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Parkinson's Disease, Deep brain stimulation

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https://www.readbyqxmd.com/read/29165837/pulse-duration-settings-in-subthalamic-stimulation-for-parkinson-s-disease
#1
Frank Steigerwald, Lars Timmermann, Andrea Kühn, Alfons Schnitzler, Martin M Reich, Anna Dalal Kirsch, Michael Thomas Barbe, Veerle Visser-Vandewalle, Julius Hübl, Christoph van Riesen, Stefan Jun Groiss, Alexia-Sabine Moldovan, Sherry Lin, Stephen Carcieri, Ljubomir Manola, Jens Volkmann
BACKGROUND: Stimulation parameters in deep brain stimulation (DBS) of the subthalamic nucleus for Parkinson's disease (PD) are rarely tested in double-blind conditions. Evidence-based recommendations on optimal stimulator settings are needed. Results from the CUSTOM-DBS study are reported, comparing 2 pulse durations. METHODS: A total of 15 patients were programmed using a pulse width of 30 µs (test) or 60 µs (control). Efficacy and side-effect thresholds and unified PD rating scale (UPDRS) III were measured in meds-off (primary outcome)...
November 22, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29165825/understanding-the-lived-experiences-of-parkinson-s-disease-and-deep-brain-stimulation-dbs-through-occupational-changes
#2
Jacki Liddle, Jessie Phillips, Louise Gustafsson, Peter Silburn
BACKGROUND: Deep brain stimulation (DBS), a surgically based treatment for people living with Parkinson's disease (PD), can result in a significant improvement of motor symptoms. However, the broader impact of DBS and the changes it creates are not well understood. Greater understanding of the experiences and needs related to DBS would enable development of relevant outcome measures and supports. OBJECTIVES: To explore the lived experiences of people undergoing DBS for Parkinson's disease...
November 22, 2017: Australian Occupational Therapy Journal
https://www.readbyqxmd.com/read/29164735/substituting-the-target-after-unsatisfactory-outcome-of-deep-brain-stimulation-in-advanced-parkinson-s-disease-cases-from-the-nstaps-trial-and-systematic-review-of-the-literature
#3
Timo R Ten Brinke, Vincent J J Odekerken, Teus van Laar, J Marc C van Dijk, Joke M Dijk, Pepijn van den Munckhof, P Rick Schuurman, Rob M A de Bie
BACKGROUND: Deep brain stimulation (DBS) of the globus pallidus pars interna (GPi) and the subthalamic nucleus (STN) are established treatment option in Parkinson's disease (PD). If DBS does not provide the desired effect, re-operation to the alternative target is a treatment option, but data on the effect of re-operation are scarce. OBJECTIVES: The objective of this study is to evaluate the clinical effect of re-operation the alternative target after failure of initial STN or GPi DBS for Parkinson's disease...
November 22, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29164724/intraoperative-localization-of-the-subthalamic-nucleus-using-long-latency-somatosensory-evoked-potentials
#4
Carlos Trenado, Saskia Elben, Lena Friggemann, Stefan Jun Groiss, Jan Vesper, Alfons Schnitzler, Lars Wojtecki
BACKGROUND: Target localization for deep brain stimulation (DBS) is a challenging step that determines not only the correct placement of stimulation electrodes, but also influences the success of the DBS procedure as reflected in the desired clinical outcome of a patient. OBJECTIVE: We report on the feasibility of DBS target localization in the subthalamic nucleus (STN) by long-latency somatosensory evoked potentials (LL-SSEPs) (>40 msec) in Parkinson's disease (PD) patients...
November 22, 2017: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29163340/the-dominant-subthalamic-nucleus-phenomenon-in-bilateral-deep-brain-stimulation-for-parkinson-s-disease-evidence-from-a-gait-analysis-study
#5
Mario Giorgio Rizzone, Maurizio Ferrarin, Michele Maria Lanotte, Leonardo Lopiano, Ilaria Carpinella
Background: It has been suggested that parkinsonian [Parkinson's disease (PD)] patients might have a "dominant" (DOM) subthalamic nucleus (STN), whose unilateral electrical stimulation [deep brain stimulation (DBS)] could lead to an improvement in PD symptoms similar to bilateral STN-DBS. Objectives: Since disability in PD patients is often related to gait problems, in this study, we wanted to investigate in a group of patients bilaterally implanted for STN-DBS: (1) if it was possible to identify a subgroup of subjects with a dominant STN; (2) in the case, if the unilateral stimulation of the dominant STN was capable to improve gait abnormalities, as assessed by instrumented multifactorial gait analysis, similarly to what observed with bilateral stimulation...
