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Subthalamic nucleus

Ariel Tankus, Anat Mirelman, Nir Giladi, Itzhak Fried, Jeffrey M Hausdorff
OBJECTIVE The ability to modulate the pace of movement is a critical factor in the smooth operation of the motor system. The authors recently described distinct and overlapping representations of movement kinematics in the subthalamic nucleus (STN), but it is still unclear how movement pace is modulated according to the demands of the task at the neuronal level in this area. The goal of this study was to clarify how different movement paces are being controlled by neurons in the STN. METHODS The authors performed direct recording of the electrical activity of single neurons in the STN of neurosurgical patients with Parkinson's disease undergoing implantation of a deep brain stimulator under local anesthesia while the patients performed repetitive foot and hand movements intraoperatively at multiple paces...
June 22, 2018: Journal of Neurosurgery
Valentin Senft, Terrence C Stewart, Trevor Bekolay, Chris Eliasmith, Bernd J Kröger
Background: Parkinson's disease affects many motor processes including speech. Besides drug treatment, deep brain stimulation (DBS) in the subthalamic nucleus (STN) and globus pallidus internus (GPi) has developed as an effective therapy. Goal: We present a neural model that simulates a syllable repetition task and evaluate its performance when varying the level of dopamine in the striatum, and the level of activity reduction in the STN or GPi. Method: The Neural Engineering Framework (NEF) is used to build a model of syllable sequencing through a cortico-basal ganglia-thalamus-cortex circuit...
2018: Frontiers in Computational Neuroscience
Shunsuke Koga, Naomi Kouri, Ronald L Walton, Mark T W Ebbert, Keith A Josephs, Irene Litvan, Neill Graff-Radford, J Eric Ahlskog, Ryan J Uitti, Jay A van Gerpen, Bradley F Boeve, Adam Parks, Owen A Ross, Dennis W Dickson
Corticobasal degeneration (CBD) is a clinically heterogeneous tauopathy, which has overlapping clinicopathologic and genetic characteristics with progressive supranuclear palsy (PSP). This study aimed to elucidate whether transactive response DNA-binding protein of 43 kDa (TDP-43) pathology contributes to clinicopathologic heterogeneity of CBD. Paraffin-embedded sections of the midbrain, pons, subthalamic nucleus, and basal forebrain from 187 autopsy-confirmed CBD cases were screened with immunohistochemistry for phospho-TDP-43...
June 20, 2018: Acta Neuropathologica
Benjamin Fisher, Jamilla Kausar, Hayley Garratt, James Hodson, Anwen White, Ismail Ughratdar, Rosalind Mitchell
OBJECTIVES: Deep brain stimulation for Parkinson's disease (PD) utilises an implantable pulse generator (IPG) whose finite lifespan in non-rechargeable systems necessitates their periodic replacement. We wish to determine if there is any significant difference in longevity of 2 commonly used IPG systems; the Medtronic Kinetra, and the Medtronic Activa Primary Cell (PC), which has come to replace it. METHODS: All patients with bilateral Subthalamic Nucleus stimulators for PD performed in our centre were included...
June 19, 2018: Stereotactic and Functional Neurosurgery
Witold H Polanski, K Daniel Martin, Swen Günther, Gabriele Schackert, Lisa Klingelhoefer, Mareike Fauser, Alexander Storch, Stephan B Sobottka
Background: For quality analysis, we applied the Six Sigma concept to define quality indicators and their boundaries as well as to compare treatment-dependent outcome data of deep brain stimulation (DBS) of the subthalamic nucleus (STN) in patients with Parkinson's disease (PD). Methods: The Unified Parkinson Disease Rating Scale (UPDRS) III with on medication and on stimulation, the reduction of daily levodopa equivalence doses (LED), and the stimulation amplitude 1 year after surgery were registered...
June 18, 2018: International Journal for Quality in Health Care
Pnina Rappel, Odeya Marmor, Atira S Bick, David Arkadir, Eduard Linetsky, Anna Castrioto, Idit Tamir, Sara A Freedman, Tomer Mevorach, Moran Gilad, Hagai Bergman, Zvi Israel, Renana Eitan
Obsessive-compulsive disorder (OCD) is a common and serious psychiatric disorder. Although subthalamic nucleus deep brain stimulation (DBS) has been studied as a treatment for OCD patients the underlying mechanism of this treatment and the optimal method of stimulation are unknown. To study the neural basis of subthalamic nucleus DBS in OCD patients we used a novel, implantable DBS system with long-term local field potential sensing capability. We focus our analysis on two patients with OCD who experienced severe treatment-resistant symptoms and were implanted with subthalamic nucleus DBS systems...
