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Deep Brain Stimulation

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https://www.readbyqxmd.com/read/29345392/who-may-benefit-from-on-demand-control-of-deep-brain-stimulation-noninvasive-evaluation-of-parkinson-patients
#1
Daniel Graupe, Nivedita Khobragade, Daniela Tuninetti, Ishita Basu, Konstantin V Slavin, Leo Verhagen Metman
BACKGROUND: In closed-loop on-demand control (ODC) of deep brain stimulation (DBS), stimulation is applied only when symptoms appear. Following stimulation of a fixed duration, DBS is switched off until the symptoms reappear. By repeating these demand-driven cycles, the amount of stimulation delivered can be decreased, thereby reducing DBS side-effects and improving battery-life of the pulse-generator. This article introduces Ro metric for quantification of degree of benefit of ODC and explores candidate selection in tremor-dominant Parkinson's disease (PD)...
January 18, 2018: Neuromodulation: Journal of the International Neuromodulation Society
https://www.readbyqxmd.com/read/29340590/efficacy-and-safety-of-deep-brain-stimulation-in-tourette-syndrome-the-international-tourette-syndrome-deep-brain-stimulation-public-database-and-registry
#2
Daniel Martinez-Ramirez, Joohi Jimenez-Shahed, James Frederick Leckman, Mauro Porta, Domenico Servello, Fan-Gang Meng, Jens Kuhn, Daniel Huys, Juan Carlos Baldermann, Thomas Foltynie, Marwan I Hariz, Eileen M Joyce, Ludvic Zrinzo, Zinovia Kefalopoulou, Peter Silburn, Terry Coyne, Alon Y Mogilner, Michael H Pourfar, Suketu M Khandhar, Man Auyeung, Jill Louise Ostrem, Veerle Visser-Vandewalle, Marie-Laure Welter, Luc Mallet, Carine Karachi, Jean Luc Houeto, Bryan Timothy Klassen, Linda Ackermans, Takanobu Kaido, Yasin Temel, Robert E Gross, Harrison C Walker, Andres M Lozano, Benjamin L Walter, Zoltan Mari, William S Anderson, Barbara Kelly Changizi, Elena Moro, Sarah Elizabeth Zauber, Lauren E Schrock, Jian-Guo Zhang, Wei Hu, Kyle Rizer, Erin H Monari, Kelly D Foote, Irene A Malaty, Wissam Deeb, Aysegul Gunduz, Michael S Okun
Importance: Collective evidence has strongly suggested that deep brain stimulation (DBS) is a promising therapy for Tourette syndrome. Objective: To assess the efficacy and safety of DBS in a multinational cohort of patients with Tourette syndrome. Design, Setting, and Participants: The prospective International Deep Brain Stimulation Database and Registry included 185 patients with medically refractory Tourette syndrome who underwent DBS implantation from January 1, 2012, to December 31, 2016, at 31 institutions in 10 countries worldwide...
January 16, 2018: JAMA Neurology
https://www.readbyqxmd.com/read/29340288/7t-mri-subthalamic-nucleus-atlas-for-use-with-3t-mri
#3
Mikhail Milchenko, Scott A Norris, Kathleen Poston, Meghan C Campbell, Mwiza Ushe, Joel S Perlmutter, Abraham Z Snyder
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) reduces motor symptoms in most patients with Parkinson disease (PD), yet may produce untoward effects. Investigation of DBS effects requires accurate localization of the STN, which can be difficult to identify on magnetic resonance images collected with clinically available 3T scanners. The goal of this study is to develop a high-quality STN atlas that can be applied to standard 3T images. We created a high-definition STN atlas derived from seven older participants imaged at 7T...
January 2018: Journal of Medical Imaging
https://www.readbyqxmd.com/read/29335882/clinical-response-to-vim-s-thalamic-stereotactic-radiosurgery-for-essential-tremor-is-associated-with-distinctive-functional-connectivity-patterns
#4
Constantin Tuleasca, Elena Najdenovska, Jean Régis, Tatiana Witjas, Nadine Girard, Jérôme Champoudry, Mohamed Faouzi, Jean-Philippe Thiran, Meritxell Bach Cuadra, Marc Levivier, Dimitri Van De Ville
INTRODUCTION: Essential tremor (ET) is the most common movement disorder. Drug-resistant ET can benefit from standard surgical stereotactic procedures (deep brain stimulation, thalamotomy) or minimally invasive high-intensity focused ultrasound (HIFU) or stereotactic radiosurgical thalamotomy (SRS-T). Resting-state fMRI (rs-fMRI) is a non-invasive imaging method acquired in absence of a task. We examined whether rs-fMRI correlates with tremor score on the treated hand (TSTH) improvement 1 year after SRS-T...
