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Parkinson's Disease, Deep brain stimulation

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https://www.readbyqxmd.com/read/28428905/deep-brain-stimulation-target-selection-in-an-advanced-parkinson-s-disease-patient-with-significant-tremor-and-comorbid-depression
#1
Amar S Patel
CLINICAL VIGNETTE: A 67-year-old female with advanced Parkinson's disease (PD), medically refractory tremor, and a history of significant depression presented for evaluation of deep brain stimulation (DBS) candidacy. CLINICAL DILEMMA: Traditionally, the subthalamic nucleus (STN) has been preferred over the globus pallidus interna (GPi) as a DBS target for PD patients with levodopa-responsive fluctuations in rigidity and akinesia, for whom tremor is also a significant source of impairment...
2017: Tremor and Other Hyperkinetic Movements
https://www.readbyqxmd.com/read/28426824/becoming-more-oneself-changes-in-personality-following-dbs-treatment-for-psychiatric-disorders-experiences-of-ocd-patients-and-general-considerations
#2
Sanneke de Haan, Erik Rietveld, Martin Stokhof, Damiaan Denys
Does DBS change a patient's personality? This is one of the central questions in the debate on the ethics of treatment with Deep Brain Stimulation (DBS). At the moment, however, this important debate is hampered by the fact that there is relatively little data available concerning what patients actually experience following DBS treatment. There are a few qualitative studies with patients with Parkinson's disease and Primary Dystonia and some case reports, but there has been no qualitative study yet with patients suffering from psychiatric disorders...
2017: PloS One
https://www.readbyqxmd.com/read/28422667/modeling-and-analysis-of-beta-oscillations-in-the-basal-ganglia
#3
Chen Liu, Jiang Wang, Huiyan Li, Chris Fietkiewicz, Kenneth A Loparo
Enhanced beta (12-30 Hz) oscillatory activity in the basal ganglia (BG) is a prominent feature of the Parkinsonian state in animal models and in patients with Parkinson's disease. Increased beta oscillations are associated with severe dopaminergic striatal depletion. However, the mechanisms underlying these pathological beta oscillations remain elusive. Inspired by the experimental observation that only subsets of neurons within each nucleus in the BG exhibit oscillatory activities, a computational model of the BG-thalamus neuronal network is proposed, which is characterized by subdivided nuclei within the BG...
April 12, 2017: IEEE Transactions on Neural Networks and Learning Systems
https://www.readbyqxmd.com/read/28421851/global-and-multi-focal-changes-in-cerebral-blood-flow-during-subthalamic-nucleus-stimulation-in-parkinson-s-disease
#4
Asim M Mubeen, Babak Ardekani, Michele Tagliati, Ron Alterman, Vijay Dhawan, David Eidelberg, John J Sidtis
Electrical stimulation of subthalamic nuclei (STN) is a widely used therapy in Parkinson's disease (PD). While deep brain stimulation (DBS) of the STN alters the neurophysiological activity in basal ganglia, the therapeutic mechanism has not been established. A positron emission tomography (PET) study of cerebral blood flow (CBF) during speech production in PD subjects treated with STN-DBS found significant increases in global (whole-brain) CBF.(1) That study utilized a series of whole-slice regions of interest to obtain global CBF values...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28416595/nonsinusoidal-beta-oscillations-reflect-cortical-pathophysiology-in-parkinson-s-disease
#5
Scott R Cole, Roemer van der Meij, Erik J Peterson, Coralie de Hemptinne, Philip A Starr, Bradley Voytek
Oscillations in neural activity play a critical role in neural computation and communication. There is intriguing new evidence that the nonsinusoidal features of the oscillatory waveforms may inform underlying physiological and pathophysiological characteristics. Time-domain waveform analysis approaches stand in contrast to traditional Fourier-based methods, which alter or destroy subtle waveform features. Recently it has been shown that the waveform features of oscillatory beta (13-30 Hz) events-a prominent motor cortical oscillation-may reflect near-synchronous excitatory synaptic inputs onto cortical pyramidal neurons...
