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DBS dementia

Radu Constantinescu, Barbro Eriksson, Yvonne Jansson, Bo Johnels, Björn Holmberg, Thordis Gudmundsdottir, Annika Renck, Peter Berglund, Filip Bergquist
OBJECTIVE: Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for motor fluctuations in Parkinson's disease (PD), but does not halt disease progression. The long-term deterioration of key functions such as cognition, speech, ability to swallow, gait, urinary bladder control, orientation and reality perception is decisive for patients' independency in daily life. In this paper we investigated patients with advanced PD operated at our center with STN-DBS for at least 15 years ago, in respect to key clinical milestones reflecting their overall function in daily living...
January 18, 2017: Clinical Neurology and Neurosurgery
Judith A Boel, Vincent J J Odekerken, Ben A Schmand, Gert J Geurtsen, Danielle C Cath, Martijn Figee, Pepijn van den Munckhof, Rob J de Haan, P Richard Schuurman, Rob M A de Bie
BACKGROUND: Effects on non-motor symptoms, mainly cognitive and psychiatric side effects, could influence the decision for either globus pallidus pars interna (GPi) or subthalamic nucleus (STN) deep brain stimulation (DBS) for patients with Parkinson's disease (PD). OBJECTIVE: 1) To compare cognitive and psychiatric outcomes 3 years after GPi DBS versus STN DBS, and 2) to report on occurrence of suicidal ideation, psychiatric diagnoses, social functioning, and marital satisfaction 3 years after DBS...
December 2016: Parkinsonism & related Disorders
Andres M Lozano, Lisa Fosdick, M Mallar Chakravarty, Jeannie-Marie Leoutsakos, Cynthia Munro, Esther Oh, Kristen E Drake, Christopher H Lyman, Paul B Rosenberg, William S Anderson, David F Tang-Wai, Jo Cara Pendergrass, Stephen Salloway, Wael F Asaad, Francisco A Ponce, Anna Burke, Marwan Sabbagh, David A Wolk, Gordon Baltuch, Michael S Okun, Kelly D Foote, Mary Pat McAndrews, Peter Giacobbe, Steven D Targum, Constantine G Lyketsos, Gwenn S Smith
BACKGROUND: Deep brain stimulation (DBS) is used to modulate the activity of dysfunctional brain circuits. The safety and efficacy of DBS in dementia is unknown. OBJECTIVE: To assess DBS of memory circuits as a treatment for patients with mild Alzheimer's disease (AD). METHODS: We evaluated active "on" versus sham "off" bilateral DBS directed at the fornix-a major fiber bundle in the brain's memory circuit-in a randomized, double-blind trial (ClinicalTrials...
September 6, 2016: Journal of Alzheimer's Disease: JAD
Siddhartha Mondragón-Rodríguez, George Perry, Fernando Pena-Ortega, Sylvain Williams
BACKGROUND: The last two decades have seen a great advance in the data that supports the two current hypotheses in Alzheimer`s disease field, the amyloid beta hypothesis and the tau hypothesis. Not surprisingly, Aβ and tau proteins are currently the major therapeutic research targets for AD treatment. Unfortunately, nothing but moderate success has emerged from such therapeutic approaches. With this in mind, we will discuss deep brain stimulation as a promising therapeutic strategy that aims to restore brain activity...
2017: Current Alzheimer Research
Anna Bersano, Michela Morbin, Elisa Ciceri, Gloria Bedini, Peter Berlit, Michele Herold, Stefania Saccucci, Valeria Fugnanesi, Hannes Nordmeyer, Giuseppe Faragò, Mario Savoiardo, Franco Taroni, MariaRita Carriero, Battista Boncoraglio Giorgio, Laura Perucca, Luigi Caputi, Agostino Parati Eugenio, Markus Kraemer
Divry van Bogaert Syndrome (DBS) is a familial juvenile-onset disorder characterized by livedo racemosa, white matter disease, dementia, epilepsy and angiographic finding of "cerebral angiomatosis". A similar syndrome including livedo racemosa and cerebrovascular disease, often associated with anticardiolipin antibodies, has been described as Sneddon Syndrome (SS) highlighting the question whether these two conditions have to be considered different entities or indeed different features of a unique syndrome...
May 15, 2016: Journal of the Neurological Sciences
Neha Shah, Daniel Leventhal, Carol Persad, Parag G Patil, Kelvin L Chou
BACKGROUND: A comprehensive, multidisciplinary screening process for deep brain stimulation (DBS) candidates is recommended, but is often time-consuming. OBJECTIVE: To determine the number of essential tremor (ET) referrals excluded from surgery and why, in order to develop recommendations for a minimum standard DBS evaluation process. METHODS: We reviewed the referrals of 100 consecutive potential DBS candidates with presumed ET at our center, identified reasons for excluding patients from DBS, and the point at which they dropped out of our evaluation process...
