934 lines
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68 KiB
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<meta name="description" content="Two BRAIN-funded studies in small groups of individuals demonstrate inclusion of DBS in therapy may improve treatment. A third BRAIN-supported paper explores questions regarding posttrial needs of study participants living with neural implanted devices and highlights the importance of integrating a neuroethical strategy from the beginning of a research project." />
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<h1 class="title"><span class="field field--name-title field--type-string field--label-hidden">Deep brain stimulation shows potential for post-stroke rehabilitation and depression recovery</span>
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<div class="field field--name-field-simple-date field--type-datetime field--label-hidden field__item"><time datetime="2023-09-29T12:00:00Z" class="datetime">September 29, 2023</time>
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<div class="clearfix text-formatted field field--name-body field--type-text-with-summary field--label-hidden field__item"><p><em>Two BRAIN-funded studies in small groups of individuals demonstrate inclusion of DBS in therapy may improve treatment. </em><em>A third BRAIN-supported paper explores questions regarding posttrial needs of study participants living with neural implanted devices and highlights the importance of integrating a neuroethical strategy from the beginning of a research project.</em></p>
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<p>Deep brain stimulation (DBS) is a neurosurgical procedure that involves implanting tiny wires into specific areas of the brain to treat various disorders and diseases. Since its initial approval in the late 1990’s to treat tremors associated with certain <a href="https://www.ninds.nih.gov/about-ninds/impact/ninds-contributions-approved-therapies/deep-brain-stimulation-dbs-treatment-parkinsons-disease-and-other-movement-disorders">neurological diseases</a>, DBS has been expanded to many more disorders. The National Institutes of Health (NIH)’s <em>Brain Research Through Advancing Innovative Neurotechnologies</em>® Initiative, or The BRAIN Initiative®, is at the forefront of supporting the acceleration of neurotechnologies, like DBS. The NIH BRAIN Initiative aims to improve our understanding of the human brain and ensure that the ethical considerations that accompany these studies are thoughtfully integrated. Specifically, two separate studies that were funded by the NIH BRAIN Initiative demonstrate how DBS can be incorporated into clinical settings—one study explored the safety and feasibility of DBS in post-stroke therapy and a second study examined the benefit of DBS as a potential treatment for individuals living with treatment-resistant depression. </p>
|
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<p><strong>Cerebellar post-stroke deep brain stimulation appears safe and feasible in a small trial</strong></p>
|
||
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<p>Stroke is a common physical and neurologically debilitating disease impacting nearly 800,000 Americans each year that is caused by the interruption of blood flow to the brain. In a study published last month in Nature Medicine, an in-human phase I trial to treat post-stroke motor deficits at the Cleveland Clinic Main Campus observed that continual DBS delivered to the dentate nucleus (DN), a cluster of neurons within the cerebellum, was safe and feasible [1]. In this study, twelve individuals with moderate-to-severe upper limb impairment received DBS for four-to-eight months with physical therapy prior, during, and after stimulation. Improvements were even seen in participants who were as much as three years removed from their stroke, which is well outside the time window typically associated with functional recovery. Specifically, nine of the twelve participants showed improved motor function, which aligned with having some preservation of motor function post-stroke. The findings of this trial, while preliminary, suggest that the addition of DBS to physical therapy post-stroke is promising and informative for subsequent larger randomized-controlled studies. Read more about this <a href="https://www.ninds.nih.gov/news-events/press-releases/cerebellar-post-stroke-deep-brain-stimulation-appears-safe-and-feasible-small-trial">DBS study</a> here. </p>
|
||
|
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<p><strong>Researchers discover biomarker for tracking depression recovery</strong></p>
|
||
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<p>Recently published last week, a novel experimental study for treatment-resistant depression conducted at Emory University, Georgia Institute of Technology, and the Icahn School of Medicine at Mount Sinai found that DBS coupled with an artificial intelligence (AI) recording tool identified a brain activity signature, known as a biomarker [2]. Treatment-resistant depression is a type of major depressive disorder (MDD) that is unresponsive to at least two different antidepressants and effects 30% of individuals diagnosed with it. In this study, ten participants with treatment-resistant depression received the same stimulation to start, which became personalized across a 6-month period that was targeted to the subcallosal cingulate cortex (SCC), a brain region involved in emotional behavior. Nine of the ten participants demonstrated significant clinical response, while 70% achieved treatment-resistant depression remission. The use of AI tools to observe a treatment-resistant depression biomarker before and after DBS provides an objective neurotechnology that can improve the treatment of a traditionally subjectively and variable clinical disorder. For more about this study, read the <a href="https://www.ninds.nih.gov/news-events/press-releases/researchers-discover-biomarker-tracking-depression-recovery">press release</a>. </p>
