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Deep Brain Stimulation

Angelo Antonini, Bianca Nitu
Development of motor fluctuations and dyskinesia characterizes the transition from early to advanced Parkinson disease stage. Current therapeutic strategies to manage motor complications aim at increasing the number of levodopa administrations and extending its benefit by the association of enzyme blockers and dopamine agonists. However, as disease progresses, mobility becomes progressively dependent on levodopa absorption and its plasma bioavailability, resulting in loss of independence, worse quality of life and increased caregiver burden...
July 13, 2018: Journal of Neural Transmission
Claire Haegelen, Clément Baumgarten, Jean-François Houvenaghel, Yulong Zhao, Julie Péron, Sophie Drapier, Pierre Jannin, Xavier Morandi
Anatomical atlases have been developed to improve the targeting of basal ganglia in deep brain stimulation. However, the sole anatomy cannot predict the functional outcome of this surgery. Deep brain stimulation is often a compromise between several functional outcomes: motor, fluency and neuropsychological outcomes in particular. In this study, we have developed anatomo-clinical atlases for the targeting of subthalamic and medial globus pallidus deep brain stimulation. The activated electrode coordinates of 42 patients implanted in the subthalamic nucleus and 29 patients in the medial globus pallidus were studied...
2018: PloS One
Klara Hagelweide, Anna Schönberger, Lutz Kracht, Theo Gründler, Gereon R Fink, Ricarda I Schubotz
Recent fMRI findings revealed that impairment in a serial prediction task in patients suffering from Parkinson's disease (PD) results from hypoactivity of the SMA. Furthermore, hyperactivity of the lateral premotor cortex sustained performance after withdrawal of medication. To further explore these findings, we here examined the impact of deep brain stimulation of the subthalamic nucleus on the activity of the putamen and premotor areas while performing the serial prediction task. To this end, we measured eight male PD patients ON and OFF deep brain stimulation and eight healthy age-matched male controls using [15 O] water positron emission tomography to measure regional cerebral blood flow...
July 9, 2018: Neuropsychologia
L Perez-Caballero, M L Soto-Montenegro, M Hidalgo-Figueroa, J A Mico, M Desco, E Berrocoso
BACKGROUND: An initial antidepressant effect when using deep brain stimulation (DBS) of the subcallosal area of the cingulate cortex (Cg25) to treat resistant depression that could be the result of electrode insertion has been described. We previously showed that electrode insertion into the infralimbic cortex (ILC; the Cg25 rodent correlate) provokes a temporally limited antidepressant-like effect that is counteracted by non-steroidal anti-inflammatory drugs, such as those routinely used for pain relief...
July 9, 2018: Brain Stimulation
Andrew Haddock, Kyle T Mitchell, Andrew Miller, Jill L Ostrem, Howard J Chizeck, Svjetlana Miocinovic
Deep brain stimulation (DBS) programming, the systematic selection of fixed electrical stimulation parameters that deliver maximal therapeutic benefit while limiting side effects, poses several challenges in the treatment of movement disorders. DBS programming requires expertise of trained neurologists or nurses who assess patient symptoms according to standardized clinical rating scales and use patient reports of DBS-related side effects to adjust stimulation parameters and optimize therapy. In this study, we describe and validate an automated software platform for DBS programming for tremor associated with Parkinson's disease (PD) and essential tremor (ET)...
July 2, 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Chen Liu, Jiang Wang, Bin Deng, Huiyan Li, Chris Fietkiewicz, Kenneth A Loparo
The benefit of noise in improving the basal ganglia (BG) dysfunctions, especially Parkinsonian state, is explored in this paper. High frequency (≥100 Hz) deep brain stimulation (DBS), as a clinical effective stimulation method, has compelling and fantastic results in alleviating the motor symptoms of Parkinson's disease (PD). However, the mechanism of DBS is still unclear. And the selection of the DBS waveform parameters faces great challenges to further optimize the stimulation effects and to reduce its energy expenditure...
June 26, 2018: IEEE Transactions on Cybernetics
Chen Liu, Changsong Zhou, Jiang Wang, Kenneth A Loparo
A mathematical modeling for description of oscillation suppression by deep brain stimulation (DBS) is explored in this work. High frequency DBS introduced to the basal ganglia network can suppress pathological neural oscillations that occur in the Parkinsonian state. However, selecting appropriate stimulation parameters remains a challenging issue due to the limited understanding of the underlying mechanisms of the Parkinsonian state and its control. In this work, we use describing function analysis to provide an intuitive way to select the optimal stimulation parameters based on a biologically plausible computational model of the Parkinsonian neural network...
