Somatotopic Array of the Ventro-Oral Nucleus of the Thalamus Based on Electrical Stimulation during Stereotactic Procedures

Rümler, B; Schaltenbrand, Georg; Spuler, H.; Wahren, W

doi:10.1159/000103057

Cited by 10 publications

(3 citation statements)

References 2 publications

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“…Walker, 1982 found that intraoperative stimulation with a current of 50–100 Hz had a higher predictive value for arresting tremors compared to facilitation or initiation. Several authors observed that “low frequency” stimulation exacerbated tremor whereas “high frequency” stimulation improved that symptom [ [64] , [65] , [66] ]. In 1979, Latinen found emotional responses to subcortical stimulation in 135 patients.…”

Section: Deep Brain Stimulation (Dbs) and Alzheimer's Diseasementioning

confidence: 99%

Targeting papez circuit for cognitive dysfunction- insights into deep brain stimulation for Alzheimer's disease

Rapaka,

Tebogo,

Mathew

et al. 2024

Heliyon

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Section: Deep Brain Stimulation (Dbs) and Alzheimer's Diseasementioning

confidence: 99%

Targeting papez circuit for cognitive dysfunction- insights into deep brain stimulation for Alzheimer's disease

Rapaka,

Tebogo,

Mathew

et al. 2024

Heliyon

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“…In the old-era DBS, including during stimulation of various brain targets prior to lesioning, the frequency of the electric current was debated in terms of low and high, often without specifying or defining what is low and what is high [68]. An examination of the old literature on the subject shows, however, that in surgery for tremor (mainly thalamotomy and subthalamotomy) the application of a higher frequency during intraoperative stimulation could be used as a prediction of good clinical effect of a subsequently performed lesioning [69][70][71][72][73][74]. Walker [75] advised that stimulation at 50-100 Hz that could arrest tremor had better predictive value than stimulation at lower frequency that facilitated or desynchronized the patient's tremor.…”

Section: Frequency Of Stimulationmentioning

confidence: 99%

Thirty Years of Global Deep Brain Stimulation: “Plus ça change, plus c’est la même chose”?

Hariz,

Cif,

Blomstedt

2023

Stereotact Funct Neurosurg

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Background: The advent of deep brain stimulation (DBS) of the subthalamic nucleus (STN) for Parkinson’s disease 30 years ago has ushered a global breakthrough of DBS as a universal method for therapy and research in wide areas of neurology and psychiatry. The literature of the last three decades has described numerous concepts and practices of DBS, often branded as novelties or discoveries. However, reading the contemporary publications often elicits a sense of déjà vu in relation to several methods, attributes, and practices of DBS. Here, we review various applications and techniques of the modern-era DBS and compare them with practices of the past. Summary: Compared with modern literature, publications of the old-era functional stereotactic neurosurgery, including old-era DBS, show that from the very beginning multidisciplinarity and teamwork were often prevalent and insisted upon, ethical concerns were recognized, brain circuitries and rational for brain targets were discussed, surgical indications were similar, closed-loop stimulation was attempted, evaluations of surgical results were debated, and controversies were common. Thus, it appears that virtually everything done today in the field of DBS bears resemblance to old-time practices, or has been done before, albeit with partly other tools and techniques. Movement disorders remain the main indications for modern DBS as was the case for lesional surgery and old-era DBS. The novelties today consist of the STN as the dominant target for DBS, the tremendous advances in computerized brain imaging, the sophistication and versatility of implantable DBS hardware, and the large potential for research. Key Messages: Many aspects of contemporary DBS bear strong resemblance to practices of the past. The dominant clinical indications remain movement disorders with virtually the same brain targets as in the past, with one exception: the STN. Other novel brain targets – that are so far subject to DBS trials – are the pedunculopontine nucleus for gait freezing, the anteromedial internal pallidum for Gilles de la Tourette and the fornix for Alzheimer’s disease. The major innovations and novelties compared to the past concern mainly the unmatched level of research activity, its high degree of sponsorship, and the outstanding advances in technology that have enabled multimodal brain imaging and the miniaturization, versatility, and sophistication of implantable hardware. The greatest benefit for patients today, compared to the past, is the higher level of precision and safety of DBS, and of all functional stereotactic neurosurgery.

