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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
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
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
A Kibleur, G Gras-Combe, D Benis, J Bastin, T Bougerol, S Chabardès, M Polosan, O David
High-frequency deep brain stimulation of the subthalamic nucleus can be used to treat severe obsessive-compulsive disorders that are refractory to conventional treatments. The mechanisms of action of this approach possibly rely on the modulation of associative-limbic subcortical-cortical loops, but remain to be fully elucidated. Here in 12 patients, we report the effects of high-frequency stimulation of the subthalamic nucleus on behavior, and on electroencephalographic responses and inferred effective connectivity during motor inhibition processes involved in the stop signal task...
October 18, 2016: Translational Psychiatry
Alexander I Tröster, Joseph Jankovic, Michele Tagliati, DeLea Peichel, Michael S Okun
OBJECTIVE: The aim of this study was to evaluate the neurobehavioral safety of constant-current subthalamic deep brain stimulation and to compare the neuropsychological effects of stimulation versus electrode placement alone. METHODS: A total of 136 patients with Parkinson's disease underwent bilateral subthalamic device implantation in this randomized trial. Patients received stimulation either immediately after device implantation (n = 101; active stimulation) or beginning 3 months after surgery (n = 35; delayed activation control)...
October 18, 2016: Movement Disorders: Official Journal of the Movement Disorder Society
Julien Bonenfant, Sophie Drapier, Jean François Houvenaghel, Florian Naudet, Claire Haegelen, Paul Sauleau, Marc Vérin
INTRODUCTION: Over a 3-year period, we monitored the efficacy and safety of deep-brain stimulation of the globus pallidus pars interna in patients with advanced Parkinson's disease whose cognitive, psychiatric impairment and/or dopa-resistant axial motor signs made them ineligible for surgery targeting the subthalamic nucleus. METHODS: A total of 25 patients were assessed before surgery, 1 year and 3 years after surgery, on the UPDRS and a neuropsychological battery...
October 11, 2016: Parkinsonism & related Disorders
Damien Benis, Olivier David, Brigitte Piallat, Astrid Kibleur, Laurent Goetz, Manik Bhattacharjee, Valérie Fraix, Eric Seigneuret, Paul Krack, Stéphan Chabardès, Julien Bastin
The subthalamic nucleus (STN) plays a critical role during action inhibition, perhaps by acting like a fast brake on the motor system when inappropriate responses have to be rapidly suppressed. However, the mechanisms involving the STN during motor inhibition are still unclear, particularly because of a relative lack of single-cell responses reported in this structure in humans. In this study, we used extracellular microelectrode recordings during deep brain stimulation surgery in patients with Parkinson's disease (PD) to study STN neurophysiological correlates of inhibitory control during a stop signal task...
September 21, 2016: Cortex; a Journal Devoted to the Study of the Nervous System and Behavior
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
Maximilian H Beck, Jens K Haumesser, Johanna Kühn, Jennifer Altschüler, Andrea A Kühn, Christoph van Riesen
Abnormally enhanced beta oscillations have been found in deep brain recordings from human Parkinson's disease (PD) patients and in animal models of PD. Recent correlative evidence suggests that beta oscillations are related to disease-specific symptoms such as akinesia and rigidity. However, this hypothesis has also been repeatedly questioned by studies showing no changes in beta power in animal models using an acute pharmacologic dopamine blockade. To further investigate the temporal dynamics of exaggerated beta synchrony in PD, we investigated the reserpine model, which is characterized by an acute and stable disruption of dopamine transmission, and compared it to the chronic progressive 6-hydroxydopamine (6-OHDA) model...
October 12, 2016: Experimental Neurology
Joohi Jimenez-Shahed, Ilknur Telkes, Ashwin Viswanathan, Nuri F Ince
Background: Deep brain stimulation (DBS) is an emerging treatment strategy for severe, medication-refractory Tourette syndrome (TS). Thalamic (Cm-Pf) and pallidal (including globus pallidus interna, GPi) targets have been the most investigated. While the neurophysiological correlates of Parkinson's disease (PD) in the GPi and subthalamic nucleus (STN) are increasingly recognized, these patterns are not well characterized in other disease states. Recent findings indicate that the cross-frequency coupling (CFC) between beta band and high frequency oscillations (HFOs) within the STN in PD patients is pathologic...
2016: Frontiers in Neuroscience
Yu Wang, Zi-Yuan Liu, Wan-Chen Dou, Wen-Bin Ma, Ren-Zhi Wang, Yi Guo
<strong>Objective</strong> To explore the efficacy of target positioning by preoperative CT/MRI image fusion technique in deep brain stimulation.<strong>Methods</strong> We retrospectively analyzed the clinical data and images of 79 cases (68 with Parkinson's disease, 11 with dystonia) who received preoperative CT/MRI image fusion in target positioning of subthalamic nucleus in deep brain stimulation. Deviation of implanted electrodes from the target nucleus of each patient were measured...
September 20, 2016: Chinese Medical Sciences Journal, Chung-kuo i Hsüeh K'o Hsüeh Tsa Chih
Sarah K B Bick, Bradley S Folley, Jutta S Mayer, Sohee Park, P David Charles, Corrie R Camalier, Srivatsan Pallavaram, Peter E Konrad, Joseph S Neimat
OBJECTIVES: Deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves motor symptoms in advanced Parkinson's disease. STN DBS may also affect emotion, possibly by impacting a parallel limbic cortico-striatal circuit. The objective of this study was to investigate changes in prefrontal cortical activity related to DBS during an emotion induction task. MATERIALS AND METHODS: We used near infrared spectroscopy to monitor prefrontal cortex hemodynamic changes during an emotion induction task...
