Abstract：
BACKGROUND:Directional Deep Brain Stimulation (D-DBS) allows axially asymmetric electrical field shaping, away from structures causing side-effects. However, concerns regarding the impact on device lifespan and complexity of the monopolar survey have contributed to sparing use of these features. OBJECTIVE:To investigate whether chronically implanted D-DBS systems can improve the therapeutic window, without a negative impact on device lifespan, in thalamic deep brain stimulation (DBS). METHODS:We evaluated stable outcomes of initial programming sessions (4-6 weeks post-implantation) retrospectively in 8 patients with drug-resistant disabling tremor syndromes. We assessed the impact of directional stimulation on the Therapeutic Window (TW), Therapeutic Current Strength (TCS), tremor scores, disability scores and total electrical energy delivered. Finally, we performed Volume of Tissue Activation (VTA) modelling, based on a range of parameters. RESULTS:We report significant gains in TW (91%) and reductions in TCS (31%) with stimulation in the best direction compared to best omnidirectional stimulation alternative. Tremor and ADL scores improvements remained unchanged at six months. There was no increase in averaged IPG power consumption (there is a 6% reduction over the omnidirectional-only alternative). Illustrative VTA modelling shows that D-DBS achieves 85% of the total activation volume at just 69% of the stimulation amplitude of non-directional configuration. CONCLUSIONS:D-DBS can improve the therapeutic window over non-directional DBS, leading to significant reduction in disability that may be sustained without additional reprogramming visits. When averaged across the cohort, power output and predicted device lifespan was not impacted by the use of directional stimulation in this study.
journal_name
Brain Stimuljournal_title
Brain stimulationauthors
Rebelo P,Green AL,Aziz TZ,Kent A,Schafer D,Venkatesan L,Cheeran Bdoi
10.1016/j.brs.2017.12.015subject
Has Abstractpub_date
2018-01-01 00:00:00pages
600-606issue
3eissn
1935-861Xissn
1876-4754pii
S1935-861X(17)31031-8journal_volume
11pub_type
临床试验,杂志文章abstract：BACKGROUND:Repetitive transcranial magnetic stimulation (rTMS) has shown promise as a treatment for refractory auditory hallucinations (AH) in Schizophrenia. Most previous studies have examined the effect of low frequency, left-sided stimulation (LFL) (1 Hz) to the temporoparietal cortex (TPC). Priming stimulation (6 H...
journal_title：Brain stimulation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.brs.2011.12.002
更新日期：2012-10-01 00:00:00
abstract：BACKGROUND:Although cervical vagus nerve stimulation is effective for reducing infarct volume in rats, it is not feasible for acute human stroke as it requires surgical incision of the neck. We hypothesized that stimulation of the dermatome in the external ear innervated by the vagus nerve (auricular vagus nerve stimul...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2014.09.009
更新日期：2015-01-01 00:00:00
abstract：BACKGROUND:Noninvasive brain stimulation is a powerful way to modify excitability of the cerebral cortex in humans and is increasingly used to treat psychiatric disorders. The observed clinical effects are in the moderate range and it has been suggested that the efficiency of brain stimulation depends on the underlying...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2010.07.002
更新日期：2011-04-01 00:00:00
abstract：BACKGROUND:Vagus nerve stimulation (VNS) significantly reduces infarct volume in rat models of cerebral ischemia, but the mechanism of this protective effect remains open. HYPOTHESIS:This study tested the hypothesis that non-invasive VNS (nVNS), during transient middle cerebral artery occlusion (MCAO), protects the bl...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2018.01.034
更新日期：2018-01-01 00:00:00
abstract：BACKGROUND:White matter hyperintensities (WMH) are estimated to occur in greater than 63% of older adults over the age of 60 years. WMH identified in the T2-weighted FLAIR images can be combined with T1-weighted images to enhance individualized current flow models of older adults by accounting for the presence of WMH a...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2020.11.009
更新日期：2021-01-01 00:00:00
abstract：OBJECTIVE:To examine the effects of transcranial direct current stimulation (tDCS) on objective and subjective indexes of exercise performance. DESIGN:Systematic review and meta-analysis. DATA SOURCES:A systematic literature search of electronic databases (PubMed, Web of Science, Scopus, Google Scholar) and reference...
journal_title：Brain stimulation
pub_type： 杂志文章,meta分析
doi：10.1016/j.brs.2018.12.002
更新日期：2019-01-01 00:00:00
abstract：OBJECTIVES:Vagus nerve stimulation represents an established treatment strategy for epilepsy and affective disorders. Recently, positive effects were also shown in animals and humans with tinnitus. Here we report the results of an open pilot study exploring feasibility, safety and efficacy of tVNS in the treatment of c...
