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Brain structures and networks responsible for stimulation-induced memory flashbacks during forniceal deep brain stimulation for Alzheimer's disease.
Germann, Jürgen; Elias, Gavin J B; Boutet, Alexandre; Narang, Keshav; Neudorfer, Clemens; Horn, Andreas; Loh, Aaron; Deeb, Wissam; Salvato, Bryan; Almeida, Leonardo; Foote, Kelly D; 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; Lozano, Andres M.
Afiliação
  • Germann J; Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada.
  • Elias GJB; Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada.
  • Boutet A; Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada.
  • Narang K; Joint Department of Medical Imaging, University of Toronto, Toronto, Canada.
  • Neudorfer C; Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada.
  • Horn A; Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada.
  • Loh A; Movement Disorders & Neuromodulation Unit, Department for Neurology, Charité - University Medicine Berlin, Berlin, Germany.
  • Deeb W; Division of Neurosurgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada.
  • Salvato B; Norman Fixel Institute for Neurological Diseases, Departments of Neurology and Neurosurgery, University of Florida Health, USA.
  • Almeida L; Florida State University, USA.
  • Foote KD; Norman Fixel Institute for Neurological Diseases, Departments of Neurology and Neurosurgery, University of Florida Health, USA.
  • Rosenberg PB; Norman Fixel Institute for Neurological Diseases, Departments of Neurology and Neurosurgery, University of Florida Health, USA.
  • Tang-Wai DF; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA.
  • Wolk DA; Department of Neurology, Toronto Western Hospital, University Health Network, University of Toronto, Canada.
  • Burke AD; University of Pennsylvania, USA.
  • Salloway S; Department of Neurology, Barrow Neurological Institute, Phoenix, USA.
  • Sabbagh MN; Department of Psychiatry and Human Behavior and Neurology, Alpert Medical School of Brown University, USA.
  • Chakravarty MM; Cleveland Clinic Lou Ruvo Center for Brain Health, USA.
  • Smith GS; Douglas Mental Health University Research Institute, Canada.
  • Lyketsos CG; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA.
  • Okun MS; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA.
  • Lozano AM; Norman Fixel Institute for Neurological Diseases, Departments of Neurology and Neurosurgery, University of Florida Health, USA.
Alzheimers Dement ; 17(5): 777-787, 2021 05.
Article em En | MEDLINE | ID: mdl-33480187
ABSTRACT

INTRODUCTION:

Fornix deep brain stimulation (fx-DBS) is under investigation for treatment of Alzheimer's disease (AD). We investigated the anatomic correlates of flashback phenomena that were reported previously during acute diencephalic stimulation.

METHODS:

Thirty-nine patients with mild AD who took part in a prior fx-DBS trial (NCT01608061) were studied. After localizing patients' implanted electrodes and modeling the volume of tissue activated (VTA) by DBS during systematic stimulation testing, we performed (1) voxel-wise VTA mapping to identify flashback-associated zones; (2) machine learning-based prediction of flashback occurrence given VTA overlap with specific structures; (3) normative functional connectomics to define flashback-associated brain-wide networks.

RESULTS:

A distinct diencephalic region was associated with greater flashback likelihood. Fornix, bed nucleus of stria terminalis, and anterior commissure involvement predicted memory events with 72% accuracy. Flashback-inducing stimulation exhibited greater functional connectivity to a network of memory-evoking and autobiographical memory-related sites.

DISCUSSION:

These results clarify the neuroanatomical substrates of stimulation-evoked flashbacks.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fórnice / Estimulação Encefálica Profunda / Doença de Alzheimer / Memória Tipo de estudo: Prognostic_studies Limite: Aged / Female / Humans / Male Idioma: En Ano de publicação: 2021 Tipo de documento: Article
Texto completo
Imprimir
XML
PubMed Links
Buscar no Google

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Fórnice / Estimulação Encefálica Profunda / Doença de Alzheimer / Memória Tipo de estudo: Prognostic_studies Limite: Aged / Female / Humans / Male Idioma: En Ano de publicação: 2021 Tipo de documento: Article