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https://www.readbyqxmd.com/read/28615985/treatment-of-movement-disorders-with-focused-ultrasound
#1
REVIEW
Paul S Fishman, Victor Frenkel
Although the use of ultrasound as a potential therapeutic modality in the brain has been under study for several decades, relatively few neuroscientists or neurologists are familiar with this technology. Stereotactic brain lesioning had been widely used as a treatment for medically refractory patients with essential tremor (ET), Parkinson disease (PD), and dystonia but has been largely replaced by deep brain stimulation (DBS) surgery, with advantages both in safety and efficacy. However, DBS is associated with complications including intracerebral hemorrhage, infection, and hardware malfunction...
2017: Journal of Central Nervous System Disease
https://www.readbyqxmd.com/read/28601961/basal-ganglia-movement-disorders-and-deep-brain-stimulation-advances-made-through-non-human-primate-research
#2
REVIEW
Thomas Wichmann, Hagai Bergman, Mahlon R DeLong
Studies in non-human primates (NHPs) have led to major advances in our understanding of the function of the basal ganglia and of the pathophysiologic mechanisms of hypokinetic movement disorders such as Parkinson's disease and hyperkinetic disorders such as chorea and dystonia. Since the brains of NHPs are anatomically very close to those of humans, disease states and the effects of medical and surgical approaches, such as deep brain stimulation (DBS), can be more faithfully modeled in NHPs than in other species...
June 10, 2017: Journal of Neural Transmission
https://www.readbyqxmd.com/read/28590521/seventy-years-with-the-globus-pallidus-pallidal-surgery-for-movement-disorders-between-1947-and-2017
#3
REVIEW
Laura Cif, Marwan Hariz
The year 2017 marks the 70th anniversary of the birth of human stereotactic neurosurgery. The first procedure was a pallidotomy for Huntington's disease. However, it was for Parkinson's disease that pallidotomy was soon adopted worldwide. Pallidotomy was abandoned in the late 1950s in favor of thalamotomy because of the latter's more striking effect on tremor. The advent of levodopa put a halt to all surgery for PD. In the mid-1980s, Laitinen reintroduced the posteroventral pallidotomy of Leksell, and this procedure spread worldwide thanks to its efficacy on most parkinsonian symptoms including levodopa-induced dyskinesias and thanks to basic scientific work confirming the role of the globus pallidus internus in the pathophysiology of PD...
June 7, 2017: Movement Disorders: Official Journal of the Movement Disorder Society
https://www.readbyqxmd.com/read/28586458/disease-stabilization-of-dyt1-positive-primary-generalized-dystonia-with-deep-brain-stimulation-of-the-globus-pallidus-interna-a-15-yr-follow-up
#4
Derrick A Dupre, Raj Nangunoori, Sravanthi Koduri, Cindy Angle, Diane Cantella, Donald Whiting
BACKGROUND AND IMPORTANCE: Primary generalized dystonia (PGD) is a genetic form of dystonia that frequently displays pharmacological resistance and progresses quickly after onset. Deep brain stimulation (DBS) has been used successfully to treat refractory dystonia, specifically globus pallidus interna (GPi) DBS for DYT1-positive PGD patients. Long-term follow-up of the safety and efficacy falls short of the longevity seen in other diseases treated with DBS. CASE PRESENTATION: A male patient presented for neurosurgical evaluation with scapular winging, hand contractures, and violent truncal spasms, which forced him to be bedridden...
