Deep Brain Stimulation of the Basolateral Amygdala: Targeting Technique and Electrodiagnostic Findings
The amygdala plays a critical role in emotion regulation. It could prove to be an effective neuromodulation target in the treatment of psychiatric conditions characterized by failure of extinction. We aim to describe our targeting technique, and intra-operative and post-operative electrodiagnostic f...
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| Format: | Article |
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MDPI AG
2016-08-01
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| Series: | Brain Sciences |
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| Online Access: | http://www.mdpi.com/2076-3425/6/3/28 |
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| author | Jean-Philippe Langevin James W. Y. Chen Ralph J. Koek David L. Sultzer Mark A. Mandelkern Holly N. Schwartz Scott E. Krahl |
| author_facet | Jean-Philippe Langevin James W. Y. Chen Ralph J. Koek David L. Sultzer Mark A. Mandelkern Holly N. Schwartz Scott E. Krahl |
| author_sort | Jean-Philippe Langevin |
| collection | DOAJ |
| description | The amygdala plays a critical role in emotion regulation. It could prove to be an effective neuromodulation target in the treatment of psychiatric conditions characterized by failure of extinction. We aim to describe our targeting technique, and intra-operative and post-operative electrodiagnostic findings associated with the placement of deep brain stimulation (DBS) electrodes in the amygdala. We used a transfrontal approach to implant DBS electrodes in the basolateral nucleus of the amygdala (BLn) of a patient suffering from severe post-traumatic stress disorder. We used microelectrode recording (MER) and awake intra-operative neurostimulation to assist with the placement. Post-operatively, the patient underwent monthly surveillance electroencephalograms (EEG). MER predicted the trajectory of the electrode through the amygdala. The right BLn showed a higher spike frequency than the left BLn. Intra-operative neurostimulation of the BLn elicited pleasant memories. The monthly EEG showed the presence of more sleep patterns over time with DBS. BLn DBS electrodes can be placed using a transfrontal approach. MER can predict the trajectory of the electrode in the amygdala and it may reflect the BLn neuronal activity underlying post-traumatic stress disorder PTSD. The EEG findings may underscore the reduction in anxiety. |
| first_indexed | 2024-12-10T11:28:57Z |
| format | Article |
| id | doaj.art-81d60791f0cb43b3aa17997d061d9f8e |
| institution | Directory Open Access Journal |
| issn | 2076-3425 |
| language | English |
| last_indexed | 2024-12-10T11:28:57Z |
| publishDate | 2016-08-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Brain Sciences |
| spelling | doaj.art-81d60791f0cb43b3aa17997d061d9f8e2022-12-22T01:50:39ZengMDPI AGBrain Sciences2076-34252016-08-01632810.3390/brainsci6030028brainsci6030028Deep Brain Stimulation of the Basolateral Amygdala: Targeting Technique and Electrodiagnostic FindingsJean-Philippe Langevin0James W. Y. Chen1Ralph J. Koek2David L. Sultzer3Mark A. Mandelkern4Holly N. Schwartz5Scott E. Krahl6Neurosurgery Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USANeurology Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USAPsychiatry and Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USAPsychiatry and Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USARadiology Service, Nuclear Medicine VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USAPsychiatry and Mental Health Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USAResearch and Development Service, VA Greater Los Angeles Healthcare System, Los Angeles, CA 90073, USAThe amygdala plays a critical role in emotion regulation. It could prove to be an effective neuromodulation target in the treatment of psychiatric conditions characterized by failure of extinction. We aim to describe our targeting technique, and intra-operative and post-operative electrodiagnostic findings associated with the placement of deep brain stimulation (DBS) electrodes in the amygdala. We used a transfrontal approach to implant DBS electrodes in the basolateral nucleus of the amygdala (BLn) of a patient suffering from severe post-traumatic stress disorder. We used microelectrode recording (MER) and awake intra-operative neurostimulation to assist with the placement. Post-operatively, the patient underwent monthly surveillance electroencephalograms (EEG). MER predicted the trajectory of the electrode through the amygdala. The right BLn showed a higher spike frequency than the left BLn. Intra-operative neurostimulation of the BLn elicited pleasant memories. The monthly EEG showed the presence of more sleep patterns over time with DBS. BLn DBS electrodes can be placed using a transfrontal approach. MER can predict the trajectory of the electrode in the amygdala and it may reflect the BLn neuronal activity underlying post-traumatic stress disorder PTSD. The EEG findings may underscore the reduction in anxiety.http://www.mdpi.com/2076-3425/6/3/28amygdalabasolateral nucleusdeep brain stimulationmicroelectrode recordingPTSDtargeting technique |
| spellingShingle | Jean-Philippe Langevin James W. Y. Chen Ralph J. Koek David L. Sultzer Mark A. Mandelkern Holly N. Schwartz Scott E. Krahl Deep Brain Stimulation of the Basolateral Amygdala: Targeting Technique and Electrodiagnostic Findings Brain Sciences amygdala basolateral nucleus deep brain stimulation microelectrode recording PTSD targeting technique |
| title | Deep Brain Stimulation of the Basolateral Amygdala: Targeting Technique and Electrodiagnostic Findings |
| title_full | Deep Brain Stimulation of the Basolateral Amygdala: Targeting Technique and Electrodiagnostic Findings |
| title_fullStr | Deep Brain Stimulation of the Basolateral Amygdala: Targeting Technique and Electrodiagnostic Findings |
| title_full_unstemmed | Deep Brain Stimulation of the Basolateral Amygdala: Targeting Technique and Electrodiagnostic Findings |
| title_short | Deep Brain Stimulation of the Basolateral Amygdala: Targeting Technique and Electrodiagnostic Findings |
| title_sort | deep brain stimulation of the basolateral amygdala targeting technique and electrodiagnostic findings |
| topic | amygdala basolateral nucleus deep brain stimulation microelectrode recording PTSD targeting technique |
| url | http://www.mdpi.com/2076-3425/6/3/28 |
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