keyword
https://read.qxmd.com/read/33386418/prevalence-and-anatomical-characteristics-of-the-human-massa-intermedia
#21
JOURNAL ARTICLE
Alireza Borghei, Ali Piracha, Sepehr Sani
Massa intermedia (MI), also known as interthalamic adhesion is an inconsistent bridge connecting the two thalami. Recent studies suggest MI contains functional neuronal tissue and is responsible for interhemispheric communication. Absence of MI has been linked to cognitive differences and psychiatric disorders. However, MI is naturally absent in up to 35 percent of cases but its true prevalence during life in humans is unknown. High resolution anatomical MR studies of 1410 subjects aged 2 months to 93 years were reviewed and those with MI were identified...
January 1, 2021: Brain Structure & Function
https://read.qxmd.com/read/33313852/structural-and-functional-imaging-in-glioma-management
#22
JOURNAL ARTICLE
Bledi C Brahimaj, Ryan B Kochanski, John J Pearce, Melike Guryildirim, Carter S Gerard, Mehmet Kocak, Sepehr Sani, Richard W Byrne
The goal of glioma surgery is maximal safe resection in order to provide optimal tumor control and survival benefit to the patient. There are multiple imaging modalities beyond traditional contrast-enhanced magnetic resonance imaging (MRI) that have been incorporated into the preoperative workup of patients presenting with gliomas. The aim of these imaging modalities is to identify cortical and subcortical areas of eloquence, and their relationship to the lesion. In this article, multiple modalities are described with an emphasis on the underlying technology, clinical utilization, advantages, and disadvantages of each...
January 13, 2021: Neurosurgery
https://read.qxmd.com/read/33207350/the-medial-subthalamic-nucleus-border-as-a-new-anatomical-reference-in-stereotactic-neurosurgery-for-parkinson-s-disease
#23
JOURNAL ARTICLE
Erik Bolier, Maarten Bot, Pepijn van den Munckhof, Gian Pal, Sepehr Sani, Leo Verhagen Metman
INTRODUCTION: The intersection of Bejjani's line with the well-delineated medial subthalamic nucleus (STN) border on MRI has recently been proposed as an individualized reference in subthalamic deep brain stimulation (DBS) surgery for Parkinson's disease (PD). We, therefore, aimed to investigate the applicability across centers of the medial STN border as a patient-specific reference point in STN DBS for PD and explore anatomical variability between left and right mesencephalic area within patients...
November 18, 2020: Stereotactic and Functional Neurosurgery
https://read.qxmd.com/read/33176368/surgical-treatments-of-epilepsy
#24
REVIEW
Shahjehan Ahmad, Ryan Khanna, Sepehr Sani
Nearly 30% of epilepsy patients are refractory to medical therapy. Surgical management of epilepsy is an increasingly viable option for these patients. Although surgery has historically been used as a palliative option, improvements in technology and outcomes show its potential in certain subsets of patients. This article reviews the two main categories of surgical epilepsy treatment-resective surgery and neuromodulation. Resective surgery includes temporal lobe resections, extratemporal resections, laser interstitial thermal therapy, and disconnection procedures...
December 2020: Seminars in Neurology
https://read.qxmd.com/read/32470421/subthalamic-nucleus-deep-brain-stimulation-with-a-multiple-independent-constant-current-controlled-device-in-parkinson-s-disease-intrepid-a-multicentre-double-blind-randomised-sham-controlled-study
#25
RANDOMIZED CONTROLLED TRIAL
Jerrold L Vitek, Roshini Jain, Lilly Chen, Alexander I Tröster, Lauren E Schrock, Paul A House, Monique L Giroux, Adam O Hebb, Sierra M Farris, Donald M Whiting, Timothy A Leichliter, Jill L Ostrem, Marta San Luciano, Nicholas Galifianakis, Leo Verhagen Metman, Sepehr Sani, Jessica A Karl, Mustafa S Siddiqui, Stephen B Tatter, Ihtsham Ul Haq, Andre G Machado, Michal Gostkowski, Michele Tagliati, Adam N Mamelak, Michael S Okun, Kelly D Foote, Guillermo Moguel-Cobos, Francisco A Ponce, Rajesh Pahwa, Jules M Nazzaro, Cathrin M Buetefisch, Robert E Gross, Corneliu C Luca, Jonathan R Jagid, Gonzalo J Revuelta, Istvan Takacs, Michael H Pourfar, Alon Y Mogilner, Andrew P Duker, George T Mandybur, Joshua M Rosenow, Scott E Cooper, Michael C Park, Suketu M Khandhar, Mark Sedrak, Fenna T Phibbs, Julie G Pilitsis, Ryan J Uitti, Philip A Starr
BACKGROUND: Deep brain stimulation (DBS) of the subthalamic nucleus is an established therapeutic option for managing motor symptoms of Parkinson's disease. We conducted a double-blind, sham-controlled, randomised controlled trial to assess subthalamic nucleus DBS, with a novel multiple independent contact current-controlled (MICC) device, in patients with Parkinson's disease. METHODS: This trial took place at 23 implanting centres in the USA. Key inclusion criteria were age between 22 and 75 years, a diagnosis of idiopathic Parkinson's disease with over 5 years of motor symptoms, and stable use of anti-parkinsonian medications for 28 days before consent...
