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Deep Brain Stimulation

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https://www.readbyqxmd.com/read/28430533/new-directions-in-the-rational-design-of-electrical-and-magnetic-seizure-therapies-individualized-low-amplitude-seizure-therapy-ilast-and-magnetic-seizure-therapy-mst
#1
Thomas Radman, Sarah H Lisanby
Electroconvulsive therapy remains a key treatment option for severe cases of depression, but undesirable side-effects continue to limit its use. Innovations in the design of novel seizure therapies seek to improve its risk benefit ratio through enhanced control of the focality of stimulation. The design of seizure therapies with increased spatial precision is motivated by avoiding stimulation of deep brain structures implicated in memory retention, including the hippocampus. The development of two innovations in seizure therapy-individualized low-amplitude seizure therapy (iLAST) and magnetic seizure therapy (MST), are detailed...
April 21, 2017: International Review of Psychiatry
https://www.readbyqxmd.com/read/28428905/deep-brain-stimulation-target-selection-in-an-advanced-parkinson-s-disease-patient-with-significant-tremor-and-comorbid-depression
#2
Amar S Patel
CLINICAL VIGNETTE: A 67-year-old female with advanced Parkinson's disease (PD), medically refractory tremor, and a history of significant depression presented for evaluation of deep brain stimulation (DBS) candidacy. CLINICAL DILEMMA: Traditionally, the subthalamic nucleus (STN) has been preferred over the globus pallidus interna (GPi) as a DBS target for PD patients with levodopa-responsive fluctuations in rigidity and akinesia, for whom tremor is also a significant source of impairment...
2017: Tremor and Other Hyperkinetic Movements
https://www.readbyqxmd.com/read/28428749/deep-brain-stimulation-improves-the-symptoms-and-sensory-signs-of-persistent-central-neuropathic-pain-from-spinal-cord-injury-a-case-report
#3
Walter J Jermakowicz, Ian D Hentall, Jonathan R Jagid, Corneliu C Luca, James Adcock, Alberto Martinez-Arizala, Eva Widerström-Noga
Central neuropathic pain (CNP) is a significant problem after spinal cord injury (SCI). Pharmacological and non-pharmacological approaches may reduce the severity, but relief is rarely substantial. While deep brain stimulation (DBS) has been used to treat various chronic pain types, the technique has rarely been used to attenuate CNP after SCI. Here we present the case of a 54-year-old female with incomplete paraplegia who had severe CNP in the lower limbs and buttock areas since her injury 30 years prior. She was treated with bilateral DBS of the midbrain periaqueductal gray (PAG)...
2017: Frontiers in Human Neuroscience
https://www.readbyqxmd.com/read/28427973/ultra-high-field-template-assisted-target-selection-for-deep-brain-stimulation-surgery-technical-note
#4
Jonathan C Lau, Keith W MacDougall, Miguel Arango, Terry M Peters, Andrew G Parrent, Ali R Khan
No abstract text is available yet for this article.
April 17, 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
#5
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
#6
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...
April 19, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28422667/modeling-and-analysis-of-beta-oscillations-in-the-basal-ganglia
#7
Chen Liu, Jiang Wang, Huiyan Li, Chris Fietkiewicz, Kenneth A Loparo
Enhanced beta (12-30 Hz) oscillatory activity in the basal ganglia (BG) is a prominent feature of the Parkinsonian state in animal models and in patients with Parkinson's disease. Increased beta oscillations are associated with severe dopaminergic striatal depletion. However, the mechanisms underlying these pathological beta oscillations remain elusive. Inspired by the experimental observation that only subsets of neurons within each nucleus in the BG exhibit oscillatory activities, a computational model of the BG-thalamus neuronal network is proposed, which is characterized by subdivided nuclei within the BG...
April 12, 2017: IEEE Transactions on Neural Networks and Learning Systems
https://www.readbyqxmd.com/read/28421851/global-and-multi-focal-changes-in-cerebral-blood-flow-during-subthalamic-nucleus-stimulation-in-parkinson-s-disease
#8
Asim M Mubeen, Babak Ardekani, Michele Tagliati, Ron Alterman, Vijay Dhawan, David Eidelberg, John J Sidtis
Electrical stimulation of subthalamic nuclei (STN) is a widely used therapy in Parkinson's disease (PD). While deep brain stimulation (DBS) of the STN alters the neurophysiological activity in basal ganglia, the therapeutic mechanism has not been established. A positron emission tomography (PET) study of cerebral blood flow (CBF) during speech production in PD subjects treated with STN-DBS found significant increases in global (whole-brain) CBF.(1) That study utilized a series of whole-slice regions of interest to obtain global CBF values...
