Christian R. Baumann

Summary Modulation of slow‐wave activity, either via pharmacological sleep induction by administering sodium oxybate or sleep restriction followed by a strong dissipation of sleep pressure, has been associated with preserved posttraumatic cognition and reduced diffuse axonal injury in traumatic brain injury rats. Although these classical strategies provided promising preclinical results, they lacked the specificity and/or translatability needed to move forward into clinical applications. Therefore, we recently developed and implemented a rodent auditory stimulation method that is a scalable, less invasive and clinically meaningful approach to modulate slow‐wave activity by targeting a particular phase of slow waves. Here, we assessed the feasibility of down‐phase targeted auditory stimulation of slow waves and evaluated its comparative modulatory strength in relation to the previously employed slow‐wave activity modulators in our rat model of traumatic brain injury. Our results indicate that, in spite of effectively reducing slow‐wave activity in both healthy and traumatic brain injury rats via down‐phase targeted stimulation, this method was not sufficiently strong to counteract the boost in slow‐wave activity associated with classical modulators, nor to alter concomitant posttraumatic outcomes. Therefore, the usefulness and effectiveness of auditory stimulation as potential standalone therapeutic strategy in the context of traumatic brain injury warrants further exploration.

Background For safety reasons, both magnetic resonance‐guided high‐intensity focused ultrasound (MRgHiFUS) thalamotomy and pallidotomy are currently approved exclusively for unilateral treatment, but axial symptoms like levodopa‐induced orofacial dyskinesia require a bilateral approach. Objectives We report the first case of successful bilateral MRgHiFUS pallidotomy for peak‐dose dyskinesia in a patient with Parkinson's disease (PD). Methods The treatment decision was based on the patient's reluctance toward brain implants and pump therapies and the fact that he had limited access to a deep brain stimulation center in his home country. The treatment was planned as staged procedure with an interval of 18 months because of travel restrictions because of the coronavirus disease (COVID)‐19 pandemic. Results After the second treatment, levodopa‐induced orofacial dyskinesia remitted and improved bradykinesia and rigidity with stable gait and good postural reflexes. Conclusions This promising result suggests that in selected PD patients with dyskinesia, staged bilateral MRgHiFUS pallidotomy might be considered.