tinnitus Questionnaire to assess the global index of distress together with the Beck Depression Inventory to evaluate the depressive symptoms accompanying tinnitus. Furthermore sLORETA analysis was performed to correlate current density distribution with distress and depression scores, revealing a lateralization effect of depression versus distress. Distress is mainly correlated with alpha 2, beta 1 and beta 2 activity of the right frontopolar cortex and orbitofrontal cortex in combination with beta 2 activation of the anterior cingulate cortex. In contrast, the more permanent depressive alterations induced by tinnitus are associated with activity of alpha 2 activity in the left frontopolar and orbitofrontal cortex. These specific neural circuits are embedded in a greater neural network, with the parahippocampal region functioning as a crucial linkage between both tinnitus related pathways.
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