Thalamic stimulation induced changes in effective connectivity.
Thalamic stimulation induced changes in effective connectivity.
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丘脑刺激引起有效连接的变化。
DOI：
10.1101/2024.03.03.24303480
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发表时间：
2024
期刊：
影响因子：
--
通讯作者：
Hermes,Dora
中科院分区：
文献类型：
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作者：
Gregg,NicholasM;Valencia,GabrielaOjeda;Huang,Harvey;Lundstrom,BrianN;VanGompel,JamieJ;Miller,KaiJ;Worrell,GregoryA;Hermes,Dora
脑深部刺激(DBS)是治疗多种神经系统疾病的一种可行方法，然而，DBS调节大规模脑网络的机制尚未解决。DBS的临床疗效是在多个时间尺度上观察的。在某些情况下，如帕金森氏症和特发性震颤，几秒钟内就能观察到临床症状的改善。在许多其他情况下，如癫痫、中枢性疼痛、肌张力障碍、神经精神疾病或Tourette综合征，DBS的相关影响被认为需要神经可塑性或重组，通常需要数小时至数月的观察。因此，为了优化DBS参数，必须开发电生理生物标记物，以表征DBS环境是否成功地参与和调节了与感兴趣疾病有关的网络。在这项研究中，10名难治性癫痫患者接受了包括丘脑电极在内的颅内立体定向脑电检查，并进行了丘脑重复刺激试验。我们在基线和145赫兹刺激治疗试验后，使用单脉冲电刺激评估了丘脑皮质的有效连通性。我们发现，当给予高频刺激1.5小时时，从偏远区域测量到的诱发电位的幅度显著降低，并且调制程度与基线连接的强度成正比。当给予刺激的时间较短时，结果更具变数。这些发现表明，DBS目标网络中有效连通性的变化会随着DBS数小时的积累而积累。刺激诱发电位提供了一种电生理生物标记物，允许对神经调节效应进行有效的数据驱动表征，这可能使个性化DBS优化的新的客观方法成为可能。
Deep brain stimulation (DBS) is a viable treatment for a variety of neurological conditions, however, the mechanisms through which DBS modulates large-scale brain networks are unresolved. Clinical effects of DBS are observed over multiple timescales. In some conditions, such as Parkinson’s disease and essential tremor, clinical improvement is observed within seconds. In many other conditions, such as epilepsy, central pain, dystonia, neuropsychiatric conditions or Tourette syndrome, the DBS related effects are believed to require neuroplasticity or reorganization and often take hours to months to observe. To optimize DBS parameters, it is therefore essential to develop electrophysiological biomarkers that characterize whether DBS settings are successfully engaging and modulating the network involved in the disease of interest. In this study, 10 individuals with drug resistant epilepsy undergoing intracranial stereotactic EEG including a thalamus electrode underwent a trial of repetitive thalamic stimulation. We evaluated thalamocortical effective connectivity using single pulse electrical stimulation, both at baseline and following a 145 Hz stimulation treatment trial. We found that when high frequency stimulation was delivered for >1.5 hours, the evoked potentials measured from remote regions were significantly reduced in amplitude and the degree of modulation was proportional to the strength of baseline connectivity. When stimulation was delivered for shorter time periods, results were more variable. These findings suggest that changes in effective connectivity in the network targeted with DBS accumulate over hours of DBS. Stimulation evoked potentials provide an electrophysiological biomarker that allows for efficient data-driven characterization of neuromodulation effects, which could enable new objective approaches for individualized DBS optimization.