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Daly SR, Soto JM, Gonzalez SM, Ankrah N, Gogineni E, Andraos TY, Skalina KA, Fekrmandi F, Quinn AE, Romanelli P, Thomas E, Danish S. Stereotactic radiosurgery for medically refractory non-lesional epilepsy: A case-based Radiosurgery Society (RSS) practice review. Clin Neurol Neurosurg 2024; 246:108550. [PMID: 39278006 DOI: 10.1016/j.clineuro.2024.108550] [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: 09/09/2024] [Accepted: 09/10/2024] [Indexed: 09/17/2024]
Abstract
INTRODUCTION Medically refractory epilepsy (MRE) occurs in about 30 % of patients with epilepsy, and the treatment options available to them have evolved over time. The classic treatment for medial temporal lobe epilepsy (mTLE) is anterior temporal lobectomy (ATL), but an initiative to find less invasive options has resulted in treatments such as neuromodulation, ablative procedures, and stereotactic radiosurgery (SRS). SRS has been an appealing non-invasive option and has developed an increasing presence in the literature over the last few decades. This article provides an overview of SRS for MRE with two example cases, and we discuss the optimal technique as well as the advantages, alternatives, and risks of this therapeutic option. CASES We present two example cases of patients with MRE, who were poor candidates for invasive surgical treatment options and underwent SRS. The first case is a 65-year-old female with multiple medical comorbidities, whose seizure focus was localized to the left temporal lobe, and the second case is a 19-year-old male with Protein C deficiency and medial temporal lobe sclerosis. Both patients underwent SRS to targets within the medial temporal lobe, and both achieve significant improvements in seizure frequency and severity. DISCUSSION SRS has generally been shown to be inferior to ATL for seizure reduction in medically refractory mTLE. However, there are patients with epilepsy for which SRS can be considered, such as patients with medical comorbidities that make surgery high risk, patients with epileptogenic foci in eloquent cortex, patients who have failed to respond to surgical management, patients who choose not to undergo surgery, and patients with geographic constraints to epilepsy centers. Patients and their physicians should be aware that SRS is not risk-free. Patients should be counseled on the latency period and monitored for risks such as delayed cerebral edema, visual field deficits, and radiation necrosis.
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Affiliation(s)
- Samuel R Daly
- Department of Neurological Surgery, Baylor Scott and White Health/Baylor College of Medicine, Temple, TX, United States.
| | - Jose M Soto
- Department of Neurological Surgery, Baylor Scott and White Health/Baylor College of Medicine, Temple, TX, United States
| | - Sarah Mc Gonzalez
- Department of Neurological Surgery, Baylor Scott and White Health/Baylor College of Medicine, Temple, TX, United States
| | - Nii Ankrah
- Department of Radiation Oncology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Emile Gogineni
- Department of Radiation Oncology, The Ohio State University, Columbus, OH, United States
| | - Therese Y Andraos
- Department of Radiation Oncology, The Ohio State University, Columbus, OH, United States
| | - Karin A Skalina
- Department of Radiation Oncology, Montefiore Medical Center, New York, NY, United States
| | - Fatemeh Fekrmandi
- Department of Radiation Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, NY, United States
| | - Annette E Quinn
- Department of Radiation Oncology, University of Pittsburgh Medical Center Hillman Cancer Center, Pittsburgh, PA, United States
| | | | - Evan Thomas
- Department of Radiation Oncology, The Ohio State University, Columbus, OH, United States
| | - Shabbar Danish
- Department of Neurosurgery, Jersey Shore University Medical Center, Neptune, NJ, United States
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2
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Arakawa H, Tokashiki M. The posterior intralaminar thalamic nucleus promotes nose-to-nose contacts leading to prosocial reception in the sequence of mouse social interaction. Eur J Neurosci 2024. [PMID: 39210622 DOI: 10.1111/ejn.16520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Revised: 08/06/2024] [Accepted: 08/15/2024] [Indexed: 09/04/2024]
Abstract
Efficient social interaction is essential for an adaptive life and consists of sequential processes of multisensory events with social counterparts. Social touch/contact is a unique component that promotes a sequence of social behaviours initiated by detection and approach to assess a social stimulus and subsequent touch/contact interaction to form prosocial relationships. We hypothesized that the thalamic sensory relay circuit from the posterior intralaminar nucleus of the thalamus (pIL) to the paraventricular nucleus of the hypothalamus (PVN) and the medial amygdala (MeA) plays a key role in the social contact-mediated sequence of events. We found that neurons in the pIL along with the PVN and MeA were activated by social encounters and that pIL activity was more abundant in a direct physical encounter, whereas MeA activity was dominant in an indirect through grid encounter. Chemogenetic inhibition of pIL neurons selectively decreased the investigatory approach and sniffing of a same-sex, but not an opposite-sex, stimulus mouse in an indirect encounter situation and decreased the facial/snout contact ratio in a direct encounter setting. Furthermore, chemogenetic pIL inhibition had no impact on anxiety-like behaviours or body coordinative motor behaviours, but it impaired whisker-related and plantar touch tactile sense. We propose that the pIL circuit can relay social tactile sensations and mediate the sequence of nonsexual prosocial interactions through an investigatory approach to tactile contact and thus plays a significant role in establishing prosocial relationships in mouse models.