June 6, 2017: Operative Neurosurgery (Hagerstown, Md.)
https://www.readbyqxmd.com/read/28552340/long-term-follow-up-of-bilateral-subthalamic-deep-brain-stimulation-for-refractory-tardive-dystonia
#5
Zheng-Dao Deng, Dian-You Li, Chen-Cheng Zhang, Yi-Xin Pan, Jin Zhang, Haiyan Jin, Kristina Zeljec, Shi-Kun Zhan, Bo-Min Sun
BACKGROUND: No effective treatment for tardive dystonia (TD) has been well established. Deep brain stimulation (DBS) can ameliorate motor manifestations in primary dystonia, and may also be an effective approach for TD. OBJECTIVES: This study aimed to illuminate the long-term efficacy and safety of subthalamic nucleus (STN)-DBS in treating TD. METHODS: Ten patients with refractory TD underwent STN-DBS therapy and were assessed by the Burke-Fahn-Marsden dystonia rating scale (BFMDRS), Abnormal Involuntary Movement Scale (AIMS), Hamilton Depression Scale (HAMD), Hamilton Anxiety Scale (HAMA), and the Short Form (36) Health Survey (SF-36) at four time points: pre-operation, 1 week post-operation, 6 months post-operation, and at a final long-term postsurgical follow-up time point...
May 19, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28536064/analysis-of-delayed-intracerebral-hemorrhage-associated-with-deep-brain-stimulation-surgery
#6
Chang Kyu Park, Na Young Jung, Min Soo Kim, Jin Woo Chang
OBJECTIVE: Deep brain stimulation (DBS) may cause various complications, including intracerebral hemorrhage (ICH). Because ICH causes devastating neurological outcomes, various surgical techniques are attempting to reduce the chances of ICH. More importantly, early detection and proper management of postoperative ICH are indispensable. ICH may occur immediate or delayed following DBS; in this study, we analyzed the clinical features of delayed ICH after DBS. METHODS: Patients (n=272) underwent postoperative brain computed tomography (CT) immediately after and 1 day after DBS between January 2008 and November 2016...
May 20, 2017: World Neurosurgery
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
#7
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/28424916/bilateral-pallidotomy-for-meige-syndrome
#8
Krasimir Minkin, Kaloyan Gabrovski, Petia Dimova, Rossitsa Tanova, Marin Penkov, Yuri Todorov, Kiril Romansky
Meige syndrome (MS) is usually described as a combination of blepharospasm with oromandibular dystonia. There are a large number of case reports of deep brain stimulation (DBS) of the globus pallidus internus (GPI) for MS and only one report of unilateral pallidotomy (PT). We report the first case of staged bilateral PT for treatment of a patient with MS using intraoperative high-frequency stimulation in order to predict and prevent postoperative deficit. There was a significant improvement of the Burk-Fahn-Marsden dystonia rating scale from 26 to 3...
July 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28413841/correlation-of-electrode-position-and-clinical-outcomes-in-globus-pallidus-stimulation-for-dystonia
#9
Hye Ran Park, Jae Min Lee, Gwanhee Ehm, Hui-Jun Yang, In Ho Song, Yong Hoon Lim, Mi-Ryoung Kim, Keyoung Ran Kim, Woong-Woo Lee, Young Eun Kim, Jae Ha Hwang, Chae Won Shin, Hyeyoung Park, Jin Wook Kim, Han-Joon Kim, Cheolyoung Kim, Dong Gyu Kim, Beom Seok Jeon, Sun Ha Paek
BACKGROUND: The correlation between the electrode location and the clinical outcome for internal globus pallidus (GPi) deep brain stimulation (DBS) has not been fully elucidated. OBJECTIVE: The aim of this study was to determine the discrepancies between the theoretical target planned by magnetic resonance imaging (MRI) and the actual electrode location in postoperative MRI, as well as to find the correlation between the final electrode locations and the clinical outcome after GPi DBS...
July 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28389718/oscillatory-reactivity-to-effortful-cognitive-processing-in-the-subthalamic-nucleus-and-internal-pallidum-a-depth-electrode-eeg-study
#10
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/28331322/the-role-of-deep-brain-stimulation-in-parkinson-s-disease-an-overview-and-update-on-new-developments
#11
REVIEW
John Y Fang, Christopher Tolleson
Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the loss of neuronal dopamine production in the brain. Oral therapies primarily augment the dopaminergic pathway. As the disease progresses, more continuous delivery of therapy is commonly needed. Deep brain stimulation (DBS) has become an effective therapy option for several different neurologic and psychiatric conditions, including PD. It currently has US Food and Drug Administration approval for PD and essential tremor, as well as a humanitarian device exception for dystonia and obsessive-compulsive disorder...