April 17, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28412499/parkinsonism-and-dystonia-are-differentially-induced-by-modulation-of-different-territories-in-the-basal-ganglia
#6
Deepak Kumbhare, Kathryn L Holloway, Mark S Baron
Numerous clinical and experimental observations suggest that deficient neuronal signaling in the globus pallidus externa (GPe) is integral to both Parkinson's disease (PD) and dystonia. In our previous studies in jaundiced dystonic rats, widespread silencing of neurons in GP (rodent equivalent to GPe) preceded and persisted during dystonic motor activity. We therefore hypothesized that on a background of slow and highly irregular and bursty neuronal activity in GP, cortical motor drive produces profound inhibition of GP as the basis for action induced dystonia in Gunn rats...
April 12, 2017: Neuroscience
https://www.readbyqxmd.com/read/28409730/chronic-multisite-brain-recordings-from-a-totally-implantable-bidirectional-neural-interface-experience-in-5-patients-with-parkinson-s-disease
#7
Nicole C Swann, Coralie de Hemptinne, Svjetlana Miocinovic, Salman Qasim, Jill L Ostrem, Nicholas B Galifianakis, Marta San Luciano, Sarah S Wang, Nathan Ziman, Robin Taylor, Philip A Starr
OBJECTIVE Dysfunction of distributed neural networks underlies many brain disorders. The development of neuromodulation therapies depends on a better understanding of these networks. Invasive human brain recordings have a favorable temporal and spatial resolution for the analysis of network phenomena but have generally been limited to acute intraoperative recording or short-term recording through temporarily externalized leads. Here, the authors describe their initial experience with an investigational, first-generation, totally implantable, bidirectional neural interface that allows both continuous therapeutic stimulation and recording of field potentials at multiple sites in a neural network...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28408788/apathy-and-reduced-speed-of-processing-underlie-decline-in-verbal-fluency-following-dbs
#8
Jennifer A Foley, Tom Foltynie, Ludvic Zrinzo, Jonathan A Hyam, Patricia Limousin, Lisa Cipolotti
Objective. Reduced verbal fluency is a strikingly uniform finding following deep brain stimulation (DBS) for Parkinson's disease (PD). The precise cognitive mechanism underlying this reduction remains unclear, but theories have suggested reduced motivation, linguistic skill, and/or executive function. It is of note, however, that previous reports have failed to consider the potential role of any changes in speed of processing. Thus, the aim of this study was to examine verbal fluency changes with a particular focus on the role of cognitive speed...
2017: Behavioural Neurology
https://www.readbyqxmd.com/read/28408262/optimization-of-microelectrode-recording-in-dbs-surgery-using-intraoperative-ct
#9
Ryan B Kochanski, Sander Bus, Gian Pal, Leo Verhagen Metman, Sepehr Sani
BACKGROUND: Microelectrode recording (MER) is used to confirm targeting accuracy during deep brain stimulation (DBS) surgery. We describe a technique using intraoperative CT extrapolation (iCTE) to predetermine and adjust the trajectory of the guide tube in order to improve microelectrode targeting accuracy. We hypothesized that this technique would decrease the number of MER tracks and operative time, while increasing the recorded length of subthalamic nucleus (STN). METHODS: Thirty-nine patients with Parkinson's disease who underwent STN DBS before the iCTE method were compared to 33 patients undergoing STN DBS using iCTE...
April 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28407815/acute-symptomatic-peri-lead-edema-33%C3%A2-hours-after-deep-brain-stimulation-surgery-a-case-report
#10
Nathan B Schoen, Walter J Jermakowicz, Corneliu C Luca, Jonathan R Jagid
BACKGROUND: Symptomatic peri-lead edema is a rare complication of deep brain stimulation that has been reported to develop 4 to 120 days postoperatively. CASE PRESENTATION: Here we report the case of a 63-year-old Hispanic man with an 8-year history of Parkinson's disease who underwent bilateral placement of subthalamic nucleus deep brain stimulation leads and presented with acute, symptomatic, unilateral, peri-lead edema just 33 hours after surgery. CONCLUSIONS: We document a thorough radiographic time course showing the evolution of these peri-lead changes and their regression with steroid therapy, and discuss the therapeutic implications of these findings...