June 2020: Lancet Neurology
https://read.qxmd.com/read/32371080/kinesthetic-cells-within-the-subthalamic-nucleus-and-deep-brain-stimulation-for-parkinson-disease
#26
JOURNAL ARTICLE
Erik Bolier, Maarten Bot, Pepijn van den Munckhof, Gian Pal, Sepehr Sani, Glenn T Stebbins, Leo Verhagen Metman
OBJECTIVE: We sought to determine the location of kinesthetic cell clusters within the subthalamic nucleus (STN) on magnetic resonance imaging, adjusted for interindividual anatomic variability by employing the medial STN border as a reference point. METHODS: We retrospectively localized microelectrode recording-defined kinesthetic cells on 3-Tesla T2-weighted and susceptibility-weighted images in patients who underwent STN deep brain stimulation for Parkinson disease and averaged the stereotactic coordinates...
July 2020: World Neurosurgery
https://read.qxmd.com/read/32124014/role-of-massa-intermedia-in-human-neurocognitive-processing
#27
JOURNAL ARTICLE
Alireza Borghei, Thomas Cothran, Bledi Brahimaj, Sepehr Sani
Massa intermedia (MI) is an inconsistent midline structure in the human brain that is absent in approximately 30% of the population. Absence of MI is seen more frequently in schizophrenia spectrum disorder and bipolar disorder. However, very little is known about the normal role of MI in the human brain. The purpose of this study was to investigate the role of human MI in cortical and subcortical cognitive processing as determined by differences between subjects with and without MI. Using the Human Connectome Project database, a cohort of randomly selected participants were selected to (1) identify presence, absence, and size of MI, and (2) explore possible cognitive process mediated by the presence of MI...
April 2020: Brain Structure & Function
https://read.qxmd.com/read/31768551/operative-technique-and-workflow-of-deep-brain-stimulation-surgery-with-pre-existing-cochlear-implants
#28
JOURNAL ARTICLE
Erik Bolier, Jessica A Karl, R Mark Wiet, Alireza Borghei, Leo Verhagen Metman, Sepehr Sani
BACKGROUND: Deep brain stimulation (DBS) surgery in patients with pre-existing cochlear implants (CIs) poses various challenges. We previously reported successful magnetic resonance imaging (MRI)-based, microelectrode recording (MER)-guided subthalamic DBS surgery in a patient with a pre-existing CI. Other case reports have described various DBS procedures in patients with pre-existing CIs using different techniques, leading to varying issues to address. A standardized operative technique and workflow for DBS surgery in the setting of pre-existing CIs is much needed...
August 1, 2020: Operative Neurosurgery (Hagerstown, Md.)
https://read.qxmd.com/read/31449992/the-impact-of-microelectrode-recording-on-lead-location-in-deep-brain-stimulation-for-the-treatment-of-movement-disorders
#29
JOURNAL ARTICLE
Ryan B Kochanski, Sander Bus, Bledi Brahimaj, Alireza Borghei, Kristen L Kraimer, Kavantissa M Keppetipola, Blake Beehler, Gian Pal, Leo Verhagen Metman, Sepehr Sani
OBJECTIVE: During deep brain stimulation (DBS) surgery, microelectrode recording (MER) leads to target refinement from the initial plan in 30% to 47% of hemispheres; however, it is unclear whether the DBS lead ultimately resides within the MER-optimized target in relation to initial radiographic target coordinates in these hemispheres. This study aimed to determine the frequency of discordance between radiographic and neurophysiologic nucleus and whether target optimization with MER leads to a significant change in DBS lead location away from initial target...
