| Central thalamic deep brain stimulation for cognitive neuromodulation - a review of proposed mechanisms and investigational studies. | |
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MedLine Citation:
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PMID: 21039953 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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We review the history of efforts to apply central thalamic deep brain stimulation (CT/DBS) to restore consciousness in patients in a coma or vegetative state by changing the arousal state. Early experimental and clinical studies, and the results of a recent single-subject human study that demonstrated both immediate behavioral facilitation and carry-over effects of CT/DBS are reviewed. We consider possible mechanisms underlying CT/DBS effects on cognitively-mediated behaviors in conscious patients in light of the anatomical connectivity and physiological specializations of the central thalamus. Immediate and carry-over effects of CT/DBS are discussed within the context of possible effects on neuronal plasticity and gene expression. We conclude that CT/DBS should be studied as a therapeutic intervention to improve impaired cognitive function in severely brain-injured patients who, in addition to demonstrating clinical evidence of consciousness and goal-directed behavior, retain sufficient preservation of large-scale cerebral networks within the anterior forebrain. Although available data provide evidence for proof-of-concept, very significant challenges for study design and development of CT/DBS for clinical use are identified. |
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Authors:
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Sudhin A Shah; Nicholas D Schiff |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review |
Journal Detail:
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Title: The European journal of neuroscience Volume: 32 ISSN: 1460-9568 ISO Abbreviation: Eur. J. Neurosci. Publication Date: 2010 Oct |
Date Detail:
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Created Date: 2010-11-02 Completed Date: 2011-02-14 Revised Date: 2012-05-07 |
Medline Journal Info:
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Nlm Unique ID: 8918110 Medline TA: Eur J Neurosci Country: France |
Other Details:
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Languages: eng Pagination: 1135-44 Citation Subset: IM |
Copyright Information:
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© 2010 The Authors. European Journal of Neuroscience © 2010 Federation of European Neuroscience Societies and Blackwell Publishing Ltd. |
Affiliation:
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Department of Neurology and Neuroscience, Weill Cornell Medical College, NY, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Animals Clinical Trials as Topic Cognition / physiology* Coma / therapy* Consciousness / physiology Deep Brain Stimulation / methods* Humans Persistent Vegetative State / therapy* Thalamus / physiology* |
| Grant Support | |
ID/Acronym/Agency:
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NS02014/NS/NINDS NIH HHS; NS02172/NS/NINDS NIH HHS |
| Comments/Corrections | |
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