scholarly journals Deep brain stimulation induced normalization of the human functional connectome in Parkinson’s disease

Brain ◽  
2019 ◽  
Vol 142 (10) ◽  
pp. 3129-3143 ◽  
Author(s):  
Andreas Horn ◽  
Gregor Wenzel ◽  
Friederike Irmen ◽  
Julius Huebl ◽  
Ningfei Li ◽  
...  

Deep brain stimulation has local effects on the target structure, but also global effects via distributed brain networks. Horn et al. show that modulating the activity of the subthalamic nucleus in patients with Parkinson’s disease normalizes signatures of widespread network connectivity towards those found in healthy controls.

2018 ◽  
Vol 2018 ◽  
pp. 1-7
Author(s):  
Hector R. Martinez ◽  
Alexis Garcia-Sarreon ◽  
Carlos Camara-Lemarroy ◽  
Fortino Salazar ◽  
María L. Guerrero-González

Background. Body motion evaluation (BME) by markerless systems is increasingly being considered as an alternative to traditional marker-based technology because they are faster, simpler, and less expensive. They are increasingly used in clinical settings in patients with movement disorders; however, the wide variety of systems available makes results conflicting. Research Question. The objective of this study was to determine whether a markerless 3D motion capture system is a useful instrument to objectively differentiate between PD patients with DBS in On and Off states and controls and its correlation with the evaluation by means of MDS-UPDRS. Methods. Six PD patients who underwent deep brain stimulation (DBS) bilaterally in the subthalamic nucleus were evaluated using BME and the Unified Parkinson’s Disease Rating Scale (UPDRS-III) with DBS turned On and Off. BME of 16 different movements in six controls paired by age and sex was compared with that in PD patients with DBS in On and Off states. Results. A better performance in the BME was correlated with a lower UPDRS-III score. There was no statistically significant difference between patients in Off and On states of DBS regarding BME. However, some items such as left shoulder flexion (p=0.038), right shoulder rotation (p=0.011), and left trunk rotation (p=0.023) were different between Off patients and healthy controls. Significance. Kinematic data obtained with this markerless system could contribute to discriminate between PD patients and healthy controls. This emerging technology may help to clinically evaluate PD patients more objectively.


2019 ◽  
Author(s):  
Kousik Sarathy Sridharan ◽  
Andreas Højlund ◽  
Erik Lisbjerg Johnsen ◽  
Niels Aagaard Sunde ◽  
Sándor Beniczky ◽  
...  

AbstractBackgroundParkinson’s disease (PD) is a debilitating neurodegenerative disorder. PD can be treated with deep brain stimulation (DBS) when dopaminergic medication is no longer a viable option. Both treatments are effective in improving motor symptoms, however, their underlying mechanisms are not fully elucidated yet.ObjectivesTo study the effects of DBS and dopaminergic medication treatments on cortical processing and corticomuscular drive during movements.MethodsMagnetoencephalography (MEG) was recorded in 10 PD patients and 10 healthy controls, performing phasic hand contractions (hand gripping). Measurements were performed in DBS-treated, untreated and dopaminergic-medicated states; healthy controls received no treatment interventions. Participants performed phasic contractions with their right hand, recorded with electromyography (EMG). Our measures of interest were beta (13-30 Hz) corticomuscular coherence (CMC) and low-gamma (31-45 Hz) power. We used Bayesian statistics on summary values from sensor space data, and we localized the sources of the effects of treatments on beta-CMC and low-gamma power using beamforming.ResultsIn PD patients, DBS led to reduced CMC values, whereas dopaminergic medication increased beta-CMC values (localized to contralateral M1) to even higher levels than the controls. DBS, on the other hand, increased low-gamma power (localized to M1) compared to controls and to other conditions. Yet both treatments had similar beneficial effects on the patients’ motor symptoms evaluated by UPDRS-III.ConclusionDespite comparable improvements from both treatments on motor symptoms, DBS and dopaminergic medication seem to have different effects on motor cortical function. This indicates that the treatments undertake different functional strategies to improve PD symptoms.


2009 ◽  
Vol 36 (S 02) ◽  
Author(s):  
J Gierthmühlen ◽  
P Arning ◽  
G Wasner ◽  
A Binder ◽  
J Herzog ◽  
...  

2019 ◽  
pp. 158-173

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder caused by a dopamine deficiency that presents with motor symptoms. Visual disorders can occur concomitantly but are frequently overlooked. Deep brain stimulation (DBS) has been an effective treatment to improve tremors, stiffness and overall mobility, but little is known about its effects on the visual system. Case Report: A 75-year-old Caucasian male with PD presented with longstanding binocular diplopia. On baseline examination, the best-corrected visual acuity was 20/25 in each eye. On observation, he had noticeable tremors with an unsteady gait. Distance alternating cover test showed exophoria with a right hyperphoria. Near alternating cover test revealed a significantly larger exophoria accompanied by a reduced near point of convergence. Additional testing with a 24-2 Humphrey visual field and optical coherence tomography (OCT) of the nerve and macula were unremarkable. The patient underwent DBS implantation five weeks after initial examination, and the device was activated four weeks thereafter. At follow up, the patient still complained of intermittent diplopia. There was no significant change in the manifest refraction or prism correction. On observation, the patient had remarkably improved tremors with a steady gait. All parameters measured were unchanged. The patient was evaluated again seven months after device activation. Although vergence ranges at all distances were improved, the patient was still symptomatic for intermittent diplopia. OCT scans of the optic nerve showed borderline but symmetric thinning in each eye. All other parameters measured were unchanged. Conclusion: The case found no significant changes on ophthalmic examination after DBS implantation and activation in a patient with PD. To the best of the authors’ knowledge, there are no other cases in the literature that investigated the effects of DBS on the visual system pathway in a patient with PD before and after DBS implantation and activation.


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