Revolutionizing treatment for disorders of consciousness: a multidisciplinary review of advancements in deep brain stimulation

Abstract Among the existing research on the treatment of disorders of consciousness (DOC), deep brain stimulation (DBS) offers a highly promising therapeutic approach. This comprehensive review documents the historical development of DBS and its role in the treatment of DOC, tracing its progression...

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Main Authors: Yi Yang, Tian-Qing Cao, Sheng-Hong He, Lu-Chen Wang, Qi-Heng He, Ling-Zhong Fan, Yong-Zhi Huang, Hao-Ran Zhang, Yong Wang, Yuan-Yuan Dang, Nan Wang, Xiao-Ke Chai, Dong Wang, Qiu-Hua Jiang, Xiao-Li Li, Chen Liu, Shou-Yan Wang
Format: Article
Language:English
Published: BMC 2024-12-01
Series:Military Medical Research
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Online Access:https://doi.org/10.1186/s40779-024-00585-w
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author Yi Yang
Tian-Qing Cao
Sheng-Hong He
Lu-Chen Wang
Qi-Heng He
Ling-Zhong Fan
Yong-Zhi Huang
Hao-Ran Zhang
Yong Wang
Yuan-Yuan Dang
Nan Wang
Xiao-Ke Chai
Dong Wang
Qiu-Hua Jiang
Xiao-Li Li
Chen Liu
Shou-Yan Wang
author_facet Yi Yang
Tian-Qing Cao
Sheng-Hong He
Lu-Chen Wang
Qi-Heng He
Ling-Zhong Fan
Yong-Zhi Huang
Hao-Ran Zhang
Yong Wang
Yuan-Yuan Dang
Nan Wang
Xiao-Ke Chai
Dong Wang
Qiu-Hua Jiang
Xiao-Li Li
Chen Liu
Shou-Yan Wang
author_sort Yi Yang
collection DOAJ
description Abstract Among the existing research on the treatment of disorders of consciousness (DOC), deep brain stimulation (DBS) offers a highly promising therapeutic approach. This comprehensive review documents the historical development of DBS and its role in the treatment of DOC, tracing its progression from an experimental therapy to a detailed modulation approach based on the mesocircuit model hypothesis. The mesocircuit model hypothesis suggests that DOC arises from disruptions in a critical network of brain regions, providing a framework for refining DBS targets. We also discuss the multimodal approaches for assessing patients with DOC, encompassing clinical behavioral scales, electrophysiological assessment, and neuroimaging techniques methods. During the evolution of DOC therapy, the segmentation of central nuclei, the recording of single-neurons, and the analysis of local field potentials have emerged as favorable technical factors that enhance the efficacy of DBS treatment. Advances in computational models have also facilitated a deeper exploration of the neural dynamics associated with DOC, linking neuron-level dynamics with macroscopic behavioral changes. Despite showing promising outcomes, challenges remain in patient selection, precise target localization, and the determination of optimal stimulation parameters. Future research should focus on conducting large-scale controlled studies to delve into the pathophysiological mechanisms of DOC. It is imperative to further elucidate the precise modulatory effects of DBS on thalamo-cortical and cortico-cortical functional connectivity networks. Ultimately, by optimizing neuromodulation strategies, we aim to substantially enhance therapeutic outcomes and greatly expedite the process of consciousness recovery in patients.
