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- W287596475 abstract "Chronic electrical stimulation of the brain, known as the deep brain stimulation (DBS), has become the preferred surgical treatment for advanced Parkinson's disease (PD). Despite its remarkable clinical success, the therapeutic mechanisms of DBS are still not completely understood, limiting opportunities to improve treatment efficacy and simplify selection of stimulation parameters. This chapter discusses three questions essential to understanding the mechanisms of DBS: (1) How does DBS affect individual neurons in the region around the electrode? (2) What are the neural elements that mediate the therapeutic effect of DBS? (3) How does DBS affect the cortico-thalamo-basal ganglia network? Results from electrophysiological experiments, biochemical analyses, computer modeling and imaging studies are integrated to provide an up to date understanding of DBS mechanisms. Early hypotheses proposed that stimulation inhibited neuronal activity at the site of stimulation, mimicking the effect of lesioning. Recent studies have challenged that view and suggested that while somatic activity near the DBS electrode is decreased by synaptic inhibition, DBS increases output from the stimulated nucleus by directly activating the axons of the local projection neurons. As a result, their intrinsic activity is replaced by high-frequency activity that is time-locked to the stimulus and more regular in pattern. The stimulation induced change in neuronal pattern prevents transmission of pathologic bursting and oscillatory activity within the basal ganglia network resulting in improved processing of sensorimotor information and reduction of disease symptoms. In addition to the targeted nucleus, surrounding structures are also stimulated by subthalamic DBS, which may contribute to its therapeutic effect." @default.
- W287596475 created "2016-06-24" @default.
- W287596475 creator A5047447270 @default.
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- W287596475 creator A5078820692 @default.
- W287596475 creator A5083835604 @default.
- W287596475 date "2008-01-01" @default.
- W287596475 modified "2023-09-26" @default.
- W287596475 title "Mechanisms of Deep Brain Stimulation" @default.
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