2017: Frontiers in Neurology
https://www.readbyqxmd.com/read/29161621/human-subthalamic-oscillatory-dynamics-following-somatosensory-stimulation
#6
Saskia Elben, Carlos Trenado, Jan Vesper, Alfons Schnitzler, Lars Wojtecki
OBJECTIVE: Electrical median nerve somatosensory stimulation leads to a distinct modulation of cortical oscillations. Initial high frequency and gamma augmentation, as well as modulation of beta and alpha oscillations have been reported. We aimed at investigating the involvement of the subthalamic nucleus in somatosensory processing by means of local field potential recordings, since recordings during passive movements and peripheral somatosensory stimulation have suggested a prominent role...
October 28, 2017: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
https://www.readbyqxmd.com/read/29152502/target-specific-deep-brain-stimulation-of-the-ventral-capsule-ventral-striatum-for-the-treatment-of-neuropsychiatric-disease
#7
Chencheng Zhang, Dianyou Li, Haiyan Jin, Kristina Zeljic, Bomin Sun
Deep brain stimulation (DBS) is a well-established therapy for Parkinson's disease and other movement disorders. An accumulating body of evidence supports the extension of DBS application for the treatment of refractory psychiatric disorders. The ventral capsule/ventral striatum (VC/VS) is the most common anatomical target for obsessive-compulsive disorder (OCD), addiction, and depression. However, no specific electrode is available for the clinical targeting of these areas for DBS. According to the anatomical features of the VC/VS, a novel electrode was developed for simultaneous and independently programmed stimulation of the nucleus accumbens (NAc) and the anterior limb of the internal capsule (ALIC)...
October 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29150873/survival-in-patients-with-parkinson-s-disease-after-deep-brain-stimulation-or-medical-management
#8
Frances M Weaver, Kevin T Stroupe, Bridget Smith, Beverly Gonzalez, Zhiping Huo, Lishan Cao, Dolores Ippolito, Kenneth A Follett
OBJECTIVE: Deep brain stimulation has been shown to have a significant long-term beneficial effect on motor function. However, whether it affects survival is not clear. In this study, we compared survival rates for Parkinson's disease (PD) patients who underwent deep brain stimulation (DBS) with those who were medically managed. METHODS: A retrospective analysis of Veterans Affairs and Medicare administrative data of veterans with PD who received DBS and were propensity score matched to a cohort of veterans with PD who did not receive DBS between 2007-2013...
November 18, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29150860/quality-of-life-outcomes-after-subthalamic-stimulation-in-parkinson-s-disease-depends-on-age
#9
Haidar S Dafsari, Paul Reker, Lisa Stalinski, Monty Silverdale, Alexandra Rizos, Keyoumars Ashkan, Michael T Barbe, Gereon R Fink, Julian Evans, Julia Steffen, Michael Samuel, Till A Dembek, Veerle Visser-Vandewalle, Angelo Antonini, K Ray-Chaudhuri, Pablo Martinez-Martin, Lars Timmermann
OBJECTIVE: The purpose of this study was to investigate how quality of life outcome after bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) in Parkinson's disease (PD) depends on age. METHODS: In this prospective, open-label, multicenter study including 120 PD patients undergoing bilateral STN-DBS, we investigated the PDQuestionnaire-8 (PDQ-8), Unified PD Rating Scale-III, Scales for Outcomes in PD-motor examination, complications, activities of daily living, and levodopa equivalent daily dose preoperatively and at 5 months follow-up...