December 2019: World Neurosurgery
https://read.qxmd.com/read/30470405/mapping-in-low-grade-glioma-surgery-low-and-high-frequency-stimulation
#30
REVIEW
Marco Rossi, Sepehr Sani, Marco Conti Nibali, Luca Fornia, Lorenzo Bello, Richard W Byrne
Surgery for lower grade glioma requires the use of brain mapping techniques to identify functional boundaries, which represent the limit of the resection. Two stimulation paradigms are currently available and their use should be tailored to the clinical context to extend tumor removal and decrease the odds of postoperative permanent deficits.
January 2019: Neurosurgery Clinics of North America
https://read.qxmd.com/read/30418622/abdominal-epilepsy-treated-with-vagal-nerve-stimulation-a-case-report
#31
JOURNAL ARTICLE
Kristen L Kraimer, Ryan B Kochanski, Fiona Lynn, Michael Smith, Sepehr Sani
BACKGROUND AND IMPORTANCE: Abdominal epilepsy is a rare seizure disorder characterized by episodic gastrointestinal symptoms with electroencephalogram abnormalities. It is typically well treated with anti-epileptic medications; however, little is known about treatment of refractory cases. CLINICAL PRESENTATION: The patient is a 16-yr-old male who began experiencing episodic abdominal pain and distension at the age of 2. After undergoing an extensive negative gastrointestinal workup, he was referred for neurological examination...
August 1, 2019: Operative Neurosurgery (Hagerstown, Md.)
https://read.qxmd.com/read/30418266/analysis-of-movement-related-beta-oscillations-in-the-off-medication-state-during-subthalamic-nucleus-deep-brain-stimulation-surgery
#32
JOURNAL ARTICLE
Ryan B Kochanski, Jay Shils, Leo Verhagen Metman, Gian Pal, Sepehr Sani
PURPOSE: Local field potential recordings from deep brain stimulation (DBS) leads provide insight into the pathophysiology of Parkinson disease (PD). We recorded local field potential activity from DBS leads within the subthalamic nucleus in patients with PD undergoing DBS surgery to identify reproducible pathophysiological signatures of the disease. METHODS: Local field potentials were recorded in 11 hemispheres from patients with PD undergoing subthalamic nucleus-DBS...
January 2019: Journal of Clinical Neurophysiology: Official Publication of the American Electroencephalographic Society
https://read.qxmd.com/read/30145596/accuracy-of-microelectrode-trajectory-adjustments-during-dbs-assessed-by-intraoperative-ct
#33
JOURNAL ARTICLE
Sander Bus, Gian Pal, Bichun Ouyang, Pepijn van den Munckhof, Maarten Bot, Sepehr Sani, Leo Verhagen Metman
BACKGROUND/AIMS: Microelectrode recording (MER)-guided deep brain stimulation (DBS) aims to place the DBS lead in the optimal electrophysiological target. When single-track MER or test stimulation yields suboptimal results, trajectory adjustments are made. The accuracy of these trajectory adjustments is unknown. Intraoperative computed tomography can visualize the microelectrode (ME) and verify ME adjustments. We aimed to determine the accuracy of ME movements in patients undergoing MER-guided DBS...
2018: Stereotactic and Functional Neurosurgery
https://read.qxmd.com/read/29997038/age-is-but-a-number-when-considering-epilepsy-surgery-in-older-adults
#34
JOURNAL ARTICLE
Rebecca O'Dwyer, Richard Byrne, Fiona Lynn, Pouya Nazari, Travis Stoub, Michael C Smith, Sepehr Sani
BACKGROUND: A quarter of patients with newly diagnosed epilepsy are older, yet they are less likely to be offered resective surgery potentially because of clinical bias that they incur increased surgical risks. There are few peer-reviewed case series that address this cohort and their outcomes. OBJECTIVE: In the context of current literature, the objective of this study was to report on all epilepsy surgeries in patients aged 50 years or older from a tertiary care center over 15 years with an average follow-up period of 6 years...
July 8, 2018: Epilepsy & Behavior: E&B
https://read.qxmd.com/read/29609085/prevalence-and-impact-of-left-handedness-in-neurosurgery
#35
JOURNAL ARTICLE
Blake Beehler, Ryan B Kochanski, Richard Byrne, Sepehr Sani
BACKGROUND: Approximately 10%-13% of the population is left-handed (LH), and certain professions have varied representation of LH individuals. LH surgeons must overcome unique difficulties owing to the right-handed (RH) operative environment. This study assesses prevalence and impact of left-handedness on training and operative experience of neurosurgeons. METHODS: An e-mail survey was designed and sent to 5109 U.S. neurosurgeons and neurosurgical trainees. The survey was completed by 1482 responders (29...
