Deep Brain Stimulation: More Complex than the Inhibition of Cells and Excitation of Fibers

Author(s)

Florence, Gerson ; Sameshima, Koichi ; Fonoff, Erich T. ; Hamani, Clement

• Document type: Journal article
• Source: NEUROSCIENTIST; v. 22, n. 4, p. 332-345, AUG 2016.
• Web of Science Citations: 23

Abstract

High-frequency deep brain stimulation (DBS) is an effective treatment for some movement disorders. Though mechanisms underlying DBS are still unclear, commonly accepted theories include a functional inhibition of neuronal cell bodies and the excitation of axonal projections near the electrodes. It is becoming clear, however, that the paradoxical dissociation local inhibition and distant excitation is far more complex than initially thought. Despite an initial increase in neuronal activity following stimulation, cells are often unable to maintain normal ionic concentrations, particularly those of sodium and potassium. Based on currently available evidence, we proposed an alternative hypothesis. Increased extracellular concentrations of potassium during DBS may change the dynamics of both cells and axons, contributing not only to the intermittent excitation and inhibition of these elements but also to interrupt abnormal pathological activity. In this article, we review mechanisms through which high extracellular potassium may mediate some of the effects of DBS. (AU)

• FAPESP's process: 11/08529-5 - Double-blind controlled study on the effect of ozone applied for spinal endoscopy in the treatment of post-laminectomy pain syndrome: differential analysis in neuropathic and non-neuropathic pain and its correlation with the level of epidural cytokines
• Grantee: Erich Talamoni Fonoff
• Support type: Regular Research Grants
• FAPESP's process: 11/21138-5 - Analysis of oscillatory patterns of intrasurgical recordings in deep brain stimulation for Parkinson's Disease
• Grantee: Gerson Florence Carvalheira de Azevedo
• Support type: Scholarships in Brazil - Post-Doctorate