June 18, 2018: Translational Psychiatry
Gang Du, Ping Zhuang, Yuqing Zhang, Jianyu Li, Yongjie Li
We compared the firing rates and proportion of patterns of oscillatory neurons in the subthalamic nucleus (STN), globus pallidus internus (GPi), and ventrolateral thalamus (VL) in Parkinson disease (PD). Twenty-nine patients with PD who underwent stereotactic neurosurgery were included in the study. Microelectrode recordings in the STN (n = 16), GPi (n = 9), and VL (n = 9) were performed. Power spectral analysis was used to explore neuronal oscillation. Of 76 STN neurons, 39.5% were tremor frequency oscillatory neurons (4-6 Hz, TFB) and 28...
June 15, 2018: Neuroscience Letters
Sara Jahfari, K Richard Ridderinkhof, Anne G E Collins, Tomas Knapen, Lourens J Waldorp, Michael J Frank
Why are we so slow in choosing the lesser of 2 evils? We considered whether such slowing relates to uncertainty about the value of these options, which arises from the tendency to avoid them during learning, and whether such slowing relates to frontosubthalamic inhibitory control mechanisms. In total, 49 participants performed a reinforcement-learning task and a stop-signal task while fMRI was recorded. A reinforcement-learning model was used to quantify learning strategies. Individual differences in lose-lose slowing related to information uncertainty due to sampling, and independently, to less efficient response inhibition in the stop-signal task...
April 18, 2018: Cerebral Cortex
Zhe Zhao, Haitao Wu
Electrical high-frequency stimulation (HFS), using implanted electrodes targeting various brain regions, has been proven as an effective treatment for various neurological and psychiatric disorders. HFS in the deep region of the brain, also named deep-brain stimulation (DBS), is becoming increasingly important in clinical trials. Recent progress in the field of high-frequency DBS (HF-DBS) surgery has begun to spread the possibility of utilizing this invasive technique to other situations, such as treatment for major depression disorder (MDD), obsessive-compulsive disorder (OCD), and so on...
June 2, 2018: Journal of Visualized Experiments: JoVE
Joaquin A Vizcarra, Miguel Situ-Kcomt, Carlo Alberto Artusi, Andrew P Duker, Leonardo Lopiano, Michael S Okun, Alberto J Espay, Aristide Merola
INTRODUCTION: While subthalamic nucleus deep brain stimulation (STN-DBS) and levodopa improve motor symptoms in Parkinson disease (PD) to a similar magnitude, their combined effect remains unclear. We sought to evaluate whether STN-DBS and levodopa yield differential effects on motor outcomes, dyskinesia, and activities of daily living (ADL) when combined compared to when administered alone. METHODS: We conducted a meta-analysis of all studies reporting motor, dyskinesia, and ADL outcomes after bilateral STN-DBS in PD with presurgical Unified Parkinson's Disease Rating Scale (UPDRS-III) in Medication-OFF and Medication-ON states and postsurgical assessments in four conditions: Stimulation-ON/Medication-ON, Stimulation-ON/Medication-OFF, Stimulation-OFF/Medication-ON, and Stimulation-OFF/Medication-OFF...
June 16, 2018: Journal of Neurology
Gerd Tinkhauser, Flavie Torrecillos, Yann Duclos, Huiling Tan, Alek Pogosyan, Petra Fischer, Romain Carron, Marie-Laure Welter, Carine Karachi, Wim Vandenberghe, Bart Nuttin, Tatiana Witjas, Jean Régis, Jean-Philippe Azulay, Alexandre Eusebio, Peter Brown
Exaggerated activity in the beta band (13-35 Hz) is a hallmark of basal ganglia signals in patients with Parkinson's disease (PD). Beta activity however is not constantly elevated, but comes in bursts. In previous work we showed that the longer beta bursts are maintained, the more the oscillatory synchronisation within the subthalamic nucleus (STN) increases, which is posited to limit the information coding capacity of local circuits. Accordingly, a higher incidence of longer bursts correlates positively with clinical impairment, while the opposite is true for short, more physiological bursts...
June 14, 2018: Neurobiology of Disease
Herbert Y Meltzer, Min Young Sim, Adam Anderson, Christopher Cannistraci, Karu Jayathilake, Daniel Barrett Share, Myung Lee
INTRODUCTION: Psychotic spectrum disorder (PSD) links the syndromes of bipolar disorder, psychotic depression, and schizophrenia, often viewed as unique disorders. AIMS: Application of the PSD concept to a single patient rather than across groups of patients and demonstration of a remarkable remission of schizophrenia phenotype with recovery of gray matter in specific brain regions. RESULTS: We report a woman who experienced discrete, nonoverlapping periods of each of the above syndromes, in the order noted, over a 30-year period, followed by abrupt ending of psychosis and full remission lasting at least 7 years...
July 2018: CNS Neuroscience & Therapeutics
Lionel Froux, Morgane Le Bon-Jego, Cristina Miguelez, Elisabeth Normand, Stephanie Morin, Stéphanie Fioramonti, Massimo Barresi, Andreas Frick, Jerome Baufreton, Anne Taupignon
Corticofugal fibers target the subthalamic nucleus (STN), a component nucleus of the basal ganglia, in addition to the striatum, their main input. The cortico-subthalamic, or hyperdirect, pathway, is thought to supplement the cortico-striatal pathways in order to interrupt/change planned actions. To explore the previously unknown properties of the neurons that project to the STN, retrograde and anterograde tools were used to specifically identify them in the motor cortex and selectively stimulate their synapses in the STN...
