title: Centromedian-parafascicular deep brain stimulation induces differential functional inhibition of the motor, associative, and limbic circuits in large animals.
abstract: BACKGROUND
  Deep brain stimulation (DBS) of the centromedian-parafascicular (CM-Pf) thalamic nuclei has been considered an option for treating Tourette syndrome. Using a large animal DBS model, this study was designed to explore the network effects of CM-Pf DBS.
  
  
  METHODS
  The combination of DBS and functional magnetic resonance imaging is a powerful means of tracing brain circuitry and testing the modulatory effects of electrical stimulation on a neuronal network in vivo. With a within-subjects design, we tested the proportional effects of CM and Pf DBS by manipulating current spread and varying stimulation contacts in healthy pigs (n = 5).
  
  
  RESULTS
  Our results suggests that CM-Pf DBS has an inhibitory modulating effect in areas that have been suggested as contributing to impaired sensory-motor and emotional processing. The results also help to define the differential neural circuitry effects of the CM and Pf with evidence of prominent sensorimotor/associative effects for CM DBS and prominent limbic/associative effects for Pf DBS.
  
  
  CONCLUSIONS
  Our results support the notion that stimulation of deep brain structures, such as the CM-Pf, modulates multiple networks with cortical effects. The networks affected by CM-Pf stimulation in this study reinforce the conceptualization of Tourette syndrome as a condition with psychiatric and motor symptoms and of CM-Pf DBS as a potentially effective tool for treating both types of symptoms.
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.|Department of Neurosurgery, CHA University, Bundang CHA Medical Center, Sungnam, Republic of Korea.
authors.forename: Joo Pyung
authors.initials: JP
authors.lastname: Kim
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.|Division of Engineering, Mayo Clinic, Rochester, Minnesota, USA.|Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Hoon-Ki
authors.initials: HK
authors.lastname: Min
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Emily J
authors.initials: EJ
authors.lastname: Knight
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Penelope S
authors.initials: PS
authors.lastname: Duffy
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Osama A
authors.initials: OA
authors.lastname: Abulseoud
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Michael P
authors.initials: MP
authors.lastname: Marsh
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Kelsey
authors.affiliation: Department of Psychology, University of Memphis, Memphis, TN, USA.
authors.forename: Charles D
authors.initials: CD
authors.lastname: Blaha
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.|Division of Engineering, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Kevin E
authors.initials: KE
authors.lastname: Bennet
authors.affiliation: Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Mark A
authors.initials: MA
authors.lastname: Frye
authors.affiliation: Department of Neurologic Surgery, Mayo Clinic, Rochester, Minnesota, USA.|Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, Minnesota, USA.
authors.forename: Kendall H
authors.initials: KH
authors.lastname: Lee
mesh_terms: D000818:Animals; D001703:Biophysics; D001931:Brain Mapping; D046690:Deep Brain Stimulation; D007091:Image Processing, Computer-Assisted; D008032:Limbic System / Q000098:blood supply / Q000502:physiology*; D008279:Magnetic Resonance Imaging; D008297:Male; D009044:Motor Cortex / Q000098:blood supply / Q000502:physiology*; D009433:Neural Inhibition / Q000502:physiology*; D010100:Oxygen / Q000097:blood; D013552:Swine; D013787:Thalamic Nuclei / Q000502:physiology*
chemical_list: D010100:Oxygen
keywords: Centromedian; Tourette syndrome; deep brain stimulation (DBS); functional magnetic resonance imaging (fMRI); neural circuitry; parafascicular; swine model