January 15, 2018: Acta Neurochirurgica
https://www.readbyqxmd.com/read/29335516/an-evaluation-of-the-effect-of-pulse-shape-on-grey-and-white-matter-stimulation-in-the-rat-brain
#5
Marjolijn Deprez, Kelly Luyck, Laura Luyten, Tim Tambuyzer, Bart Nuttin, Myles Mc Laughlin
Despite the current success of neuromodulation, standard biphasic, rectangular pulse shapes may not be optimal to achieve symptom alleviation. Here, we compared stimulation efficiency (in terms of charge) between complex and standard pulses in two areas of the rat brain. In motor cortex, Gaussian and interphase gap stimulation (IPG) increased stimulation efficiency in terms of charge per phase compared with a standard pulse. Moreover, IPG stimulation of the deep mesencephalic reticular formation in freely moving rats was more efficient compared to a standard pulse...
January 15, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29332087/adaptive-brain-stimulation-for-movement-disorders
#6
Martijn Beudel, Hayriye Cagnan, Simon Little
Deep brain stimulation (DBS) has markedly changed how we treat movement disorders including Parkinson's disease (PD), dystonia, and essential tremor (ET). However, despite its demonstrable clinical benefit, DBS is often limited by side effects and partial efficacy. These limitations may be due in part to the fact that DBS interferes with both pathological and physiological neural activities. DBS could, therefore, be potentially improved were it applied selectively and only at times of enhanced pathological activity...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332086/current-and-expected-advances-in-deep-brain-stimulation-for-movement-disorders
#7
Ausaf A Bari, Jasmine Thum, Diana Babayan, Andres M Lozano
Deep brain stimulation (DBS) has become an established treatment for medically refractory movement disorders including Parkinson's disease, essential tremor, and dystonia. The field of DBS continues to evolve with advances in patient selection, target identification, electrode and pulse generator technology, and the development of more effective stimulation paradigms such as closed-loop stimulation. Furthermore, as the safety and efficacy of DBS improves through better hardware design and deeper understanding of its mechanisms of action, the indications for DBS will continue to expand to cover a wider range of disorders...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332085/deep-brain-stimulation-of-the-subthalamic-nucleus-and-globus-pallidus-for-parkinson-s-disease
#8
Philip S Lee, Donald J Crammond, R Mark Richardson
The concept of deep brain stimulation (DBS) for Parkinson's disease (PD) was introduced over 20 years ago, but our understanding of the nuances of this procedure continues to improve. The average motor outcomes of internal segment of the globus pallidus (GPi) and subthalamic nucleus (STN) DBS appear to be similar, although GPi DBS may allow greater recovery of verbal fluency and may provide greater relief of depression symptoms and improvement in the quality of life, and STN DBS appears more likely to result in decrease in levodopa equivalent doses...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332084/thalamic-deep-brain-stimulation
#9
Benjamin B Whiting, Alexander C Whiting, Donald M Whiting
The use of deep brain stimulation (DBS) of the thalamus has been proven to be a safe and efficacious treatment for the management of many diseases. The most common indication for thalamic DBS remains essential tremor (ET), one of the most common movement disorders in the world. ET patients should be considered for surgical intervention when their tremor has demonstrated to be refractory to medication, a characteristic estimated to be present in roughly 50% of ET cases. Advantages of DBS over thalamotomy include its reversibility, the ability to adjust stimulation settings to optimize efficacy and minimize side effects, the ability to perform bilateral procedures safely, and an association with a lower risk of postoperative cognitive problems...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332083/deep-brain-stimulation-interventional-and-intraoperative-mri-approaches
#10
Paul S Larson, Philip A Starr, Alastair J Martin
Interventional and intraoperative MRI approaches to deep brain stimulator implantation are relatively new, and in their purest form represent a distinct departure from traditional stereotactic techniques. They employ a novel means of stereotaxis based on regions of interest in the MR space and simple geometric principles, which eliminate the need for a stereotactic frame. This approach is appropriate for targets that are MR visible, and for whom the local anatomy and function are well characterized. It may also be appropriate for targets that do not have a well-described physiologic signature and for which clinical response to macrostimulation does not play a critical role...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332082/frameless-functional-stereotactic-approaches
#11
Viktoras Palys, Kathryn L Holloway
The stereotactic frame has served as the gold standard apparatus for accurate and precise targeting of deep brain structures since 1947. Despite passing the test of time, the stereotactic frame has several limitations from the perspective of both neurosurgeons and patients. Therefore, there was a need to develop a frameless system that had equivalent accuracy and reliability to the frame. This need was met with 3 commercially available frameless stereotactic systems designed specifically for deep brain stimulation surgery: Nexframe, STarFix, and ClearPoint...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332081/radiosurgical-subthalamic-nucleotomy
#12
Jean Régis, Romain Carron, Tatiana Witjas
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) is the reference technique in Parkinson's disease (PD) at different stages of complications. Some patients cannot afford DBS due to anticoagulation or comorbidities or due to pecuniary reasons. Radiosurgery is a minimally invasive stereotactic technique, with no craniotomy and subsequently no risk of bleeding or infection. Its good safety efficacy profile has been established in the treatment of tremor, and the postoperative care issues are simple with a much shorter hospital stay (mean 48 h)...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332080/radiosurgical-pallidotomy-for-parkinson-s-disease
#13
Leslie D Cahan, Ronald F Young, Francisco Li
