Deep brain stimulation can regulate arterial blood pressure in awake humans

The periaqueductal grey matter is known to play a role in cardiovascular control in animals. Cardiovascular responses to electrical stimulation of the periventricular/periaqueductal grey matter were measured in 15 awake human study participants following implantation of deep brain stimulating electrodes for treatment of chronic pain. We found that stimulation of the ventral periventricular/periaqueductal grey matter caused a mean reduction in systolic blood pressure of 14.2±3.6 mmHg in seven patients and stimulation of the dorsal periventricular/periaqueductal grey matter caused a mean increase of 16.7±5.9 mmHg in six patients. A comparison between ventral and dorsal electrodes demonstrated significant differences (P<0.05). These changes were accompanied by analogous changes in diastolic blood pressure, pulse pressure, maximum dP / dt but not in the time interval between each R wave on the electrocardiogram.

[1]  Tipu Z. Aziz,et al.  Deep brain stimulation for pain relief: A meta-analysis , 2005, Journal of Clinical Neuroscience.

[2]  T. Finnegan,et al.  Effect of the μ Opioid on Excitatory and Inhibitory Synaptic Inputs to Periaqueductal Gray-Projecting Neurons in the Amygdala , 2005, Journal of Pharmacology and Experimental Therapeutics.

[3]  S. Lightman,et al.  A Functional Subset of Serotonergic Neurons in the Rat Ventrolateral Periaqueductal Gray Implicated in the Inhibition of Sympathoexcitation and Panic , 2004, Annals of the New York Academy of Sciences.

[4]  E. Burgard,et al.  Capsaicin infused into the PAG affects rat tail flick responses to noxious heat and alters neuronal firing in the RVM. , 2003, Journal of neurophysiology.

[5]  M. Antal,et al.  The projections of the midbrain periaqueductal grey to the pons and medulla oblongata in rats , 2001, The European journal of neuroscience.

[6]  A. Loewy,et al.  Periaqueductal gray matter projections to midline and intralaminar thalamic nuclei of the rat , 2000, The Journal of comparative neurology.

[7]  Eszter Farkas,et al.  Periaqueductal gray matter input to cardiac-related sympathetic premotor neurons , 1998, Brain Research.

[8]  J. Miles Neurosurgical Management of Pain , 1998, Spinal Cord.

[9]  Eszter Farkas,et al.  Periaqueductal gray matter projection to vagal preganglionic neurons and the nucleus tractus solitarius , 1997, Brain Research.

[10]  J. Kuo,et al.  Attenuation of cardiovascular reactions of vocalized and non-vocalized defence areas of periaqueductal grey following lesions in dorsomedial or ventrolateral medulla of cats. , 1997, Journal of the autonomic nervous system.

[11]  Elliott H. Albers,et al.  Neural circuitry controlling vasopressin‐stimulated scent marking in Syrian hamsters (Mesocricetus auratus) , 1996, The Journal of comparative neurology.

[12]  W. Willis,et al.  The efferent projections of the periaqueductal gray in the rat: A Phaseolus vulgaris‐leucoagglutinin study. II. Descending projections , 1995, The Journal of comparative neurology.

[13]  R. Bandler,et al.  Viscerotopic organization of neurons subserving hypotensive reactions within the midbrain periaqueductal grey: a correlative functional and anatomical study , 1991, Brain Research.

[14]  M. Marcinkiewicz,et al.  CNS connections with the median raphe nucleus: Retrograde tracing with WGA‐apoHRP‐gold complex in the rat , 1989, The Journal of comparative neurology.

[15]  D. Newman,et al.  Nuclear terminations of corticoreticular fiber systems in rats. , 1989, Brain, behavior and evolution.

[16]  T. Lovick Ventrolateral medullary lesions block the antinociceptive and cardiovascular responses elicited by stimulating the dorsal periaqueductal grey matter in rats , 1985, Pain.

[17]  A. Duggan,et al.  Periaqueductal grey stimulation: an association between selective inhibition of dorsal horn neurones and changes in peripheral circulation , 1983, Pain.

[18]  D. Dooley Book Review: Atlas of the Human Brain , 1971 .

[19]  V. C. Abrahams,et al.  Active muscle vasodilatation produced by stimulation of the brain stem: its significance in the defence reaction , 1960, The Journal of physiology.

[20]  S. W. Ranson,et al.  ELECTRICAL STIMULATION OF POINTS IN THE FOREBRAIN AND MIDBRAIN: THE RESULTANT ALTERATIONS IN BLOOD PRESSURE , 1935 .

[21]  R. Bandler,et al.  Quiescence and hyporeactivity evoked by activation of cell bodies in the ventrolateral midbrain periaqueductal gray of the rat , 2004, Experimental Brain Research.

[22]  R. Bandler,et al.  Control of extracranial and hindlimb blood flow by the midbrain periaqueductal grey of the cat , 2004, Experimental Brain Research.

[23]  T. Lovick Inhibitory modulation of the cardiovascular defence response by the ventrolateral periaqueductal grey matter in rats , 2004, Experimental Brain Research.

[24]  W. Willis,et al.  The efferent projections of the periaqueductal gray in the rat: A Phaseolus vulgaris‐leucoagglutinin study. I. Ascending projections , 1995, The Journal of comparative neurology.

[25]  R. Young,et al.  Brain stimulation. , 1990, Neurosurgery clinics of North America.

[26]  W P Wilson,et al.  Sensations evoked by stimulation in the midbrain of man. , 1969, Journal of neurosurgery.