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Affiliation(s)
- Hiroyuki Arakawa
- Edward F Domino Research Center, Department of Pharmacology, University of Michigan School of Medicine, Ann Arbor, Michigan, USA
- Department of Systems Physiology, University of the Ryukyus Graduate School of Medicine, Okinawa, Japan
| | - Mana Tokashiki
- Faculty of Medicine, University of the Ryukyus, Okinawa, Japan
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3
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Alanazi FI, Bravo CAR, Moreno JSS, Botero-Posada LF, Ladino LD, Rios ALL, Hutchison WD. Modulation of neuronal activity in human centromedian nucleus during an auditory attention and working memory task. Neuroimage 2024; 296:120686. [PMID: 38871037 DOI: 10.1016/j.neuroimage.2024.120686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2024] [Revised: 06/08/2024] [Accepted: 06/11/2024] [Indexed: 06/15/2024] Open
Abstract
Centromedian nucleus (CM) is one of several intralaminar nuclei of the thalamus and is thought to be involved in consciousness, arousal, and attention. CM has been suggested to play a key role in the control of attention, by regulating the flow of information to different brain regions such as the ascending reticular system, basal ganglia, and cortex. While the neurophysiology of attention in visual and auditory systems has been studied in animal models, combined single unit and LFP recordings in human have not, to our knowledge, been reported. Here, we recorded neuronal activity in the CM nucleus in 11 patients prior to insertion of deep brain stimulation electrodes for the treatment of epilepsy while subjects performed an auditory attention task. Patients were requested to attend and count the infrequent (p = 0.2) odd or "deviant" tones, ignore the frequent standard tones and report the total number of deviant tones at trial completion. Spikes were discriminated, and LFPs were band pass filtered (5-45 Hz). Average peri‑stimulus time histograms and spectra were constructed by aligning on tone onsets and statistically compared. The firing rate of CM neurons showed selective, multi-phasic responses to deviant tones in 81% of the tested neurons. Local field potential analysis showed selective beta and low gamma (13-45 Hz) modulations in response to deviant tones, also in a multi-phasic pattern. The current study demonstrates that CM neurons are under top-down control and participate in the selective processing during auditory attention and working memory. These results, taken together, implicate the CM in selective auditory attention and working memory and support a role of beta and low gamma oscillatory activity in cognitive processes. It also has potential implications for DBS therapy for epilepsy and non-motor symptoms of PD, such as apathy and other disorders of attention.
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Affiliation(s)
- Frhan I Alanazi
- Department of Physiology, University of Toronto, Canada; Krembil Brain Institute, Leonard St, Toronto Ontario, Canada; Department of Basic Sciences, Prince Sultan bin Abdulaziz College for Emergency Medical Services, King Saud University, Riyadh, Kingdom of Saudi Arabia.
