Central thalamic deep brain stimulation for cognitive neuromodulation - a review of proposed mechanisms and investigational studies Review uri icon

Overview

MeSH Major

  • Cognition
  • Coma
  • Deep Brain Stimulation
  • Persistent Vegetative State
  • Thalamus

abstract

  • 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.

publication date

  • October 2010

Research

keywords

  • Review

Identity

Language

  • eng

PubMed Central ID

  • PMC3058925

Digital Object Identifier (DOI)

  • 10.1111/j.1460-9568.2010.07420.x

PubMed ID

  • 21039953

Additional Document Info

start page

  • 1135

end page

  • 44

volume

  • 32

number

  • 7