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Deep Brain Stimulation literature

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151 papers 25 to 100 followers
András Jakab, Beat Werner, Marco Piccirelli, Kázmér Kovács, Ernst Martin, John S Thornton, Tarek Yousry, Gabor Szekely, Ruth O'Gorman Tuura
Functional stereotactic neurosurgery by means of deep brain stimulation or ablation provides an effective treatment for movement disorders, but the outcome of surgical interventions depends on the accuracy by which the target structures are reached. The purpose of this pilot study was to evaluate the feasibility of diffusion tensor imaging (DTI) based probabilistic tractography of deep brain structures that are commonly used for pre- and perioperative targeting for functional neurosurgery. Three targets were reconstructed based on their significance as intervention sites or as a no-go area to avoid adverse side effects: the connections propagating from the thalamus to (1) primary and supplementary motor areas, (2) to somatosensory areas and the cerebello-thalamic tract (CTT)...
2016: Frontiers in Neuroanatomy
Justin Sharim, Daniel Yazdi, Amy Baohan, Eric Behnke, Nader Pouratian
OBJECTIVE: Neurosurgical interventions such as deep brain stimulation surgery of the globus pallidus internus (GPi) play an important role in the treatment of medically refractory Parkinson's disease (PD), and require high targeting accuracy. Variability in the laterality of the GPi across patients with PD has not been well characterized. The aim of this report is to identify factors that may contribute to differences in position of the motor region of GPi. MATERIALS AND METHODS: The charts and operative reports of 101 PD patients following deep brain stimulation surgery (70 males, aged 11-78 years) representing 201 GPi were retrospectively reviewed...
July 28, 2016: Neuromodulation: Journal of the International Neuromodulation Society
Jonathan J Rasouli, Brian Harris Kopell
No abstract text is available yet for this article.
July 26, 2016: World Neurosurgery
Antonella Macerollo, Davide Martino
Movement disorders comprise hyperkinetic involuntary movements (eg tremor, myoclonus, tics, dystonia and chorea) and hypokinetic (parkinsonism) disorders. Tics are cardinal features of primary tic disorders encompassing Tourette syndrome (TS), but are also found in some neurodegenerative conditions and may be induced by psychoactive substances. The first line treatment for tics is pharmacological (mainly dopamine receptor blockers or alpha-2 adrenergic agonists) and behavioural. Dystonia and chorea syndromes are considerably heterogeneous in aetiology, and age at onset, body distribution of the movement disorder, accompanying neurological motor and non-motor features, and systemic manifestations are all important to reach a correct aetiological diagnosis...
August 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
Alik S Widge, Kristen K Ellard, Angelique C Paulk, Ishita Basu, Ali Yousefi, Samuel Zorowitz, Anna Gilmour, Afsana Afzal, Thilo Deckersbach, Sydney S Cash, Mark A Kramer, Uri T Eden, Darin D Dougherty, Emad N Eskandar
Mental disorders are a leading cause of disability, morbidity, and mortality among civilian and military populations. Most available treatments have limited efficacy, particularly in disorders where symptoms vary over relatively short time scales. Targeted modulation of neural circuits, particularly through open-loop deep brain stimulation (DBS), showed initial promise but has failed in blinded clinical trials. We propose a new approach, based on targeting neural circuits linked to functional domains that cut across diagnoses...
July 30, 2016: Experimental Neurology
Max-Philipp Stenner, Stefan Dürschmid, Robb B Rutledge, Tino Zaehle, Friedhelm C Schmitt, Jörn Kaufmann, Jürgen Voges, Hans-Jochen Heinze, Raymond J Dolan, Mircea Ariel Schoenfeld
The human nucleus accumbens is thought to play an important role in guiding future action selection via an evaluation of current action outcomes. Here we provide electrophysiological evidence for a more direct, i.e., online, role during action preparation. We recorded local field potentials from the nucleus accumbens in patients with epilepsy undergoing surgery for deep brain stimulation. We found a consistent decrease in the power of alpha/beta oscillations (10-30 Hz) before and around the time of movements...
October 1, 2016: Journal of Neurophysiology
Tanmoy K Maiti, Subhas Konar, Shyamal Bir, Piyush Kalakoti, Anil Nanda
The field of functional neurosurgery has experienced a rise, fall and lastly a renaissance over the past 75years. Micro-electrode recording (MER) played a key role during this eventful journey. However, as the intra-operative MRI continues to evolve, a pertinent question about the utility of MER has been raised in recent years. In this article, we critically review these current controversies. The English literature is reviewed and the complex technique of MER is discussed in a simplified manner. The improvement of neuroimaging and its application in functional neurosurgery, especially in deep brain stimulation, is discussed...