January 1, 2017: Journal of Cerebral Blood Flow and Metabolism
https://www.readbyqxmd.com/read/28416595/nonsinusoidal-beta-oscillations-reflect-cortical-pathophysiology-in-parkinson-s-disease
#9
Scott R Cole, Roemer van der Meij, Erik J Peterson, Coralie de Hemptinne, Philip A Starr, Bradley Voytek
Oscillations in neural activity play a critical role in neural computation and communication. There is intriguing new evidence that the nonsinusoidal features of the oscillatory waveforms may inform underlying physiological and pathophysiological characteristics. Time-domain waveform analysis approaches stand in contrast to traditional Fourier-based methods, which alter or destroy subtle waveform features. Recently it has been shown that the waveform features of oscillatory beta (13-30 Hz) events-a prominent motor cortical oscillation-may reflect near-synchronous excitatory synaptic inputs onto cortical pyramidal neurons...
April 17, 2017: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/28415166/holmes-tremor-with-shoulder-pain-treated-by-deep-brain-stimulation-of-unilateral-ventral-intermediate-thalamic-nucleus-and-globus-pallidus-internus
#10
Sabri Aydın, Huseyin Canaz, Ezgi Tuna Erdogan, Nazlı Durmaz, Barıs Topcular
A 21-year-old male was admitted with severe right arm and hand tremors after a thalamic hemorrhage caused by a traffic accident. He was also suffering from agonizing pain in his right shoulder that manifested after the tremor. Neurologic examination revealed a disabling, severe, and irregular kinetic and postural tremor in the right arm during target-directed movements. There was also an irregular ipsilateral rest tremor and dystonic movements in the distal part of the right arm. The amplitude was moderate at rest and extremely high during kinetic and intentional movements...
April 18, 2017: Journal of Movement Disorders
https://www.readbyqxmd.com/read/28413841/correlation-of-electrode-position-and-clinical-outcomes-in-globus-pallidus-stimulation-for-dystonia
#11
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...
April 17, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28412499/parkinsonism-and-dystonia-are-differentially-induced-by-modulation-of-different-territories-in-the-basal-ganglia
#12
Deepak Kumbhare, Kathryn L Holloway, Mark S Baron
Numerous clinical and experimental observations suggest that deficient neuronal signaling in the globus pallidus externa (GPe) is integral to both Parkinson's disease (PD) and dystonia. In our previous studies in jaundiced dystonic rats, widespread silencing of neurons in GP (rodent equivalent to GPe) preceded and persisted during dystonic motor activity. We therefore hypothesized that on a background of slow and highly irregular and bursty neuronal activity in GP, cortical motor drive produces profound inhibition of GP as the basis for action induced dystonia in Gunn rats...
April 12, 2017: Neuroscience
https://www.readbyqxmd.com/read/28409730/chronic-multisite-brain-recordings-from-a-totally-implantable-bidirectional-neural-interface-experience-in-5-patients-with-parkinson-s-disease
#13
Nicole C Swann, Coralie de Hemptinne, Svjetlana Miocinovic, Salman Qasim, Jill L Ostrem, Nicholas B Galifianakis, Marta San Luciano, Sarah S Wang, Nathan Ziman, Robin Taylor, Philip A Starr
OBJECTIVE Dysfunction of distributed neural networks underlies many brain disorders. The development of neuromodulation therapies depends on a better understanding of these networks. Invasive human brain recordings have a favorable temporal and spatial resolution for the analysis of network phenomena but have generally been limited to acute intraoperative recording or short-term recording through temporarily externalized leads. Here, the authors describe their initial experience with an investigational, first-generation, totally implantable, bidirectional neural interface that allows both continuous therapeutic stimulation and recording of field potentials at multiple sites in a neural network...
April 14, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28408788/apathy-and-reduced-speed-of-processing-underlie-decline-in-verbal-fluency-following-dbs
#14
Jennifer A Foley, Tom Foltynie, Ludvic Zrinzo, Jonathan A Hyam, Patricia Limousin, Lisa Cipolotti
Objective. Reduced verbal fluency is a strikingly uniform finding following deep brain stimulation (DBS) for Parkinson's disease (PD). The precise cognitive mechanism underlying this reduction remains unclear, but theories have suggested reduced motivation, linguistic skill, and/or executive function. It is of note, however, that previous reports have failed to consider the potential role of any changes in speed of processing. Thus, the aim of this study was to examine verbal fluency changes with a particular focus on the role of cognitive speed...
2017: Behavioural Neurology
https://www.readbyqxmd.com/read/28408262/optimization-of-microelectrode-recording-in-dbs-surgery-using-intraoperative-ct
#15
Ryan B Kochanski, Sander Bus, Gian Pal, Leo Verhagen Metman, Sepehr Sani
BACKGROUND: Microelectrode recording (MER) is used to confirm targeting accuracy during deep brain stimulation (DBS) surgery. We describe a technique using intraoperative CT extrapolation (iCTE) to predetermine and adjust the trajectory of the guide tube in order to improve microelectrode targeting accuracy. We hypothesized that this technique would decrease the number of MER tracks and operative time, while increasing the recorded length of subthalamic nucleus (STN). METHODS: Thirty-nine patients with Parkinson's disease who underwent STN DBS before the iCTE method were compared to 33 patients undergoing STN DBS using iCTE...
