Memory enhancement induced by hypothalamic/fornix deep brain stimulation

Hamani, Clement; McAndrews, Mary Pat; Cohn, Mélanie; Oh, Michael; Zumsteg, Dominik; Shapiro, Colin M.; Wennberg, Richard; Lozano, Andrés M.

doi:10.1002/ana.21295

Cited by 467 publications

(369 citation statements)

References 19 publications

Supporting

Mentioning

354

Contrasting

Unclassified

Order By: Relevance

“…Recent studies have demonstrated a growing potential for treating diseases of the mind 3,7,11 and perhaps eventually enhancing nonpathological states. 12 Because there are potential financial incentives for surgeons and likely a substantial demand by patients, assessing whether an ethical marketplace for psychosurgery and neuroenhancement exists among providers of the interventions is important for both practical reasons and policymaking considerations. To the best of our knowledge, this is the first study to examine neurosurgeons' opinions on the ethics of surgically treating psychiatric illness and enhancing nonpathological states.…”

Section: Discussionmentioning

confidence: 99%

“…12 2) "Neuroethics embodies the theoretical and practical issues in the neurological sciences that have moral and social consequences in the laboratory, in health care, and in the public domain." …”

Section: Appendix: Interview Guidementioning

confidence: 99%

“…The use of DBS to treat obesity, the development of a brainmachine interface to facilitate independence for paralyzed patients, and the potential use of functional imaging for "lie detection" underscores both the concerns and promise regarding technical advances. 2,12,28 Neuroethics is the dedicated field that explores the ethical implications of these advances.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Neurosurgeons' perspectives on psychosurgery and neuroenhancement: a qualitative study at one center

Mendelsohn¹,

Lipsman²,

Bernstein³

2010

JNS

View full text Add to dashboard Cite

Object. Advances in the neurosciences are stirring debate regarding the ethical issues surrounding novel neurosurgical interventions. The application of deep brain stimulation (DBS) for treating refractory psychiatric disease, for instance, has introduced the prospect of altering disorders of mind and behavior and the potential for neuroenhancement. The attitudes of current and future providers of this technology and their position regarding its possible future applications are unknown. The authors sought to gauge the opinions of neurosurgical staff and trainees toward various uses of neuromodulation technology including psychosurgery and neuroenhancement.Methods. The authors conducted a qualitative study involving indepth interviews with 47 neurosurgery staff, trainees, and other neuroclinicians at a quaternary care center.Results. Several general themes emerged from the interviews. These included universal support for psychosurgery given adequate informed consent and rigorous scientific methodology, as well as a relative consensus regarding the priority given to patient autonomy and the preservation of personal identity. Participants' attitudes toward the future use of DBS and other means of neuromodulation for cognitive enhancement and personality alteration revealed less agreement, although most participants felt that alteration of nonpathological traits is objectionable.Conclusions. There is support in the neurosurgical community for the surgical management of refractory psychiatric disease. The use of neuromodulation for the alteration of nonpathological traits is morally and ethically dubious when it is out of sync with the values of society at large. Both DBS and neuromodulation will have farreaching and profound public health implications. (DOI: 10.3171/2010.5.JNS091896) key WorDs • enhancement • neuroethics • personal identity • psychosurgeryAbbreviations used in this paper: DBS = deep brain stimulation; GKS = Gamma Knife surgery; OCD = obsessivecompulsive disorder; PTSD = posttraumatic stress disorder.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Appendix: Interview Guidementioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Neurosurgeons' perspectives on psychosurgery and neuroenhancement: a qualitative study at one center

Mendelsohn¹,

Lipsman²,

Bernstein³

2010

JNS

View full text Add to dashboard Cite

show abstract

“…99 This was attributed using electroencephalographic source localization to be related to activation of mesial temporal lobe structures. Others reported correlation of obsessions, with hyperactivity of the caudate nucleus observed during intraoperative electrophysiologic study in patients treated for severe forms of OCD by using DBS of the caudate nucleus.…”