October 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Mikkel V Petersen, Torben E Lund, Niels Sunde, Jesper Frandsen, Frederikke Rosendal, Niels Juul, Karen Østergaard
OBJECTIVE Diffusion-weighted MRI (DWI) and tractography allows noninvasive mapping of the structural connections of the brain, and may provide important information for neurosurgical planning. The hyperdirect pathway, connecting the subthalamic nucleus (STN) with the motor cortex, is assumed to play a key role in mediating the effects of deep brain stimulation (DBS), which is an effective but poorly understood treatment for Parkinson disease. This study aimed to apply recent methodological advances in DWI acquisition and analysis to the delineation of the hyperdirect pathway in patients with Parkinson disease selected for surgery...
July 8, 2016: Journal of Neurosurgery
Elena Jiltsova, Timo Möttönen, Markus Fahlström, Joonas Haapasalo, Timo Tähtinen, Jukka Peltola, Juha Öhman, Elna-Marie Larsson, Tommi Kiekara, Kai Lehtimäki
BACKGROUND: Deep brain stimulation (DBS) of the anterior nucleus of thalamus (ANT) is an evolving treatment option in refractory focal epilepsy. Due to poor visualization of ANT in traditional MRI sequences used for movement disorder surgery, targeting of ANT is mainly based on stereotactic atlas information. Sophisticated 3T MRI methods enable visualization of ANT, but 1.5T MRI is still preferred or more readily available in a large number of centers performing DBS. OBJECTIVE: In the present study, we sought to determine whether ANT could be adequately visualized at 1...
July 11, 2016: Neuromodulation: Journal of the International Neuromodulation Society
Justin D Hilliard, Alberto Bona, Sasha Vaziri, Roger Walz, Michael S Okun, Kelly D Foote
INTRODUCTION: Deep brain stimulation (DBS) is an established therapeutic modality for movement disorders, however, complications related to the surgical technique and the implanted hardware do occur and must be minimized to optimize outcomes. Delayed erosion of the scalp overlying protruding DBS hardware is one such adverse event that universally requires surgical treatment and often necessitates explantation of the DBS system. In this study, we evaluated the incidence of delayed scalp erosion in a large single-center series of DBS patients, and we propose a surgical strategy for avoiding this complication...
August 2016: Neurosurgery
Tushar Krishnan, Richard Mustakos, G Karl Steinke
INTRODUCTION: Directional deep brain stimulation (DBS) leads designed to preferentially stimulate structures radially about the DBS lead are currently under development. Recent publications have demonstrated the ability of these leads to obtain directional effects during acute testing in patients. Here we will use computational modeling to demonstrate that combining directional leads with Multiple Independent Current Control (MICC) will offer additional control over the shape of the Volume of Tissue Activated (VTA)...
August 2016: Neurosurgery
Jens Volkmann, Stephan Chabardes, G Karl Steinke, Stephen Carcieri
INTRODUCTION: Historically, deep brain stimulation (DBS) systems have delivered stimulation using cylindrical electrodes, which stimulate neurons around the entire circumference of the lead. In this study, we will test a directional DBS lead, which includes radially segmented electrodes designed for selective stimulation in directions orthogonal to the lead trajectory, in addition to standard cylindrical electrodes. Bilateral directional DBS leads will be connected to the Boston Scientific Vercise PC pulse generator, which provides an independent current source for each of its 16 contacts...
August 2016: Neurosurgery
Andrea A Kühn, Jens Volkmann
Deep brain stimulation is a powerful clinical method for movement disorders that no longer respond satisfactorily to pharmacological management, but its progress has been hampered by stagnation in technological procedure solutions and device development. Recently, the combined research efforts of bioengineers, neuroscientists, and clinicians have helped to better understand the mechanisms of deep brain stimulation, and solutions for the translational roadblock are emerging. Here, we define the needs for methodological advances in deep brain stimulation from a neurophysiological perspective and describe technological solutions that are currently evaluated for near-term clinical application...
July 12, 2016: Movement Disorders: Official Journal of the Movement Disorder Society
Luke A Johnson, Shane D Nebeck, Abirami Muralidharan, Matthew D Johnson, Kenneth B Baker, Jerrold L Vitek
BACKGROUND: Incorporating feedback controls based on real-time measures of pathological brain activity may improve deep brain stimulation (DBS) approaches for the treatment of Parkinson's disease (PD). Excessive beta oscillations in subthalamic nucleus (STN) local field potentials (LFP) have been proposed as a potential biomarker for closed-loop DBS (CL-DBS). OBJECTIVE: In a non-human primate PD model we compared CL-DBS, which delivered stimulation only when STN LFP beta activity was elevated, to traditional continuous DBS (tDBS)...