Deep brain stimulation (DBS) has been widely accepted as a tool for treating many symptoms of Parkinson's disease (PD); pallidotomy has been nearly abandoned. Concerns about both the safety and efficacy of pallidotomy are based on small series, isolated case reports, and techniques that would now be considered obsolete. The senior author recently reviewed long-term follow-up of a series of patients who had gamma knife pallidotomy (GKP) for advanced PD. GKP leads to durable, clinically significant benefit. Bilateral GKP adds incremental improvement...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332079/radiosurgical-thalamotomy
#14
Edward A Monaco Iii, Samuel S Shin, Ajay Niranjan, L Dade Lunsford
Tremor is a common movement disorder that can be disabling, and its initial treatment is in the form of medical therapies. Often patients are refractory and seek surgical intervention. Treatment options for these patients include surgical radiofrequency thalamotomy and deep brain stimulation. There are a subset of patients who, for various reasons, are not candidates for open surgical procedures, or who opt to avoid them. For these patients, radiosurgical thalamotomy is a safe and useful alternative. Herein, we provide a review of the use of radiosurgical thalamotomy for the treatment of medically refractory tremor by discussing its history, defining the technique and its indications, evaluating its efficacy, and exploring its complications and shortcomings...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332077/stereotactic-radiofrequency-lesioning-for-movement-disorders
#15
Takaomi Taira, Shiro Horisawa, Nobuhiko Takeda, Prajakta Ghate
During the past 2 decades, deep brain stimulation (DBS) took over the position of radiofrequency (RF) lesioning of thalamic or pallidal targets for control of movement disorders. Superiority of DBS over RF lesioning is widely accepted, and most neurosurgeons even regard RF lesioning to be old-fashioned and dangerous. Such concepts emerged from the data of old stereotactic operations with ventriculography and without computerized planning. Hardware-related complications are not negligible in long-term DBS therapy, and DBS only controls the symptoms...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332076/image-guided-asleep-deep-brain-stimulation
#16
Andrew L Ko, Kim J Burchiel
Deep brain stimulation (DBS) has become an established treatment for medically refractory movement disorders including Parkinson's disease, essential tremor, and dystonia. The field of DBS continues to evolve with advances in patient selection, target identification, electrode and pulse generator technology, and the development of more effective stimulation paradigms such as closed-loop stimulation. Furthermore, as the safety and efficacy of DBS improves through better hardware design and deeper understanding of its mechanisms of action, the indications for DBS will continue to expand to cover a wider range of disorders...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332075/patient-evaluation-and-selection-for-movement-disorders-surgery-the-changing-spectrum-of-indications
#17
Steffen Paschen, Günther Deuschl
This report summarizes the state-of-the-art and controversies around patient selection for deep brain stimulation (DBS) for various conditions. Parkinson's disease (PD): several class I studies have shown superiority of DBS over best medical treatment for advanced PD with fluctuations and further inclusion criteria. One class I study suggests that PD patients with early motor complications might gain more quality of life if operated within 3 years after the onset of fluctuations. The subthalamic nucleus (STN) is still the standard target...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332074/diffusion-tensor-imaging-of-the-basal-ganglia-for-functional-neurosurgery-applications
#18
Francesco Sammartino, Mojgan Hodaie
Since its introduction, diffusion tensor imaging (DTI) has become an important tool in neuroscience given its unprecedented ability to image brain white matter in vivo. The interest in understanding the mechanisms of action of Deep Brain Stimulation in different targets and indications, together with the constant drive towards the improvement in long-term clinical outcomes, has found a logical complement in the application of tractography in this field. Diffusion tensor imaging has been traditionally associated with an increased susceptibility to MRI artifacts, and expensive computational resources...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29332069/the-history-of-movement-disorder-brain-surgery
#19
L Dade Lunsford, Ajay Niranjan
The first surgical procedures for abnormal movement disorders began in the 1930s, when surgeons first proposed ablative techniques of the caudate nucleus or transection of motor (pyramidal) pathways to reduce involuntary movements in patients with Parkinson's related tremor. During the 50-year interval between 1945 and 1995, the development of precise intracranial guiding devices, brain maps, and advanced imaging led to the refinement of appropriate deep brain targets affecting extrapyramidal pathways. Lesional surgery and subsequent neuroaugmentation using deep brain stimulation extended the role of deep brain surgery for a wider group of patients with tremor, rigidity, dyskinesia, and other involuntary movement disorders...
2018: Progress in Neurological Surgery
https://www.readbyqxmd.com/read/29331449/quantifying-axonal-responses-in-patient-specific-models-of-subthalamic-deep-brain-stimulation
#20
Kabilar Gunalan, Bryan Howell, Cameron C McIntyre
Medical imaging has played a major role in defining the general anatomical targets for deep brain stimulation (DBS) therapies. However, specifics on the underlying brain circuitry that is directly modulated by DBS electric fields remain relatively undefined. Detailed biophysical modeling of DBS provides an approach to quantify the theoretical responses to stimulation at the cellular level, and has established a key role for axonal activation in the therapeutic mechanisms of DBS. Estimates of DBS-induced axonal activation can then be coupled with advances in defining the structural connectome of the human brain to provide insight into the modulated brain circuitry and possible correlations with clinical outcomes...
January 10, 2018: NeuroImage
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