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J Neurosci 2019 Feb 19. Epub 2019 Feb 19.

Centro de Tecnologia em Medicina Molecular

Neuromodulation of deep brain structures (deep brain stimulation - DBS) is the current surgical procedure for treatment of Parkinson's disease. Less studied is the stimulation of cortical motor areas to treat PD symptoms, although also known to alleviate motor disturbances in PD. We were able to show that optogenetic activation of secondary (M2) motor cortex improves motor functions in dopamine-depleted male mice. Read More

Indian J Psychiatry 2019 Jan-Feb;61(1):13-21

Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bengaluru, Karnataka, India.

Neurosurgery for psychiatric disorders (NPD) has been practiced for >80 years. However, the interests have waxed and waned, from 1000s of surgeries in 1940-1950s to handful of surgery in 60-80s. This changed with the application of deep brain stimulation surgery, a surgery, considered to be "reversible" there has been a resurgence in interest. Read More

Biol Psychiatry 2019 Mar 20;85(6):454-465. Epub 2018 Sep 20.

Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania. Electronic address:

Until recently, therapeutic development in psychiatry was targeted solely toward symptom reduction. While this is a worthwhile goal, it has yielded little progress in improved therapeutics in the last several decades in the field of mood disorders. Recent advancements in our understanding of pathophysiology suggests that an impairment of neuroplasticity may be a critical part of the development of neuropsychiatric disorders. Read More

Br J Psychiatry 2018 05;212(5):274-278

Centre for Affective Disorders,Institute of Psychiatry,Psychology and Neuroscience,King's College London,London and South London and Maudsley NHS Foundation Trust,London.

Many novel therapeutic options for depression exist that are either not mentioned in clinical guidelines or recommended only for use in highly specialist services. The challenge faced by clinicians is when it might be appropriate to consider such 'non-standard' interventions. This analysis proposes a framework to aid this decision. Read More

Pain Manag 2019 Jan 5;9(1):93-106. Epub 2018 Dec 5.

Neuromodulation Center, Spaulding Rehabilitation Hospital, Harvard Medical School, Boston, MA, 02129, USA.

Opioid misuse leading to dependence is a major health issue. Recent studies explored valid alternatives to treat pain in postsurgical settings. This systematic review aims to discuss the role of transcranial direct current stimulation (tDCS) in preventing and treating postoperative pain and opioid dependence. Read More

Acta Anaesthesiol Scand 2018 Nov;62(10):1473-1480

Department of Anesthesiology and Critical Care, University of Pennsylvania School of Medicine, Philadelphia, PA, USA.

Cognitive change affecting patients after anaesthesia and surgery has been recognised for more than 100 yr. Research into cognitive change after anaesthesia and surgery accelerated in the 1980s when multiple studies utilised detailed neuropsychological testing for assessment of cognitive change after cardiac surgery. This body of work consistently documented decline in cognitive function in elderly patients after anaesthesia and surgery, and cognitive changes have been identified up to 7. Read More

Neuron 2018 Oct 27;100(1):61-74.e2. Epub 2018 Sep 27.

Center for Biomedical Imaging and Neuromodulation, Nathan S. Kline Institute for Psychiatric Research, Orangeburg, NY 10962, USA; Department of Neurological Surgery, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA; Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA.

Non-human primate neuroimaging is a rapidly growing area of research that promises to transform and scale translational and cross-species comparative neuroscience. Unfortunately, the technological and methodological advances of the past two decades have outpaced the accrual of data, which is particularly challenging given the relatively few centers that have the necessary facilities and capabilities. The PRIMatE Data Exchange (PRIME-DE) addresses this challenge by aggregating independently acquired non-human primate magnetic resonance imaging (MRI) datasets and openly sharing them via the International Neuroimaging Data-sharing Initiative (INDI). Read More

Neuromodulation 2018 Aug 22. Epub 2018 Aug 22.

Department of Neurosurgery, King's College Hospital, Denmark Hill, London, UK.