June 11, 2018: Scientific Reports
Hai Lin, Xiao-Dong Cai, Dou-Dou Zhang, Jia-Li Liu, Wei-Ping Li
BACKGROUND: Primary dystonia is a neurological disease with the characteristics of abnormal, involuntary twisting and turning movements, which greatly affects life quality of patients. Treatments for dystonia consist of oral medications, botulinum neurotoxin injections, physical therapy and surgeries. For medication-refractory dystonia, surgeries, especially deep brain stimulation (DBS), are the optimal option. CASE DESCRIPTION: the patient was a 13-year-old boy suffering from extremely severe primary dystonia, with a BFMDRS-M score of 118 and a TWSTRS-S score of 29...
June 8, 2018: World Neurosurgery
Yonglu Huang, Joshua P Aronson, Julie G Pilitsis, Lucy Gee, Jennifer Durphy, Eric Steven Molho, Adolfo Ramirez-Zamora
Introduction: Subthalamic nucleus deep brain stimulation (STN-DBS) is a well-established treatment for the management of motor complications in Parkinson's disease. Uncontrollable laughter has been reported as a rare side effect of STN stimulation. The precise mechanism responsible for this unique phenomenon remains unclear. We examined in detail the DBS electrode position and stimulation parameters in two patients with uncontrollable laughter during programming after STN-DBS surgery and illustrated the anatomical correlates of the acute mood changes with STN stimulation...
2018: Frontiers in Neurology
Michael Caiola, Mark H Holmes
Parkinson's disease (PD) is a degenerative neurological disease that disrupts the movement cycle in the basal ganglia. As the disease progresses, dopamine depletion leads to changes to how the basal ganglia functions as well as the appearance of abnormal beta oscillations. There is much debate on just exactly how these connection strengths change and just how the oscillations emerge. One leading hypothesis claims that the oscillations develop in the globus pallidus external, subthalamic nucleus, and globus pallidus internal loop...
May 3, 2018: International Journal of Neural Systems
Yann Pelloux, Mickaël Degoulet, Alix Tiran-Cappello, Candie Cohen, Sylvie Lardeux, Olivier George, George F Koob, Serge H Ahmed, Christelle Baunez
One of the key features of addiction is the escalated drug intake. The neural mechanisms involved in the transition to addiction remain to be elucidated. Since abnormal neuronal activity within the subthalamic nucleus (STN) stands as potential general neuromarker common to impulse control spectrum deficits, as observed in obsessive-compulsive disorders, the present study recorded and manipulated STN neuronal activity during the initial transition to addiction (i.e., escalation) and post-abstinence relapse (i...
June 7, 2018: Molecular Psychiatry
Philip E Mosley, David Smith, Terry Coyne, Peter Silburn, Michael Breakspear, Alistair Perry
Deep brain stimulation of the subthalamic nucleus for Parkinson's disease is an established advanced therapy that addresses motor symptoms and improves quality of life. However, it has also been associated with neuropsychiatric symptoms such as impulsivity and hypomania. When significant, these symptoms can be distressing, necessitating psychiatric intervention. However, a comprehensive analysis of neurocognitive and neuropsychiatric outcomes with reference to the site of subthalamic stimulation has not been undertaken...
2018: NeuroImage: Clinical
Gabriele Arnulfo, Nicolò Gabriele Pozzi, Chiara Palmisano, Alice Leporini, Andrea Canessa, Joachim Brumberg, Gianni Pezzoli, Cordula Matthies, Jens Volkmann, Ioannis Ugo Isaias
The role of the subthalamic nucleus in human locomotion is unclear although relevant, given the troublesome management of gait disturbances with subthalamic deep brain stimulation in patients with Parkinson's disease. We investigated the subthalamic activity and inter-hemispheric connectivity during walking in eight freely-moving subjects with Parkinson's disease and bilateral deep brain stimulation. In particular, we compared the subthalamic power spectral densities and coherence, amplitude cross-correlation and phase locking value between resting state, upright standing, and steady forward walking...
2018: PloS One
Sarah L Kang, Aasef G Shaikh, Fatema F Ghasia
Maintaining proper eye alignment is necessary to generate a cohesive visual image. This involves the coordination of complex neural networks, which can become impaired by various neurodegenerative diseases. When the vergence system is affected, this can result in strabismus and disorienting diplopia. While previous studies have detailed the effect of these disorders on other eye movements, such as saccades, relatively little is known about strabismus. Here, we focus on the prevalence, clinical characteristics, and treatment of strabismus and disorders of vergence in Parkinson's disease, spinocerebellar ataxia, Huntington disease, and multiple system atrophy...
2018: Frontiers in Neurology
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