2017: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/28304188/the-effect-of-unilateral-thalamic-deep-brain-stimulation-on-the-vocal-dysfunction-in-a-patient-with-spasmodic-dysphonia-interrogating-cerebellar-and-pallidal-neural-circuits
#12
Anujan Poologaindran, Zurab Ivanishvili, Murray D Morrison, Linda A Rammage, Mini K Sandhu, Nancy E Polyhronopoulos, Christopher R Honey
Spasmodic dysphonia (SD) is a neurological disorder of the voice where a patient's ability to speak is compromised due to involuntary contractions of the intrinsic laryngeal muscles. Since the 1980s, SD has been treated with botulinum toxin A (BTX) injections into the throat. This therapy is limited by the delayed-onset of benefits, wearing-off effects, and repeated injections required every 3 months. In a patient with essential tremor (ET) and coincident SD, the authors set out to quantify the effects of thalamic deep brain stimulation (DBS) on vocal function while investigating the underlying motor thalamic circuitry...
March 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28297686/-early-experience-with-the-vercise-sup-tm-sup-dbs-system-in-the-treatment-of-dystonic-tremor
#13
Yasushi Miyagi
Six cases of dystonic tremor were treated with the Vercise<sup>TM</sup> deep brain stimulation(DBS)system, which has the multiple independent current control(MICC)technology. The mean preoperative score of Burke-Fahn-Marsden dystonia rating scale was 16.2±9.4, which was reduced to 6.1±4.6 at 5 months postoperatively. A 65-year-old male presented an intractable dystonic tremor of the jaw, neck, and shoulders due to tardive syndrome. He experienced the successful tremor relief after unipolar DBS in the globus pallidus internus(GPi)with Vercise<sup>TM</sup> but complained of dysarthria...
March 2017: No Shinkei Geka. Neurological Surgery
https://www.readbyqxmd.com/read/28273176/pulsatile-desynchronizing-delayed-feedback-for-closed-loop-deep-brain-stimulation
#14
Oleksandr V Popovych, Borys Lysyansky, Michael Rosenblum, Arkady Pikovsky, Peter A Tass
High-frequency (HF) deep brain stimulation (DBS) is the gold standard for the treatment of medically refractory movement disorders like Parkinson's disease, essential tremor, and dystonia, with a significant potential for application to other neurological diseases. The standard setup of HF DBS utilizes an open-loop stimulation protocol, where a permanent HF electrical pulse train is administered to the brain target areas irrespectively of the ongoing neuronal dynamics. Recent experimental and clinical studies demonstrate that a closed-loop, adaptive DBS might be superior to the open-loop setup...
2017: PloS One
https://www.readbyqxmd.com/read/28268677/improved-electrode-material-for-deep-brain-stimulation
#15
A Petrossians, J J Whalen, J D Weiland
Deep brain stimulation (DBS) devices have been implanted for treatment of basic tremor, Parkinson's disease and dystonia. These devices use electrodes in contact with tissue to deliver electrical pulses to targeted cells, to elicit specific therapeutic responses. In general, the neuromodulation industry has been evolving towards smaller, less invasive electrodes. However, current electrode materials do not support small sizes without severely restricting the stimulus output. Hence, an improved electrode material will benefit present and future DBS systems...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28247116/considerations-in-deep-brain-stimulation-dbs-for-pediatric-secondary-dystonia
#16
Deki Tsering, Laura Tochen, Bennett Lavenstein, Srijaya K Reddy, Yael Granader, Robert F Keating, Chima O Oluigbo
PURPOSE: There is a paucity of effective long-term medication treatment for secondary dystonias. In situations where significantly impairing secondary dystonias fail to respond to typical enteral medications and intrathecal (or even intraventricular) baclofen, consideration should be given to the use of deep brain stimulation (DBS). While Level I evidence and long-term follow-up clearly demonstrate the efficacy of DBS for primary dystonia, the evidence for secondary dystonia remains mixed and unclear...
