Central thalamic deep brain stimulation for cognitive neuromodulation - a review of proposed mechanisms and investigational studies.
| Publication Type | Review |
| Authors | Shah S, Schiff N |
| Journal | Eur J Neurosci |
| Volume | 32 |
| Issue | 7 |
| Pagination | 1135-44 |
| Date Published | 10/01/2010 |
| ISSN | 1460-9568 |
| Keywords | 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. |
| DOI | 10.1111/j.1460-9568.2010.07420.x |
| PubMed ID | 21039953 |
| PubMed Central ID | PMC3058925 |