Deep Brain Stimulation for Cognitive Neuromodulation Chapter uri icon

Overview

MeSH Major

  • Blood Flow Velocity
  • Brain
  • Cerebrovascular Circulation
  • Echo-Planar Imaging
  • Magnetic Resonance Angiography
  • Models, Biological

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

  • December 2009

Research

keywords

  • Book Chapter

Identity

Digital Object Identifier (DOI)

  • 10.1016/B978-0-12-374248-3.00084-7

Additional Document Info

start page

  • 1135

end page

  • 44

volume

  • 2