| | | | - Juan Sebastián Saavedra Moreno
- Hospital Universitario San Vicente Fundación, Medellín, Colombia; Hospital San Vicente Fundación, Rionegro, Colombia; Department of Neurology, University of Antioquia, Medellín, Colombia
| | - Luis Fernando Botero-Posada
- Hospital Universitario San Vicente Fundación, Medellín, Colombia; Hospital San Vicente Fundación, Rionegro, Colombia
| | - Lady Diana Ladino
- Hospital Universitario San Vicente Fundación, Medellín, Colombia; Hospital San Vicente Fundación, Rionegro, Colombia; Department of Neurology, University of Antioquia, Medellín, Colombia
| | - Adriana Lucia Lopez Rios
- Hospital Universitario San Vicente Fundación, Medellín, Colombia; Hospital San Vicente Fundación, Rionegro, Colombia
| | - William D Hutchison
- Department of Physiology, University of Toronto, Canada; Krembil Brain Institute, Leonard St, Toronto Ontario, Canada; Hospital San Vicente Fundación, Rionegro, Colombia; Department of Surgery, University of Toronto, Canada
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Zhang Z, Huang Y, Chen X, Li J, Yang Y, Lv L, Wang J, Wang M, Wang Y, Wang Z. State-specific Regulation of Electrical Stimulation in the Intralaminar Thalamus of Macaque Monkeys: Network and Transcriptional Insights into Arousal. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2024:e2402718. [PMID: 38938001 DOI: 10.1002/advs.202402718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2024] [Revised: 06/03/2024] [Indexed: 06/29/2024]
Abstract
Long-range thalamocortical communication is central to anesthesia-induced loss of consciousness and its reversal. However, isolating the specific neural networks connecting thalamic nuclei with various cortical regions for state-specific anesthesia regulation is challenging, with the biological underpinnings still largely unknown. Here, simultaneous electroencephalogram-fuctional magnetic resonance imaging (EEG-fMRI) and deep brain stimulation are applied to the intralaminar thalamus in macaques under finely-tuned propofol anesthesia. This approach led to the identification of an intralaminar-driven network responsible for rapid arousal during slow-wave oscillations. A network-based RNA-sequencing analysis is conducted of region-, layer-, and cell-specific gene expression data from independent transcriptomic atlases and identifies 2489 genes preferentially expressed within this arousal network, notably enriched in potassium channels and excitatory, parvalbumin-expressing neurons, and oligodendrocytes. Comparison with human RNA-sequencing data highlights conserved molecular and cellular architectures that enable the matching of homologous genes, protein interactions, and cell types across primates, providing novel insight into network-focused transcriptional signatures of arousal.
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Affiliation(s)
- Zhao Zhang
- Department of Anesthesiology, Huashan Hospital, Fudan University, 12 Urumqi Middle Rd, Jing'an District, Shanghai, 200040, China
| | - Yichun Huang
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, State Key Laboratory of General Artificial Intelligence, IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Peking University, 5 Yiheyuan Rd, Haidian District, Beijing, 100871, China
| | - Xiaoyu Chen
- Institute of Natural Sciences and School of Mathematical Sciences, Shanghai Jiao Tong University, 800 Dongchuan RD, Minhang District, Shanghai, 200240, China
| | - Jiahui Li
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, State Key Laboratory of General Artificial Intelligence, IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Peking University, 5 Yiheyuan Rd, Haidian District, Beijing, 100871, China
| | - Yi Yang
- Department of Neurosurgery, Brain Computer Interface Transition Research Center, Beijing Tiantan Hospital, Capital Medical University, 119 South Fourth Ring Rd West, Fengtai District, Beijing, 100070, China
| | - Longbao Lv
- National Resource Center for Non-Human Primates, Kunming Primate Research Center, National Research Facility for Phenotypic & Genetic Analysis of Model Animals (Primate Facility), Kunming Institute of Zoology, Chinese Academy of Sciences, 32 East of Jiaochang Rd, Kunming, Yunnan, 650223, China
| | - Jianhong Wang
- National Resource Center for Non-Human Primates, Kunming Primate Research Center, National Research Facility for Phenotypic & Genetic Analysis of Model Animals (Primate Facility), Kunming Institute of Zoology, Chinese Academy of Sciences, 32 East of Jiaochang Rd, Kunming, Yunnan, 650223, China
| | - Meiyun Wang
- Department of Medical Imaging, Henan Provincial People's Hospital & the People's Hospital of Zhengzhou University, No. 7 Weiwu Road, Zhengzhou, Henan, 450003, China
| | - Yingwei Wang
- Department of Anesthesiology, Huashan Hospital, Fudan University, 12 Urumqi Middle Rd, Jing'an District, Shanghai, 200040, China
| | - Zheng Wang
- School of Psychological and Cognitive Sciences, Beijing Key Laboratory of Behavior and Mental Health, State Key Laboratory of General Artificial Intelligence, IDG/McGovern Institute for Brain Research, Peking-Tsinghua Center for Life Sciences, Peking University, 5 Yiheyuan Rd, Haidian District, Beijing, 100871, China
- School of Biomedical Engineering, Hainan University, 58 Renmin Avenue, Haikou, Hainan, 570228, China
