Abstract
The central thalamus (CT) is a key node in the arousal regulation network of the mammalian brain hypothesized to modulate large-scale activity patterns across the anterior forebrain in response to internal and external demands during wakefulness. Damage of the CT in humans, due to traumatic brain injury (TBI) or stroke, results in enduring cognitive deficits in the allocation of attention, maintenance of concentration and focus, working memory, impulse control, processing speed, and motivation. Central thalamic deep brain stimulation (CT-DBS) is an investigational therapy to treat these enduring cognitive dysfunctions, however, the mechanisms of CT-DBS promoting restoration of cognitive function are unknown, and the heterogeneous etiology and recovery profiles in structurally brain injured (SBI) patients contribute to variable outcomes using conventional DBS strategies that may have off-target effects due to activation of multiple pathways.
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