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Anders Fytagoridis, Mattias Åström, Jennifer Samuelsson, Patric Blomstedt
BACKGROUND: The caudal zona incerta (cZi) and posterior subthalamic area (PSA) are an emerging deep brain stimulation (DBS) target for essential tremor (ET). OBJECTIVES: To evaluate the efficacy of tremor control in relation to the anatomical locations of stimulation fields in 50 patients with ET and DBS of the cZi. METHODS: A total of 240 contacts were evaluated separately with monopolar stimulation, and amplitudes were optimized for improvement of tremor and hand function...
October 27, 2016: Stereotactic and Functional Neurosurgery
Zhe Li, Jian-Guo Zhang, Yan Ye, Xiaoping Li
BACKGROUND: Accurate implantation of a depth electrode into the brain is of the greatest importance in deep brain stimulation (DBS), and various stereotactic systems have been developed for electrode implantation. However, an updated analysis of depth electrode implantation in the modern era of DBS is lacking. OBJECTIVE: This study aims at providing an updated review on targeting accuracy of DBS electrode implantation by analyzing contemporary DBS electrode implantation operations from the perspective of precision engineering...
October 27, 2016: Stereotactic and Functional Neurosurgery
Rowshanak Hashemiyoon, Jens Kuhn, Veerle Visser-Vandewalle
Gilles de la Tourette syndrome is a complex, idiopathic neuropsychiatric disorder whose pathophysiological mechanisms have yet to be elucidated. It is phenotypically heterogeneous and manifests more often than not with both motor and behavioral impairment, although tics are its clinical hallmark. Tics themselves present with a complex profile as they characteristically wax and wane and are often preceded by premonitory somatosensory sensations to which it is said a tic is the response. Highly comorbid with obsessive-compulsive disorder and attention deficit-hyperactivity disorder, it is purported to be an epigenetic, neurodevelopmental spectrum disorder with a complex genetic profile...
October 25, 2016: Brain Topography
M M Broadney, N Chahal, K A Michels, A C McLain, A Ghassabian, D A Lawrence, E H Yeung
BACKGROUND/OBJECTIVES: Maternal obesity may influence neonatal and childhood morbidities through increased inflammation and/or altered immune response. Less is known about paternal obesity. We hypothesized that excessive parental weight contributes to elevated inflammation and altered immunoglobulin (Ig) profiles in neonates. SUBJECTS/METHODS: In the Upstate KIDS Study maternal pre-pregnancy body mass index (BMI) was obtained from vital records and paternal BMI from maternal report...
October 26, 2016: International Journal of Obesity: Journal of the International Association for the Study of Obesity
Han Wang, Huiqin Gao, Tianyu Jiao, Zhongli Luo
Postural instability and gait disturbance (PIGD) are common symptoms in patients with advanced Parkinson's disease (PD). The deep-brain stimulation (DBS) of the pedunculopontine nucleus (PPN) shows a promising effect on PIGD. However, the quantitative effects of PPN DBS for PD, especially for PIGD, and the efficacy of PPN DBS combined with levodopa are controversial and ambiguous to clinical practice. We carried out a meta-analysis of original researches on PPN to PIGD/PD from the electronic databases MEDLINE and EMBASE...
October 24, 2016: Neuroreport
Imelda Ryona, Jack Henion
Despite many benefits including simple point-of-care sample collection, reduced costs, and simplified shipping and storage, dried blood spot (DBS) techniques have faced adoption resistance such as the hematocrit (Hct) effects and the established preference for bioanalysis of plasma rather than whole blood. One way to potentially circumvent these challenges is to adopt the concept of a dried plasma spot (DPS) technique. One approach to accomplishing this is through an on-card red blood cell (RBC) filtration to generate plasma from whole blood without the need for centrifugation...
October 24, 2016: Analytical Chemistry
Nicholas Brandmeir, Elena Nehrbass, James McInerney
INTRODUCTION:  Deep brain stimulator (DBS) infections are a persistent problem for patients undergoing this procedure. They may require further surgery, treatment with antibiotics, or even removal of the device. To date, no consensus exists on the best practices to avoid DBS infections or what factors predispose patients to an eventual infection. The goal of this study was to examine several patient factors for association with DBS infection. METHODS:  A single-center, single-surgeon quality improvement database was queried...
