Abstract
Deep brain stimulation (DBS) is being used to treat a growing number of neurological disorders. Until recently, DBS has been thought to act mainly by suppressing local neuronal activity, essentially producing a functional lesion. Numerous studies are now demonstrating that DBS has widespread network effects mediated by white matter pathways. The new science of connectomics aims to map the connectivity between brain regions in health and disease. Targeting DBS specifically to pathways which exhibit pathological connectivity could greatly expand the possibilities for treating brain diseases. This brief review examines the current state of brain imaging for visualization of these networks and describes how DBS might be used to restore normal connectivity in pathological states.
Highlights
Since its initial introduction in the early 1950s (Delgado et al, 1952), and its refinement in the late 1980s to its current modern form (Benabid et al, 1987), deep brain stimulation (DBS) has been increasingly employed in the treatment of neurodegenerative diseases
DIFFUSION TENSOR IMAGING AND TRACTOGRAPHY White matter tracts are formed from the axonal projections of cortical and subcortical neurons, creating the structural connective scaffolding of the brain
Suggested by preliminary studies, it remains to be definitively demonstrated whether these modulatory influences are due to changes in connectivity, and whether connectivity normalization can be related to other markers such as oscillatory synchronization or frequency of DBS
Summary
“Connectomic surgery”: diffusion tensor imaging (DTI) tractography as a targeting modality for surgical modulation of neural networks. Deep brain stimulation (DBS) is being used to treat a growing number of neurological disorders. Numerous studies are demonstrating that DBS has widespread network effects mediated by white matter pathways. The new science of connectomics aims to map the connectivity between brain regions in health and disease. Targeting DBS to pathways which exhibit pathological connectivity could greatly expand the possibilities for treating brain diseases. This brief review examines the current state of brain imaging for visualization of these networks and describes how DBS might be used to restore normal connectivity in pathological states
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