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5
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Nica A. Drug-resistant juvenile myoclonic epilepsy: A literature review. Rev Neurol (Paris) 2024; 180:271-289. [PMID: 38461125 DOI: 10.1016/j.neurol.2024.02.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 03/11/2024]
Abstract
The ILAE's Task Force on Nosology and Definitions revised in 2022 its definition of juvenile myoclonic epilepsy (JME), the most common idiopathic generalized epilepsy disorder, but this definition may well change again in the future. Although good drug response could almost be a diagnostic criterion for JME, drug resistance (DR) is observed in up to a third of patients. It is important to distinguish this from pseudoresistance, which is often linked to psychosocial problems or psychiatric comorbidities. After summarizing these aspects and the various definitions applied to JME, the present review lists the risk factors for DR-JME that have been identified in numerous studies and meta-analyses. The factors most often cited are absence seizures, young age at onset, and catamenial seizures. By contrast, photosensitivity seems to favor good treatment response, at least in female patients. Current hypotheses on DR mechanisms in JME are based on studies of either simple (e.g., cortical excitability) or more complex (e.g., anatomical and functional connectivity) neurophysiological markers, bearing in mind that JME is regarded as a neural network disease. This research has revealed correlations between the intensity of some markers and DR, and above all shed light on the role of these markers in associated neurocognitive and neuropsychiatric disorders in both patients and their siblings. Studies of neurotransmission have mainly pointed to impaired GABAergic inhibition. Genetic studies have generally been inconclusive. Increasing restrictions have been placed on the use of valproate, the standard antiseizure medication for this syndrome, owing to its teratogenic and developmental risks. Levetiracetam and lamotrigine are prescribed as alternatives, as is vagal nerve stimulation, and there are several other promising antiseizure drugs and neuromodulation methods. The development of better alternative treatments is continuing to take place alongside advances in our knowledge of JME, as we still have much to learn and understand.
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Affiliation(s)
- A Nica
- Epilepsy Unit, Reference Center for Rare Epilepsies, Neurology Department, Clinical Investigation Center 1414, Rennes University Hospital, Rennes, France; Signal and Image Processing Laboratory (LTSI), INSERM, Rennes University, Rennes, France.
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6
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Cif L, Castro Jimenez M, Bally JF. Concerns about efficacy of deep brain stimulation (DBS) in centromedian-parafascicular thalamic complex for rapid onset dystonia-parkinsonism (DYT12-ATP1A3). Brain Stimul 2024; 17:491-492. [PMID: 38685261 DOI: 10.1016/j.brs.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 02/04/2024] [Accepted: 02/13/2024] [Indexed: 05/02/2024] Open
Affiliation(s)
- Laura Cif
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland; Laboratoire de Recherche en Neurosciences Cliniques (LRENC), France.
| | - Mayté Castro Jimenez
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
| | - Julien F Bally
- Service of Neurology, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne (UNIL), Lausanne, Switzerland
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7
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Wang KL, Li JP, Shan YZ, Zhao GG, Ma JH, Ramirez-Zamora A, Zhang YQ. Letter of response to "concerns about efficacy of deep brain stimulation (DBS) in centromedian-parafascicular thalamic complex for rapid onset dystonia-parkinsonism (DYT12-ATP1A3)". Brain Stimul 2024; 17:493-495. [PMID: 38685262 DOI: 10.1016/j.brs.2024.02.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2024] [Accepted: 02/22/2024] [Indexed: 05/02/2024] Open
Affiliation(s)
- Kai-Liang Wang
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China; International Neuroscience Institute (China-INI), Clinical Research Center for Epilepsy, Capital Medical University, China; China National Medical Center for Neurological Diseases, China.
| | - Ji-Ping Li
- Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
| | - Yong-Zhi Shan
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China; International Neuroscience Institute (China-INI), Clinical Research Center for Epilepsy, Capital Medical University, China; China National Medical Center for Neurological Diseases, China.
| | - Guo-Guang Zhao
- Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China; International Neuroscience Institute (China-INI), Clinical Research Center for Epilepsy, Capital Medical University, China; China National Medical Center for Neurological Diseases, China.
| | - Jing-Hong Ma
- Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
| | - Adolfo Ramirez-Zamora
- University of Florida, Department of Neurology, Fixel Center for Neurological Diseases, Program in Movement Disorders and Neurorestoration, Gainesville, FL, 32607, USA.
| | - Yu-Qing Zhang
- Department of Functional Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing, 100053, China.