September 20, 2016: Curēus
Elias Paolo Casula, Mario Stampanoni Bassi, Maria Concetta Pellicciari, Viviana Ponzo, Domenica Veniero, Antonella Peppe, Livia Brusa, Paolo Stanzione, Carlo Caltagirone, Alessandro Stefani, Giacomo Koch
BACKGROUND: The effects of deep brain stimulation of the subthalamic nucleus (DBS-STN) and L-dopa (LD) on cortical activity in Parkinson's disease (PD) are poorly understood. OBJECTIVES: By combining transcranial magnetic stimulation (TMS) and electroencephalography (EEG) we explored the effects of STN-DBS, either alone or in combination with L-Dopa (LD), on TMS-evoked cortical activity in a sample of implanted PD patients. METHODS: PD patients were tested in three clinical conditions: i) LD therapy with STN-DBS turned on (ON/ON condition); ii) without LD therapy with STN-DBS turned on (OFF/ON condition); iii) without LD therapy with STN-DBS turned off (OFF/OFF condition)...
October 17, 2016: Parkinsonism & related Disorders
Fraser Henderson, Istvan Takacs
BACKGROUND: Troubleshooting of deep brain stimulators (Activa SC/PC/RC Medtronic PLC) sometimes results in a decision to replace a tunneled stretch-coil extension cable. We present a simple technique to accomplish this atraumatically without a tunneling tool. OBJECTIVES: In the treatment of patients with deep brain stimulators, complication avoidance and efficiency of operative time are paramount. We sought to find the most safe, effective, and rapid method for performing the conceptually-simple yet technically-nuanced act of replacing lead extension cables...
October 18, 2016: World Neurosurgery
C Schlenstedt, A Shalash, M Muthuraman, D Falk, K Witt, G Deuschl
The aim of this meta-analysis was to summarize the short- and long-term effects of bilateral deep brain stimulation of the subthalamic nucleus (STN-DBS) on gait and freezing of gait (FOG) in Parkinson's disease and to detect predictors of post-stimulation outcome. A comprehensive review of the literature was conducted up to October 2015 using Medline Ovid databases for studies analyzing the effect of bilateral STN-DBS on FOG and/or gait. Sixteen studies with available data for the gait item (no. 29) of the Unified Parkinson's Disease Rating Scale (UPDRS) and six studies with the FOG item (no...
October 20, 2016: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
Aristide Merola, Alberto Romagnolo, Laura Rizzi, Mario Giorgio Rizzone, Maurizio Zibetti, Michele Lanotte, George Mandybur, Andrew P Duker, Alberto J Espay, Leonardo Lopiano
To determine the clinical and demographic correlates of persistent, remitting, and new-onset impulse control behaviors (ICBs) before and after subthalamic deep brain stimulation (STN-DBS) in Parkinson's disease (PD). We compared the pre- and post-surgical prevalence of ICBs, classified as impulse control disorders (ICD), dopamine dysregulation syndrome (DDS), and punding in 150 consecutive PD STN-DBS-treated patients and determined the association with motor, cognitive, neuropsychological, and neuropsychiatric endpoints...
October 19, 2016: Journal of Neurology
Xin Wang, Jing Wang, Haikang Zhao, Nan Li, Shunnan Ge, Lei Chen, Jiaming Li, Jiangpeng Jing, Mingming Su, Zhaohui Zheng, Jinan Zhang, Guodong Gao, Xuelian Wang
BACKGROUND: Symptomatic intracranial hemorrhage (ICH) may lead to permanent neurological disability of patients and has impeded the extensive clinical application of deep brain stimulation (DBS). The present study was conducted to discuss the incidence, prevention, and treatment of symptomatic ICH after DBS surgery. METHODS: From January 2009 to December 2014, 396 patients underwent DBS with a total of 691 implanted leads. In all, 10 patients had symptomatic ICH...
October 20, 2016: British Journal of Neurosurgery
David S Xu, Francisco Ponce
High-frequency deep brain stimulation (DBS) is a neurosurgical procedure that was introduced in the late 1980s for the treatment of movement disorders. It is a reversible, adjustable, and non-ablative therapy that has been used in over 100,000 people worldwide. The surgical procedure used to implant the DBS system, as well as the effects of chronic electrical stimulation, have been shown to be safe and effective through many clinical trials. The ability to therapeutically modulate the motor circuits of the brain in this manner has resulted in consideration of use of this surgical strategy for other neurodegenerative and neuropsychiatric disorders involving non-motor circuits, including appetite, mood, and cognition...
October 14, 2016: Current Alzheimer Research
Chloe A Smith, Cong Sun, Angela Pezic, Christine Rodda, Fergus Cameron, Katie Allen, Maria E Craig, John Carlin, Terry Dwyer, Robyn M Lucas, Darryl W Eyles, Andrew S Kemp, Justine A Ellis, Anne-Louise Ponsonby
BACKGROUND: Vitamin D deficiency is linked to adverse childhood health outcomes, yet data on the distribution and quantifiable determinants of neonatal 25-hydroxyvitamin D3 (25OHD) concentration, a vitamin D biomarker, are limited. OBJECTIVE: Our aim was to identify determinants of neonatal 25OHD concentration, measured using neonatal dried blood spots (DBS). METHODS: A total of 259 ethnically diverse children aged 0-16 years born in Victoria, Australia, were recruited...
