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- Johansson, Veronica, et al.
(författare)
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Beyond Blind Optimism and Unfounded Fears : Deep Brain Stimulation for Treatment Resistant Depression
- 2013
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Ingår i: Neuroethics. - : Springer Science and Business Media LLC. - 1874-5504 .- 1874-5490. ; 6:3, s. 457-471
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Tidskriftsartikel (refereegranskat)abstract
- The introduction of new medical treatments based on invasive technologies has often been surrounded by both hopes and fears. Hope, since a new intervention can create new opportunities either in terms of providing a cure for the disease or impairment at hand; or as alleviation of symptoms. Fear, since an invasive treatment involving implanting a medical device can result in unknown complications such as hardware failure and undesirable medical consequences. However, hopes and fears may also arise due to the cultural embeddedness of technology, where a therapy due to ethical, social, political and religious concerns could be perceived as either a blessing or a threat. While Deep Brain Stimulation (DBS) for treatment resistant depression (TRD) is still in its cradle, it is important to be proactive and try to scrutinize both surfacing hopes and fears. Patients will not benefit if a promising treatment is banned or avoided due to unfounded fears, nor will they benefit if DBS is used without scrutinizing the arguments which call for caution. Hence blind optimism is equally troublesome. We suggest that specificity, both in terms of a detailed account of relevant scientific concerns as well as ethical considerations, could be a way to analyse expressed concerns regarding DBS for TRD. This approach is particularly fruitful when applied to hopes and fears evoked by DBS for TRD, since it can reveal if our comprehension of DBS for TRD suffer from various biases which may remain unnoticed at first glance. We suggest that such biases exist, albeit a further analysis is needed to explore this issue in full.
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- Johansson, Veronica, et al.
(författare)
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Thinking Ahead on Deep Brain Stimulation: An Analysis of the Ethical Implications of a Developing Technology.
- 2014
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Ingår i: AJOB Neuroscience. - : Informa UK Limited. - 2150-7740 .- 2150-7759. ; 5:1, s. 24-33
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Tidskriftsartikel (refereegranskat)abstract
- Deep brain stimulation (DBS) is a developing technology. New generations of DBS technology are already in the pipeline, yet this particular fact has been largely ignored among ethicists interested in DBS. Focusing only on ethical concerns raised by the current DBS technology is, albeit necessary, not sufficient. Since current bioethical concerns raised by a specific technology could be quite different from the concerns it will raise a couple of years ahead, an ethical analysis should be sensitive to such alterations, or it could end up with results that soon become dated. The goal of this analysis is to address these changing bioethical concerns, to think ahead on upcoming and future DBS concerns both in terms of a changing technology and changing moral attitudes. By employing the distinction between inherent and noninherent bioethical concerns we identify and make explicit the particular limits and potentials for change within each category, respectively, including how present and upcoming bioethical concerns regarding DBS emerge and become obsolete. Many of the currently identified ethical problems with DBS, such as stimulation-induced mania, are a result of suboptimal technology. These challenges could be addressed by technical advances, while for instance perceptions of an altered body image caused by the mere awareness of having an implant may not. Other concerns will not emerge until the technology has become sophisticated enough for new uses to be realized, such as concerns on DBS for enhancement purposes. As a part of the present analysis, concerns regarding authenticity are used as an example.
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- Andersson, G, et al.
(författare)
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Evidence for a GABA-mediated cerebellar inhibition of the inferior olive in the cat
- 1988
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Ingår i: Experimental Brain Research. - 0014-4819. ; 72:3, s. 450-456
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Tidskriftsartikel (refereegranskat)abstract
- 1. Climbing fibres were activated by peripheral nerve stimulation at 'high' frequencies (greater than 3 Hz) for 15-25 s and then at 0.9 Hz for about 1 min. The high frequency activation induced a post-conditioning inhibition, lasting up to about 1 min, of climbing fibre responses recorded from the cerebellar surface. 2. Electrolytic lesions were made in the superior cerebellar peduncle (brachium conjunctivum). After the lesion, the post-conditioning inhibition was completely eliminated. 3. Injections of the GABA-receptor blocker bicuculline methiodide into the inferior olive reversibly blocked the post-conditioning inhibition. 4. The results support the hypothesis proposed by Andersson and Hesslow (1987a), that post-conditioning inhibition is mediated by a GABA-ergic interposito-olivary pathway.
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- Apps, R, et al.
