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Journal of Neural Transmission

, Volume 123, Issue 7, pp 797–806 | Cite as

Central thalamic deep brain stimulation to support anterior forebrain mesocircuit function in the severely injured brain

Neurology and Preclinical Neurological Studies - Original Article

Abstract

This integrative review frames a general rationale for the use of central thalamic deep brain stimulation (CT-DBS) to support arousal regulation mechanisms in the severely injured brain. The organizing role of the anterior forebrain mesocircuit in recovery mechanisms following widespread deafferentation produced by multi-focal structural brain injuries is emphasized. The mesocircuit model provides the conceptual foundation for the key role of the central thalamus as a privileged node for neuromodulation to support forebrain arousal regulation. In this context, cellular mechanisms arising at the neocortical, striatal, and thalamic population level are considered in the assessment of an individual patient’s capacity for harboring underlying reserve that could be recruited for further recovery. Recent preclinical studies and pilot clinical results are compared to frame the detailed rationale for CT-DBS. Application of CT-DBS across the range of outcomes following severe-to-moderate brain injuries is discussed with the aim of improving consciousness and cognition in patients with non-progressive brain injuries.

Keywords

Mesocircuit Severe-to-moderate traumatic brain injury Consciousness Intralaminar nuclei Executive function impairment 

Notes

Compliance with ethical standards

Conflicts of interest

None.

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Copyright information

© Springer-Verlag Wien 2016

Authors and Affiliations

  1. 1.Jerold B. Katz Professor of Neurology and Neuroscience, Laboratory of Cognitive Neuromodulation, Weill Cornell Medical CollegeNew YorkUSA

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