Role of functional imaging in the development and refinement of invasive neuromodulation for psychiatric disorders

• 作者: Colleen A Hanlon E Baron Short Joseph J Taylor Kayla Lamb Mark S George Nolan R Williams
• 来源期刊: 世界放射学杂志：英文版（电子版）
• 学科: 医学
• 关键词: Deep brain stimulation FUNCTIONAL neu-roimaging FUNCTIONAL magnetic resonance IMAGING CORTICAL stimu-lation Nuclear IMAGING
• 年，卷（期）: 2014,（10）
• 页码范围: 756-778
• 页数: 23页
• 分类号: R741

摘要

Deep brain stimulation(DBS) is emerging as a pow-erful tool for the alleviation of targeted symptoms in treatment-resistant neuropsychiatric disorders. Despite the expanding use of neuropsychiatric DBS, the mecha-nisms responsible for its effects are only starting to be elucidated. Several modalities such as quantitative elec-troencephalography as well a intraoperative recordings have been utilized to attempt to understand the under-pinnings of this new treatment modality, but functional imaging appears to offer several unique advantages. Functional imaging techniques like positron emission tomography, single photon emission computed tomog-raphy and functional magnetic resonance imaging have been used to examine the effects of focal DBS on activ-ity in a distributed neural network. These investigations are critical for advancing the field of invasive neuro-modulation in a safe and effective manner, particularly in terms of defining the neuroanatomical targets and refining the stimulation protocols. The purpose of this review is to summarize the current functional neuroim-aging findings from neuropsychiatric DBS implantation for three disorders: treatment-resistant depression, obsessive-compulsive disorder, and Tourette syndrome. All of the major targets will be discussed(Nucleus ac-cumbens, anterior limb of internal capsule, subcallosal cingulate, Subthalamic nucleus, Centromedial nucleus of the thalamus-Parafasicular complex, frontal pole, and dorsolateral prefrontal cortex). We will also address some apparent inconsistencies within this literature, and suggest potential future directions for this promis-ing area.