Personalized “Brain Maps” May Help Improve Deep Brain Stimulation
Not everyone’s brain connections map at precisely the same location, which may explain why deep brain stimulation (DBS) therapy, used for treating severe cases of Parkinson’s, works for some patients and not for others.
Brain mapping could help doctors choose where in the brain to implant electrodes for DBS.
DBS is a surgical procedure in which electric stimulators are placed at target regions inside the brain to relieve Parkinson’s motor symptoms.
The procedure is typically reserved for people who have had the disease for at least four years and whose motor symptoms cannot be adequately controlled by medication.
While symptoms such as stiffness, slowness, and tremor can be decreased, the procedure is not entirely effective enough to resolve imbalance, freezing and other non-motor symptoms.
While this surgical procedure can be transformative for some, for others, it causes side effects that outweigh the benefits, including cognitive or memory problems.
Researchers have now mapped specific circuits in the brain using magnetic resonance imaging (MRI) and found that each person’s brain networks position a bit differently.
This may help explain why the effects of DBS vary so much from person to person and point to a possible way of improving the treatment.
Why Use Brain Mapping?
After scanning the brains of ten individual who were healthy, researchers could manage to form three-dimensional maps of the functional networks that run through structures located deep within the brain.
The regions that the researchers focused on are usually targeted by DBS and known as the thalamus and the basal ganglia.
Researchers discovered that the distinct networks that control vision, movement, attention, goal-oriented behaviours and the brain’s default resting state, intermingle and share information at nine hubs inside the basal ganglia and thalamus.
As each person’s functional networks can be positioned a bit differently, when DBS electrodes are placed in the same anatomical spot, they may yet influence different functions in different people.
Some networks such as the motor integration zone, where the control of movement and goal-directed behaviour share paths are “consistently successful sites of deep brain stimulation,” the researchers wrote.
What Now for DBS Research?
The research team is now exploring ways of using each person’s brain map to personalize the best regions to target to provide relief while avoiding side effects.
Researchers also want to look for other brain spots that might provide even better results.
What this study suggests is that a particular patient may do better if the wire is placed in relation to their personal functional brain map rather than in the context of the population average.
A personalized functional map — as opposed to an anatomical map, which is what is currently used — could help neurosurgeons place a wire in the exact place that could potentially provide the patient with the most benefit.
SOURCE: Neuron Journal, “Integrative and Network-Specific Connectivity of the Basal Ganglia and Thalamus Defined in Individuals”
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