PMC:6218602 / 64138-65476 JSONTXT

{"project":"2_test","denotations":[{"id":"30425662-29242310-41865531","span":{"begin":886,"end":889},"obj":"29242310"},{"id":"30425662-26517767-41865531","span":{"begin":886,"end":889},"obj":"26517767"},{"id":"30425662-27104842-41865531","span":{"begin":886,"end":889},"obj":"27104842"},{"id":"30425662-7477318-41865532","span":{"begin":1333,"end":1336},"obj":"7477318"}],"text":"Neurosurgical DBS strategies are also now being considered to be used in ultra-resistant schizophrenia to target those relevant brain hubs that may improve the interconnectivity of relevant neuronal circuits. The implantation of electrodes into accessible anatomical nodes can be targeted to normalize or reset abnormal patterns of cortical network GBO activity that disrupt neural circuits. The stimulation settings of the electrodes can be titrated to tune the neurons to specific frequencies and recalibrate neuronal asynchrony. There is current interest in targeting several important network hubs using DBS in ultra-resistant schizophrenia involved in basal ganglia-thalamocortical and DLPFC brain circuits. Hubs identified include the hippocampus, ventral and associated striatum, medial and DLPFC, substantia nigra, nucleus accumbens and the mediodorsal nucleus of the thalamus (203–205). These hubs have been chosen primarily based on known pathological findings in schizophrenia and/or their interconnectedness to other brain hubs that are circuit-specific and related to the excessive and mistimed dopamine release in the striatum. Hippocampal dysfunction that drives downstream dopamine release in the striatum contributing to persistent positive symptoms is one of the clinical hallmarks for treatment-resistant disease (206)."}