(författare)
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Anatomical and physiological foundations of cerebellar information processing
- 2005
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Ingår i: Nature Reviews Neuroscience. - : Springer Science and Business Media LLC. - 1471-003X .- 1471-0048. ; 6:4, s. 297-311
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Forskningsöversikt (refereegranskat)abstract
- A coordinated movement is easy to recognize, but we know little about how it is achieved. In search of the neural basis of coordination, we present a model of spinocerebellar interactions in which the structure-functional organizing principle is a division of the cerebellum into discrete microcomplexes. Each microcomplex is the recipient of a specific motor error signal-that is, a signal that conveys information about an inappropriate movement. These signals are encoded by spinal reflex circuits and conveyed to the cerebellar cortex through climbing fibre afferents. This organization reveals salient features of cerebellar information processing, but also highlights the importance of systems level analysis for a fuller understanding of the neural mechanisms that underlie behaviour.
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- Apps, Richard, et al.
(författare)
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Gating of cutaneous input to cerebellar climbing fibres during a reaching task in the cat
- 1997
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Ingår i: Journal of Physiology. - 1469-7793. ; 502:Pt 1, s. 203-214
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Tidskriftsartikel (refereegranskat)abstract
- 1. Task-dependent modulation of cutaneous input to climbing fibres projecting to the C1, C2 and C3 zones in the cerebellar paravermal lobule V was investigated in awake cats during performance of a reaching task. 2. Climbing fibre responses resulting from low intensity (non-noxious) electrical stimulation of the ipsilateral superficial radial nerve were recorded as extracellular field potentials in the cerebellar cortex using chronically implanted microwires. 3. Response size, measured as the time-voltage integral of the evoked field potential, was assessed during three phases of the reaching movement, reaction, reach and grasp, and compared with the response size at rest. 4. At C1 and C3 zone recording sites response size was usually reduced during the task (7/10 sites). The reduction was most pronounced in the grasp phase, occasionally accompanied by a smaller reduction in the reach and reaction phases. In one case an enhancement was found in the reach phase. 5. Response size was also modulated during the task at four of six C2 zone recording sites. However, the results were mixed. In three cases the modulation resembled the pattern at C1/C3 sites with the responses being reduced in the grasp phase accompanied on occasion by a lesser reduction in the reach phase. In the remaining case there was an enhancement during grasp. In this case and one other there was also an enhancement during the reaction phase. 6. The findings indicate significant gating of cutaneous input to climbing fibres projecting to the C1, C2 and C3 zones during reaching movements, while the variability between recording sites suggests functional differences, both between and within zones.
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- Apps, R, et al.
(författare)
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Precise matching of olivo-cortical divergence and cortico-nuclear convergence between somatotopically corresponding areas in the medial C1 and medial C3 zones of the paravermal cerebellum
- 2000
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Ingår i: European Journal of Neuroscience. - : Wiley. - 1460-9568 .- 0953-816X. ; 12:1, s. 205-214
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Tidskriftsartikel (refereegranskat)abstract
- The paravermal cerebellar cortex contains three spatially separate zones (the C1, C3 and Y zones) which form a functionally coupled system involved in the control of voluntary limb movements. A series of 'modules' has been postulated, each defined by a set of olivary neurons with similar receptive fields, the cortical microzones innervated by these neurons and the group of deep cerebellar nuclear neurons upon which the microzones converge. A key feature of this modular organization is a correspondence between cortical input and output, irrespective of the zonal identity of the microzone. This was tested directly using a combined electrophysiological and bi-directional tracer technique in barbiturate-anaesthetized cats. During an initial operation, small injections of a mix of retrograde and anterograde tracer material (red beads combined with Fluoro-Ruby or green beads combined with biotinylated dextran amine or Fluoro-Emerald) were made into areas of the medial C1 and medial C3 zones in cerebellar lobule V characterized by olivo-cerebellar input from the ventral forelimb. The inferior olive and the deep cerebellar nuclei were then scrutinized for retrogradely labelled cells and anterogradely labelled axon terminals, respectively. For individual experiments, the degree of C1-C3 zone terminal field overlap in the nucleus interpositus anterior was plotted as a function of either the regional overlap of single-labelled cells or the proportion of double-labelled cells in the dorsal accessory olive. The results were highly positively correlated, indicating that cortico-nuclear convergence between parts of the two zones is in close proportion to the corresponding olivo-cerebellar divergence, entirely consistent with the modular hypothesis.
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| 9. |
- Axelsson, Inge, 1947-, et al.
(författare)
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Satsa på cochrane i sverige
- 2018
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Ingår i: Läkartidningen. - 0023-7205 .- 1652-7518. ; 115:39
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)
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