April 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28399152/tackling-psychosocial-maladjustment-in-parkinson-s-disease-patients-following-subthalamic-deep-brain-stimulation-a-randomised-clinical-trial
#11
Joao Flores Alves Dos Santos, Sophie Tezenas du Montcel, Marcella Gargiulo, Cecile Behar, Sébastien Montel, Thierry Hergueta, Soledad Navarro, Hayat Belaid, Pauline Cloitre, Carine Karachi, Luc Mallet, Marie-Laure Welter
BACKGROUND: Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for the motor and non-motor signs of Parkinson's disease (PD), however, psychological disorders and social maladjustment have been reported in about one third of patients after STN-DBS. We propose here a perioperative psychoeducation programme to limit such social and familial disruption. METHODS: Nineteen PD patients and carers were included in a randomised single blind study...
2017: PloS One
https://www.readbyqxmd.com/read/28391276/how-efficient-is-subthalamic-deep-brain-stimulation-in-reducing-dyskinesia-in-parkinson-s-disease
#12
Annamária Juhász, Gabriella Deli, Zsuzsanna Aschermann, József Janszky, Márk Harmat, Attila Makkos, Márton Kovács, Sámuel Komoly, István Balás, Tamás Dóczi, András Büki, Norbert Kovács
BACKGROUND: Dyskinesia is among the most troublesome symptoms of advanced Parkinson's disease (PD). The recently developed Unified Dyskinesia Rating Scale (UDysRS) can simultaneously measure several subjective and objective aspects of dyskinesia, irrespective of the other motor symptoms of PD. Despite the advantages of deep brain stimulation (DBS), previous studies on DBS have not used the UDysRS yet. METHODS: In this prospective study, 71 consecutive patients undergoing DBS implantation were enrolled...
April 8, 2017: European Neurology
https://www.readbyqxmd.com/read/28391201/using-wearable-technology-to-generate-objective-parkinson-s-disease-dyskinesia-severity-score-possibilities-for-home-monitoring
#13
Mehdi Delrobaei, Navid Baktash, Greydon Gilmore, Kenneth McIsaac, Mandar Jog
A variety of clinical scales are available to assess dyskinesia severity in Parkinson's disease patients; however, such assessments are subjective, do not provide long term monitoring, and their use is subject to inter- and intra-rater variability. In this study, an objective dyskinesia score was developed using an IMU-based motion capture system. Deep brain stimulation (DBS) surgery is currently the only acute intervention that results in rapidly progressive reduction of dyskinesia's severity, hence this form of therapy was selected as a model to validate the proposed method...
April 3, 2017: IEEE Transactions on Neural Systems and Rehabilitation Engineering
https://www.readbyqxmd.com/read/28390148/toward-an-electrophysiological-sweet-spot-for-deep-brain-stimulation-in-the-subthalamic-nucleus
#14
Andreas Horn, Wolf-Julian Neumann, Katharina Degen, Gerd-Helge Schneider, Andrea A Kühn
Enhanced beta-band activity recorded in patients suffering from Parkinson's Disease (PD) has been described as a potential physiomarker for disease severity. Beta power is suppressed by Levodopa intake and STN deep brain stimulation (DBS) and correlates with disease severity across patients. The aim of the present study was to explore the promising signature of the physiomarker in the spatial domain. Based on local field potential data acquired from 54 patients undergoing STN-DBS, power values within alpha, beta, low beta, and high beta bands were calculated...
April 8, 2017: Human Brain Mapping
https://www.readbyqxmd.com/read/28389718/oscillatory-reactivity-to-effortful-cognitive-processing-in-the-subthalamic-nucleus-and-internal-pallidum-a-depth-electrode-eeg-study
#15
Martina Bočková, Jan Chládek, Pavel Jurák, Josef Halámek, Steven Z Rapcsak, Marek Baláž, Jan Chrastina, Ivan Rektor
This study investigates how complex motor-cognitive activities are processed in the subthalamic nucleus (STN) and internal globus pallidum (GPi), as adverse neuropsychiatric effects may accompany deep brain stimulation (DBS), mainly in Parkinson's disease (PD) and STN-DBS. Dystonia patients with GPi-DBS electrodes (n = 5) and PD subjects (n = 5) with STN-DBS electrodes performed two tasks: (1) copying letters; and (2) writing any letter other than that appearing on the monitor. The cognitive load of the second task was greater than that of the first...