March 15, 2016: Journal of the Neurological Sciences
Sarah Hescham, Yasin Temel, Sandra Schipper, Mélanie Lagiere, Lisa-Maria Schönfeld, Arjan Blokland, Ali Jahanshahi
Deep brain stimulation (DBS) is an established symptomatic treatment modality for movement disorders and constitutes an emerging therapeutic approach for the treatment of memory impairment. In line with this, fornix DBS has shown to ameliorate cognitive decline associated with dementia. Nonetheless, mechanisms mediating clinical effects in demented patients or patients with other neurological disorders are largely unknown. There is evidence that DBS is able to modulate neurophysiological activity in targeted brain regions...
February 1, 2016: Brain Structure & Function
Mayur Sharma, Vikas Naik, Milind Deogaonkar
Deep brain stimulation (DBS) implantation surgery is an established treatment modality for a variety of medical refractory movement disorders such as Parkinson's disease, essential tremors and dystonia. Following the success of DBS in these movement disorders with a high rate of safety and efficacy, there is a resurgence of interest in the utility of this modality in other medical refractory disorders. Consequently, neuromodulation has been explored for a variety of refractory conditions such as neuropsychiatric disorders (major depressive disorders, obsessive-compulsive disorders, addictions), eating disorders including obesity, traumatic brain injury, post-traumatic stress disorders (PTSD), dementias and chronic pain...
June 2016: Journal of Neurosurgical Sciences
Erika K Ross, Joo Pyung Kim, Megan L Settell, Seong Rok Han, Charles D Blaha, Hoon-Ki Min, Kendall H Lee
INTRODUCTION: Deep brain stimulation (DBS) is a circuit-based treatment shown to relieve symptoms from multiple neurologic and neuropsychiatric disorders. In order to treat the memory deficit associated with Alzheimer's disease (AD), several clinical trials have tested the efficacy of DBS near the fornix. Early results from these studies indicated that patients who received fornix DBS experienced an improvement in memory and quality of life, yet the mechanisms behind this effect remain controversial...
March 2016: NeuroImage
Sarah Hescham, Ali Jahanshahi, Judith V Schweimer, Stephen N Mitchell, Guy Carter, Arjan Blokland, Trevor Sharp, Yasin Temel
Deep brain stimulation (DBS) of the fornix has gained interest as a potential therapy for advanced treatment-resistant dementia, yet the mechanism of action remains widely unknown. Previously, we have reported beneficial memory effects of fornix DBS in a scopolamine-induced rat model of dementia, which is dependent on various brain structures including hippocampus. To elucidate mechanisms of action of fornix DBS with regard to memory restoration, we performed c-Fos immunohistochemistry in the hippocampus. We found that fornix DBS induced a selective activation of cells in the CA1 and CA3 subfields of the dorsal hippocampus...
November 2016: Brain Structure & Function
Daniela Ovadia, Gabriella Bottini
PURPOSE OF REVIEW: The use of deep brain stimulation (DBS) in degenerative diseases involving cognitive impairment raises important ethical issues. This review takes into account the previous publications on the ethical issues of DBS to re-evaluate this technique in the framework of cognitive degenerative diseases, especially Alzheimer's disease and dementia associated to Parkinson's disease. RECENT FINDINGS: The serendipitous discovery of the properties of DBS in memory enhancement fostered the expectations of the patients, the experts, and the industry involved in the production of the devices...
December 2015: Current Opinion in Neurology
P Odin, K Ray Chaudhuri, J T Slevin, J Volkmann, E Dietrichs, P Martinez-Martin, J K Krauss, T Henriksen, R Katzenschlager, A Antonini, O Rascol, W Poewe
Navigate PD was an educational program established to supplement existing guidelines and provide recommendations on the management of Parkinson's disease (PD) refractory to oral/transdermal therapies. It involved 103 experts from 13 countries overseen by an International Steering Committee (ISC) of 13 movement disorder specialists. The ISC identified 71 clinical questions important for device-aided management of PD. Fifty-six experts responded to a web-based survey, rating 15 questions as 'critically important;' these were refined to 10 questions by the ISC to be addressed through available evidence and expert opinion...
October 2015: Parkinsonism & related Disorders
Darlene Floden, Robyn M Busch, Scott E Cooper, Cynthia S Kubu, Andre G Machado
BACKGROUND: Presence of dementia is a contraindication for DBS treatment of Parkinson's disease. Recent evidence suggests that borderline cognitive function, as measured with a common screening measure, the Mattis Dementia Rating Scale, has a negative impact on quality of life (QoL) after DBS of the STN. METHODS: We attempted to replicate and extend this finding in a larger group of patients with a wider range of preoperative global cognitive performance. RESULTS: Our data indicate that performance on the screening measure is not associated with QoL or medical outcomes, even with scores well below the cutoff for identifying dementia...
