Neuroimaging and electrophysiology meet invasive neurostimulation for causal interrogations and modulations of brain states
Neuroimaging and electrophysiology meet invasive neurostimulation for causal interrogations and modulations of brain states
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DOI：
10.1016/j.neuroimage.2020.117144
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发表时间：
2020-10-15
期刊：
影响因子：
5.7
通讯作者：
Groppa, Sergiu
中科院分区：
文献类型：
--
作者：
Gonzalez-Escamilla, Gabriel;Muthuraman, Muthuraman;Groppa, Sergiu
深部脑刺激（DBS）在过去二十年中已发展成为一种针对神经精神疾病的高效循证治疗选择。此外，它已成为一种令人着迷的工具，可为大脑网络的运作提供具有启发性的见解。新的DBS作用的解剖学和病理生理学模型加速了我们对神经和精神疾病以及大脑功能的理解。大脑网络的描述源于一种独特的能力，即能够展示从先进的神经影像学（结构、弥散和功能性磁共振成像）中得出的相互连接的大脑区域之间的长程相互作用，以及有机会以毫秒级的时间分辨率记录局部和大规模的大脑活动（微电极记录、局部场电位、脑电图和脑磁图）。在本综述的第一部分，我们描述了神经影像学技术如何通过识别和细化DBS靶点，从而形成对DBS效果的当前理解，并阐明电极位置与临床效果之间关系的实际观点。更进一步，我们讨论了神经影像学如何将局部DBS效应的观点转变为对特定大脑回路的调节，这是通过将电极位置重建与最近引入的网络成像方法相结合而实现的。我们强调这些发现如何与临床效果相关联，从而假定神经影像学是理解DBS对行为和临床效果的作用机制的关键因素。在第二部分，我们展示了侵入性电生理学技术如何有效地整合到DBS设置中，以便根据不同区域特定的神经活动模式精确定位DBS的神经解剖学靶点。接下来，我们展示了多部位电生理记录如何为DBS靶点内外的异常大脑回路提供一个实时窗口，以量化和绘制节律性振荡的动态特性。我们还讨论了DBS在静息、基于任务和运动条件下如何改变振荡网络在时间和空间域的瞬时同步状态，以及这种大脑状态的调节最终如何塑造功能反应。最后，我们展示了对异常大脑回路的电生理指标（β波爆发、相位 - 幅度耦合）的成功解码和处理如何转化为自适应DBS刺激范式，以实现有针对性的和依赖状态的侵入性电神经调节。
Deep brain stimulation (DBS) has developed over the last twenty years into a highly effective evidenced-based treatment option for neuropsychiatric disorders. Moreover, it has become a fascinating tool to provide illustrative insights into the functioning of brain networks. New anatomical and pathophysiological models of DBS action have accelerated our understanding of neurological and psychiatric disorders and brain functioning. The description of the brain networks arose through the unique ability to illustrate long-range interactions between interconnected brain regions as derived from state-of-the-art neuroimaging (structural, diffusion, and functional MRI) and the opportunity to record local and large-scale brain activity at millisecond temporal resolution (microelectrode recordings, local field potential, electroencephalography, and magnetoencephalography).In the first part of this review, we describe how neuroimaging techniques have led to current understanding of DBS effects, by identifying and refining the DBS targets and illustrate the actual view on the relationships between electrode locations and clinical effects. One step further, we discuss how neuroimaging has shifted the view of localized DBS effects to a modulation of specific brain circuits, which has been possible from the combination of electrode location reconstructions with recently introduced network imaging methods. We highlight how these findings relate to clinical effects, thus postulating neuroimaging as a key factor to understand the mechanisms of DBS action on behavior and clinical effects. In the second part, we show how invasive electrophysiology techniques have been efficiently integrated into the DBS set-up to precisely localize the neuroanatomical targets of DBS based on distinct region-specific patterns of neural activity. Next, we show how multi-site electrophysiological recordings have granted a real-time window into the aberrant brain circuits within and beyond DBS targets to quantify and map the dynamic properties of rhythmic oscillations. We also discuss how DBS alters the transient synchrony states of oscillatory networks in temporal and spatial domains during resting, task-based and motion conditions, and how this modulation of brain states ultimately shapes the functional response. Finally, we show how a successful decoding and management of electrophysiological proxies (beta bursts, phase-amplitude coupling) of aberrant brain circuits was translated into adaptive DBS stimulation paradigms for a targeted and state-dependent invasive electrical neuromodulation.