18 March 2008

Deep brain stimulation papers 3

The hypothalamus, apparently a common deep brain stimulation (DBS) target in the treatment of cluster headaches (CH), has also been tried for facial pain, obesity, and aggression. The lateral portion of the hypothalamus contains a segment of the medial forebrain bundle (MFB) and is exceptionally supportive of brain stimulation reward (BSR).

Obesity

Sani et al (2007) DBS for treatment of obesity in rats. Rush University Medical Center. DBS of the lateral hypothalamus decreased food intake in rats. Interestingly, the authors use 0.25mm diameter bipolar electrodes.

Lacan et al (2008) Modulation of food intake following DBS of the ventromedial hypothalamus in the vervet monkey. Laboratory investigation. David Geffen School of Medicine at UCLA. Bilateral DBS of the ventromedial hypothalamus increased food intake in two vervet monkeys.

Hamani et al (2008) Memory enhancement induced by hypothalamuc/fornix DBS. University of Toronto. Hypothalamic DBS inadvertently triggered strong recall.

Aggression

Franzini et al (2007) Chronic high frequency stimulation of the posteromedial hypothalamus in fascial pain syndromes and behaviour disorders. Instituto Nazionale Neurologico Carlo Besta. Posteromedial hypothalamus DBS as a treatment for aggression.

Franzini et al (2005) Stimulation of the posterior hypothalamus for medically intractable impulsive and violent behavior. Instituto Nazionale Neurologico Carlo Besta. Posterior hypothalamus DBS effective treatment for aggression in two patients.

Cluster headache

Vetrugno et al (2007) Effect on sleep of posterior hypothalamus stimulation in CH. University of Bologna. Posterior hypothalamus DBS improved sleep in three CH patients and had no effect on body temperature.

Starr (2007) Chronic stimulation of the posterior hypothalamuc region for CH: technique and 1-year results in four patients. University of California at San Francisco. Posterior hypothalamus DBS produced a 50% reduction in CH intensity/frequency in two of four patients.

Bussone et al (2007) DBS in craniofascial pain: seven years' experience. Fondazione IRCCS Instituto Neurologico Carlo Besta. Posterior inferior hypothalamus DBS resulted in a persistent pain-free or almost pain-free state in 13 of 16 treatment-resistent CH patients. (a similar paper from the same group here.)

May et al (2006) Hypothalamic DBS in positron emission tomography. University of Hamburg. The authors argue against a simple inhibition based model of hypothalamic DBS in CH treatment.

Schoenen et al (2005) Hypothalamic stimulation in chronic cluster headache: a pilot study of efficacy and mode of action. CHR Citadelle. Out of six patients ventroposterior hypothalamus DBS is highly effective in three cases, fatal in one.

Miscellaneous

Cortelli et al (2007) Effect of DBS of the posterior hypothalamic area on the cardiovascular system in chronic CH patients. University of Bologna. Posterior hypothalamic DBS is associated with certain cardiovascular changes.

Cordella et al (2007) Spontaneous neuronal activity of the posterior hypothalamus in trigeminal autonomic cephalalgias. Fondazione IRCCS, Istituto Nazionale Neurologico C. The authors seems to have used the DBS electrodes of three patients to record the activity (24 spikes/s, random, tonic) of a handful of neurons in the posterior hypothalamus. Did not know you could just do that.
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