|
||
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<p><strong>Continuing trial responsibilities for implantable neural devices</strong></p>
|
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<p>The NIH BRAIN Initiative supports research projects that examine the neuroethical and societal implications of BRAIN-funded tools and technologies, such as DBS. A portion of a multi-part strategy that seeks to achieve proactive management and ongoing assessment of the neuroethical implications of BRAIN-supported work includes the neuroethical considerations researchers should examine regarding continuing responsibilities to participants of implanted neural device trials, after the trial has ended. A new paper, highlighted in a recent <a href="https://braininitiative.nih.gov/news-events/blog/continuing-trial-responsibilities-implantable-neural-devices">BRAIN Blog post</a> and published in Neuron, takes an in-depth look at the posttrial needs of study participants, including posttrial-associated care, continued access to the device and maintenance, and/or removal of the device [3]. The authors suggest several strategies for approaching posttrial needs, along with specific points to consider when planning a trial. To further explore the details of these recommendations, read the complete article in <a href="https://www.sciencedirect.com/science/article/pii/S089662732300541X?dgcid=author">Neuron</a>.</p>
|
||
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<p>Together, these BRAIN-funded studies highlight how expanding the use of DBS neurotechnology may have a direct impact on human health, with the potential to treat brain disorders and diseases. As these technologies continue to advance, BRAIN is also leading the way in ensuring that neuroethical questions that may arise in human studies and posttrial care are well integrated with the science. </p>
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||
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||
<p>References</p>
|
||
|
||
<p>[1] Baker KB, et al. “Cerebellar deep brain stimulation for chronic post-stroke motor rehabilitation: a phase I trial.” August 14, 2023. Nature Medicine. DOI: <a href="https://www.nature.com/articles/s41591-023-02507-0">10.1038/s41591-023-02507-0</a></p>
|
||
|
||
<p>[2] Alagapan, S, et al. “Cingulate dynamics track depression recovery with deep brain stimulation.” September 20, 2023. Nature. DOI: <a href="https://www.nature.com/articles/s41586-023-06541-3">10.1038/s41586-023-06541-3</a></p>
|
||
|
||
<p>[3] Hendriks, S, et al. "Continuing trial responsibilities for implantable neural devices." August 14, 2023. Neuron. DOI: <a href="https://doi.org/10.1016/j.neuron.2023.07.008">https://doi.org/10.1016/j.neuron.2023.07.008</a> </p></div>
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<span id="webform-submission-subscription-webform-node-3147-form-ajax-content"></span><div id="webform-submission-subscription-webform-node-3147-form-ajax" class="webform-ajax-form-wrapper" data-effect="fade" data-progress-type="fullscreen">
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<input data-drupal-selector="edit-subscription" type="hidden" name="subscription" value="blog_entry" class="form-control" />
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<input data-drupal-selector="edit-subscription-name" type="hidden" name="subscription_name" value="The BRAIN Blog" class="form-control" />
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<div class="recaptcha_container js-form-wrapper form-group" data-sitekey="6LdBRjgeAAAAAMxQXlEJoHa3fp0iQH54b61cqiCy" data-drupal-selector="edit-recaptcha-container" id="edit-recaptcha-container"></div>
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<div class="col-lg-8 col-12 js-form-wrapper form-group" data-drupal-selector="edit-left-content" id="edit-left-content">
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<fieldset id="edit-content" class="js-form-item js-form-type-processed-text form-type-processed-text js-form-item- form-item- form-no-label form-group">
|
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<h2><a href="/news-events/blog">Latest from The BRAIN Blog</a></h2>
|
||
|
||
<p>The BRAIN Blog covers updates and announcements on BRAIN Initiative research, events, and news. </p>
|
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|
||
<p>Hear from BRAIN Initiative trainees, learn about new scientific advancements, and find out about recent funding opportunities by visiting The BRAIN Blog.</p>
|
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</fieldset>
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</div>
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<div class="col-lg-4 no-gutter d-lg-flex d-none js-form-wrapper form-group" data-drupal-selector="edit-right-content" id="edit-right-content">