Section: Dbs and Imaging: Understanding Dbs Mechanisms And The Human mentioning

confidence: 99%

Neuroimaging and Deep Brain Stimulation

Dormont¹,

Seidenwurm²,

Galanaud³

et al. 2009

AJNR Am J Neuroradiol

View full text Add to dashboard Cite

SUMMARY: Deep brain stimulation (DBS) is a new neurosurgical method principally used for the treatment of Parkinson disease (PD).Many new applications of DBS are under development, including the treatment of intractable psychiatric diseases. Brain imaging is used for the selection of patients for DBS, to localize the target nucleus, to detect complications, and to evaluate the final electrode contact position. In patients with implanted DBS systems, there is a risk of electrode heating when MR imaging is performed. This contraindicates MR imaging unless specific precautions are taken. Involvement of neuroradiologists in DBS procedures is essential to optimize presurgical evaluation, targeting, and postoperative anatomic results. The precision of the neuroradiologic correlation with anatomic data and clinical outcomes in DBS promises to yield significant basic science and clinical advances in the future. Chronic high-frequency stimulation of the ventral intermediate nucleus (VIM) of the thalamus was first described in the early 1990s by Benabid et al.1 These authors implanted chronic stimulating electrodes in the VIM connected to a subcutaneous pulse generator positioned in the thoracic region to treat disabling tremor in 26 patients with Parkinson disease (PD) and in 6 with essential tremor.1 They demonstrated the effectiveness of this technique and its ability to produce complete relief from tremor. Improvement was maintained for up to 29 months. This was the first clinical demonstration that chronic high-frequency stimulation of nuclei (deep brain stimulation [DBS]) could replace destructive lesion-producing functional neurosurgery such as thalamotomy. This new technique was reversible and led to a renaissance in functional neurosurgery.Next, the same team introduced bilateral DBS of the subthalamic nucleus (STN) in patients with disabling akineticrigid PD and severe motor fluctuations.2 This work extended data obtained in a 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine monkey model of PD showing that lesions and electric stimulation of the subthalamic nucleus reduced all of the major motor disturbances in this animal model. The results in patients with advanced PD were striking and were reproduced in many centers internationally. The US Food and Drug Administration approved the use of DBS for treatment of advanced PD with bilateral STN stimulation in 2002 and internal globus pallidus (GPi) stimulation in 2003. The main indication for DBS remains advanced PD, but numerous additional applications have been developed, ranging from dystonia to cluster headache, Tourette syndrome, and even psychiatric indications like obsessive-compulsive disorders (OCD) and major depression.DBS is a neurosurgical method, but the role of neuroimaging in successful DBS intervention is critical. Neuroimaging is used for the preoperative selection of patients who will have DBS and to localize the intended target nuclei. In the postoperative period, imaging detects complications that uncommonly accompany the procedure, confirms the pos...

show abstract

“…Other sites include the substantia nigra, caudate nucleus, nucleus accumbens, and the ventral tegmental area. A case study of bilateral stimulation of the ventromedial nuclei of the hypothalamus in a human induce sensations of déjà vu, vague flashes of memory, and appeared to show improved hippocampal-dependent memory [53]. High-frequency (200 Hz) electrical stimulation of the caudate, striatum or anterior cingulate during reinforcement might accelerate learning acquisition [171].…”

Section: Subcortical and Peripheral Stimulationmentioning

confidence: 97%

Techniques and devices to restore cognition

Serruya

Kahana

2008

Behavioural Brain Research

View full text Add to dashboard Cite

Executive planning, the ability to direct and sustain attention, language and several types of memory may be compromised by conditions such as stroke, traumatic brain injury, cancer, autism, cerebral palsy and Alzheimer's disease. No medical devices are currently available to help restore these cognitive functions. Recent findings about the neurophysiology of these conditions in humans coupled with progress in engineering devices to treat refractory neurological conditions imply that the time has arrived to consider the design and evaluation of a new class of devices. Like their neuromotor counterparts, neurocognitive prostheses might sense or modulate neural function in a non-invasive manner or by means of implanted electrodes. In order to paint a vision for future device development, it is essential to first review what can be achieved using behavioral and external modulatory techniques. While non-invasive approaches might strengthen a patient's remaining intact cognitive abilities, neurocognitive prosthetics comprised of direct brain-computer interfaces could in theory physically reconstitute and augment the substrate of cognition itself.

show abstract

Memory enhancement induced by hypothalamic/fornix deep brain stimulation

Cited by 467 publications

References 19 publications

Neurosurgeons' perspectives on psychosurgery and neuroenhancement: a qualitative study at one center

Neurosurgeons' perspectives on psychosurgery and neuroenhancement: a qualitative study at one center

Neuroimaging and Deep Brain Stimulation

Techniques and devices to restore cognition

Contact Info

Product

Resources

About