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Optimal deep brain stimulation sites and networks for stimulation of the fornix in Alzheimer's disease.
Ríos, Ana Sofía; Oxenford, Simón; Neudorfer, Clemens; Butenko, Konstantin; Li, Ningfei; Rajamani, Nanditha; Boutet, Alexandre; Elias, Gavin J B; Germann, Jurgen; Loh, Aaron; Deeb, Wissam; Wang, Fuyixue; Setsompop, Kawin; Salvato, Bryan; Almeida, Leonardo Brito de; Foote, Kelly D; Amaral, Robert; Rosenberg, Paul B; Tang-Wai, David F; Wolk, David A; Burke, Anna D; Salloway, Stephen; Sabbagh, Marwan N; Chakravarty, M Mallar; Smith, Gwenn S; Lyketsos, Constantine G; Okun, Michael S; Anderson, William S; Mari, Zoltan; Ponce, Francisco A; Lozano, Andres M; Horn, Andreas.
Afiliação
  • Ríos AS; Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
  • Oxenford S; Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
  • Neudorfer C; Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
  • Butenko K; Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
  • Li N; Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
  • Rajamani N; Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
  • Boutet A; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, ON, M5T2S8, Canada.
  • Elias GJB; Krembil Research Institute, University of Toronto, Toronto, ON, M5T2S8, Canada.
  • Germann J; Joint Department of Medical Imaging, University of Toronto, Toronto, ON, M5T1W7, Canada.
  • Loh A; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, ON, M5T2S8, Canada.
  • Deeb W; Krembil Research Institute, University of Toronto, Toronto, ON, M5T2S8, Canada.
  • Wang F; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, ON, M5T2S8, Canada.
  • Setsompop K; Krembil Research Institute, University of Toronto, Toronto, ON, M5T2S8, Canada.
  • Salvato B; Division of Neurosurgery, Department of Surgery, University Health Network and University of Toronto, Toronto, ON, M5T2S8, Canada.
  • Almeida LB; Krembil Research Institute, University of Toronto, Toronto, ON, M5T2S8, Canada.
  • Foote KD; UMass Chan Medical School, Department of Neurology, Worcester, MA, 01655, USA.
  • Amaral R; UMass Memorial Health, Department of Neurology, Worcester, MA, 01655, USA.
  • Rosenberg PB; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA.
  • Tang-Wai DF; Harvard-MIT Health Sciences and Technology, MIT, Cambridge, MA, USA.
  • Wolk DA; Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Harvard Medical School, Massachusetts General Hospital, Charlestown, MA, USA.
  • Burke AD; Harvard-MIT Health Sciences and Technology, MIT, Cambridge, MA, USA.
  • Salloway S; Department of Radiology, Stanford University, Stanford, CA, USA.
  • Sabbagh MN; University of Florida Health Jacksonville, Jacksonville, FL, USA.
  • Chakravarty MM; Norman Fixel Institute for Neurological Diseases, Departments of Neurology and Neurosurgery, University of Florida, Gainesville, FL, USA.
  • Smith GS; Norman Fixel Institute for Neurological Diseases, Departments of Neurology and Neurosurgery, University of Florida, Gainesville, FL, USA.
  • Lyketsos CG; Cerebral Imaging Centre, Douglas Research Centre, Montreal, QC, Canada.
  • Okun MS; Department of Psychiatry and Behavioral Sciences and Richman Family Precision Medicine Center of Excellence, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
  • Anderson WS; Krembil Research Institute, University of Toronto, Toronto, ON, M5T2S8, Canada.
  • Mari Z; Department of Medicine, Division of Neurology, University Health Network and University of Toronto, Toronto, ON, M5T2S8, Canada.
  • Ponce FA; Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
  • Lozano AM; Barrow Neurological Institute, Phoenix, AZ, USA.
  • Horn A; Department of Psychiatry and Human Behavior and Neurology, Alpert Medical School of Brown University, Providence, RI, USA.
Nat Commun ; 13(1): 7707, 2022 12 14.
Article em En | MEDLINE | ID: mdl-36517479
ABSTRACT
Deep brain stimulation (DBS) to the fornix is an investigational treatment for patients with mild Alzheimer's Disease. Outcomes from randomized clinical trials have shown that cognitive function improved in some patients but deteriorated in others. This could be explained by variance in electrode placement leading to differential engagement of neural circuits. To investigate this, we performed a post-hoc analysis on a multi-center cohort of 46 patients with DBS to the fornix (NCT00658125, NCT01608061). Using normative structural and functional connectivity data, we found that stimulation of the circuit of Papez and stria terminalis robustly associated with cognitive improvement (R = 0.53, p < 0.001). On a local level, the optimal stimulation site resided at the direct interface between these structures (R = 0.48, p < 0.001). Finally, modulating specific distributed brain networks related to memory accounted for optimal outcomes (R = 0.48, p < 0.001). Findings were robust to multiple cross-validation designs and may define an optimal network target that could refine DBS surgery and programming.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Estimulação Encefálica Profunda / Doença de Alzheimer Tipo de estudo: Clinical_trials Limite: Humans Idioma: En Revista: Nat Commun Assunto da revista: BIOLOGIA / CIENCIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Alemanha
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Estimulação Encefálica Profunda / Doença de Alzheimer Tipo de estudo: Clinical_trials Limite: Humans Idioma: En Revista: Nat Commun Assunto da revista: BIOLOGIA / CIENCIA Ano de publicação: 2022 Tipo de documento: Article País de afiliação: Alemanha