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<fieldset id="edit-image" class="js-form-item js-form-type-processed-text form-type-processed-text js-form-item- form-item- form-no-label form-group">
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<source srcset="/sites/default/files/styles/full_width_small/public/2023-07/brain_blog_image_2x.jpg?itok=bfbKqZe6 1x" media="all and (min-width: 34em) and (max-width: 47.99em)" type="image/jpeg" width="440" height="440">
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<img loading="eager" src="/sites/default/files/styles/full_width_small/public/2023-07/brain_blog_image_2x.jpg?itok=bfbKqZe6" width="440" height="440" alt="black and white image of people working on laptops at a counter height table on stools at the annual BRAIN meeting">
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</picture>
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<input data-drupal-selector="form-r-jl0vfbvb1wlrr09mdyzyoo5zm4bh94qtqby0soaca" type="hidden" name="form_build_id" value="form-r-jl0vfBVb1WLrr09MDyzyoO5zM4BH94QtQBy0soACA" class="form-control" />
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<input data-drupal-selector="edit-webform-submission-subscription-webform-node-3147-add-form" type="hidden" name="form_id" value="webform_submission_subscription_webform_node_3147_add_form" class="form-control" />
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<li class="nav-item active">
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<a href="/news-events/blog" title="Latest updates from the BRAIN Blog" class="nav-link active" data-drupal-link-system-path="news-events/blog">The BRAIN Blog</a>
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<a href="/news-events/brain-initiative-photo-and-video-contest" class="nav-link" data-drupal-link-system-path="node/252">The BRAIN Initiative Photo and Video Contest</a>
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<li class="nav-item">
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<a href="/news-events/communications-toolkit" class="nav-link" data-drupal-link-system-path="node/4724">Communications Toolkit</a>
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<div class="content">
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<span id="webform-submission-was-this-page-helpful-node-3147-form-ajax-content"></span><div id="webform-submission-was-this-page-helpful-node-3147-form-ajax" class="webform-ajax-form-wrapper" data-effect="fade" data-progress-type="throbber">
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<form class="webform-submission-form webform-submission-add-form webform-submission-was-this-page-helpful-form webform-submission-was-this-page-helpful-add-form webform-submission-was-this-page-helpful-node-3147-form webform-submission-was-this-page-helpful-node-3147-add-form js-webform-details-toggle webform-details-toggle" data-drupal-selector="webform-submission-was-this-page-helpful-node-3147-add-form" action="/news-events/blog/deep-brain-stimulation-shows-potential-post-stroke-rehabilitation-and-depression" method="post" id="webform-submission-was-this-page-helpful-node-3147-add-form" accept-charset="UTF-8">
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<fieldset data-drupal-selector="edit-find-content" class="webform-vote-options find-content webform-vote--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-webform-vote webform-type-webform-vote js-form-item form-item js-form-wrapper form-group" id="edit-find-content--wrapper">
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<div class="fieldset-wrapper">
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<div id="edit-find-content" class="js-webform-webform-vote radio">
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<input data-drupal-selector="edit-find-content-yes" data-type="webform_vote" data-icon="fa-thumbs-up" data-icon-size="fa-2x" class="form-radio" type="radio" id="edit-find-content-yes" name="find_content" value="Yes">
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<label tabindex="0" class="form-check-label" for="edit-find-content-yes">
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<span class="sr-only">Yes, I did find the content I was looking for</span>
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<i class="fa fa-thumbs-up fa-2x" title="Yes"></i>
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</label>
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<input data-drupal-selector="edit-find-content-no" class="webform-vote-options form-radio" data-type="webform_vote" data-icon="fa-thumbs-down" data-icon-size="fa-2x" type="radio" id="edit-find-content-no" name="find_content" value="No">
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<span class="sr-only">No, I did not find the content I was looking for</span>
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</fieldset>
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<div class="hidden-elements js-webform-states-hidden js-form-wrapper form-group" data-drupal-selector="edit-hidden-elements" data-drupal-states="{"visible-slide":{".webform-submission-was-this-page-helpful-node-3147-add-form :input[name=\u0022find_content\u0022]":{"checked":true}}}" id="edit-hidden-elements"><fieldset data-drupal-selector="edit-rating" class="webform-vote-options webform-rating webform-vote--wrapper fieldgroup form-composite webform-composite-visible-title js-webform-type-webform-vote webform-type-webform-vote js-form-item form-item js-form-wrapper form-group" id="edit-rating--wrapper">