June 2018: World Neurosurgery
https://read.qxmd.com/read/29444303/the-utility-of-vancomycin-powder-in-reducing-surgical-site-infections-in-deep-brain-stimulation-surgery
#36
JOURNAL ARTICLE
Ryan B Kochanski, Pouya Nazari, Sepehr Sani
BACKGROUND: The impact of vancomycin powder on reducing postoperative surgical site infections (SSIs) in spine surgery has been studied extensively and is considered standard of care at many institutions. More recently, vancomycin powder has been shown to reduce SSI in cranial neurosurgery; however, limited studies have been performed assessing its impact in reducing SSIs in deep brain stimulation (DBS) surgery. OBJECTIVE: To investigate the use of vancomycin powder as an adjunct to the current antibiotic prophylaxis regimen in DBS surgery in a large cohort of patients...
November 1, 2018: Operative Neurosurgery (Hagerstown, Md.)
https://read.qxmd.com/read/29408589/identification-of-stria-medullaris-fibers-in-the-massa-intermedia-using-diffusion-tensor-imaging
#37
JOURNAL ARTICLE
Ryan B Kochanski, Robert Dawe, Mehmet Kocak, Sepehr Sani
BACKGROUND: The massa intermedia (MI) or interthalamic adhesion is an inconsistent band spanning between bilateral medial thalami that is absent in up to 20%-30% of individuals. Little is known of its significance, especially in regard to functional pathways. Probabilistic diffusion tensor imaging (DTI) has recently been used to seed the lateral habenula and define its afferent white matter pathway, the stria medullaris thalami (SM). We sought to determine whether the MI serves as a conduit for crossing of limbic fibers such as the SM...
April 2018: World Neurosurgery
https://read.qxmd.com/read/29396073/microelectrode-accuracy-in-deep-brain-stimulation-surgery
#38
JOURNAL ARTICLE
Bledi Brahimaj, Ryan B Kochanski, Sepehr Sani
Microelectrode recording (MER) provides vital neurophysiological information about target nuclei during deep brain stimulation (DBS). There have been extensive studies looking at the accuracy of DBS lead placement; however, to date, no large series have assessed the accuracy of the microelectrode. In this study, we report the accuracy of microelectrode tip placement in comparison to preoperatively planned radiographic target. Patients who underwent DBS with MER from 2014 to 2016 were included in the study. At the authors' institution, intra-operative CT (iCT) is routinely performed after the first microelectrode track to confirm tip accuracy...
April 2018: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://read.qxmd.com/read/29351243/awake-versus-asleep-deep-brain-stimulation-surgery-technical-considerations-and-critical-review-of-the-literature
#39
REVIEW
Ryan B Kochanski, Sepehr Sani
Advancements in neuroimaging have led to a trend toward direct, image-based targeting under general anesthesia without the use of microelectrode recording (MER) or intraoperative test stimulation, also referred to as "asleep" deep brain stimulation (DBS) surgery. Asleep DBS, utilizing imaging in the form of intraoperative computed tomography (iCT) or magnetic resonance imaging (iMRI), has demonstrated reliable targeting accuracy of DBS leads implanted within the globus pallidus and subthalamic nucleus while also improving clinical outcomes in patients with Parkinson's disease...
January 19, 2018: Brain Sciences
https://read.qxmd.com/read/29275518/borders-of-stn-determined-by-mri-versus-the-electrophysiological-stn-a-comparison-using-intraoperative-ct
#40
JOURNAL ARTICLE
Sander Bus, Pepijn van den Munckhof, Maarten Bot, Gian Pal, Bichun Ouyang, Sepehr Sani, Leo Verhagen Metman
BACKGROUND: It is unclear which magnetic resonance imaging (MRI) sequence most accurately corresponds with the electrophysiological subthalamic nucleus (STN) obtained during microelectrode recording (MER, MER-STN). CT/MRI fusion allows for comparison between MER-STN and the STN visualized on preoperative MRI (MRI-STN). OBJECTIVE: To compare dorsal and ventral STN borders as seen on 3-Tesla T2-weighted (T2) and susceptibility weighted images (SWI) with electrophysiological STN borders in deep brain stimulation (DBS) for Parkinson's disease (PD)...
February 2018: Acta Neurochirurgica
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