Background: Deep brain stimulation (DBS) is increasingly used to treat a wide variety of neurological and psychiatric disorders. Implantable pulse generators (implantable pulse generators/batteries) for DBS were originally only available as a nonrechargeable option. However, there is now a choice between fixed-life and rechargeable batteries, with each having their own advantages and disadvantages. Read More

J Neural Eng 2018 Dec 20;15(6):066003. Epub 2018 Aug 20.

School of Engineering, Deakin University, Geelong, VIC 3216, Australia. Department of Neurologic Surgery, Mayo Clinic, Rochester, MN, United States of America. Mayo Clinic Graduate School of Biomedical Sciences, Mayo Clinic, Rochester, MN 55905, United States of America.

Objective: Stereotactic frame systems are the gold-standard for stereotactic surgeries, such as implantation of deep brain stimulation (DBS) devices for treatment of medically resistant neurologic and psychiatric disorders. However, frame-based systems require that the patient is awake with a stereotactic frame affixed to their head for the duration of the surgical planning and implantation of the DBS electrodes. While frameless systems are increasingly available, a reusable re-attachable frame system provides unique benefits. Read More

Psychiatr Clin North Am 2018 09 17;41(3):485-503. Epub 2018 Jul 17.

Neuromodulation Research Clinic, Depressive Disorders Program, Douglas Mental Health University Institute, McGill University, 6875 LaSalle Boulevard, Montréal, Québec H4H 1R3, Canada. Electronic address:

The authors conducted a meta-review of meta-analyses published in the past decade on therapeutic neuromodulation (ie, repetitive transcranial magnetic stimulation, transcranial direct current stimulation, vagus nerve stimulation and deep brain stimulation) for major depression. Active repetitive transcranial magnetic stimulation and transcranial direct current stimulation have been generally associated with small to moderate effect sizes vis-à-vis their efficacy and with similar acceptability compared with sham. Vagus nerve stimulation and deep brain stimulation (although more challenging to investigate) have demonstrated preliminary effectiveness, particularly during longer-term follow-up. Read More

Psychiatr Clin North Am 2018 09 17;41(3):479-483. Epub 2018 Jul 17.

Department of Psychiatry and Psychology, Mayo Clinic, 200 First Street Southwest, Rochester, MN 55905, USA. Electronic address:

Although the application of noninvasive brain stimulation methods to children and adolescents has been frequently studied in depression, autism spectrum disorder, attention-deficit/hyperactivity disorder, and other neuropsychiatric disorders, invasive methods such as deep brain stimulation (DBS) and vagal nerve stimulation (VNS) have received less attention. DBS and VNS have demonstrated utility in young patients especially for dystonia and epilepsy. VNS has FDA clearance for intractable epilepsy in patients aged 4 years and older. Read More

Neurosci Bull 2018 Aug 18;34(4):615-625. Epub 2018 Jun 18.

Department of Neurosurgery, PLA Army General Hospital, Beijing, 100700, China.

Treatment for disorders of consciousness (DOCs) is still a Gordian knot. Evidence-based guidelines on the treatment of DOC patients are not currently available, while neuromodulation techniques are seen as a potential treatment. Multiple neuromodulation therapies have been applied. Read More

J Alzheimers Dis 2018 ;64(2):597-606

Department of Psychiatry and Behavioral Sciences, Memory and Alzheimer's Treatment Center andAlzheimer's Disease Research Center, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins University School of Medicine, Baltimore, MD, USA.

Background: Given recent challenges in developing new treatments for Alzheimer dementia (AD), it is vital to explore alternate treatment targets, such as neuromodulation for circuit dysfunction. We previously reported an exploratory Phase IIb double-blind trial of deep brain stimulation targeting the fornix (DBS-f) in mild AD (the ADvance trial). We reported safety but no clinical benefits of DBS-f versus the delayed-on (sham) treatment in 42 participants after one year. Read More

Front Psychiatry 2018 31;9:207. Epub 2018 May 31.

Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland.