August 2015: Movement Disorders: Official Journal of the Movement Disorder Society
Sarah Hescham, Ali Jahanshahi, Céline Meriaux, Lee Wei Lim, Arjan Blokland, Yasin Temel
Deep brain stimulation (DBS) has gained interest as a potential therapy for advanced treatment-resistant dementia. However, possible targets for DBS and the optimal stimulation parameters are not yet clear. Here, we compared the effects of DBS of the CA1 sub-region of the hippocampus, mammillothalamic tract, anterior thalamic nucleus, and entorhinal cortex in an experimental rat model of dementia. Rats with scopolamine-induced amnesia were assessed in the object location task with different DBS parameters. Moreover, anxiety-related side effects were evaluated in the elevated zero maze and open field...
October 1, 2015: Behavioural Brain Research
Han-Joon Kim, Beom S Jeon, Sun Ha Paek
Subthalamic deep brain stimulation (STN DBS) is an established treatment for the motor symptoms in patients with advanced Parkinson's disease (PD). In addition to improvements in motor symptoms, many studies have reported changes in various nonmotor symptoms (NMSs) after STN DBS in patients with PD. Psychiatric symptoms, including depression, apathy, anxiety, and impulsivity, can worsen or improve depending on the electrical stimulation parameters, the locations of the stimulating contacts within the STN, and changes in medications after surgery...
May 2015: Journal of Movement Disorders
Christina Rose Kyrtsos, Mark C Stahl, Paul Eslinger, Thyagarajan Subramanian, Elisabeth B Lucassen
Capgras syndrome is a delusional misidentification syndrome (DMS) which can be seen in neurodegenerative diseases such as Lewy body dementia and, to a lesser extent, in Parkinson's disease (PD). Here, we report the case of a 78-year-old man with a history of idiopathic PD who developed Capgras syndrome following bilateral subthalamic nucleus deep brain stimulation (DBS) implantation. As the risk of DMS has been related to deficits in executive, memory, and visuospatial function preoperatively, this case highlights the importance of continuing to improve patient selection for DBS surgery...
May 2015: Case Reports in Neurology
Vanessa Fleury, François Vingerhoets, Judit Horvath, Pierre Pollak, Pierre Burkhard
Movement disorders such as Parkinson's disease (PD), essential tremor (ET) and dystonia can benefit from deep brain stimulation (DBS). DBS is considered when symptoms are disabling despite optimal medical therapy. Contraindications include dementia, uncontrolled psychiatric disease and/or comorbid conditions with potential for evolution. Targets are the subthalamic nucleus for PD, the ventral intermediate nucleus for ET and the globus pallidus internus for dystonia. The beneficial effet of DBS has been well documented for symptom control...
April 29, 2015: Revue Médicale Suisse
Philipp Mahlknecht, Patricia Limousin, Thomas Foltynie
Modern deep brain stimulation (DBS) has become a routine therapy for patients with movement disorders such as Parkinson's disease, generalized or segmental dystonia and for multiple forms of tremor. Growing numbers of publications also report beneficial effects in other movement disorders such as Tourette's syndrome, various forms of chorea and DBS is even being studied for Parkinson's-related dementia. While exerting remarkable effects on many motor symptoms, DBS does not restore normal neurophysiology and therefore may also have undesirable side effects including speech and gait deterioration...
November 2015: Journal of Neurology
Keyvan Mirsaeedi-Farahani, C H Halpern, G H Baltuch, D A Wolk, S C Stein
Alzheimer disease (AD) is characterized by impairments in memory function. Standard AD treatment provides marginal improvements in this domain. Recent reports, however, suggested that deep brain stimulation (DBS) may result in improved memory. Given significant equipment costs and health expenses required for DBS surgery, we determine clinical and economic thresholds required for it to be as effective as standard AD treatment. Literature review yielded annual AD progression probabilities, health-related quality of life (QoL), and costs by AD stage...
May 2015: Journal of Neurology
Hesham Abboud, Darlene Floden, Nicolas R Thompson, Gencer Genc, Srivadee Oravivattanakul, Faisal Alsallom, Bengwei Swa, Cynthia Kubu, Mayur Pandya, Michal Gostkowski, Scott Cooper, Andre G Machado, Hubert H Fernandez
INTRODUCTION: Unlike dementia, the effect of mild cognitive impairment (MCI) on outcomes after deep brain stimulation (DBS) in Parkinson's disease (PD) is less clear. We aimed to examine the effect of MCI on short- and long-term DBS outcomes. METHODS: To study the effect of MCI type, cognitive domains (attention, language, visuospatial, memory, executive function), and Dementia Rating Scale (DRS) score on immediate postoperative outcomes (postoperative confusion, hospitalization days), PD patients who underwent DBS at our Center from 2006 to 2011 were analyzed...
March 2015: Parkinsonism & related Disorders
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