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Thalamic deep brain stimulation in traumatic brain injury: a phase 1, randomized feasibility study.

作者信息

Schiff Nicholas D, Giacino Joseph T, Butson Christopher R, Choi Eun Young, Baker Jonathan L, O'Sullivan Kyle P, Janson Andrew P, Bergin Michael, Bronte-Stewart Helen M, Chua Jason, DeGeorge Laurel, Dikmen Sureyya, Fogarty Adam, Gerber Linda M, Krel Mark, Maldonado Jose, Radovan Matthew, Shah Sudhin A, Su Jason, Temkin Nancy, Tourdias Thomas, Victor Jonathan D, Waters Abigail, Kolakowsky-Hayner Stephanie A, Fins Joseph J, Machado Andre G, Rutt Brian K, Henderson Jaimie M

机构信息

Feil Family Brain Mind Institute, Weill Cornell Medicine, New York, NY, USA.

Department of Neurology, Weill Cornell Medicine, New York, NY, USA.

出版信息

Nat Med. 2023 Dec;29(12):3162-3174. doi: 10.1038/s41591-023-02638-4. Epub 2023 Dec 4.


DOI:10.1038/s41591-023-02638-4
PMID:38049620
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11087147/
Abstract

Converging evidence indicates that impairments in executive function and information-processing speed limit quality of life and social reentry after moderate-to-severe traumatic brain injury (msTBI). These deficits reflect dysfunction of frontostriatal networks for which the central lateral (CL) nucleus of the thalamus is a critical node. The primary objective of this feasibility study was to test the safety and efficacy of deep brain stimulation within the CL and the associated medial dorsal tegmental (CL/DTTm) tract.Six participants with msTBI, who were between 3 and 18 years post-injury, underwent surgery with electrode placement guided by imaging and subject-specific biophysical modeling to predict activation of the CL/DTTm tract. The primary efficacy measure was improvement in executive control indexed by processing speed on part B of the trail-making test.All six participants were safely implanted. Five participants completed the study and one was withdrawn for protocol non-compliance. Processing speed on part B of the trail-making test improved 15% to 52% from baseline, exceeding the 10% benchmark for improvement in all five cases.CL/DTTm deep brain stimulation can be safely applied and may improve executive control in patients with msTBI who are in the chronic phase of recovery.ClinicalTrials.gov identifier: NCT02881151 .

摘要

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[9]
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本文引用的文献

[1]
Subject and Family Perspectives from the Central Thalamic Deep Brain Stimulation for Traumatic Brain Injury Study: Part I.

Camb Q Healthc Ethics. 2022-10

[2]
Longitudinal alterations in gamma-aminobutyric acid (GABA) receptor availability over ∼ 1 year following traumatic brain injury.

Brain Commun. 2022-6-15

[3]
Deep brain stimulation of the thalamus restores signatures of consciousness in a nonhuman primate model.

Sci Adv. 2022-3-18

[4]
Selective activation of central thalamic fiber pathway facilitates behavioral performance in healthy non-human primates.

Sci Rep. 2021-11-29

[5]
Thalamic circuits for independent control of prefrontal signal and noise.

Nature. 2021-12

[6]
The Traumatic Brain Injury Model Systems National Database: A Review of Published Research.

Neurotrauma Rep. 2021-3-12

[7]
Neural effects of propofol-induced unconsciousness and its reversal using thalamic stimulation.

Elife. 2021-4-27

[8]
Patterns of Functional Change Five to Ten Years after Moderate-Severe Traumatic Brain Injury.

J Neurotrauma. 2021-6-1

[9]
A Manual for the Glasgow Outcome Scale-Extended Interview.

J Neurotrauma. 2021-9-1

[10]
The subcortical basis of outcome and cognitive impairment in TBI: A longitudinal cohort study.

Neurology. 2020-9-9

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