Bipolar disorder (BD) is a common, highly heritable neuropsychiatric disease characterized by recurrent episodes of mania and depression. Lithium is the best-established long-term treatment for BD, even though individual response is highly variable. Evidence suggests that some of this variability has a genetic basis. Read More

Methods Mol Biol 2018 ;1780:463-481

Laboratory of Neurotherapies and Neuromodulation (LNCM), Neuroscience Research Center (CRN), Lausanne University Hospital (CHUV), Lausanne, Switzerland.

This chapter describes the potential use of viral-mediated gene transfer in the central nervous system for genome editing in the context of Huntington's disease. Here, we provide protocols that cover the design of various genome editing strategies, the cloning of CRISPR/Cas9 elements into lentiviral vectors, and the assessment of cleavage efficiency, as well as potential unwanted effects. Read More

Neural Plast 2018 1;2018:3678534. Epub 2018 Apr 1.

Siena Brain Investigation & Neuromodulation Lab (Si-BIN Lab), Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Siena, Italy.

Insomnia might occur as result of increased cognitive and physiological arousal caused by acute or long acting stressors and associated cognitive rumination. This might lead to alterations in brain connectivity patterns as those captured by functional connectivity fMRI analysis, leading to potential insight about primary insomnia (PI) pathophysiology as well as the impact of long-term exposure to sleep deprivation. We investigated changes of voxel-wise connectivity patterns in a sample of 17 drug-naïve PI patients and 17 age-gender matched healthy controls, as well as the relationship between brain connectivity and age of onset, illness duration, and severity. Read More

Neurosci Biobehav Rev 2018 09 12;92:291-303. Epub 2018 May 12.

School of Psychology, College of Applied Health and Communities, University of East London, United Kingdom; Centre for Affective Disorders, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, United Kingdom.

We examined the efficacy and acceptability of non-invasive brain stimulation in adult unipolar and bipolar depression. Randomised sham-controlled trials of transcranial direct current stimulation (tDCS), transcranial magnetic stimulation (TMS) and theta-burst stimulation (TBS), without co-initiation of another treatment, were included. We analysed effects on response, remission, all-cause discontinuation rates and continuous depression severity measures. Read More

Trends Neurosci 2018 07 4;41(7):418-428. Epub 2018 May 4.

Krembil Research Institute, University Health Network, Toronto, ON, Canada; Division of Neurosurgery, Department of Surgery, Krembil Neuroscience Centre, University Health Network, University of Toronto, Toronto, ON, Canada.

Pharmacological neuromodulation strategies have shown limited efficacy in treating memory deficits related to Alzheimer's disease (AD). Despite encouraging results from a few preclinical studies, clinical trials investigating open-loop deep brain stimulation (DBS) for AD have not been successful. Recent refinements in understanding the various phases of memory processes, animal studies investigating phase-specific modulation of hippocampal activity during memorization, and clinical studies using closed-loop DBS strategies to treat patients with movement disorders, all point to the need to investigate closed-loop fornical DBS strategies to better understand memory dynamics and potentially treat memory deficits in AD preclinical models. Read More

J Neurol 2018 Jul 3;265(7):1573-1579. Epub 2018 May 3.

Department of Neurology, Centre for Movement Disorders and Neuromodulation, Medical Faculty, Heinrich-Heine-University Düsseldorf, Moorenstrasse 5, 40225, Düsseldorf, Germany.

Background: Recently, therapeutic attempts to control motor choreatic hyperkinesia of Huntington's disease (HD) by means of pallidal deep brain stimulation (Gp-DBS) were successful. With respect to the clinical effects of Gp-DBS in juvenile hypokinetic-rigid HD (jHD; Westphal variant), only one single-case has been reported up to date. Oscillatory patterns of the Gp in jHD are not known. Read More

Nat Rev Dis Primers 2018 May 3;4:18024. Epub 2018 May 3.

Department of Neuroscience, Central Clinical School, Monash University, Melbourne, Victoria, Australia.

Epilepsy affects all age groups and is one of the most common and most disabling neurological disorders. The accurate diagnosis of seizures is essential as some patients will be misdiagnosed with epilepsy, whereas others will receive an incorrect diagnosis. Indeed, errors in diagnosis are common, and many patients fail to receive the correct treatment, which often has severe consequences. Read More

Cogn Affect Behav Neurosci 2018 06;18(3):495-508

Siena Brain Investigation & Neuromodulation Laboratory (Si-Bin Lab), Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Siena, Italy.