June 22, 2016: Brain Stimulation
Joseph R Phillips, Abeer M Eissa, Doaa H Hewedi, Marjan Jahanshahi, Mohamed El-Gamal, Szabolcs Keri, Ahmed A Moustafa
Parkinson's disease (PD) is primarily a motor disorder that involves the gradual loss of motor function. Symptoms are observed initially in the extremities, such as hands and arms, while advanced stages of the disease can effect blinking, swallowing, speaking, and breathing. PD is a neurodegenerative disease, with dopaminergic neuronal loss occurring in the substantia nigra pars compacta, thus disrupting basal ganglia functions. This leads to downstream effects on other neurotransmitter systems such as glutamate, γ-aminobutyric acid, and serotonin...
June 30, 2016: Reviews in the Neurosciences
Peter Jan van Laar, D L Marinus Oterdoom, Gert J Ter Horst, Arjen L J van Hulzen, Eva K L de Graaf, Hans Hoogduin, Linda C Meiners, J Marc C van Dijk
BACKGROUND: In deep brain stimulation (DBS), accurate placement of the lead is critical. Target definition is highly dependent on visual recognition on magnetic resonance imaging (MRI). We prospectively investigated whether the 7-T MRI enabled better visualization of targets and led to better placement of leads compared with the 1.5-T and the 3-T MRI. METHODS: Three patients with PD (mean, 55 years) were scanned on 1.5-, 3-, and 7-T MRI before surgery. Tissue contrast and signal-to-noise ratio were measured...
September 2016: World Neurosurgery
Efstathios D Kondylis, Michael J Randazzo, Ahmad Alhourani, Witold J Lipski, Thomas A Wozny, Yash Pandya, Avniel S Ghuman, Robert S Turner, Donald J Crammond, R M Richardson
Recent electrocorticography data have demonstrated excessive coupling of beta-phase to gamma-amplitude in primary motor cortex and that deep brain stimulation facilitates motor improvement by decreasing baseline phase-amplitude coupling. However, both the dynamic modulation of phase-amplitude coupling during movement and the general cortical neurophysiology of other movement disorders, such as essential tremor, are relatively unexplored. To clarify the relationship of these interactions in cortical oscillatory activity to movement and disease state, we recorded local field potentials from hand sensorimotor cortex using subdural electrocorticography during a visually cued, incentivized handgrip task in subjects with Parkinson's disease (n = 11), with essential tremor (n = 9) and without a movement disorder (n = 6)...
August 2016: Brain: a Journal of Neurology
Jutta S Mayer, Joseph Neimat, Bradley S Folley, Sarah K Bourne, Peter E Konrad, David Charles, Sohee Park
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves the motor symptoms of Parkinson's disease (PD). The STN may represent an important relay station not only in the motor but also the associative cortico-striato-thalamocortical pathway. Therefore, STN stimulation may alter cognitive functions, such as working memory (WM). We examined cortical effects of STN-DBS on WM in early PD patients using functional near-infrared spectroscopy. The effects of dopaminergic medication on WM were also examined...
August 2016: Neurocase
J Mathers, C Rick, C Jenkinson, R Garside, H Pall, R Mitchell, S Bayliss, L L Jones
OBJECTIVE: To review and synthesise qualitative research studies that have explored patients' experience of deep brain stimulation (DBS) in advanced Parkinson's disease (PD). DESIGN: Systematic review and meta-synthesis of 7 original papers, using metaethnography. SETTING: Studies conducted in Denmark, France and Sweden. PARTICIPANTS: 116 patients who had undergone DBS and 9 spouses of patients. RESULTS: Prior to surgery, the experience of advancing PD is one of considerable loss and a feeling of loss of control...
2016: BMJ Open
Robert Micieli, Adriana Lucia Lopez Rios, Ricardo Plata Aguilar, Luis Fernando Botero Posada, William D Hutchison
OBJECTIVE Deep brain stimulation (DBS) of the posterior hypothalamus (PH) has been reported to be effective for aggressive behavior in a number of isolated cases. Few of these case studies have analyzed single-unit recordings in the human PH and none have quantitatively analyzed single units in the red nucleus (RN). The authors report on the properties of ongoing neuronal discharges in bilateral trajectories targeting the PH and the effectiveness of DBS of the PH as a treatment for aggressive behavior. METHODS DBS electrodes were surgically implanted in the PH of 1 awake patient with Sotos syndrome and 3 other anesthetized patients with treatment-resistant aggressivity...
June 24, 2016: Journal of Neurosurgery
2016-06-29 05:39:23
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