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Stimulating at the right time: phase-specific deep brain stimulation
See Moll and Engel (doi:10.1093/aww308) for a scientific commentary on this article. Brain regions dynamically engage and disengage with one another to execute everyday actions from movement to decision making. Pathologies such as Parkinson’s disease and tremor emerge when brain regions controlling...
Autores principales: | , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Oxford University Press
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5226063/ https://www.ncbi.nlm.nih.gov/pubmed/28007997 http://dx.doi.org/10.1093/brain/aww286 |
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author | Cagnan, Hayriye Pedrosa, David Little, Simon Pogosyan, Alek Cheeran, Binith Aziz, Tipu Green, Alexander Fitzgerald, James Foltynie, Thomas Limousin, Patricia Zrinzo, Ludvic Hariz, Marwan Friston, Karl J Denison, Timothy Brown, Peter |
author_facet | Cagnan, Hayriye Pedrosa, David Little, Simon Pogosyan, Alek Cheeran, Binith Aziz, Tipu Green, Alexander Fitzgerald, James Foltynie, Thomas Limousin, Patricia Zrinzo, Ludvic Hariz, Marwan Friston, Karl J Denison, Timothy Brown, Peter |
author_sort | Cagnan, Hayriye |
collection | PubMed |
description | See Moll and Engel (doi:10.1093/aww308) for a scientific commentary on this article. Brain regions dynamically engage and disengage with one another to execute everyday actions from movement to decision making. Pathologies such as Parkinson’s disease and tremor emerge when brain regions controlling movement cannot readily decouple, compromising motor function. Here, we propose a novel stimulation strategy that selectively regulates neural synchrony through phase-specific stimulation. We demonstrate for the first time the therapeutic potential of such a stimulation strategy for the treatment of patients with pathological tremor. Symptom suppression is achieved by delivering stimulation to the ventrolateral thalamus, timed according to the patient’s tremor rhythm. Sustained locking of deep brain stimulation to a particular phase of tremor afforded clinically significant tremor relief (up to 87% tremor suppression) in selected patients with essential tremor despite delivering less than half the energy of conventional high frequency stimulation. Phase-specific stimulation efficacy depended on the resonant characteristics of the underlying tremor network. Selective regulation of neural synchrony through phase-locked stimulation has the potential to both increase the efficiency of therapy and to minimize stimulation-induced side effects. |
format | Online Article Text |
id | pubmed-5226063 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Oxford University Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-52260632017-01-18 Stimulating at the right time: phase-specific deep brain stimulation Cagnan, Hayriye Pedrosa, David Little, Simon Pogosyan, Alek Cheeran, Binith Aziz, Tipu Green, Alexander Fitzgerald, James Foltynie, Thomas Limousin, Patricia Zrinzo, Ludvic Hariz, Marwan Friston, Karl J Denison, Timothy Brown, Peter Brain Original Articles See Moll and Engel (doi:10.1093/aww308) for a scientific commentary on this article. Brain regions dynamically engage and disengage with one another to execute everyday actions from movement to decision making. Pathologies such as Parkinson’s disease and tremor emerge when brain regions controlling movement cannot readily decouple, compromising motor function. Here, we propose a novel stimulation strategy that selectively regulates neural synchrony through phase-specific stimulation. We demonstrate for the first time the therapeutic potential of such a stimulation strategy for the treatment of patients with pathological tremor. Symptom suppression is achieved by delivering stimulation to the ventrolateral thalamus, timed according to the patient’s tremor rhythm. Sustained locking of deep brain stimulation to a particular phase of tremor afforded clinically significant tremor relief (up to 87% tremor suppression) in selected patients with essential tremor despite delivering less than half the energy of conventional high frequency stimulation. Phase-specific stimulation efficacy depended on the resonant characteristics of the underlying tremor network. Selective regulation of neural synchrony through phase-locked stimulation has the potential to both increase the efficiency of therapy and to minimize stimulation-induced side effects. Oxford University Press 2017-01 2016-12-22 /pmc/articles/PMC5226063/ /pubmed/28007997 http://dx.doi.org/10.1093/brain/aww286 Text en © The Author (2016). Published by Oxford University Press on behalf of the Guarantors of Brain. http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Articles Cagnan, Hayriye Pedrosa, David Little, Simon Pogosyan, Alek Cheeran, Binith Aziz, Tipu Green, Alexander Fitzgerald, James Foltynie, Thomas Limousin, Patricia Zrinzo, Ludvic Hariz, Marwan Friston, Karl J Denison, Timothy Brown, Peter Stimulating at the right time: phase-specific deep brain stimulation |
title | Stimulating at the right time: phase-specific deep brain stimulation |
title_full | Stimulating at the right time: phase-specific deep brain stimulation |
title_fullStr | Stimulating at the right time: phase-specific deep brain stimulation |
title_full_unstemmed | Stimulating at the right time: phase-specific deep brain stimulation |
title_short | Stimulating at the right time: phase-specific deep brain stimulation |
title_sort | stimulating at the right time: phase-specific deep brain stimulation |
topic | Original Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5226063/ https://www.ncbi.nlm.nih.gov/pubmed/28007997 http://dx.doi.org/10.1093/brain/aww286 |
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