Coping abilities represent the individual set of mental and behavioral strategies adopted when facing stress or traumatic experiences. Coping styles related to avoidance have been linked to a disposition to develop psychiatric disorders such as PTSD, anxiety, and major depression, whereas problem-oriented coping skills have been positively correlated with well-being and high quality of life. Even though coping styles constitute an important determinant of resilience and can impact many aspects of everyday living, no study has investigated their brain functional connectivity underpinnings in humans. Read More

World Neurosurg 2018 Jun 9;114:e518-e523. Epub 2018 Mar 9.

Department of Neurosurgery, Osaka University Graduate School of Medicine, Suita, Japan.

Objective: The aim of this study was to investigate the incidence of and risk factors for postoperative delirium (POD) after deep brain stimulation (DBS) surgery in patients with Parkinson disease.

Methods: We analyzed the preoperative T1-weighted magnetic resonance imaging data of 71 patients with Parkinson disease who underwent DBS surgery. Multiple regression analysis was performed with age, l-dopa equivalent daily dose, laterality of the surgery, target regions, number of electrode trajectories tried, gray matter volume, and white matter (WM) volume as explanatory variables and the duration (number of days) of POD as the response variable. Read More

Neurol India 2018 Mar-Apr;66(Supplement):S102-S112

Department of Neurosurgery, Jaslok Hospital and Research Centre, Mumbai, Maharashtra, India.

It has been three decades since the first application of deep brain stimulation (DBS) for tremors was described by Benabid. Over the years, the indications for the performance of DBS have been expanding. There are now more than 1,50,000 patients around the world who have undergone DBS for various disorders. Read More

Pharmacol Ther 2018 06 31;186:168-175. Epub 2018 Jan 31.

Department of Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany.

This narrative review summarizes the recent literature on deep brain stimulation for treatment resistant obsessive-compulsive disorder highlighting both progress and challenges of this novel treatment. Common targets of psychiatric deep brain stimulation involve both white matter trajectories (anterior limb of the internal capsule, inferior thalamic peduncle, and medial forebrain bundle) and grey matter subcortical nuclei (nucleus accumbens, nucleus subthalamicus, and bed nucleus of the stria terminalis) each of which have been reported with a relevant beneficial effect on obsessive-compulsive symptoms. The mechanisms of action are only partially understood but increasing evidence points towards network effects involving the prefrontal cortex, the striatum and possibly anxiety-related anatomical structures. Read More

J Neurol Neurosurg Psychiatry 2018 Aug 25;89(8):886-896. Epub 2018 Jan 25.

Department of Neurosurgery, Baylor College of Medicine, Houston, TX, USA.

Objective: Refractory psychiatric disease is a major cause of morbidity and mortality worldwide, and there is a great need for new treatments. In the last decade, investigators piloted novel deep brain stimulation (DBS)-based therapies for depression and obsessive-compulsive disorder (OCD). Results from recent pivotal trials of these therapies, however, did not demonstrate the degree of efficacy expected from previous smaller trials. Read More

Ann Neurol 2018 02;83(2):352-362

Division of Neurology, Department of Medicine, University Health Network, Toronto, Ontario, Canada.

Objective: Internal globus pallidus (GPi) deep brain stimulation (DBS) relieves symptoms in dystonia patients. However, the physiological effects produced by GPi DBS are not fully understood. In particular, how a single-pulse GPi DBS changes cortical circuits has never been investigated. Read More

JAMA Neurol 2018 Mar;75(3):353-359

Center for Movement Disorders and Neurorestoration, Department of Neurology, University of Florida, Gainesville.

Importance: Collective evidence has strongly suggested that deep brain stimulation (DBS) is a promising therapy for Tourette syndrome.

Objective: To assess the efficacy and safety of DBS in a multinational cohort of patients with Tourette syndrome.