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8
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Arnts H, Tewarie P, van Erp W, Schuurman R, Boon LI, Pennartz CMA, Stam CJ, Hillebrand A, van den Munckhof P. Deep brain stimulation of the central thalamus restores arousal and motivation in a zolpidem-responsive patient with akinetic mutism after severe brain injury. Sci Rep 2024; 14:2950. [PMID: 38316863 PMCID: PMC10844373 DOI: 10.1038/s41598-024-52267-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 01/16/2024] [Indexed: 02/07/2024] Open
Abstract
After severe brain injury, zolpidem is known to cause spectacular, often short-lived, restorations of brain functions in a small subgroup of patients. Previously, we showed that these zolpidem-induced neurological recoveries can be paralleled by significant changes in functional connectivity throughout the brain. Deep brain stimulation (DBS) is a neurosurgical intervention known to modulate functional connectivity in a wide variety of neurological disorders. In this study, we used DBS to restore arousal and motivation in a zolpidem-responsive patient with severe brain injury and a concomitant disorder of diminished motivation, more than 10 years after surviving hypoxic ischemia. We found that DBS of the central thalamus, targeted at the centromedian-parafascicular complex, immediately restored arousal and was able to transition the patient from a state of deep sleep to full wakefulness. Moreover, DBS was associated with temporary restoration of communication and ability to walk and eat in an otherwise wheelchair-bound and mute patient. With the use of magnetoencephalography (MEG), we revealed that DBS was generally associated with a marked decrease in aberrantly high levels of functional connectivity throughout the brain, mimicking the effects of zolpidem. These results imply that 'pathological hyperconnectivity' after severe brain injury can be associated with reduced arousal and behavioral performance and that DBS is able to modulate connectivity towards a 'healthier baseline' with lower synchronization, and, can restore functional brain networks long after severe brain injury. The presence of hyperconnectivity after brain injury may be a possible future marker for a patient's responsiveness for restorative interventions, such as DBS, and suggests that lower degrees of overall brain synchronization may be conducive to cognition and behavioral responsiveness.
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Affiliation(s)
- Hisse Arnts
- Department of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
- Department of Neurosurgery, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Prejaas Tewarie
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Systems and Network Neurosciences, Amsterdam, The Netherlands
| | - Willemijn van Erp
- Department of Primary and Community Care, Centre for Family Medicine, Geriatric Care and Public Health, Radboud University Medical Centre, Nijmegen, The Netherlands
- Accolade Zorg, Bosch en Duin, The Netherlands
- Libra Rehabilitation & Audiology, Tilburg, The Netherlands
| | - Rick Schuurman
- Department of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Lennard I Boon
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Systems and Network Neurosciences, Amsterdam, The Netherlands
| | - Cyriel M A Pennartz
- Cognitive and Systems Neuroscience Group, Swammerdam Institute, Center for Neuroscience, University of Amsterdam, Amsterdam, The Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Systems and Network Neurosciences, Amsterdam, The Netherlands
| | - Arjan Hillebrand
- Department of Clinical Neurophysiology and Magnetoencephalography Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Brain Imaging, Amsterdam, The Netherlands
- Amsterdam Neuroscience, Systems and Network Neurosciences, Amsterdam, The Netherlands
| | - Pepijn van den Munckhof
- Department of Neurosurgery, Amsterdam Neuroscience, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands.
