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Parkinson's Disease, Deep brain stimulation

Sabato Santaniello, John T Gale, Sridevi V Sarma
Over the last 30 years, deep brain stimulation (DBS) has been used to treat chronic neurological diseases like dystonia, obsessive-compulsive disorders, essential tremor, Parkinson's disease, and more recently, dementias, depression, cognitive disorders, and epilepsy. Despite its wide use, DBS presents numerous challenges for both clinicians and engineers. One challenge is the design of novel, more efficient DBS therapies, which are hampered by the lack of complete understanding about the cellular mechanisms of therapeutic DBS...
March 20, 2018: Wiley Interdisciplinary Reviews. Systems Biology and Medicine
Tora Bonnevie, Kareem A Zaghloul
How do we decide what we do? This is the essence of action control, the process of selecting the most appropriate response among multiple possible choices. Suboptimal action control can involve a failure to initiate or adapt actions, or conversely it can involve making actions impulsively. There has been an increasing focus on the specific role of the subthalamic nucleus (STN) in action control. This has been fueled by the clinical relevance of this basal ganglia nucleus as a target for deep brain stimulation (DBS), primarily in Parkinson's disease but also in obsessive-compulsive disorder...
March 1, 2018: Neuroscientist: a Review Journal Bringing Neurobiology, Neurology and Psychiatry
Shao-Hua Xu, Chao Yang, Wen-Biao Xian, Jing Gu, Jin-Long Liu, Lu-Lu Jiang, Jing Ye, Yan-Mei Liu, Qi-Yu Guo, Yi-Fan Zheng, Lei Wu, Wan-Ru Chen, Zhong Pei, Ling Chen
Deep brain stimulation of the subthalamic nucleus is recognized as the most effective treatment for moderate and advanced Parkinson's disease. Programming of the stimulation parameters is important for maintaining the efficacy of deep brain stimulation. Voltage is considered to be the most effective programming parameter. The present study is a retrospective analysis of six patients with Parkinson's disease (four men and two women, aged 37-65 years), who underwent bilateral deep brain stimulation of the subthalamic nucleus at the First Affiliated Hospital of Sun Yat-sen University, China, and who subsequently adjusted only the stimulation voltage...
February 2018: Neural Regeneration Research
Omid Abbasi, Jan Hirschmann, Lena Storzer, Tolga Esat Özkurt, Saskia Elben, Jan Vesper, Lars Wojtecki, Georg Schmitz, Alfons Schnitzler, Markus Butz
Deep brain stimulation (DBS) is an established therapy to treat motor symptoms in movement disorders such as Parkinson's disease (PD). The mechanisms leading to the high therapeutic effectiveness of DBS are poorly understood so far, but modulation of oscillatory activity is likely to play an important role. Thus, investigating the effect of DBS on cortical oscillatory activity can help clarifying the neurophysiological mechanisms of DBS. Here, we aimed at scrutinizing changes of cortical oscillatory activity by DBS at different frequencies using magnetoencephalography (MEG)...
March 15, 2018: NeuroImage
Moran Gilat, Ana Lígia Silva de Lima, Bastiaan R Bloem, James M Shine, Jorik Nonnekes, Simon J G Lewis
Freezing of gait is a devastating symptom of Parkinson's disease and other forms of parkinsonism. It poses a major burden on both patients and their families, as freezing often leads to falls, fall-related injuries and a loss of independence. Treating freezing of gait is difficult for a variety of reasons: it has a paroxysmal and unpredictable nature; a multifaceted pathophysiology, with an interplay between motor elements (disturbed stepping mechanisms) and non-motor elements (cognitive decline, anxiety); and a complex (and likely heterogeneous) underlying neural substrate, involving multiple failing neural networks...
March 12, 2018: Parkinsonism & related Disorders
Antonella Macerollo, Matt J N Brown, James M Kilner, Robert Chen
Measurements of somatosensory evoked potentials (SEPs), recorded using electroencephalography during different phases of movement, have been fundamental in understanding the neurophysiological changes related to motor control. SEP recordings have also been used to investigate adaptive plasticity changes in somatosensory processing related to active and observational motor learning tasks. Combining noninvasive brain stimulation with SEP recordings and intracranial SEP depth recordings, including recordings from deep brain stimulation electrodes, has been critical in identifying neural areas involved in specific temporal stages of somatosensory processing...