Design, Setting, And Participants: The prospective International Deep Brain Stimulation Database and Registry included 185 patients with medically refractory Tourette syndrome who underwent DBS implantation from January 1, 2012, to December 31, 2016, at 31 institutions in 10 countries worldwide. Read More

World Neurosurg 2018 Mar 20;111:e471-e477. Epub 2017 Dec 20.

Department of Neurosurgery, Hannover Medical School, Hannover, Germany.

Background: Deep brain stimulation (DBS) has been introduced as a treatment option for treatment-resistant obsessive-compulsive disorder (OCD). However, the optimal stimulation target and the corresponding stimulation settings remain unclear. Furthermore, there is limited knowledge about the acute effects of DBS. Read More

Neuromodulation 2018 Aug 20;21(6):532-540. Epub 2017 Dec 20.

Department of Neurology, University Hospital Cologne, Cologne, Germany.

Objective: The optimal timing of subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson's disease (PD) is a topic of ongoing debate. In patients with short disease duration an improvement of quality of life (QoL) has been demonstrated for patients aged younger than 61 years. However, this has not been systematically investigated in older patients yet. Read More

Neuromodulation 2018 Dec 19;21(8):805-808. Epub 2017 Dec 19.

Department of Urology, Toronto Western Hospital, Toronto, Canada.

Introduction: Sacral neuromodulation (SNM) is a safe and effective therapy for patients with lower urinary tract dysfunction (LUTD). It is used in patients who have exhausted conservative and first line therapeutic options. The selection of eligible candidates could predict a successful therapeutic outcome. Read More

Encephale 2018 Apr 11;44(2):183-187. Epub 2017 Dec 11.

CHUM, Notre-Dame, Montréal, QC, Canada; Department of Psychiatry, University of Montréal, h2l 2w5 Montréal, QC, Canada; Neuromodulation unit, CHUM, Montréal, QC, Canada.

Background: Electroconvulsive therapy is indicated in cases of catatonic schizophrenia following a failure of the challenge test with lorazepam or Zolpidem. Some patients need maintenance treatment with ECT. Repetitive Transcranial Magnetic Stimulation (rTMS) and anodal Transcranial direct-current stimulation (tDCS) might be effective against catatonia. Read More

Clin EEG Neurosci 2018 Sep 10;49(5):306-315. Epub 2017 Dec 10.

1 Laboratory of Brain, Behavior, and Pharmacology, TMS Clinical and Research Program, Neuromodulation Division, Semel Institute at UCLA, Los Angeles, CA, USA.

Repetitive transcranial magnetic stimulation (rTMS) has demonstrated efficacy in major depressive disorder (MDD), although clinical outcome is variable. Change in the resting-state quantitative electroencephalogram (qEEG), particularly in theta cordance early in the course of treatment, has been linked to antidepressant medication outcomes but has not been examined extensively in clinical rTMS. This study examined change in theta cordance over the first week of clinical rTMS and sought to identify a biomarker that would predict outcome at the end of 6 weeks of treatment. Read More

World Neurosurg 2018 02 10;110:133-144. Epub 2017 Nov 10.

Department of Neurosurgery, Istanbul University, Cerrahpasa Faculty of Medicine, Istanbul, Turkey.

Background: Recently, neuromodulation through deep brain stimulation (DBS) has appeared as a new surgical procedure in the treatment of some types of dementia and epilepsy. The mammillothalamic and mammillotegmental tracts are involved among the new targets. To our knowledge, a review article focused specifically on these mammillary body efferents is lacking in the medical literature. Read More

JAMA Psychiatry 2018 Jan;75(1):65-74

Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia.

Importance: Lithium is a first-line mood stabilizer for the treatment of bipolar affective disorder (BPAD). However, the efficacy of lithium varies widely, with a nonresponse rate of up to 30%. Biological response markers are lacking. Read More

Clin Neurophysiol 2017 12 16;128(12):2510-2518. Epub 2017 Oct 16.

Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia; Asia Pacific Centre for Neuromodulation, Queensland Brain Institute, Brisbane, Queensland, Australia.