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<legend>
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<span class="fieldset-legend">Please rate how easy it was to navigate the NINDS website</span>
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<div class="fieldset-wrapper">
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<div id="edit-rating" class="js-webform-webform-vote radio">
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<input data-drupal-selector="edit-rating-very-easy-to-navigate" data-type="webform_vote" data-icon="fa-star" data-icon-size="fa-2x" class="webform-rating form-radio" type="radio" id="edit-rating-very-easy-to-navigate" name="rating" value="Very easy to navigate">
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<label tabindex="0" class="form-check-label" for="edit-rating-very-easy-to-navigate">
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<span class="sr-only">Very easy to navigate</span>
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<i class="fa fa-star fa-2x" title="Very easy to navigate"></i>
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</label>
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<input data-drupal-selector="edit-rating-easy-to-navigate" class="webform-vote-options webform-rating form-radio" data-type="webform_vote" data-icon="fa-star" data-icon-size="fa-2x" type="radio" id="edit-rating-easy-to-navigate" name="rating" value="Easy to navigate">
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<label tabindex="0" class="form-check-label" for="edit-rating-easy-to-navigate">
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<span class="sr-only">Easy to navigate</span>
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<i class="fa fa-star fa-2x" title="Easy to navigate"></i>
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</label>
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<input data-drupal-selector="edit-rating-neutral" class="webform-vote-options webform-rating form-radio" data-type="webform_vote" data-icon="fa-star" data-icon-size="fa-2x" type="radio" id="edit-rating-neutral" name="rating" value="Neutral">
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<span class="sr-only">Neutral</span>
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<i class="fa fa-star fa-2x" title="Neutral"></i>
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</label>
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<input data-drupal-selector="edit-rating-difficult-to-navigate" class="webform-vote-options webform-rating form-radio" data-type="webform_vote" data-icon="fa-star" data-icon-size="fa-2x" type="radio" id="edit-rating-difficult-to-navigate" name="rating" value="Difficult to navigate">
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<span class="sr-only">Difficult to navigate</span>
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</label>
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<input data-drupal-selector="edit-rating-very-difficult-to-navigate" class="webform-vote-options webform-rating form-radio" data-type="webform_vote" data-icon="fa-star" data-icon-size="fa-2x" type="radio" id="edit-rating-very-difficult-to-navigate" name="rating" value="Very difficult to navigate">
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<span class="sr-only">Very difficult to navigate</span>
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<div class="js-webform-states-hidden js-form-wrapper" data-drupal-states="{"visible":{".webform-submission-was-this-page-helpful-node-3147-add-form :input[name=\u0022find_content\u0022]":{"checked":true}}}">
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<fieldset class="recaptcha_disclaimer js-form-item js-form-type-processed-text form-type-processed-text js-form-item- form-item- form-no-label form-group" id="edit-recaptcha-disclaimer">
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<input data-drupal-selector="edit-webform-submission-was-this-page-helpful-node-3147-add-form" type="hidden" name="form_id" value="webform_submission_was_this_page_helpful_node_3147_add_form" class="form-control" />
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</form>
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</aside>
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</div>
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<div class="text-right small container last-updated" role="complementary">
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Last reviewed on September 29, 2023
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<a href="/about/contact-us" class="nav-link nav-link--about-contact-us" data-drupal-link-system-path="node/1040">Contact Us</a>
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<a href="/news-events/blog" class="nav-link nav-link--news-events-blog" data-drupal-link-system-path="news-events/blog">The BRAIN Blog</a>
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<a href="https://www.youtube.com/c/BRAINInitiative" class="nav-link nav-link-https--wwwyoutubecom-c-braininitiative">YouTube</a>
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<a href="https://www.braininitiative.org/" class="nav-link nav-link-https--wwwbraininitiativeorg-">BRAIN Initiative Alliance</a>
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