journal_title：Brain stimulation
pub_type： 临床试验,杂志文章
doi：10.1016/j.brs.2014.05.003
更新日期：2014-09-01 00:00:00
abstract：BACKGROUND:Pairing sensory or motor events with vagus nerve stimulation (VNS) can reorganize sensory or motor cortex. Repeatedly pairing a tone with a brief period of VNS increases the proportion of primary auditory cortex (A1) responding to the frequency of the paired tone. However, the relationship between VNS intens...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2015.08.018
更新日期：2016-01-01 00:00:00
abstract：BACKGROUND:Combined transcranial magnetic stimulation (TMS) and electroencephalography (EEG) can provide insights into how differing cognitive contexts produce different brain states, through TMS-based measures of effective connectivity. For instance, in a recent study, the amplitude of the TMS-evoked response (TMS-ER)...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2013.11.004
更新日期：2014-03-01 00:00:00
abstract：BACKGROUND:Chronic severe tinnitus can be greatly detrimental to quality of life. Some authors have reported benefit of repetitive transcranial magnetic stimulation, others of electrical cortical stimulation by stimulating the Heschl's gyrus or secondary auditory areas. OBJECTIVE:To evaluate the efficacy of chronic el...
journal_title：Brain stimulation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.brs.2014.05.008
更新日期：2014-09-01 00:00:00
abstract：BACKGROUND:Transcranial direct current stimulation (tDCS), a neuromodulatory non-invasive brain stimulation technique, has shown promising results in basic and clinical studies. The known interindividual variability of the effects, however, limits the efficacy of the technique. Recently we reported neurophysiological e...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2021.01.016
更新日期：2021-01-28 00:00:00
abstract：BACKGROUND:Direct stimulation of the vagus nerve in the neck via surgically implanted electrodes is protective in animal models of stroke. We sought to determine the safety and efficacy of a non-invasive cervical VNS (nVNS) method using surface electrodes applied to the skin overlying the vagus nerve in the neck in a m...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2015.11.008
更新日期：2016-03-01 00:00:00
abstract：BACKGROUND:Although one of the most frequent diagnosed mental illnesses worldwide, it appears to be challenging to successfully treat major depressive disorder (MDD). Although the phenomenon of treatment-resistant depression (TRD) still remains unclear, the subgenual anterior cingulate cortex (sgACC) has been put forwa...
journal_title：Brain stimulation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.brs.2015.01.415
更新日期：2015-07-01 00:00:00
abstract：BACKGROUND:Movies and television (TV) programs are an important source of public information about ECT. OBJECTIVE:To narratively review the portrayal of ECT in international movies and TV programs from 1948 until present. METHODS:Several Internet movie databases and a database of phrases appearing in movies and TV pr...
journal_title：Brain stimulation
pub_type： 历史文章,杂志文章,评审
doi：10.1016/j.brs.2016.07.005
更新日期：2016-01-01 00:00:00
abstract：CONTEXT:The aim of this study was to assess whether the combination of low frequency repetitive transcranial magnetic stimulation (rTMS) and venlafaxine (150-225 mg/day) is effective and safe for treatment-resistant unipolar depression (TRD). METHOD:In a multicenter (18 centers) randomized double blind controlled tria...
journal_title：Brain stimulation
pub_type： 杂志文章,多中心研究,随机对照试验
doi：10.1016/j.brs.2014.07.040
更新日期：2014-11-01 00:00:00
abstract：BACKGROUND:Previous studies have shown that primary motor cortex (M1) excitability is modulated by motor skill learning and that the M1 plays a crucial role in motor memory. However, the following questions remain: (1) At what stage do changes in M1 excitability occur? (2) Are learning-induced changes in leg M1 excitab...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2015.07.025
更新日期：2015-11-01 00:00:00
abstract：BACKGROUND:Corticospinal excitability depends on the current brain state. The recent development of real-time EEG-triggered transcranial magnetic stimulation (EEG-TMS) allows studying this relationship in a causal fashion. Specifically, it has been shown that corticospinal excitability is higher during the scalp surfac...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2018.09.009
更新日期：2019-01-01 00:00:00
abstract：BACKGROUND:Theories of executive control propose that communication between medial frontal cortex (MFC) and lateral prefrontal cortex (lPFC) is critical for learning. 6-Hz phase synchronization may be the mechanism by which neural activity between MFC and lPFC is coordinated into a functional network. Recent evidence s...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2018.02.008
更新日期：2018-01-01 00:00:00
abstract：BACKGROUND:Lesions of the angular gyrus (AnG) region of human parietal cortex do not cause amnesia, but appear to be associated with reduction in the ability to consciously experience the reliving of previous events. OBJECTIVES/HYPOTHESIS:We used continuous theta burst stimulation to test the hypothesis that the cogni...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2017.02.011
更新日期：2017-01-01 00:00:00
abstract：BACKGROUND:Repetitive transcranial magnetic stimulation (rTMS) has been proposed for stabilizing the antidepressant effect of sleep deprivation (SD) by preventing the relapse after a night of recovery sleep. In this study, we aimed to replicate these data coming from a small pilot study in a larger patient sample. MET...
