title: Robust modulation of arousal regulation, performance, and frontostriatal activity through central thalamic deep brain stimulation in healthy nonhuman primates.
abstract: The central thalamus (CT) is a key component of the brain-wide network underlying arousal regulation and sensory-motor integration during wakefulness in the mammalian brain. Dysfunction of the CT, typically a result of severe brain injury (SBI), leads to long-lasting impairments in arousal regulation and subsequent deficits in cognition. Central thalamic deep brain stimulation (CT-DBS) is proposed as a therapy to reestablish and maintain arousal regulation to improve cognition in select SBI patients. However, a mechanistic understanding of CT-DBS and an optimal method of implementing this promising therapy are unknown. Here we demonstrate in two healthy nonhuman primates (NHPs), Macaca mulatta, that location-specific CT-DBS improves performance in visuomotor tasks and is associated with physiological effects consistent with enhancement of endogenous arousal. Specifically, CT-DBS within the lateral wing of the central lateral nucleus and the surrounding medial dorsal thalamic tegmental tract (DTTm) produces a rapid and robust modulation of performance and arousal, as measured by neuronal activity in the frontal cortex and striatum. Notably, the most robust and reliable behavioral and physiological responses resulted when we implemented a novel method of CT-DBS that orients and shapes the electric field within the DTTm using spatially separated DBS leads. Collectively, our results demonstrate that selective activation within the DTTm of the CT robustly regulates endogenous arousal and enhances cognitive performance in the intact NHP; these findings provide insights into the mechanism of CT-DBS and further support the development of CT-DBS as a therapy for reestablishing arousal regulation to support cognition in SBI patients.
authors: Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York; job2037@med.cornell.edu.
authors: Jonathan L
authors: JL
authors: Baker
authors: Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York.
authors: Jae-Wook
authors: JW
authors: Ryou
authors: College of New Jersey, Department of Biomedical Engineering, Ewing Township, New Jersey; and.
authors: Xuefeng F
authors: XF
authors: Wei
authors: University of Utah, Scientific Computing & Imaging (SCI) Institute, Department of Bioengineering, Salt Lake City, Utah.
authors: Christopher R
authors: CR
authors: Butson
authors: Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York.
authors: Nicholas D
authors: ND
authors: Schiff
authors: Feil Family Brain and Mind Research Institute, Weill Cornell Medicine, New York, New York.
authors: Keith P
authors: KP
authors: Purpura
mesh_terms: D000818:Animals; D001143:Arousal / Q000502:physiology*; D003342:Corpus Striatum / Q000502:physiology*; D046690:Deep Brain Stimulation / Q000379:methods*; D005625:Frontal Lobe / Q000502:physiology*; D008253:Macaca mulatta; D009434:Neural Pathways / Q000502:physiology; D011597:Psychomotor Performance / Q000502:physiology*; D011930:Reaction Time / Q000502:physiology; D013788:Thalamus / Q000502:physiology*
keywords: arousal regulation; central thalamus; deep brain stimulation; intralaminar nuclei; severe brain injury