March 14, 2018: Trends in Neurosciences
Rubens Gisbert Cury, Margarete de Jesus Carvalho, Fernando Jeyson Lopez Lasteros, Alice Estevo Dias, Maria Gabriela Dos Santos Ghilardi, Anderson Rodrigues Brandão Paiva, Artur Martins Coutinho, Carlos Alberto Buchpiguel, Manoel J Teixeira, Egberto Reis Barbosa, Erich Talamoni Fonoff
BACKGROUND: Olfactory dysfunction is a non-motor symptom of Parkinson's disease (PD) associated with reduction in quality of life. There is no evidence on whether improvements in olfaction after subthalamic deep brain stimulation (STN-DBS) may be directly attributable to motor improvement or whether this reflect a direct effect of DBS on olfactory brain areas. The aim of this study was to evaluate the effect of DBS on olfactory function (OF) in PD as well as to explore the correlation between these changes and changes in motor symptoms and brain metabolism...
March 13, 2018: World Neurosurgery
Tsinsue Chen, Zaman Mirzadeh, Kristina M Chapple, Margaret Lambert, Holly A Shill, Guillermo Moguel-Cobos, Alexander I Tröster, Rohit Dhall, Francisco A Ponce
OBJECTIVE Recent studies have shown similar clinical outcomes between Parkinson disease (PD) patients treated with deep brain stimulation (DBS) under general anesthesia without microelectrode recording (MER), so-called "asleep" DBS, and historical cohorts undergoing "awake" DBS with MER guidance. However, few studies include internal controls. This study aims to compare clinical outcomes after globus pallidus internus (GPi) and subthalamic nucleus (STN) DBS using awake and asleep techniques at a single institution...
March 16, 2018: Journal of Neurosurgery
Chih-Wei Hsu, Chin-Chuen Lin, Tiao-Lai Huang
No abstract text is available yet for this article.
March 2018: Psychiatria Danubina
Anand Rughani, Jason M Schwalb, Christos Sidiropoulos, Julie Pilitsis, Adolfo Ramirez-Zamora, Jennifer A Sweet, Sandeep Mittal, Alberto J Espay, Jorge Gonzalez Martinez, Aviva Abosch, Emad Eskandar, Robert Gross, Ron Alterman, Clement Hamani
QUESTION 1: Is bilateral subthalamic nucleus deep brain stimulation (STN DBS) more, less, or as effective as bilateral globus pallidus internus deep brain stimulation (GPi DBS) in treating motor symptoms of Parkinson's disease, as measured by improvements in Unified Parkinson's Disease Rating Scale, part III (UPDRS-III) scores? RECOMMENDATION: Given that bilateral STN DBS is at least as effective as bilateral GPi DBS in treating motor symptoms of Parkinson's disease (as measured by improvements in UPDRS-III scores), consideration can be given to the selection of either target in patients undergoing surgery to treat motor symptoms...
March 12, 2018: Neurosurgery
Fabian Blasberg, Lars Wojtecki, Saskia Elben, Philipp Jörg Slotty, Jan Vesper, Alfons Schnitzler, Stefan Jun Groiss
BACKGROUND: Deep brain stimulation (DBS) surgery for Parkinson's disease (PD) is usually performed as awake surgery allowing sufficient intraoperative testing. Recently, outcomes after asleep surgery have been assumed comparable. However, direct comparisons between awake and asleep surgery are scarce. OBJECTIVE: To investigate the difference between awake and asleep surgery comparing motor and nonmotor outcome after subthalamic nucleus (STN)-DBS in a large single center PD population...
March 13, 2018: Neuromodulation: Journal of the International Neuromodulation Society
Fei Cong, Jia-Wei Wang, Bo Wang, Zhangyan Yang, Jing An, Zhentao Zuo, Zihao Zhang, Yu-Qing Zhang, Yan Zhuo
OBJECTIVES: To image the pedunculopontine tegmental nucleus (PPN), a deep brain stimulation (DBS) target for Parkinson disease, using MRI with validated results. METHODS: This study used the MP2RAGE sequence with high resolution and enhanced grey-white matter contrast on a 7-T ultra-high-field MRI system to image the PPN as well as a diffusion spectrum imaging method on a 3-T MRI system to reconstruct the main fibre systems surrounding the PPN. The coordinates of the rostral and caudal PPN poles of both sides were measured in relation to the third and fourth ventricular landmarks on the 7-T image...
March 12, 2018: European Radiology
Masataka Tanaka, Naoki Tani, Tomoyuki Maruo, Satoru Oshino, Koichi Hosomi, Youichi Saitoh, Haruhiko Kishima
OBJECTIVE: The aim of this study was to investigate the incidence of and risk factors for postoperative delirium (POD) after deep brain stimulation (DBS) surgery in patients with Parkinson's disease (PD). METHODS: We analyzed the preoperative T1-weigthed magnetic resonance imaging data of 71 PD patients who underwent DBS surgery. Multiple regression analysis was done with age, l-dopa equivalent daily dose, laterality of the surgery, target regions, number of electrode trajectories tried, grey matter (GM) volume, and white matter (WM) volume as explanatory variables and the duration (number of days) of POD as the response variable...