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Chauvin RJ, Newbold DJ, Nielsen AN, Miller RL, Krimmel SR, Metoki A, Wang A, Van AN, Montez DF, Marek S, Suljic V, Baden NJ, Ramirez-Perez N, Scheidter KM, Monk JS, Whiting FI, Adeyemo B, Snyder AZ, Kay BP, Raichle ME, Laumann TO, Gordon EM, Dosenbach NU. Disuse-driven plasticity in the human thalamus and putamen. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2024:2023.11.07.566031. [PMID: 37987000 PMCID: PMC10659348 DOI: 10.1101/2023.11.07.566031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/22/2023]
Abstract
Motor adaptation in cortico-striato-thalamo-cortical loops has been studied mainly in animals using invasive electrophysiology. Here, we leverage functional neuroimaging in humans to study motor circuit plasticity in the human subcortex. We employed an experimental paradigm that combined two weeks of upper-extremity immobilization with daily resting-state and motor task fMRI before, during, and after the casting period. We previously showed that limb disuse leads to decreased functional connectivity (FC) of the contralateral somatomotor cortex (SM1) with the ipsilateral somatomotor cortex, increased FC with the cingulo-opercular network (CON) as well as the emergence of high amplitude, fMRI signal pulses localized in the contralateral SM1, supplementary motor area and the cerebellum. From our prior observations, it remains unclear whether the disuse plasticity affects the thalamus and striatum. We extended our analysis to include these subcortical regions and found that both exhibit strengthened cortical FC and spontaneous fMRI signal pulses induced by limb disuse. The dorsal posterior putamen and the central thalamus, mainly CM, VLP and VIM nuclei, showed disuse pulses and FC changes that lined up with fmri task activations from the Human connectome project motor system localizer, acquired before casting for each participant. Our findings provide a novel understanding of the role of the cortico-striato-thalamo-cortical loops in human motor plasticity and a potential link with the physiology of sleep regulation. Additionally, similarities with FC observation from Parkinson Disease (PD) questions a pathophysiological link with limb disuse.
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Affiliation(s)
- Roselyne J. Chauvin
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - Dillan J. Newbold
- Department of Neurology, New York University Grossman School of Medicine, New York, New York 10016, USA
| | - Ashley N. Nielsen
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - Ryland L. Miller
- Basque Center on Cognition, Brain and Language, Donostia, Gipuzkoa, Spain
| | - Samuel R. Krimmel
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - Athanasia Metoki
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - Anxu Wang
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
- Department of Biomedical Engineering, Washington University in St. Louis, MO 63130
| | - Andrew N. Van
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
- Division of Computation and Data Science, Washington University School of Medicine, St. Louis, MO 63110
| | - David F. Montez
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
| | - Scott Marek
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110
| | - Vahdeta Suljic
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - Noah J. Baden
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | | | - Kristen M. Scheidter
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - Julia S. Monk
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - Forrest I. Whiting
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - Babatunde Adeyemo
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - Abraham Z. Snyder
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110
| | - Benjamin P. Kay
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
| | - Marcus E. Raichle
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St Louis, MO, USA
- Department of Neuroscience, Washington University School of Medicine, St Louis, MO, USA
| | - Timothy O. Laumann
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
| | - Evan M. Gordon
- Mallinckrodt Institute of Radiology, Washington University School of Medicine, St. Louis, MO 63110
| | - Nico U.F. Dosenbach
- Department of Neurology, Washington University School of Medicine, St. Louis, MO 63110
- Department of Biomedical Engineering, Washington University in St. Louis, MO 63130
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO 63110
- Department of Pediatrics, Washington University School of Medicine, St. Louis, MO 63110
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Chudy D, Deletis V, Paradžik V, Dubroja I, Marčinković P, Orešković D, Chudy H, Raguž M. Deep brain stimulation in disorders of consciousness: 10 years of a single center experience. Sci Rep 2023; 13:19491. [PMID: 37945710 PMCID: PMC10636144 DOI: 10.1038/s41598-023-46300-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Accepted: 10/30/2023] [Indexed: 11/12/2023] Open
Abstract
Disorders of consciousness (DoC), namely unresponsive wakefulness syndrome (UWS) and minimally conscious state (MCS), represent severe conditions with significant consequences for patients and their families. Several studies have reported the regaining of consciousness in such patients using deep brain stimulation (DBS) of subcortical structures or brainstem nuclei. Our study aims to present the 10 years' experience of a single center using DBS as a therapy on a cohort of patients with DoC. Eighty Three consecutive patients were evaluated between 2011 and 2022; entry criteria consisted of neurophysiological and neurological evaluations and neuroimaging examinations. Out of 83, 36 patients were considered candidates for DBS implantation, and 32 patients were implanted: 27 patients had UWS, and five had MCS. The stimulation target was the centromedian-parafascicular complex in the left hemisphere in hypoxic brain lesion or the one better preserved in patients with traumatic brain injury. The level of consciousness was improved in seven patients. Three out of five MCS patients emerged to full awareness, with the ability to interact and communicate. Two of them can live largely independently. Four out of 27 UWS patients showed consciousness improvement with two patients emerging to full awareness, and the other two reaching MCS. In patients with DoC lasting longer than 12 months following traumatic brain injury or 6 months following anoxic-ischemic brain lesion, spontaneous recovery is rare. Thus, DBS of certain thalamic nuclei could be recommended as a treatment option for patients who meet neurological, neurophysiological and neuroimaging criteria, especially in earlier phases, before occurrence of irreversible musculoskeletal changes. Furthermore, we emphasize the importance of cooperation between centers worldwide in studies on the potentials of DBS in treating patients with DoC.