journal_title：Brain stimulation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.brs.2011.02.005
更新日期：2012-04-01 00:00:00
abstract：BACKGROUND:Repetitive transcranial magnetic stimulation (TMS) is a non-invasive, safe, and efficacious treatment for depression. TMS has been shown to normalize abnormal functional connectivity of cortico-cortical circuits in depression and baseline functional connectivity of these circuits predicts treatment response....
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2017.07.002
更新日期：2017-01-01 00:00:00
abstract：:Inhibitory control mechanisms are important in a range of behaviours to prevent execution of motor acts which, having been planned, are no longer necessary or appropriate. Examples of this can be seen in a range of sports, such as cricket and baseball, where the choice between execution and inhibition of a bat swing m...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2012.03.012
更新日期：2012-04-01 00:00:00
abstract：BACKGROUND:Burning mouth syndrome (BMS) is a burning oral sensation without any corresponding abnormal findings. In some cases, BMS is refractory to pharmacologic treatments. Repetitive transcranial magnetic stimulation (rTMS) over left prefrontal cortex induces analgesic effect in both acute and chronic pain. However,...
journal_title：Brain stimulation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.brs.2015.10.005
更新日期：2016-03-01 00:00:00
abstract：BACKGROUND:Repetitive transcranial magnetic stimulation (rTMS) for the experimental treatment of tinnitus or auditory hallucinations aims at a modulation of cortical activity in areas of auditory perception and processing. Continuous theta burst stimulation (cTBS) is a patterned rTMS paradigm with lower stimulation int...
journal_title：Brain stimulation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.brs.2012.10.005
更新日期：2013-07-01 00:00:00
abstract：BACKGROUND:Although some studies have reported significant reductions in food cravings following the single-session of repetitive transcranial magnetic stimulation (rTMS), there is little research on the effects of multi-session of rTMS on food consumption and body weight in obese subjects. OBJECTIVE:We conducted 4-we...
journal_title：Brain stimulation
pub_type： 杂志文章,随机对照试验
doi：10.1016/j.brs.2019.07.020
更新日期：2019-01-01 00:00:00
abstract：BACKGROUND:Despite recent developments in navigation and modeling techniques, the type and location of the structures that are activated by transcranial magnetic stimulation (TMS) remain unknown. OBJECTIVE:We studied the relationships between electrophysiological measurements and electric fields induced in the brain t...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2017.09.011
更新日期：2018-01-01 00:00:00
abstract：BACKGROUND:Volume increases of the hippocampus after electroconvulsive therapy (ECT) are a robust finding, pointing into the direction of neurogenesis. However, such volumetric increases could also be explained by edema and/or neuroplastic changes (such as angiogenesis). OBJECTIVES:If edema explains the volume increas...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2020.04.017
更新日期：2020-01-01 00:00:00
abstract：BACKGROUND:Repetitive transcranial magnetic stimulation (rTMS) is an effective treatment for depression, but only some individuals respond. Predicting response could reduce patient and clinical burden. Neural activity related to working memory (WM) has been related to mood improvements, so may represent a biomarker for...
journal_title：Brain stimulation
pub_type： 临床试验,杂志文章
doi：10.1016/j.brs.2017.10.015
更新日期：2018-01-01 00:00:00
abstract：BACKGROUND:Deep brain stimulation (DBS) is a surgical neuromodulation procedure with a historically wide range of possible therapeutic indications, including movement disorders, neuropsychiatric conditions, and cognitive disorders. Ongoing research in this field is critical to gain further insights into the mechanisms ...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2019.11.008
更新日期：2020-01-01 00:00:00
abstract：:Right unilateral ultra-brief electroconvulsive therapy (RUL UB ECT) has been shown to be efficacious with minimal cognitive adverse effects in adult patients with major depression. We present the case of a 14-year-old girl with major depressive disorder with catatonic and psychotic features whose symptoms remitted aft...
journal_title：Brain stimulation
pub_type： 杂志文章
doi：10.1016/j.brs.2009.07.003
更新日期：2010-01-01 00:00:00
