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van den Munckhof, P.

Publications and source records attributed to van den Munckhof, P..

2 recordsLinked to original sources

Conscious perception and the role of the basal ganglia: preliminary findings from a deep brain stimulation study

Conscious perception is thought to depend on global amplification of sensory input. In recent years, the basal ganglia have been implicated in gating conscious access due to their consistent involvement in thalamocortical loops. However, much of the evidence implicating the basal ganglia in these processes in humans is correlational. The current study is a preliminary investigation in four patients to explore whether deep brain stimulation (DBS) in the basal ganglia might improve conscious perception. In our study, treatment-resistant obsessive-compulsive disorder (OCD) patients with a striatal DBS implant completed two canonical conscious perception tasks: emotion-induced blindness and backward masking. We found preliminary evidence in support of a role played by the basal ganglia in conscious perception at the behavioral level: patients performed better when stimulation was active, but we could not establish neural effects corresponding to these behavioral findings, possibly due to our small sample size. We discuss the potential implications and limitations of our study and delineate avenues for future research.

neuroscience↗

Deep brain stimulation modulates directional frontolimbic connectivity in obsessive-compulsive disorder

Deep brain stimulation (DBS) is effective for patients with treatment-refractory obsessive-compulsive disorder. DBS of the ventral anterior limb of the internal capsule (vALIC) rapidly improves mood and anxiety with optimal stimulation parameters. To understand these rapid effects of vALIC-DBS, we studied functional interactions within the affective amygdala circuit. We compared resting state functional magnetic resonance imaging data during chronic stimulation versus one week of stimulation discontinuation in patients, and obtained two resting state scans from matched healthy volunteers to account for test-retest effects. Imaging data were analyzed using functional connectivity analysis and dynamic causal modelling. Improvement in mood and anxiety following DBS was associated with reduced amygdala-insula functional connectivity. Directional connectivity analysis revealed that DBS increased the impact of the ventromedial prefrontal cortex on the amygdala, and decreased the impact of the amygdala on the insula. These results highlight the importance of the amygdala circuit in the pathophysiology of OCD, and suggest a neural systems model through which negative mood and anxiety are modulated by vALIC-DBS for OCD and possibly other psychiatric disorders.\n\nOne Sentence SummaryDeep brain stimulation improves mood and anxiety in obsessive-compulsive disorder by altering connectivity between the amygdala, insula and prefrontal cortex.

neuroscience↗