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Cognitive Task Performance During Titration Predicts Deep Brain Stimulation Treatment Efficacy: Evidence From a Case Study

Device titration is a major challenge when using deep brain stimulation (DBS) to treat behavioral disorders. Unlike in movement disorders, there is no reliable real-time clinical feedback for changes in complex behaviors resulting from DBS. Here, a female patient receiving DBS of the nucleus accumbe...

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Autores principales: Weichart, Emily R., Sederberg, Per B., Sammartino, Francesco, Krishna, Vibhor, Corrigan, John D., Rezai, Ali R.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043267/
https://www.ncbi.nlm.nih.gov/pubmed/32140113
http://dx.doi.org/10.3389/fpsyt.2020.00030
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author Weichart, Emily R.
Sederberg, Per B.
Sammartino, Francesco
Krishna, Vibhor
Corrigan, John D.
Rezai, Ali R.
author_facet Weichart, Emily R.
Sederberg, Per B.
Sammartino, Francesco
Krishna, Vibhor
Corrigan, John D.
Rezai, Ali R.
author_sort Weichart, Emily R.
collection PubMed
description Device titration is a major challenge when using deep brain stimulation (DBS) to treat behavioral disorders. Unlike in movement disorders, there is no reliable real-time clinical feedback for changes in complex behaviors resulting from DBS. Here, a female patient receiving DBS of the nucleus accumbens for the treatment of morbid obesity underwent cognitive testing via the flanker task alongside traditional methods of device titration. One set of stimulation parameters administered during titration resulted in acute cognitive improvement (p = 0.033) and increased frontal engagement as measured by electroencephalography (left anterior: p = 0.007, right anterior: p = 0.005) relative to DBS-OFF. The same parameters resulted in the most weight-loss during long-term continuous stimulation (47.8 lbs lost in 129 days) compared to the results of other stimulation settings. Diffusion tensor imaging analyses showed increased connectivity to dorsal attention networks and decreased connectivity to the default mode network for optimal parameters (p < 0.01). Our results provide evidence that targeted cognitive testing is a potentially useful tool for capturing acute effects of DBS stimulation during titration and predicting long-term treatment outcomes. CLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov, identifier: NCT01512134.
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spelling pubmed-70432672020-03-05 Cognitive Task Performance During Titration Predicts Deep Brain Stimulation Treatment Efficacy: Evidence From a Case Study Weichart, Emily R. Sederberg, Per B. Sammartino, Francesco Krishna, Vibhor Corrigan, John D. Rezai, Ali R. Front Psychiatry Psychiatry Device titration is a major challenge when using deep brain stimulation (DBS) to treat behavioral disorders. Unlike in movement disorders, there is no reliable real-time clinical feedback for changes in complex behaviors resulting from DBS. Here, a female patient receiving DBS of the nucleus accumbens for the treatment of morbid obesity underwent cognitive testing via the flanker task alongside traditional methods of device titration. One set of stimulation parameters administered during titration resulted in acute cognitive improvement (p = 0.033) and increased frontal engagement as measured by electroencephalography (left anterior: p = 0.007, right anterior: p = 0.005) relative to DBS-OFF. The same parameters resulted in the most weight-loss during long-term continuous stimulation (47.8 lbs lost in 129 days) compared to the results of other stimulation settings. Diffusion tensor imaging analyses showed increased connectivity to dorsal attention networks and decreased connectivity to the default mode network for optimal parameters (p < 0.01). Our results provide evidence that targeted cognitive testing is a potentially useful tool for capturing acute effects of DBS stimulation during titration and predicting long-term treatment outcomes. CLINICAL TRIAL REGISTRATION: www.ClinicalTrials.gov, identifier: NCT01512134. Frontiers Media S.A. 2020-02-19 /pmc/articles/PMC7043267/ /pubmed/32140113 http://dx.doi.org/10.3389/fpsyt.2020.00030 Text en Copyright © 2020 Weichart, Sederberg, Sammartino, Krishna, Corrigan and Rezai http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Psychiatry
Weichart, Emily R.
Sederberg, Per B.
Sammartino, Francesco
Krishna, Vibhor
Corrigan, John D.
Rezai, Ali R.
Cognitive Task Performance During Titration Predicts Deep Brain Stimulation Treatment Efficacy: Evidence From a Case Study
title Cognitive Task Performance During Titration Predicts Deep Brain Stimulation Treatment Efficacy: Evidence From a Case Study
title_full Cognitive Task Performance During Titration Predicts Deep Brain Stimulation Treatment Efficacy: Evidence From a Case Study
title_fullStr Cognitive Task Performance During Titration Predicts Deep Brain Stimulation Treatment Efficacy: Evidence From a Case Study
title_full_unstemmed Cognitive Task Performance During Titration Predicts Deep Brain Stimulation Treatment Efficacy: Evidence From a Case Study
title_short Cognitive Task Performance During Titration Predicts Deep Brain Stimulation Treatment Efficacy: Evidence From a Case Study
title_sort cognitive task performance during titration predicts deep brain stimulation treatment efficacy: evidence from a case study
topic Psychiatry
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7043267/
https://www.ncbi.nlm.nih.gov/pubmed/32140113
http://dx.doi.org/10.3389/fpsyt.2020.00030
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