Objectives: Our goal was to provide a detailed analysis of neurons' electrophysiological activity recorded in sub-territories of Globus pallidus internus (GPi) used as Deep Brain Stimulation (DBS) targets for these clinical conditions to potentially assist electrode targeting.

Methods: We used intra-operative microelectrode recording during stereotactic neurosurgery to guide implantation of DBS lead.

Results: Units in the medial anterior part of GPi of 7 Tourette's syndrome patients under general anesthesia were firing at mean and median rate of 32. Read More

Tijdschr Psychiatr 2017;59(10):588-593

Background: Brain stimulation is the most direct form of neuromodulation. Direct brain stimulation is an older procedure that has taken various forms, but 'non-invasive brain stimulation' is a more recent development.

Aim: To provide an overview of the current arsenal of non-invasive brain stimulation techniques. Read More

Brain Stimul 2017 Nov - Dec;10(6):1013-1023. Epub 2017 Aug 24.

Unit of Functional Neurosurgery, Institute of Neurology, University College London, Queen Square, WC1N 3BG, London, UK; Department of Clinical Neuroscience, Umeå University, SE-901 87, Umeå, Sweden. Electronic address:

Background: A treatment for patients suffering from prolonged severely altered consciousness is not available. The success of Deep Brain Stimulation (DBS) in diseases such as Parkinson's, dystonia and essential tremor provided a renewed impetus for its application in Disorders of Consciousness (DoC).

Objective: To evaluate the rationale for DBS in patients with DoC, through systematic review of literature containing clinical data and ethical considerations. Read More

Hum Brain Mapp 2017 12 14;38(12):6107-6117. Epub 2017 Sep 14.

Department of Neurological Surgery, Columbia University Medical Center, New York, New York.

The anterior limb of the internal capsule (ALIC) is an important locus of frontal-subcortical fiber tracts involved in cognitive and limbic feedback loops. However, the structural organization of its component fiber tracts remains unclear. Therefore, although the ALIC is a promising target for various neurosurgical procedures for psychiatric disorders, more precise understanding of its organization is required to optimize target localization. Read More

Mayo Clin Proc 2017 09;92(9):1427-1444

Department of Neurologic Surgery, Mayo Clinic, Rochester, MN; Department of Surgery, Mayo Clinic, Rochester, MN. Electronic address:

Rapid advancements in neurostimulation technologies are providing relief to an unprecedented number of patients affected by debilitating neurologic and psychiatric disorders. Neurostimulation therapies include invasive and noninvasive approaches that involve the application of electrical stimulation to drive neural function within a circuit. This review focuses on established invasive electrical stimulation systems used clinically to induce therapeutic neuromodulation of dysfunctional neural circuitry. Read More

Neurosurg Focus 2017 Sep;43(3):E14

Neurosurgery Unit, Department of Neuroscience and Neurorehabilitation, IRCCS Bambino Gesù Children's Hospital, Rome; and.

Neurological surgery offers an opportunity to study brain functions, through either resection or implanted neuromodulation devices. Pathological aggressive behavior in patients with intellectual disability is a frequent condition that is difficult to treat using either supportive care or pharmacological therapy. The bulk of the laboratory studies performed throughout the 19th century enabled the formulation of hypotheses on brain circuits involved in the generation of emotions. Read More

Neurosurg Focus 2017 Sep;43(3):E8

Department of Neurosurgery.

Neurosurgery for the treatment of psychological disorders has a checkered history in the United States. Prior to the advent of antipsychotic medications, individuals with severe mental illness were institutionalized and subjected to extreme therapies in an attempt to palliate their symptoms. Psychiatrist Walter Freeman first introduced psychosurgery, in the form of frontal lobotomy, as an intervention that could offer some hope to those patients in whom all other treatments had failed. Read More

Curr Opin Psychiatry 2017 Nov;30(6):458-473

King's College London, Department of Psychological Medicine, Section of Eating Disorders, Institute of Psychiatry, Psychology and Neuroscience, London, UK.

