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Zhang Y, Yang Y, Si J, Xia X, He J, Jiang T. Influence of inter-stimulus interval of spinal cord stimulation in patients with disorders of consciousness: A preliminary functional near-infrared spectroscopy study. Neuroimage Clin 2017; 17:1-9. [PMID: 29619317 PMCID: PMC5883216 DOI: 10.1016/j.nicl.2017.09.017] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/01/2017] [Revised: 09/12/2017] [Accepted: 09/23/2017] [Indexed: 11/30/2022]
Abstract
Spinal cord stimulation (SCS) is a promising treatment for disorders of consciousness (DOC), but the underlying mechanism and most effective procedures remain uncertain. To optimize the protocol, previous studies evaluated the frequency-specific effects of SCS on neurophysiological activities. However, whether and how the inter-stimulus interval (ISI) parameter affects the SCS neuromodulation in DOC remains unknown. We enrolled nine DOC patients who had implanted SCS devices and conducted three different durations of ISIs. Using functional near-infrared spectroscopy (fNIRS), we monitored the blood volume fluctuations in the prefrontal and occipital cortices during the SCS. The results showed that short stimuli (30 s) induced significant cerebral blood volume changes, especially in the prefrontal cortex, an important area in the consciousness system. By comparing the mean value of the responses from the first and the last block in each session, a shorter ISI was found to improve the blood volume in the prefrontal cortex. This phenomenon was more significant for the subgroup of patients with a favorable prognosis. These preliminary results imply that the ISI may be an important factor for SCS. The research paradigm proposed here also provides insights for further quantitative evaluations of the therapeutic effects of neuromodulation. Spinal cord stimulation rapidly evokes activity in consciousness-related brain areas. Inter-stimulus interval of neuromodulation is important for treating disorders of consciousness. Shorter inter-stimulus interval can better improve the blood volume in frontal area. Near-infrared spectroscopy is feasible for evaluating neuromodulation effects.
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Key Words
- ARAS, ascending reticular activating system
- CBF, cerebral blood flow
- DBS, deep brain stimulation
- DOC, disorders of consciousness
- Disorders of consciousness
- EEG, electroencephalography
- FWHM, full-width-at-half-maximum
- Functional near-infrared spectroscopy
- GOS, Glasgow Outcome Scale
- HbO, oxygenated hemoglobin
- HbR, deoxygenated hemoglobin
- HbT, total hemoglobin
- ISI, inter-stimulus interval
- Inter-stimulus interval
- JFKCRS-R, JFK Coma Recovery Scale
- LTP, long-term potentiation
- MBLL, modified Beer-Lambert law
- MCS, minimally conscious state
- MSN, medium spiny neuron
- Prefrontal cortex
- SCS, spinal cord stimulation
- Spinal cord stimulation
- TMS, transcranial magnetic stimulation
- VS, vegetative state
- fMRI, functional magnetic resonance imaging
- fNIRS, functional near-infrared spectroscopy
- rCBV, regional cerebral blood volume
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Affiliation(s)
- Yujin Zhang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China; National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Yi Yang
- Department of Neurosurgery, PLA Army General Hospital, Beijing 100700, China
| | - Juanning Si
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China; National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China
| | - Xiaoyu Xia
- Department of Neurosurgery, PLA Army General Hospital, Beijing 100700, China
| | - Jianghong He
- Department of Neurosurgery, PLA Army General Hospital, Beijing 100700, China.
| | - Tianzi Jiang
- Brainnetome Center, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China; National Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China; Key Laboratory for NeuroInformation of the Ministry of Education, School of Life Science and Technology, University of Electronic Science and Technology of China, Chengdu 625014, China; CAS Center for Excellence in Brain Science, Institute of Automation, Chinese Academy of Sciences, Beijing 100190, China; Queensland Brain Institute, University of Queensland, St. Lucia, Queensland 4072, Australia.
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