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spelling doaj-art-3c7737dc5cfa4bda92a78d7b6646174b2024-12-22T12:22:19ZengBMCMilitary Medical Research2054-93692024-12-0111112510.1186/s40779-024-00585-wRevolutionizing treatment for disorders of consciousness: a multidisciplinary review of advancements in deep brain stimulationYi Yang0Tian-Qing Cao1Sheng-Hong He2Lu-Chen Wang3Qi-Heng He4Ling-Zhong Fan5Yong-Zhi Huang6Hao-Ran Zhang7Yong Wang8Yuan-Yuan Dang9Nan Wang10Xiao-Ke Chai11Dong Wang12Qiu-Hua Jiang13Xiao-Li Li14Chen Liu15Shou-Yan Wang16Department of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityMedical Research Council Brain Network Dynamics Unit, Nuffield Department of Clinical Neurosciences, University of OxfordInstitute of Science and Technology for Brain-Inspired Intelligence, Fudan UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityNational Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of SciencesInstitute of Medical Engineering and Translational Medicine, Tianjin UniversityNational Laboratory of Pattern Recognition, Institute of Automation, Chinese Academy of SciencesState Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal UniversityDepartment of Neurosurgery, Chinese PLA General HospitalDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Beijing Tiantan Hospital, Capital Medical UniversityDepartment of Neurosurgery, Ganzhou People’s HospitalDepartment of Neurosurgery, Ganzhou People’s HospitalSchool of Automation Science and Engineering, South China University of TechnologySchool of Electrical and Information Engineering, Tianjin UniversityInstitute of Science and Technology for Brain-Inspired Intelligence, Fudan UniversityAbstract Among the existing research on the treatment of disorders of consciousness (DOC), deep brain stimulation (DBS) offers a highly promising therapeutic approach. This comprehensive review documents the historical development of DBS and its role in the treatment of DOC, tracing its progression from an experimental therapy to a detailed modulation approach based on the mesocircuit model hypothesis. The mesocircuit model hypothesis suggests that DOC arises from disruptions in a critical network of brain regions, providing a framework for refining DBS targets. We also discuss the multimodal approaches for assessing patients with DOC, encompassing clinical behavioral scales, electrophysiological assessment, and neuroimaging techniques methods. During the evolution of DOC therapy, the segmentation of central nuclei, the recording of single-neurons, and the analysis of local field potentials have emerged as favorable technical factors that enhance the efficacy of DBS treatment. Advances in computational models have also facilitated a deeper exploration of the neural dynamics associated with DOC, linking neuron-level dynamics with macroscopic behavioral changes. Despite showing promising outcomes, challenges remain in patient selection, precise target localization, and the determination of optimal stimulation parameters. Future research should focus on conducting large-scale controlled studies to delve into the pathophysiological mechanisms of DOC. It is imperative to further elucidate the precise modulatory effects of DBS on thalamo-cortical and cortico-cortical functional connectivity networks. Ultimately, by optimizing neuromodulation strategies, we aim to substantially enhance therapeutic outcomes and greatly expedite the process of consciousness recovery in patients.https://doi.org/10.1186/s40779-024-00585-wDeep brain stimulationDisorders of consciousnessSegmentation of thalamic nucleiLocal field potentialsComputational modeling
spellingShingle Yi Yang
Tian-Qing Cao
Sheng-Hong He
Lu-Chen Wang
Qi-Heng He
Ling-Zhong Fan
Yong-Zhi Huang
Hao-Ran Zhang
Yong Wang
Yuan-Yuan Dang
Nan Wang
Xiao-Ke Chai
Dong Wang
Qiu-Hua Jiang
Xiao-Li Li
Chen Liu
Shou-Yan Wang
Revolutionizing treatment for disorders of consciousness: a multidisciplinary review of advancements in deep brain stimulation
Military Medical Research
Deep brain stimulation
Disorders of consciousness
Segmentation of thalamic nuclei
Local field potentials
Computational modeling
title Revolutionizing treatment for disorders of consciousness: a multidisciplinary review of advancements in deep brain stimulation
title_full Revolutionizing treatment for disorders of consciousness: a multidisciplinary review of advancements in deep brain stimulation
title_fullStr Revolutionizing treatment for disorders of consciousness: a multidisciplinary review of advancements in deep brain stimulation
title_full_unstemmed Revolutionizing treatment for disorders of consciousness: a multidisciplinary review of advancements in deep brain stimulation
title_short Revolutionizing treatment for disorders of consciousness: a multidisciplinary review of advancements in deep brain stimulation
title_sort revolutionizing treatment for disorders of consciousness a multidisciplinary review of advancements in deep brain stimulation
topic Deep brain stimulation
Disorders of consciousness
Segmentation of thalamic nuclei
Local field potentials
Computational modeling
url https://doi.org/10.1186/s40779-024-00585-w
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