Deep brain stimulation and autonomic control

Lovick, T.A.

doi:10.1113/expphysiol.2013.072694

Cited by 12 publications

(12 citation statements)

References 57 publications

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“…Green et al [ 25 ] determined these effects to be due to modulation of sympathetic activity, due to the presence of changes in both total peripheral resistance (TPR) and myocardial contractility [ 25 ]. Later publications, reviews, and case reports by Green et al and other groups all report similar findings in humans and in animal models [ 12 , 13 , 22 , 23 , 26 , 27 , 28 , 29 , 30 , 31 , 32 ].…”

Section: Sympathetic Autonomic Modulationmentioning

confidence: 68%

“…DBS is even being investigated as a surgical intervention for obesity, major depression, and a therapy for restoring memory to patients with Alzheimer disease [ 7 , 8 , 9 , 10 , 11 ]. In addition to the primary symptoms treated by DBS, many groups have investigated its effect on autonomic functions at various target sites in the brain [ 12 , 13 ]. Dysfunction of autonomic processes is common in neurological diseases [ 14 , 15 , 16 , 17 , 18 ].…”

Section: Introductionmentioning

confidence: 99%

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Effects of Deep Brain Stimulation on Autonomic Function

Basiago

Binder

2016

Brain Sciences

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Over the course of the development of deep brain stimulation (DBS) into a well-established therapy for Parkinson’s disease, essential tremor, and dystonia, its utility as a potential treatment for autonomic dysfunction has emerged. Dysfunction of autonomic processes is common in neurological diseases. Depending on the specific target in the brain, DBS has been shown to raise or lower blood pressure, normalize the baroreflex, to alter the caliber of bronchioles, and eliminate hyperhidrosis, all through modulation of the sympathetic nervous system. It has also been shown to improve cortical control of the bladder, directly induce or inhibit the micturition reflex, and to improve deglutition and gastric emptying. In this review, we will attempt to summarize the relevant available studies describing these effects of DBS on autonomic function, which vary greatly in character and magnitude with respect to stimulation target.

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Section: Sympathetic Autonomic Modulationmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Effects of Deep Brain Stimulation on Autonomic Function

Basiago

Binder

2016

Brain Sciences

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“…However, the full clinical applicability of these neuromodulatory approaches in patients with otherwise intractable autonomic dysfunctions will remain a 'therapeutic opportunity' [44,45] Data accessibility. There is no additional or supplementary data.…”

Section: Transcranial Direct Current Stimulationmentioning

confidence: 99%

Nonlinear effects of respiration on the crosstalk between cardiovascular and cerebrovascular control systems

Bari

Marchi

Maria

et al. 2016

Phil. Trans. R. Soc. A.

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Cardiovascular and cerebrovascular regulatory systems are vital control mechanisms responsible for guaranteeing homeostasis and are affected by respiration. This work proposes the investigation of cardiovascular and cerebrovascular control systems and the nonlinear influences of respiration on both regulations through joint symbolic analysis (JSA), conditioned or unconditioned on respiration. Interactions between cardiovascular and cerebrovascular regulatory systems were evaluated as well by performing correlation analysis between JSA indexes describing the two control systems. Heart period, systolic and mean arterial pressure, mean cerebral blood flow velocity and respiration were acquired on a beat-to-beat basis in 13 subjects experiencing recurrent syncope episodes (SYNC) and 13 healthy individuals (non-SYNC) in supine resting condition and during head-up tilt test at 60° (TILT). Results showed that JSA distinguished conditions and groups, whereas time domain parameters detected only the effect of TILT. Respiration affected cardiovascular and cerebrovascular regulatory systems in a nonlinear way and was able to modulate the interactions between the two control systems with different outcome in non-SYNC and SYNC groups, thus suggesting that the analysis of the impact of respiration on cardiovascular and cerebrovascular regulatory systems might improve our understanding of the mechanisms underpinning the development of postural-related syncope.

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“…In conclusion, available studies demonstrated some potential of brain stimulation techniques in modulating cardiovascular function acutely, with most consistent effects in the long term shown for DBS of the PAV/PAG on blood pressure control (table 1). However, the full clinical applicability of these neuromodulatory approaches in patients with otherwise intractable autonomic dysfunctions will remain a 'therapeutic opportunity' [44,45] trials of neuromodulatory therapies, even if performed on patients in which the autonomic dysfunction is not the primary reason for the neuromodulatory intervention.…”

Section: Transcranial Direct Current Stimulationmentioning

confidence: 99%

The heart side of brain neuromodulation

Rossi

Santarnecchi

Valenza

et al. 2016

Phil. Trans. R. Soc. A.

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Neuromodulation refers to invasive, minimally invasive or non-invasive techniques to stimulate discrete cortical or subcortical brain regions with therapeutic purposes in otherwise intractable patients: for example, thousands of advanced Parkinsonian patients, as well as patients with tremor or dystonia, benefited by deep brain stimulation (DBS) procedures (neural targets: basal ganglia nuclei). A new era for DBS is currently opening for patients with drug-resistant depression, obsessive-compulsive disorders, severe epilepsy, migraine and chronic pain (neural targets: basal ganglia and other subcortical nuclei or associative fibres). Vagal nerve stimulation (VNS) has shown clinical benefits in patients with pharmacoresistant epilepsy and depression. Non-invasive brain stimulation neuromodulatory techniques such as repetitive transcranial magnetic stimulation (rTMS) and transcranial direct current stimulation (tDCS) are also being increasingly investigated for their therapeutic potential in several neurological and psychiatric disorders. In this review, we first address the most common neural targets of each of the mentioned brain stimulation techniques, and the known mechanisms of their neuromodulatory action on stimulated brain networks. Then, we discuss how DBS, VNS, rTMS and tDCS could impact on the function of brainstem centres controlling vital functions, critically reviewing their acute and long-term effects on brain sympathetic outflow controlling heart function and blood pressure. Finally, as there is clear experimental evidence in animals that brain stimulation can affect autonomic and heart functions, we will try to give a critical perspective on how it may enhance our understanding of the cortical/subcortical mechanisms of autonomic cardiovascular regulation, and also if it might find a place among therapeutic opportunities in patients with otherwise intractable autonomic dysfunctions.

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Deep brain stimulation and autonomic control

Abstract: New Findings

Cited by 12 publications

References 57 publications

Effects of Deep Brain Stimulation on Autonomic Function

Effects of Deep Brain Stimulation on Autonomic Function

Nonlinear effects of respiration on the crosstalk between cardiovascular and cerebrovascular control systems

The heart side of brain neuromodulation

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