Purpose Of Review: Psychological interventions are the treatment of choice for most eating disorders; however, significant proportions of patients do not recover with these. Advances in understanding of the neurobiology of eating disorders have led to the development of targeted treatments, such as deep brain stimulation (DBS), noninvasive brain stimulation (NIBS), and neurofeedback. We review the emerging clinical evidence for the use of these interventions in eating disorders and obesity, together with their theoretical rationale. Read More

Curr Neurol Neurosci Rep 2017 Sep;17(9):68

Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neurosciences, Kings College London, Box PO 70, De Crespigny Park, London, SE5 8AF, UK.

This article reviews current treatment strategies and recent advances for the Lewy body dementias (LBDs). Current available symptom treatment strategies are based on monoaminergic, cholinergic and glutaminergic neurotransmitter systems. Relatively robust evidence exists for cholinesterase inhibitors for cognitive impairment in LBD and in Parkinson's disease for antidepressants, clozapine and recently pimavanserin for psychosis. Read More

Clin Neurophysiol 2017 09 29;128(9):1629-1646. Epub 2017 Jun 29.

Department of Medicine, Surgery and Neuroscience, Section of Human Physiology, University of Siena, Italy; Department of Medicine, Surgery and Neuroscience, Section of Neurology and Clinical Neurophysiology, Brain Investigation & Neuromodulation Lab (Si-BIN Lab), University of Siena, Italy.

The identification of signs of awareness in patients with prolonged disorders of consciousness (DoC) after severe brain injury is a challenging task for clinicians. Differentiating on behavioural examination the vegetative state (VS) from the minimally conscious state (MCS) can lead to a high misdiagnosis rate. Advanced neuroimaging and neurophysiological techniques can supplement clinical evaluation by providing physiological evidence of brain activity. Read More

Clin Neurophysiol 2017 09 19;128(9):1774-1809. Epub 2017 Jun 19.

Department of Clinical Neurophysiology, University Medical Center Göttingen, Georg August University, Göttingen, Germany.

Low intensity transcranial electrical stimulation (TES) in humans, encompassing transcranial direct current (tDCS), transcutaneous spinal Direct Current Stimulation (tsDCS), transcranial alternating current (tACS), and transcranial random noise (tRNS) stimulation or their combinations, appears to be safe. No serious adverse events (SAEs) have been reported so far in over 18,000 sessions administered to healthy subjects, neurological and psychiatric patients, as summarized here. Moderate adverse events (AEs), as defined by the necessity to intervene, are rare, and include skin burns with tDCS due to suboptimal electrode-skin contact. Read More

Neuromodulation 2018 Feb 27;21(2):184-190. Epub 2017 Jun 27.

Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany.

Objectives: First reports on the application of deep brain stimulation (DBS) of the Nucleus basalis of Meynert (NBM) showed feasibility and safety of the intervention in patients with Alzheimer´s disease. However, clinical effects vary and the mechanisms of actions are still not well understood. The aim of this study was to characterize neuroimaging changes that are associated with the responsiveness to the treatment. Read More

J Alzheimers Dis 2017 ;58(4):1065-1076

Berenson-Allen Center for Non-invasive Brain Stimulation, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.

Seizures occur at a higher frequency in people with Alzheimer's disease (AD) but overt, clinically obvious events are infrequent. Evidence from animal models and studies in mild cognitive impairment suggest that subclinical epileptic discharges may play a role in the clinical and pathophysiological manifestations of AD. In this feasibility study, the neurophysiological and cognitive effects of acute administration of levetiracetam (LEV) are measured in patients with mild AD to test whether it could have a therapeutic benefit. Read More

Int Rev Psychiatry 2017 04 10;29(2):191-204. Epub 2017 Feb 10.

a Department of Psychiatry , Massachusetts General Hospital , Charlestown , MA , USA.

Despite deep brain stimulation's positive early results in psychiatric disorders, well-designed clinical trials have yielded inconsistent clinical outcomes. One path to more reliable benefit is closed-loop therapy: stimulation that is automatically adjusted by a device or algorithm in response to changes in the patient's electrical brain activity. These interventions may provide more precise and patient-specific treatments. Read More