INVESTIGATING DIFFERENT TARGETS IN DEEP BRAIN STIMULATION ON PARKINSON'S DISEASE USING A MEAN-FIELD MODEL OF THE BASAL GANGLIA-THALAMOCORTICAL SYSTEM

2012 ◽  
Vol 12 (02) ◽  
pp. 1240004 ◽  
Author(s):  
ALIREZA NAHVI ◽  
FARIBA BAHRAMI ◽  
SAMIRA HEMMATI
Keyword(s):  
Parkinson’S Disease ◽  
Deep Brain Stimulation ◽  
Basal Ganglia ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Field Model ◽  
Mean Field ◽  
Mean Field Model ◽  
Thalamocortical System ◽  
Deep Brain

In this paper, we investigated effects of deep brain stimulation (DBS) on Parkinson's disease (PD) when different target sites in the basal ganglia are stimulated. The targets which are investigated are subthalamic nucleus (STN), globus pallidus interna (GPi), and globus pallidus externa (GPe). For this purpose we used a computational model of the basal ganglia-thalamocortical system (BGTCS) with parameters calculated for mean field. This model is able to reproduce both the normal and Parkinsonian activities of basal ganglia, thalamus and cortex in a unified structure. In the present study, we used a mean-field model of the BGTCS, allowing a more complete framework to simulate DBS and to interpret its effects in the BGTCS. Our results suggest that DBS in the STN and GPe could restore the thalamus relay activity, while DBS in the GPi could inhibit it. Our results are compatible with the experimental and the clinical outcomes about the effects of DBS of different targets.

Comparison of Subthalamic Nucleus and Globus Pallidus Deep Brain Stimulation in Parkinson’s Disease: A Systematic Review

2021 ◽  
Vol 5 (1) ◽  
Author(s):  
Azari H ◽  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Adverse Effects ◽  
Globus Pallidus ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Stn Dbs ◽  
Deep Brain

Background: Deep Brain Stimulation (DBS) is regarded as a viable therapeutic choice for Parkinson’s Disease (PD). The two most common sites for DBS are the Subthalamic Nucleus (STN) and Globus Pallidus (GPi). In this study, the clinical effectiveness of these two targets was compared. Methods: A systematic literature search in electronic databases were restricted to English language publications 2010 to 2021. Specified MeSH terms were searched in all databases. Studies that evaluated the Unified Parkinson’s Disease Rating Scale (UPDRS) III were selected by meeting the following criteria: (1) had at least three months follow-up period; (2) compared both GPi and STN DBS; (3) at least five participants in each group; (4) conducted after 2010. Study quality assessment was performed using the Modified Jadad Scale. Results: 3577 potentially relevant articles were identified 3569 were excluded based on title and abstract, duplicate and unsuitable article removal. Eight articles satisfied the inclusion criteria and were scrutinized (458 PD patients). Majority of studies reported no statistically significant between-group difference for improvements in UPDRS III scores. Conclusions: Although there were some results in terms of action tremor, rigidity, and urinary symptoms, which indicated that STN DBS might be a better choice or regarding the adverse effects, GPi seemed better; but it cannot be concluded that one target is superior. Other larger randomized clinical trials with longer follow-up periods and control groups are needed to decide which target is more efficient for stimulation and imposes fewer adverse effects on the patients.

scholarly journals Influence of basal ganglia on upper limb locomotor synergies. Evidence from deep brain stimulation and L-DOPA treatment in Parkinson's disease

Brain ◽  
2008 ◽  
Vol 131 (12) ◽  
pp. 3410-3420 ◽  
Author(s):  
P. Crenna ◽  
I. Carpinella ◽  
L. Lopiano ◽  
A. Marzegan ◽  
M. Rabuffetti ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Basal Ganglia ◽  
Upper Limb ◽  
Brain Stimulation ◽  
Deep Brain

scholarly journals Understanding Parkinson’s disease and deep brain stimulation: Role of monkey models

2019 ◽  
Vol 116 (52) ◽  
pp. 26259-26265 ◽  
Author(s):  
Jerrold L. Vitek ◽  
Luke A. Johnson
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Basal Ganglia ◽  
Medical Therapy ◽  
Brain Stimulation ◽  
Functional Organization ◽  
Surgical Approaches ◽  
Drug Induced ◽  
Deep Brain

Parkinson’s disease (PD) is a progressive neurodegenerative movement disorder affecting over 10 million people worldwide. In the 1930s and 1940s there was little understanding regarding what caused PD or how to treat it. In a desperate attempt to improve patients’ lives different regions of the neuraxis were ablated. Morbidity and mortality were common, but some patients’ motor signs improved with lesions involving the basal ganglia or thalamus. With the discovery ofl-dopa the advent of medical therapy began and surgical approaches became less frequent. It soon became apparent, however, that medical therapy was associated with side effects in the form of drug-induced dyskinesia and motor fluctuations and surgical therapies reemerged. Fortunately, during this time studies in monkeys had begun to lay the groundwork to understand the functional organization of the basal ganglia, and with the discovery of the neurotoxin MPTP a monkey model of PD had been developed. Using this model scientists were characterizing the physiological changes that occurred in the basal ganglia in PD and models of basal ganglia function and dysfunction were proposed. This work provided the rationale for the return of pallidotomy, and subsequently deep brain stimulation procedures. In this paper we describe the evolution of these monkey studies, how they provided a greater understanding of the pathophysiology underlying the development of PD and provided the rationale for surgical procedures, the search to understand mechanisms of DBS, and how these studies have been instrumental in understanding PD and advancing the development of surgical therapies for its treatment.

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