November 18, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/29150478/early-versus-late-application-of-subthalamic-deep-brain-stimulation-to-parkinson-s-disease-patients-with-motor-complications-elass-protocol-of-a-multicentre-prospective-and-observational-study
#10
Lulu Jiang, Wai Sang Poon, Elena Moro, Wenbiao Xian, Chao Yang, Xian Lun Zhu, Jing Gu, Xiaodong Cai, Jinlong Liu, Vincent Mok, Yanmei Liu, Shaohua Xu, Qiyu Guo, Wanru Chen, Ling Chen
INTRODUCTION: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is a well-established surgical treatment for Parkinson's disease (PD). However, there is currently no consensus on the best timing for this surgery. The aim of our study is to compare the therapeutic efficacy of bilateral STN DBS in patients with PD with early and late motor complications. METHODS AND ANALYSIS: 200 patients with PD will be enrolled in this multicentre, prospective, observational study, and will be followed up for 4 years...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29147598/dbs-programming-an-evolving-approach-for-patients-with-parkinson-s-disease
#11
REVIEW
Aparna Wagle Shukla, Pam Zeilman, Hubert Fernandez, Jawad A Bajwa, Raja Mehanna
Deep brain stimulation (DBS) surgery is a well-established therapy for control of motor symptoms in Parkinson's disease. Despite an appropriate targeting and an accurate placement of DBS lead, a thorough and efficient programming is critical for a successful clinical outcome. DBS programming is a time consuming and laborious manual process. The current approach involves use of general guidelines involving determination of the lead type, electrode configuration, impedance check, and battery check. However there are no validated and well-established programming protocols...
2017: Parkinson's Disease
https://www.readbyqxmd.com/read/29142796/impact-of-depression-on-hospitalization-and-related-outcomes-for-parkinson-s-disease-patients-a-nationwide-inpatient-sample-based-retrospective-study
#12
Rikinkumar S Patel, Ramkrishna Makani, Zeeshan Mansuri, Upenkumar Patel, Rupak Desai, Amit Chopra
Background Major Depressive Disorder (MDD) is a common comorbidity that significantly affects the quality of life and disease outcomes in Parkinson's disease (PD) patients. No studies have been conducted to our knowledge to address the health care utilization and its outcomes in these patients. The aim of this study is to analyze and discern the differences in the hospitalization outcomes, comorbid conditions, and utilization of procedures in PD patients versus patients with comorbid MDD. Methods We used the Nationwide Inpatient Sample from the Healthcare Cost and Utilization Project from year's 2010-2014...
September 3, 2017: Curēus
https://www.readbyqxmd.com/read/29139079/neuromodulatory-procedures-for-gait-disorders-in-parkinson-s-disease
#13
REVIEW
Patrick Santens
The neurophysiology of gait is complex and involves numerous structures in the central nervous system. Gait disorders occur frequently in Parkinson's disease (PD), and their management may become cumbersome, especially in the more advanced stages. Neuromodulatory treatments, including deep brain stimulation, cortical stimulation and spinal cord stimulation, are reviewed with respect to their effectiveness to improve gait in PD patients. Although positive effects have been reported for all of these procedures, many issues remain in view of methodological heterogeneity, variability in outcome measures and sample size...
November 14, 2017: Acta Neurologica Belgica
https://www.readbyqxmd.com/read/29132271/capgras-syndrome-in-advanced-parkinson-s-disease
#14
Christopher L Groth, Antonia Pusso, Scott A Sperling, Diane S Huss, W Jeffrey Elias, G Frederick Wooten, Matthew J Barrett
Psychosis is common in Parkinson's disease (PD), especially in advanced disease, and can lead to a number of psychotic symptoms, including delusions. One uncommon delusion is Capgras syndrome (CS). The authors report on three PD patients with a history of deep brain stimulation (DBS) who developed this delusion. The anatomic targets in these three patients were the subthalamic nuclei in two patients and the globus pallidus interna in one patient. The length of time between surgery and development of CS varied but was greater than 6 months...
November 14, 2017: Journal of Neuropsychiatry and Clinical Neurosciences
https://www.readbyqxmd.com/read/29130551/a-localized-pallidal-physiomarker-in-cervical-dystonia
#15
Wolf-Julian Neumann, Andreas Horn, Siobhan Ewert, Julius Huebl, Christof Brücke, Colleen Slentz, Gerd-Helge Schneider, Andrea A Kühn
OBJECTIVE: Deep brain stimulation (DBS) allows for direct recordings of neuronal activity from the human basal ganglia. In Parkinson's disease, a disease-specific physiomarker was identified that is now used to investigate adaptive closed-loop stimulation in first studies. In dystonia such a physiomarker is missing. METHODS: Pallidal oscillations were recorded from 153 contact pairs in 27 patients. We investigated whether power amplitudes in theta and beta bands correlate with dystonic symptom severity across patients...