April 7, 2017: Journal of Neural Transmission
https://www.readbyqxmd.com/read/28389156/response-of-non-motor-symptoms-to-levodopa-in-late-stage-parkinson-s-disease-results-of-a-levodopa-challenge-test
#16
Margherita Fabbri, Miguel Coelho, Leonor Correia Guedes, Ines Chendo, Catarina Sousa, Mario M Rosa, Daisy Abreu, Nilza Costa, Catarina Godinho, Angelo Antonini, Joaquim J Ferreira
BACKGROUND: Non-motor symptoms (NMS) are extremely common among late-stage Parkinson's disease (LSPD) patients. Levodopa (L-dopa) responsiveness seems to decrease with disease progression but its effect on NMS in LSPD still needs to be investigated. OBJECTIVE: To assess the response of blood pressure (BP), pain, fatigue and anxiety to L-dopa in LSPD patients. METHODS: 20 LSPD patients, defined as Schwab and England ADL Scale <50 or Hoehn Yahr Stage >3 (MED ON) and 22 PD patients treated with subthalamic deep brain stimulation (advanced PD group) underwent an L-dopa challenge...
February 7, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28387629/is-staged-bilateral-thalamic-radiosurgery-an-option-for-otherwise-surgically-ineligible-patients-with-medically-refractory-bilateral-tremor
#17
Ajay Niranjan, Sudesh S Raju, Edward A Monaco, John C Flickinger, L Dade Lunsford
OBJECTIVE Unilateral Gamma Knife thalamotomy (GKT) is a well-established treatment for patients with medically refractory tremor who are not eligible for invasive procedures due to increased risk of compications. The purpose of this study was to evaluate whether staged bilateral GKT provides benefit with acceptable risk to patients suffering from disabling medically refractory bilateral tremor. METHODS Eleven patients underwent staged bilateral GKT during a 17-year period (1999-2016). Eight patients had essential tremor (ET), 2 had Parkinson's disease (PD)-related tremor, and 1 had multiple-sclerosis (MS)-related tremor...
April 7, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28380317/back-to-the-future-30th-anniversary-of-deep-brain-stimulation-for-parkinson-s-disease
#18
EDITORIAL
N G Pozzi, Claudio Pacchetti
No abstract text is available yet for this article.
January 2017: Functional Neurology
https://www.readbyqxmd.com/read/28376692/neuroversion-using-electroconvulsive-therapy-as-a-bridge-to-deep-brain-stimulation-implantation
#19
Nolan R Williams, Greg Sahlem, Jaspreet Pannu, Istvan Takacs, Baron Short, Gonzalo Revuelta, Mark S George
Parkinson's disease (PD) is a movement disorder with significant neuropsychiatric comorbidities. Electroconvulsive therapy (ECT) is effective in treating these neuropsychiatric symptoms; however, clinicians are reluctant to use ECT in patients with deep brain stimulation (DBS) implantations for fear of damaging the device, as well as potential cognitive side effects. Right unilateral ultra-brief pulse (RUL UBP) ECT has a more favorable cognitive side-effect profile yet has never been reported in PD patients with DBS implants...
February 2017: Neurocase
https://www.readbyqxmd.com/read/28376379/the-effect-of-subthalamic-stimulation-on-viscoelastic-stiffness-of-skeletal-muscles-in-patients-with-parkinson-s-disease
#20
Tõnu Rätsep, Toomas Asser
BACKGROUND: Myotonometric evaluation of viscoelastic stiffness of skeletal muscles has been proposed to document the effect of surgical or pharmacological treatment on rigidity in patients with Parkinson's disease. The aim of the study was to analyze the changes of viscoelastic stiffness induced by deep brain stimulation. METHODS: Fifteen patients in an advanced stage of Parkinson's disease participated in the study. The study took place in the off-medication conditions after one night of drug withdrawal...
March 29, 2017: Clinical Biomechanics
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