March 9, 2018: World Neurosurgery
Sun Qifeng, Zhao Dechun, Cheng Shanshan, Hou Xiaorong, Zhao Xing, Tian Yin
Local field potential of a patient with Parkinson's disease often shows abnormal oscillation phenomenon. Extracting and studying this phenomenon and designing adaptive deep brain stimulation control library have great significance in treatment of patients. This paper has designed a feature extraction method based on modified empirical mode decomposition which extracts the abnormal oscillation signal in the time domain to increase the overall performance. The IMF component which contains abnormal oscillation is extracted by using empirical mode decomposition before an intrinsic characteristic of the oscillation signal is obtained...
March 12, 2018: International Journal of Neuroscience
F Vitale, A Capozzo, P Mazzone, E Scarnati
The interest in the pedunculopontine tegmental nucleus (PPTg), a structure located in the brainstem at the level of the pontomesencephalic junction, has greatly increased in recent years because it is involved in the regulation of physiological functions that fail in Parkinson's disease and because it is a promising target for deep brain stimulation in movement disorders. The PPTg is highly interconnected with the main basal ganglia nuclei and relays basal ganglia activity to thalamic and brainstem nuclei and to spinal effectors...
March 7, 2018: Neurobiology of Disease
Yanyan Wang, Yong Wang, Junhua Liu, Xiaomin Wang
Previous studies have shown that electroacupuncture (EA) promotes recovery of motor function in Parkinson's disease (PD). However the mechanisms are not completely understood. Clinically, the subthalamic nucleus (STN) is a critical target for deep brain stimulation treatment of PD, and vesicular glutamate transporter 1 (VGluT1) plays an important role in the modulation of glutamate in the STN derived from the cortex. In this study, a 6-hydroxydopamine (6-OHDA)-lesioned rat model of PD was treated with 100 Hz EA for 4 weeks...
March 5, 2018: Neuroscience Bulletin
Chuyi Huang, Heling Chu, Yan Zhang, Xiaoping Wang
Freezing of gait (FOG) is a gait disorder featured by recurrent episodes of temporary gait halting and mainly found in advanced Parkinson's disease (PD). FOG has a severe impact on the quality of life of patients with PD. The pathogenesis of FOG is unclear and considered to be related to several brain areas and neural circuits. Its close connection with cognitive disorder has been proposed and some researchers explain the pathogenesis using the cognitive model theory. FOG occurs concurrently with cognitive disorder in some PD patients, who are poorly responsive to medication therapy...
2018: Frontiers in Neuroscience
Abhishek Lenka, Ketan R Jhunjhunwala, Albert Stezin, M Manjunath, Dwarakanath Srinivas, Ravi Yadav, Pramod K Pal
Improvement in motor symptoms with levodopa is one of the hallmark features of Parkinson's disease (PD). The response to levodopa may reduce during the course of the illness. Few studies have also reported reduced response to levodopa in patients with PD several years after deep brain stimulation (DBS) of the subthalamic nucleus (STN) on both the sides. In this study, we report an extreme unresponsiveness to levodopa in the presence of a good response to STN stimulation in a patient 5 years after the DBS proceudre had been carried out...
March 2018: Neurology India
Manmohan Singh, K V Shabari Girishan, Jitin Bajaj, Kanwaljeet Garg
Parkinson's disease (PD) and dystonia are common indications for the deep brain stimulation (DBS) procedure. It is very important to be diligent about target localization and execution of the procedure. The single most important predictor of a good postoperative outcome is proper patient selection. The various steps of performing DBS include taking a preoperative non - stereotactic MRI, stereotactic frame fixation, fusion of MRI with stereotactic CT scan images, planning of the target and trajectory, lead placement at target through the planned trajectory, implantation of pulse generator/ battery and programming of the implanted device...
March 2018: Neurology India
Paresh K Doshi
It has been three decades since the first application of deep brain stimulation (DBS) for tremors was described by Benabid. Over the years, the indications for the performance of DBS have been expanding. There are now more than 1,50,000 patients around the world who have undergone DBS for various disorders. The main appeal of DBS is in its reversibility and titratability. Though the initial interest in DBS was for pain, the main indications for DBS have been movement disorders. Despite its wide appeal and "perceived" advantage, United States Food and Drug Administration, the nodal agency for approving therapies, has been cautious and guarded in providing approvals...
March 2018: Neurology India
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