April 10, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28407815/acute-symptomatic-peri-lead-edema-33%C3%A2-hours-after-deep-brain-stimulation-surgery-a-case-report
#16
Nathan B Schoen, Walter J Jermakowicz, Corneliu C Luca, Jonathan R Jagid
BACKGROUND: Symptomatic peri-lead edema is a rare complication of deep brain stimulation that has been reported to develop 4 to 120 days postoperatively. CASE PRESENTATION: Here we report the case of a 63-year-old Hispanic man with an 8-year history of Parkinson's disease who underwent bilateral placement of subthalamic nucleus deep brain stimulation leads and presented with acute, symptomatic, unilateral, peri-lead edema just 33 hours after surgery. CONCLUSIONS: We document a thorough radiographic time course showing the evolution of these peri-lead changes and their regression with steroid therapy, and discuss the therapeutic implications of these findings...
April 14, 2017: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/28400200/thalamic-dbs-with-a-constant-current-device-in-essential-tremor-a%C3%A2-controlled-clinical-trial
#17
Robert E Wharen, Michael S Okun, Barton L Guthrie, Ryan J Uitti, Paul Larson, Kelly Foote, Harrison Walker, Frederick J Marshall, Jason Schwalb, Blair Ford, Joseph Jankovic, Richard Simpson, Khashayar Dashtipour, Fenna Phibbs, Joseph S Neimat, R Malcolm Stewart, DeLea Peichel, Rajesh Pahwa, Jill L Ostrem
INTRODUCTION: This study of thalamic deep brain stimulation (DBS) investigated whether a novel constant-current device improves tremor and activities of daily living (ADL) in patients with essential tremor (ET). METHODS: A prospective, controlled, multicenter study was conducted at 12 academic centers. We investigated the safety and efficacy of unilateral and bilateral constant-current DBS of the ventralis intermedius (VIM) nucleus of the thalamus in patients with essential tremor whose tremor was inadequately controlled by medications...
March 30, 2017: Parkinsonism & related Disorders
https://www.readbyqxmd.com/read/28399152/tackling-psychosocial-maladjustment-in-parkinson-s-disease-patients-following-subthalamic-deep-brain-stimulation-a-randomised-clinical-trial
#18
Joao Flores Alves Dos Santos, Sophie Tezenas du Montcel, Marcella Gargiulo, Cecile Behar, Sébastien Montel, Thierry Hergueta, Soledad Navarro, Hayat Belaid, Pauline Cloitre, Carine Karachi, Luc Mallet, Marie-Laure Welter
BACKGROUND: Subthalamic nucleus deep brain stimulation (STN-DBS) is an effective treatment for the motor and non-motor signs of Parkinson's disease (PD), however, psychological disorders and social maladjustment have been reported in about one third of patients after STN-DBS. We propose here a perioperative psychoeducation programme to limit such social and familial disruption. METHODS: Nineteen PD patients and carers were included in a randomised single blind study...
2017: PloS One
https://www.readbyqxmd.com/read/28397839/a-connectomic-approach-for-subcallosal-cingulate-deep-brain-stimulation-surgery-prospective-targeting-in-treatment-resistant-depression
#19
P Riva-Posse, K S Choi, P E Holtzheimer, A L Crowell, S J Garlow, J K Rajendra, C C McIntyre, R E Gross, H S Mayberg
Target identification and contact selection are known contributors to variability in efficacy across different clinical indications of deep brain stimulation surgery. A retrospective analysis of responders to subcallosal cingulate deep brain stimulation (SCC DBS) for depression demonstrated the common impact of the electrical stimulation on a stereotypic connectome of converging white matter bundles (forceps minor, uncinate fasciculus, cingulum and fronto-striatal fibers). To test the utility of a prospective connectomic approach for SCC DBS surgery, this pilot study used the four-bundle tractography 'connectome blueprint' to plan surgical targeting in 11 participants with treatment-resistant depression...
April 11, 2017: Molecular Psychiatry
https://www.readbyqxmd.com/read/28395278/cost-of-deep-brain-stimulation-infection-resulting-in-explantation
#20
Tsinsue Chen, Zaman Mirzadeh, Margaret Lambert, Omar Gonzalez, Ana Moran, Andrew G Shetter, Francisco A Ponce
BACKGROUND: Deep brain stimulation (DBS) hardware infection is a serious complication, often resulting in multiple hardware salvage attempts, hospitalizations, and long-term antibiotic therapy. OBJECTIVES: We aimed to quantify the costs of DBS hardware-related infections in patients undergoing eventual device explantation. METHODS: Of 362 patients who underwent 530 electrode placements (1 January 2010 to 30 December 2014), 16 (4.4%) had at least 2 hardware salvage procedures...
April 11, 2017: Stereotactic and Functional Neurosurgery
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