October 12, 2016: Neuromodulation: Journal of the International Neuromodulation Society
Adolfo Ramirez-Zamora, Heather Smith, Vignessh Kumar, Julia Prusik, Sujoy Phookan, Julie G Pilitsis
BACKGROUND: Although thalamic deep brain stimulation (DBS) has been established as an effective therapy for refractory tremor in Parkinson's disease and essential tremor, reports investigating the efficacy of posterior subthalamic area (PSA) DBS for severe, debilitating tremors continue to emerge. However, questions regarding the optimal anatomical target, surgical approach, programming paradigms and effectiveness compared to other targets remain. OBJECTIVES: In this report, we aimed to review the current literature to assess different stereotactic techniques, anatomical considerations, adverse effects and stimulation settings in PSA DBS...
October 12, 2016: Stereotactic and Functional Neurosurgery
Johann Zwirner, Dustin Möbius, Ingo Bechmann, Thomas Arendt, Karl-Titus Hoffmann, Carsten Jäger, Donald Lobsien, Robert Möbius, Uwe Planitzer, Dirk Winkler, Markus Morawski, Niels Hammer
The subthalamic nucleus (STN) is a main target structure of deep brain stimulation (DBS) in idiopathic Parkinson's disease. Nevertheless, there is an ongoing discussion regarding human STN volumes and neuron count, which could potentially have an impact on STN-DBS. Moreover, a suspected functional subdivision forms the basis of the tripartite hypothesis, which has not yet been morphologically substantiated. In this study, it was aimed to investigate the human STN by means of combined magnetic resonance imaging (MRI) and stereology...
October 11, 2016: Human Brain Mapping
Omid Talakoub, Bogdan Neagu, Kaviraja Udupa, Eric Tsang, Robert Chen, Milos R Popovic, Willy Wong
We are interested in characterizing how brain networks interact and communicate with each other during voluntary movements. We recorded electrical activities from the globus pallidus pars interna (GPi), subthalamic nucleus (STN) and the motor cortex during voluntary wrist movements. Seven patients with dystonia and six patients with Parkinson's disease underwent bilateral deep brain stimulation (DBS) electrode placement. Local field potentials from the DBS electrodes and scalp EEG from the electrodes placed over the motor cortices were recorded while the patients performed externally triggered and self-initiated movements...
October 11, 2016: Scientific Reports
Takamitsu Yamamoto, Chikashi Fukaya, Toshiki Obuchi, Mitsuru Watanabe, Takashi Ohta, Kazutaka Kobayashi, Hideki Oshima, Atsuo Yoshino
BACKGROUND: In this reported case, 7 years after the start of deep brain stimulation (DBS) of the bilateral subthalamic nucleus (STN), glioblastoma multiforme (GBM) developed around the implanted DBS lead. CASE REPORT: The brain tumor formed from the subcortical white matter to the corpus callosum bilaterally around the DBS lead but did not extend in the direction of the contact points of the lead. The GBM showed a typical invasion pattern of the butterfly type...
October 11, 2016: Stereotactic and Functional Neurosurgery
Bryan Howell, Cameron C McIntyre
BACKGROUND: Bioelectric field models of deep brain stimulation (DBS) are commonly utilized in research and industrial applications. However, the wide range of different representations used for the human head in these models may be responsible for substantial variance in the stimulation predictions. OBJECTIVE: Determine the relative error of ignoring cerebral vasculature and soft-tissue heterogeneity outside of the brain in computational models of DBS. METHODS: We used a detailed atlas of the human head, coupled to magnetic resonance imaging data, to construct a range of subthalamic DBS volume conductor models...
September 8, 2016: Brain Stimulation
Lars Wojtecki, Saskia Elben, Jan Vesper, Alfons Schnitzler
We investigated neurophysiological mechanisms of subthalamic nucleus involvement in verbal fluency by means of a verbal generation task. The subthalamic nucleus is thought to act as a behavioural go/no-go instance by means of oscillatory communication in theta band with the prefrontal cortex. Because subthalamic alpha-theta frequency stimulation has been shown to exert beneficial effects on verbal fluency in Parkinson's disease, we hypothesized that an alpha-theta oscillatory network involving the subthalamic nucleus underlies verbal generation task performance as a gating instance for speech execution...
October 8, 2016: European Journal of Neuroscience
Takako Kita, Naoki Shigematsu, Hitoshi Kita
Projections from the posterior intralaminar thalamic nuclei and the superior colliculus (SC) to the subthalamic nucleus (STN) and the zona incerta (ZI) have been described in the primate and rodent. The aims of this study was to investigate several questions on these projections, using modern neurotracing techniques in rats, to advance our understanding of the role of STN and ZI. We examined whether projection patterns to the subthlamus can be used to identify homologues of the primate centromedian (CM) and the parafascicular nucleus (Pf) in the rodent, the topography of the projection including what percent of intralaminar neurons participate in the projections, and electron microscopic examination of intralaminar synaptic boutons in STN...
September 26, 2016: European Journal of Neuroscience
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