July 5, 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Daqu Zhang, Hangdao Li, Junfeng Sun, Weiwei Hu, Wen Jin, Shengtian Li, Shanbao Tong
OBJECTIVE: Transcranial ultrasound stimulation (TUS) is a noninvasive neuromodulation technique with good spatial resolution and deep penetration. This study aims to investigate whether TUS has antidepressant-like effect to depressed rats. METHODS: Rats were divided into five groups, including two groups (ST-Ctr and ST-Res) for evaluating the short-term impact of restraint stress and three groups (LT-Ctr-ShamTUS, LT-Res-ShamTUS and LT-Res-TUS) for studying the long-term effects of restraint and TUS stimulation...
June 8, 2018: IEEE Transactions on Bio-medical Engineering
Ioannis Karampelas, Andrew E Sloan
Laser-induced interstitial thermotherapy (LITT) is a modern minimally invasive treatment modality applied for management of a variety of diseases. Recent developments of techniques for precise targeting of the lesion, accurate delivery of the prescribed therapeutically effective thermal doses, and real-time visualization of the induced tissue damage during the procedure by means of intraoperative MR thermometry have stimulated a number of clinical studies testing LITT in cases of different brain pathologies, including gliomas...
2018: Progress in Neurological Surgery
Alireza Azimi, Mansour Parvaresh, Gholamali Shahidi, Amirhassan Habibi, Sadra Rohani, Mahdi Safdarian, Arash Fattahi, Morteza Taheri, Mohammad Rohani
OBJECTIVES: Tourette syndrome (TS) is a neuropsychiatric disorder characterized by childhood onset motor and phonic tics. In refractory cases, deep brain stimulation (DBS) with different targets including anteromedial Globus pallidus (AM-GPi) looks promising. PATIENTS AND METHODS: Patients with TS diagnosed according to DSM-IV TR criteria with severe medication-recalcitrant disease referred to our DBS clinic, were recruited for this study. They underwent bilateral AM-GPi DBS with Model 3389, Medtronic electrodes...
July 4, 2018: Clinical Neurology and Neurosurgery
Barbara Carl, Miriam Bopp, Marko Gjorgjevski, Christopher Nimsky
OBJECTIVE: To investigate how frameless navigational techniques can be implemented to support standard frame-based stereotactic procedures. PATIENTS & METHODS: In 25 patients (18 deep brain stimulation (DBS) procedures, 3 stereotactic biopsies, 4 stereo-encephalography procedures) 57 trajectories were planned. A navigation reference array was attached to the stereotactic frame for automatic registration applying intraoperative computed tomography (iCT). RESULTS: User-independent automatic registration resulted in a low navigation registration error (0...
July 7, 2018: World Neurosurgery
Christian Schmidt, Ursula van Rienen
OBJECTIVE: The aim of this study is to propose an adaptive scheme embedded into an open-source environment for the estimation of the neural activation extent during deep brainstimulation and to investigate the feasibility of approximating the neural activation extent by thresholds of the field solution. METHODS: Open-source solutions for solving the field equation in volume conductor models of deep brain stimulation and computing the neural activation are embedded into a Python package to estimate the neural activation dependent on the dielectric tissue properties and axon parameters by employing a spatially adaptive scheme...
December 6, 2017: IEEE Transactions on Bio-medical Engineering
Ana Lusicic, Koen Rj Schruers, Stefano Pallanti, David J Castle
Repetitive transcranial magnetic stimulation (rTMS) is a noninvasive neurostimulation technique receiving increasing attention in the treatment of different psychiatric disorders. Evidence for rTMS use in obsessive-compulsive disorder (OCD) is accumulating and informing further developments in the neurostimulation field, the latest being deep transcranial magnetic stimulation (dTMS). dTMS allows direct stimulation of deeper subcortical structures and larger brain volume than conventional rTMS. Underlying neurobiological mechanisms related to transcranial magnetic stimulation are still under evaluation, but appear to offer a novel "third" way of addressing symptoms via localized electrical stimulation compared to pharmacotherapy and psychotherapy approaches...
2018: Neuropsychiatric Disease and Treatment
Shuang Zou, Yu-Long Lan, Ya-Ping Hu, Xiao-Xue Yin, Wen-Long Liu, Tao Li, Zhanhua Liang
Sleep dysfunctions, including rapid eye movement sleep behavior disorder, sleep fragmentation, excessive daytime sleepiness and various other dysfunctions, can seriously affect quality of life in patients with Parkinson's disease (PD). Emerging evidence suggests that deep brain stimulation (DBS) exerts a substantial effect when used to treat sleep dysfunctions, which are common nonmotor symptoms experienced by patients with PD. However, far less is known about the specific mechanisms underlying the effects of DBS on sleep processes and the factors that potentially influence these effects...