November 11, 2017: Annals of Neurology
https://www.readbyqxmd.com/read/29126889/impaired-glutamatergic-projection-from-the-motor-cortex-to-the-subthalamic-nucleus-in-6-hydroxydopamine-lesioned-hemi-parkinsonian-rats
#16
Yan-Yan Wang, Yong Wang, Hai-Fei Jiang, Jun-Hua Liu, Jun Jia, Ke Wang, Fei Zhao, Min-Hua Luo, Min-Min Luo, Xiao-Min Wang
The glutamatergic projection from the motor cortex to the subthalamic nucleus (STN) constitutes the cortico-basal ganglia circuit and plays a critical role in the control of movement. Emerging evidence shows that the cortico-STN pathway is susceptible to dopamine depletion. Specifically in Parkinson's disease (PD), abnormal electrophysiological activities were observed in the motor cortex and STN, while the STN serves as a key target of deep brain stimulation for PD therapy. However, direct morphological changes in the cortico-STN connectivity in response to PD progress are poorly understood at present...
November 8, 2017: Experimental Neurology
https://www.readbyqxmd.com/read/29116383/deep-brain-stimulation-custom-made-silicone-coated-pulse-generator-implantation-after-allergic-reaction-to-generator-compounds
#17
Judith Anthofer, Andreas Herbst, Annettte Janzen, Max Lange, Alexander Brawanski, Juergen Schlaier
Deep brain stimulation for Parkinson's disease has become an established treatment option in recent years. The method and its application in clinical practice has proved to be safe and effective. Nevertheless, procedure-related and hardware-related complications occur. We present a rare case of a patient with an allergic reaction to the impulse generator. The patient suffered from delayed wound-healing deficits with several wound revisions and generator repositionings. After diagnosis of an allergic reaction to components of the generator, a custom-made silicon-coated model was implanted...
November 7, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29114364/outcome-of-subthalamic-nucleus-deep-brain-stimulation-on-long-term-motor-function-of-patients-with-advanced-parkinson-disease
#18
Gholam Ali Shahidi, Mohammad Rohani, Mansour Parvaresh, Bahram Haghi-Ashtiani, Maryam Saeedi, Romina Rashedi, Zeynab Noori-Motlagh
Background: The objective of our study was to assess Unified Parkinson Disease Rating Scale (UPDRS) score in Parkinson disease (PD) patients who underwent subthalamic nucleus (STN) deep brain stimulation (DBS) 6 years after their surgery and to compare their UPDRS score 6 years after DBS with their score before surgery and 6 months after their operation. Methods: In this cross sectional study which was carried out at Neurology Department of Rasool-e Akram Hospital, Tehran, Iran, affiliated to Iran University of Medical Sciences between 2008 and 2014, 37 patients with advanced PD were enrolled using non-randomized sampling method...
July 6, 2017: Iranian Journal of Neurology
https://www.readbyqxmd.com/read/29113472/cell-therapy-for-parkinson-s-disease
#19
Takao Yasuhara, Masahiro Kameda, Tatsuya Sasaki, Naoki Tajiri, Isao Date
Cell therapy for Parkinson's disease (PD) began in 1979 with the transplantation of fetal rat dopamine-containing neurons that improved motor abnormalities in the PD rat model with good survival of grafts and axonal outgrowth. Thirty years have passed since the 2 clinical trials using cell transplantation for PD patients were first reported. Recently, cell therapy is expected to develop as a realistic treatment option for PD patients owing to the advancement of biotechnology represented by pluripotent stem cells...
September 2017: Cell Transplantation
https://www.readbyqxmd.com/read/29105245/comparison-of-the-battery-life-of-nonrechargeable-generators-for-deep-brain-stimulation
#20
Ann-Kristin Helmers, Isabel Lübbing, Günther Deuschl, Karsten Witt, Michael Synowitz, Hubertus Maximilian Mehdorn, Daniela Falk
OBJECTIVE: Nonrechargeable deep brain stimulation (DBS) generators must be replaced when the battery capacity is exhausted. Battery life depends on many factors and differs between generator models. A new nonrechargeable generator model replaced the previous model in 2008. Our clinical impression is that the earlier model had a longer battery life than the new one. We conducted this study to substantiate this. METHODS: We determined the battery life of every DBS generator that had been implanted between 2005 and 2012 in our department for the treatment of Parkinson's disease, and compared the battery lives of the both devices...
November 3, 2017: Neuromodulation: Journal of the International Neuromodulation Society
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