October 19, 2016: Neonatology
Ameneh Madjd, Moira A Taylor, Alireza Delavari, Reza Malekzadeh, Ian A Macdonald, Hamid R Farshchi
AIMS: To compare the effect of replacing diet beverages (DBs) with water or continuing to drink DBs in patients with type 2 diabetes during a 24-week weight loss program. The primary endpoint was the effect of intervention on weight over a 24-week period. The main secondary endpoints included anthropometric measurement and glucose and fat metabolism during the 24-week period. METHODS: A total of 81 overweight and obese women with type 2 diabetes, who usually consumed DBs in their diet, were asked to either substitute water for DBs or continue drinking DBs five times per week after lunch for 24 weeks (DBs group) during a weight loss program...
October 16, 2016: Diabetes, Obesity & Metabolism
Andreas Hartmann
In patients with severe, treatment-refractory Gilles de la Tourette syndrome (GTS), deep brain stimulation (DBS) of various targets has been increasingly explored over the past 15 years. The multiplicity of surgical targets is intriguing and may be partly due to the complexity of GTS, specifically the various and frequent associated psychiatric comorbidities in this disorder. Thus, the target choice may not only be aimed at reducing tics but also comorbidities. While this approach is laudable, it also carries the risk to increase confounding factors in DBS trials and patient evaluation...
2016: F1000Research
Yi Wang, HongBin Liu, Peng Li, Wei Wang
A 40-year-old male who had a severe tremor, bradykinesia, and rigidity for 6 years underwent bilateral subthalamic nucleus (STN) deep brain stimulation (DBS) at our hospital. The patient did not have any prior ischemia events or any risk factors in his medical history. Six and 9 months post-operation, this patient was admitted to the hospital twice for lower left limb involuntary twitching. Two magnetic resonance imaging (MRI) scans showed cerebral ischemia surrounding the implanted electrode. To our knowledge, this is the first case of recurrent cerebral ischemia associated with DBS...
October 15, 2016: Acta Neurochirurgica
Astrid Kibleur, Mircea Polosan, Pauline Favre, David Rudrauf, Thierry Bougerol, Stéphan Chabardès, Olivier David
Deep brain stimulation (DBS) of the subgenual cingulate gyrus (area CG25) is beneficial in treatment resistant depression. Though the mechanisms of action of Cg25 DBS remain largely unknown, it is commonly believed that Cg25 DBS modulates limbic activity of large networks to achieve thymic regulation of patients. To investigate how emotional attention is influenced by Cg25 DBS, we assessed behavioral and electroencephalographic (EEG) responses to an emotional Stroop task in 5 patients during ON and OFF stimulation conditions...
October 12, 2016: NeuroImage
Isabelle Beaulieu-Boire, Camila C Aquino, Alfonso Fasano, Yu-Yan Poon, Melanie Fallis, Antony E Lang, Mojgan Hodaie, Suneil K Kalia, Andres Lozano, Elena Moro
BACKGROUND: Rare causes of inherited movement disorders often present with a debilitating phenotype of dystonia, sometimes combined with parkinsonism and other neurological signs. Since these disorders are often resistant to medications, DBS may be considered as a possible treatment. METHODS: Patients with identified genetic diseases (ataxia-telangiectasia, chorea-achantocytosis, dopa-responsive dystonia, congenital nemaline myopathy, methylmalonic aciduria, neuronal ceroid lipofuscinosis, spinocerebellar ataxia types 2 and 3, Wilson's disease, Woodhouse-Sakati syndrome, methylmalonic aciduria, and X trisomy) and disabling dystonia underwent bilateral GPi DBS (bilateral thalamic Vim nucleus in 1 case)...
October 4, 2016: Brain Stimulation
Adam M Nagy, Christopher M Tolleson
Deep brain stimulation (DBS) is a unique, functional neurosurgical therapy indicated for medication refractory movement disorders as well as some psychiatric diseases. Multicontact electrodes are placed in "deep" structures within the brain with targets varying depending on the surgical indication. An implanted programmable pulse generator supplies the electrodes with a chronic, high frequency electrical current that clinically mimics the effects of ablative lesioning techniques. DBS's efficacy has been well established for its movement disorder indications (Parkinson's disease, essential tremor, and dystonia)...
October 8, 2016: Brain Sciences
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