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Affiliation(s)
- Darko Chudy
- Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia.
- Department of Surgery, School of Medicine, University of Zagreb, Zagreb, Croatia.
| | - Vedran Deletis
- Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia
- Albert Einstein College of Medicine, New York, USA
| | - Veronika Paradžik
- Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia
| | - Ivan Dubroja
- Brain Trauma Unit, Specialty Hospital for Medical Rehabilitation, Krapinske Toplice, Croatia
| | - Petar Marčinković
- Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia
| | - Darko Orešković
- Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia
| | - Hana Chudy
- Department of Neurology, Dubrava University Hospital, Zagreb, Croatia
| | - Marina Raguž
- Department of Neurosurgery, Dubrava University Hospital, Zagreb, Croatia
- School of Medicine, Catholic University of Croatia, Zagreb, Croatia
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Ghosh S, Sinha JK, Ghosh S, Sharma H, Bhaskar R, Narayanan KB. A Comprehensive Review of Emerging Trends and Innovative Therapies in Epilepsy Management. Brain Sci 2023; 13:1305. [PMID: 37759906 PMCID: PMC10527076 DOI: 10.3390/brainsci13091305] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 09/09/2023] [Accepted: 09/10/2023] [Indexed: 09/29/2023] Open
Abstract
Epilepsy is a complex neurological disorder affecting millions worldwide, with a substantial number of patients facing drug-resistant epilepsy. This comprehensive review explores innovative therapies for epilepsy management, focusing on their principles, clinical evidence, and potential applications. Traditional antiseizure medications (ASMs) form the cornerstone of epilepsy treatment, but their limitations necessitate alternative approaches. The review delves into cutting-edge therapies such as responsive neurostimulation (RNS), vagus nerve stimulation (VNS), and deep brain stimulation (DBS), highlighting their mechanisms of action and promising clinical outcomes. Additionally, the potential of gene therapies and optogenetics in epilepsy research is discussed, revealing groundbreaking findings that shed light on seizure mechanisms. Insights into cannabidiol (CBD) and the ketogenic diet as adjunctive therapies further broaden the spectrum of epilepsy management. Challenges in achieving seizure control with traditional therapies, including treatment resistance and individual variability, are addressed. The importance of staying updated with emerging trends in epilepsy management is emphasized, along with the hope for improved therapeutic options. Future research directions, such as combining therapies, AI applications, and non-invasive optogenetics, hold promise for personalized and effective epilepsy treatment. As the field advances, collaboration among researchers of natural and synthetic biochemistry, clinicians from different streams and various forms of medicine, and patients will drive progress toward better seizure control and a higher quality of life for individuals living with epilepsy.
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Affiliation(s)
- Shampa Ghosh
- GloNeuro, Sector 107, Vishwakarma Road, Noida 201301, India
- ICMR—National Institute of Nutrition, Tarnaka, Hyderabad 500007, India
| | | | - Soumya Ghosh
- GloNeuro, Sector 107, Vishwakarma Road, Noida 201301, India
| | | | - Rakesh Bhaskar
- School of Chemical Engineering, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk 38541, Republic of Korea
| | - Kannan Badri Narayanan
- School of Chemical Engineering, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk 38541, Republic of Korea
- Research Institute of Cell Culture, Yeungnam University, 280 Daehak-Ro, Gyeongsan, Gyeongbuk 38541, Republic of Korea
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