OBJECTIVE: Initial studies applying deep brain stimulation (DBS) of the posteromedial hypothalamus (PMH) to patients with pathological aggressiveness have yielded encouraging results. However, the anatomical structures involved in its therapeutic effect have not been precisely identified. The authors' objective was to describe the long-term outcome in their 7-patient series, and the tractography analysis of the volumes of tissue activated in 2 of the responders. METHODS: This was a retrospective study of 7 subjects with pathological aggressiveness. The findings on MRI with diffusion tensor imaging (DTI) in 2 of the responders were analyzed. The authors generated volumes of tissue activated according to the parameters used, and selected those volumes as regions of interest to delineate the tracts affected by stimulation. RESULTS: The series consisted of 5 men and 2 women. Of the 7 patients, 5 significantly improved with stimulation. The PMH, ventral tegmental area, dorsal longitudinal fasciculus, and medial forebrain bundle seem to be involved in the stimulation field. CONCLUSIONS: In this series, 5 of 7 medication-resistant patients with severe aggressiveness who were treated with bilateral PMH DBS showed a significant long-lasting improvement. The PMH, ventral tegmental area, dorsal longitudinal fasciculus, and medial forebrain bundle seem to be in the stimulation field and might be responsible for the therapeutic effect of DBS.
OBJECTIVE: Initial studies applying deep brain stimulation (DBS) of the posteromedial hypothalamus (PMH) to patients with pathological aggressiveness have yielded encouraging results. However, the anatomical structures involved in its therapeutic effect have not been precisely identified. The authors' objective was to describe the long-term outcome in their 7-patient series, and the tractography analysis of the volumes of tissue activated in 2 of the responders. METHODS: This was a retrospective study of 7 subjects with pathological aggressiveness. The findings on MRI with diffusion tensor imaging (DTI) in 2 of the responders were analyzed. The authors generated volumes of tissue activated according to the parameters used, and selected those volumes as regions of interest to delineate the tracts affected by stimulation. RESULTS: The series consisted of 5 men and 2 women. Of the 7 patients, 5 significantly improved with stimulation. The PMH, ventral tegmental area, dorsal longitudinal fasciculus, and medial forebrain bundle seem to be involved in the stimulation field. CONCLUSIONS: In this series, 5 of 7 medication-resistant patients with severe aggressiveness who were treated with bilateral PMH DBS showed a significant long-lasting improvement. The PMH, ventral tegmental area, dorsal longitudinal fasciculus, and medial forebrain bundle seem to be in the stimulation field and might be responsible for the therapeutic effect of DBS.
Authors: Clemens Neudorfer; Gavin J B Elias; Martin Jakobs; Alexandre Boutet; Jürgen Germann; Keshav Narang; Aaron Loh; Michelle Paff; Andreas Horn; Walter Kucharczyk; Wissam Deeb; Bryan Salvato; Leonardo Almeida; Kelly D Foote; Paul B Rosenberg; David F Tang-Wai; William S Anderson; Zoltan Mari; Francisco A Ponce; David A Wolk; Anna D Burke; Stephen Salloway; Marwan N Sabbagh; M Mallar Chakravarty; Gwenn S Smith; Constantine G Lyketsos; Michael S Okun; Andres M Lozano Journal: Brain Date: 2021-10-22 Impact factor: 13.501
Authors: Volker A Coenen; Máté D Döbrössy; Shi Jia Teo; Johanna Wessolleck; Bastian E A Sajonz; Peter C Reinacher; Annette Thierauf-Emberger; Björn Spittau; Jochen Leupold; Dominik von Elverfeldt; Thomas E Schlaepfer; Marco Reisert Journal: Brain Struct Funct Date: 2021-09-05 Impact factor: 3.270
Authors: Petra Heiden; Daniel Tim Weigel; Ricardo Loução; Christina Hamisch; Enes M Gündüz; Maximilian I Ruge; Jens Kuhn; Veerle Visser-Vandewalle; Pablo Andrade Journal: Front Hum Neurosci Date: 2022-08-24 Impact factor: 3.473
Authors: Clemens Neudorfer; Jürgen Germann; Gavin J B Elias; Robert Gramer; Alexandre Boutet; Andres M Lozano Journal: Sci Data Date: 2020-09-15 Impact factor: 6.444