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“…Common observations reported by several authors in the process of performing thalamotomies and subthalamotomies in awake patients were that "lowfrequency" stimulation could exacerbate tremor whereas "high-frequency" stimulation resulted in an improvement of that symptom. 2,46,53,73,83,95 In 1963 in France, neurophysiologist Albe-Fessard, 2 who pioneered the technique of subcortical semimicrorecording, reported that stimulation in the region of the ventrointermediate nucleus of the thalamus at frequencies of 100-200 Hz would effectively inhibit tremor in parkinsonian patients. In the same year, psychiatrist Robert Heath from Tulane University in New Orleans published a paper, "Electrical self-stimulation of the brain in Man;" 48 electrodes were implanted in the caudate, septal area, amygdala, central medial thalamus, and various areas of the hypothalamus to study "rewarding" and "aversive" reactions at various current intensities.…”

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confidence: 99%

Deep brain stimulation between 1947 and 1987: the untold story

Hariz

Blomstedt

Zrinzo

2010

FOC

199

120

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Deep brain stimulation (DBS) is the most rapidly expanding field in neurosurgery. Movement disorders are well-established indications for DBS, and a number of other neurological and psychiatric indications are currently being investigated. Numerous contemporary opinions, reviews, and viewpoints on DBS fail to provide a comprehensive account of how this method came into being. Misconceptions in the narrative history of DBS conveyed by the wealth of literature published over the last 2 decades can be summarized as follows: Deep brain stimulation was invented in 1987. The utility of high-frequency stimulation was also discovered in 1987. Lesional surgery preceded DBS. Deep brain stimulation was first used in the treatment of movement disorders and was subsequently used in the treatment of psychiatric and behavioral disorders. Reports of nonmotor effects of subthalamic nucleus DBS prompted its use in psychiatric illness. Early surgical interventions for psychiatric illness failed to adopt a multidisciplinary approach; neurosurgeons often worked “in isolation” from other medical specialists. The involvement of neuro-ethicists and multidisciplinary teams are novel standards introduced in the modern practice of DBS for mental illness that are essential in avoiding the unethical behavior of bygone eras. In this paper, the authors examined each of these messages in the light of literature published since 1947 and formed the following conclusions. Chronic stimulation of subcortical structures was first used in the early 1950s, very soon after the introduction of human stereotaxy. Studies and debate on the stimulation frequency most likely to achieve desirable results and avoid side effects date back to the early days of DBS; several authors advocated the use of “high” frequency, although the exact frequency was not always specified. Ablative surgery and electrical stimulation developed in parallel, practically since the introduction of human stereotactic surgery. The first applications of both ablative surgery and chronic subcortical stimulation were in psychiatry, not in movement disorders. The renaissance of DBS in surgical treatment of psychiatric illness in 1999 had little to do with nonmotor effects of subthalamic nucleus DBS but involved high-frequency stimulation of the very same brain targets previously used in ablative surgery. Pioneers in functional neurosurgery mostly worked in multidisciplinary groups, including when treating psychiatric illness; those “acting in isolation” were not neurosurgeons. Ethical concerns have indeed been addressed in the past, by neurosurgeons and others. Some of the questionable behavior in surgery for psychiatric illness, including the bygone era of DBS, was at the hands of nonneurosurgeons. These practices have been deemed as “dubious and precarious by yesterday's standards.”

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Somatotopic Array of the Ventro-Oral Nucleus of the Thalamus Based on Electrical Stimulation during Stereotactic Procedures

Cited by 10 publications

References 2 publications

Targeting papez circuit for cognitive dysfunction- insights into deep brain stimulation for Alzheimer's disease

Targeting papez circuit for cognitive dysfunction- insights into deep brain stimulation for Alzheimer's disease

Thirty Years of Global Deep Brain Stimulation: “Plus ça change, plus c’est la même chose”?

Deep brain stimulation between 1947 and 1987: the untold story

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