April 2017: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28226861/improved-electrode-material-for-deep-brain-stimulation
#17
A Petrossians, J J Whalen, J D Weiland, A Petrossians, J J Whalen, J D Weiland, J J Whalen, A Petrossians, J D Weiland
Deep brain stimulation (DBS) devices have been implanted for treatment of basic tremor, Parkinson's disease and dystonia. These devices use electrodes in contact with tissue to deliver electrical pulses to targeted cells, to elicit specific therapeutic responses. In general, the neuromodulation industry has been evolving towards smaller, less invasive electrodes. However, current electrode materials do not support small sizes without severely restricting the stimulus output. Hence, an improved electrode material will benefit present and future DBS systems...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28220756/deep-brain-stimulation-for-childhood-dystonia-is-where-as-important-as-in-whom
#18
REVIEW
Daniel E Lumsden, Margaret Kaminska, Keyoumars Ashkan, Richard Selway, Jean-Pierre Lin
Deep brain stimulation (DBS) has become a mainstay of dystonia management in adulthood. Typically targeting electrode placement in the GPi, sustained improvement in dystonic symptoms are anticipated in adults with isolated genetic dystonias. Dystonia in childhood is more commonly a symptomatic condition, with dystonia frequently expressed on the background of a structurally abnormal brain. Outcomes following DBS in this setting are much more variable, the reasons for which have yet to be elucidated. Much of the focus on improving outcomes following DBS in dystonia management has been on the importance of patient selection, with, until recently, little discussion of the choice of target...
January 2017: European Journal of Paediatric Neurology: EJPN
https://www.readbyqxmd.com/read/28199993/intraoperative-thresholds-for-capsular-stimulation-are-reliable-for-chronic-pallidal-deep-brain-stimulation-in-dystonia
#19
René Reese, Martin M Reich, Daniela Falk, Günther Deuschl, H Maximilian Mehdorn, Jens Volkmann
BACKGROUND: The threshold current for inducing muscle contractions by stimulation of pyramidal tract fibres adjacent to the globus pallidus internus (GPi) is, besides microelectrode recordings for the determination of nuclear boundaries, currently the only neurophysiological marker for intraoperative refinement of the anatomically planned target point for pallidal deep brain stimulation (GPi-DBS) in dystonia. OBJECTIVES: To determine the relationship between intraoperative thresholds for muscle contractions under general anaesthesia and postoperative thresholds in GPi-DBS...
2017: Stereotactic and Functional Neurosurgery
https://www.readbyqxmd.com/read/28195407/a-pilot-trial-of-square-biphasic-pulse-deep-brain-stimulation-for-dystonia-the-bip-dystonia-study
#20
Leonardo Almeida, Daniel Martinez-Ramirez, Bilal Ahmed, Wissam Deeb, Sol De Jesus, Jared Skinner, Matthew J Terza, Umer Akbar, Robert S Raike, Chris J Hass, Michael S Okun
BACKGROUND: Dystonia often has inconsistent benefits and requires more energy-demanding DBS settings. Studies suggest that squared biphasic pulses could provide significant clinical benefit; however, dystonia patients have not been explored. OBJECTIVES: To assess safety and tolerability of square biphasic DBS in dystonia patients. METHODS: This study included primary generalized or cervical dystonia patients with bilateral GPi DBS. Square biphasic pulses were implemented and patients were assessed at baseline, immediately postwashout, post-30-minute washout, 1 hour post- and 2 hours postinitiation of investigational settings...
April 2017: Movement Disorders: Official Journal of the Movement Disorder Society
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