July 9, 2018: Acta Neurologica Belgica
Mar Carreño, Maria José Martí, Ibán Aldecoa, Celia Painous, Estefanía Conde, Francesc Valldeoriola, Josep Valls-Solé, Núria Bargalló, Francisco Gil, Isabel Manzanares, Xavier Setoain, Antonio Donaire, Esteban Muñoz, Pedro Roldán, Teresa Boget, Luis Pintor, Eva Bailles, Jordi Rumià
OBJECTIVE: To describe an adult patient with Rasmussen's disease with focal dystonia as the most disabling symptom and the good response to unilateral globus pallidus internus (GPi) deep brain stimulation (DBS). METHODS: Retrospective review of clinical records and diagnostic tests. RESULTS: The patient had displayedmild focal seizures with sensory and motor symptoms on the left arm and hemiface since the age of 22. Ten years later she experienced abrupt onset of focal left dystonia involving mainly the leg...
July 9, 2018: Journal of Neurology, Neurosurgery, and Psychiatry
Tao Yu, Xueyuan Wang, Yongjie Li, Guojun Zhang, Gregory Worrell, Patrick Chauvel, Duanyu Ni, Liang Qiao, Chang Liu, Liping Li, Liankun Ren, Yuping Wang
Epilepsy has been classically seen as a brain disorder resulting from abnormally enhanced neuronal excitability and synchronization. Although it has been described since antiquity, there are still significant challenges achieving the therapeutic goal of seizure freedom. Deep brain stimulation of the anterior nucleus of the thalamus has emerged as a promising therapy for focal drug-resistant epilepsy; the basic mechanism of action, however, remains unclear. Here, we show that desynchronization is a potential mechanism of deep brain stimulation of the anterior nucleus of the thalamus by studying local field potentials recordings from the cortex during high-frequency stimulation (130 Hz) of the anterior nucleus of the thalamus in nine patients with drug-resistant focal epilepsy...
July 6, 2018: Brain: a Journal of Neurology
Syed Ahmar Shah, Huiling Tan, Gerd Tinkhauser, Peter Brown
Lack of force information and longevity issues are impediments to the successful translation of brain-computer interface systems for prosthetic control from experimental settings to widespread clinical application. The ability to decode force using deep brain stimulation electrodes in the subthalamic nucleus (STN) of the basal ganglia provides an opportunity to address these limitations. This paper explores the use of various classes of algorithms (Wiener filter, Wiener-Cascade model, Kalman filter, and dynamic neural networks) and recommends the use of a Wiener-Cascade model for decoding force from STN...
July 2018: IEEE Transactions on Neural Systems and Rehabilitation Engineering
Juho Joutsa, Andreas Horn, Joey Hsu, Michael D Fox
Bradykinesia, rigidity, and tremor frequently co-occur, a clinical syndrome known as parkinsonism. Because this syndrome is commonly seen in Parkinson's disease, symptoms are often attributed to cell loss in the substantia nigra. However, parkinsonism occurs in several other neurological disorders and often fails to correlate with nigrostriatal pathology, raising the question of which brain region(s) cause this syndrome. Here, we studied cases of new-onset parkinsonism following focal brain lesions. We identified 29 cases, only 31% of which hit the substantia nigra...
July 2, 2018: Brain: a Journal of Neurology
Linda Sandström, Fredrik Karlsson, Patric Blomstedt
BACKGROUND/AIMS: Deep brain stimulation (DBS) is less effective on voice tremor than arm tremor, and it is generally assumed that successful voice tremor treatment requires bilateral DBS and possibly more precise thalamic stimulation. However, recent findings suggest that these assumptions should be reconsidered. OBJECTIVES: To evaluate whether unilateral DBS targeting the caudal zona incerta (cZi) may be sufficient to alleviate voice tremor in patients with essential tremor, or whether bilateral stimulation is needed...
July 4, 2018: Stereotactic and Functional Neurosurgery
Pedro Brandão, Talyta Cortez Grippe, Luiz Cláudio Modesto, André Gustavo Fonseca Ferreira, Flávia Martins da Silva, Flávio Faria Pereira, Marcelo Evangelista Lobo, Nasser Allam, Tiago da Silva Freitas, Renato P Munhoz
Parkinson's disease can be treated surgically in patients who present with motor complications such as fluctuations and dyskinesias, or medically-refractory disabling tremor. In this review, a group of specialists formulated suggestions for a preoperative evaluation protocol after reviewing the literature published up to October 2017. In this protocol, eligibility and ineligibility criteria for surgical treatment were suggested, as well as procedures that should be carried out before the multidisciplinary therapeutic decisions...
June 2018: Arquivos de Neuro-psiquiatria
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