Mapping of microstimulation evoked responses and unit activity patterns in the lateral hypothalamic area recorded in awake humans

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Major contributions to the understanding of human brain function have come from detailed clinical reports of responses evoked by electrical stimulation and specific brain regions during neurosurgical procedures in awake humans. In this study, microstimulation evoked responses and extracellular unit recordings were obtained intraoperatively in 3 awake patients undergoing bilateral implantation of deep brain stimulation electrodes in the lateral hypothalamus. The microstimulation evoked responses exhibited a clear anatomical distribution. Anxiety was most reliably evoked by stimulation directed ventromedially within or adjacent to the ventromedial nucleus of the hypothalamus, nausea was most reliably evoked by stimulation directed at the center of the lateral hypothalamus, and paresthesias were most reliably evoked by stimulation at the border of the lateral hypothalamus and basal nuclei. Regarding the unit recordings, the firing rates of individual neurons did not have an anatomical distribution, but a small subpopulation of neurons located at the border of the lateral hypothalamus and basal nuclei exhibited a fast rhythmically bursting behavior with an intraburst frequency of 200–400 Hz and an interburst frequency of 10–20 Hz. Based on animal studies, the lateral hypothalamic area and surrounding hypothalamic nuclei are putatively involved with a variety of physiological, behavioral, and sensory functions. The lateral hypothalamus is situated to play a dynamic and complex role in human behavior and this report further shows that to be true. In addition, this report should serve as a valuable resource for future intracranial work in which accurate targeting within this region is required.

Abbreviations used in this paper: DBS = deep brain stimulation; RMS = root mean square; VMH = ventromedial hypothalamus.

Article Information

Address correspondence to: Donald M. Whiting, M.D., Department of Neurosurgery, Allegheny General Hospital, 420 East North Avenue, Suite 302, Pittsburgh, Pennsylvania 15212. email: whiting.donald@gmail.com.

Please include this information when citing this paper: published online April 15, 2011; DOI: 10.3171/2011.3.JNS101574.

© AANS, except where prohibited by US copyright law.

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Figures

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    Mapping of microstimulation evoked responses. Coronal images shown are from the midcommissural point (0.0 mm) to 9.4 mm posterior to the anterior commissure. Circles represent responses from Case 1, squares represent responses from Case 2, and polygons represent responses from Case 3. The color of each symbol represents response stimulus at that site: gray = no response, yellow = anxiety, green = nausea, red = thermal change, and blue = paresthesias. Relevant abbreviations: al = ansa leticularis; BSTC = bed nucleus of the stria terminalis, central division; fx = fornix; IGP = internal globus pallidus; LH = lateral hypothalamus; liml = limiting medullary lamina of globus pallidus; LTu = lateral tuberular nucleus; mfb = medial forebrain bundle; mml = medial medullary lamina of globus pallidus; opt = optic tract; PeF = perfifornical nucleus; PRt = prereticular zone; sox = supraoptic commissure; TM = tuberomammilary nucleus; VMH = ventromedial hypothalamus.

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    Mapping of RMS error. Coronal images shown are from the midcommissural point (0.0 mm) to 9.4 mm posterior to the anterior commissure. Circles represent responses from Case 1, squares represent responses from Case 2, and polygons represent responses from Case 3. The color of each symbol represents response RMS error expressed as percentage increase from baseline RMS error. See Fig. 1 for definitions of abbreviations.

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    Example of a fast, rhythmic bursting firing pattern. Histogram of interspike interval (ISI) of all spikes recorded from unit. The peak at 3–5 msec (ms) is indicative of 200–400 Hz interburst firing, and the second peak at 40–45 msec indicates 15–20 Hz intraburst frequency. Inset at top shows unfiltered firing of unit.

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