scholarly journals Deep brain stimulation. How it controls movements in Parkinson’s disease?

2019 ◽  
Vol 21 (3) ◽  
pp. 93-99
Author(s):  
Z. A. Zalyalova
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Treatment Rate ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Pain Syndromes ◽  
The Brain ◽  
Deep Brain

Deep brain stimulation (DBS) involves implantation of electrodes in the basal ganglia of the brain. Dysregulation of neuronal activity in these structures is the cause of motor disorders. DBS is used in many motor (Parkinson’s disease, essential tremor, dystonia, ticks, tardive dyskinesia and others), psychological, behavioral and affective (depression, obsessive-compulsive disorder, epilepsy and others) disorders, as well as in severe pain syndromes resistant to drug therapy. However, the mechanisms of action of DBS are not fully understood. Currently, different theories and hypotheses are considered which explain its mechanism of treatment: rate model, “jamming” theory, hypotheses about the effect on neurogenesis, astrocyte activity, increased brain circulation, electrotaxis, etc.

Deep brain stimulation and anterior capsulotomy: The question of autonomy

2017 ◽  
Vol 41 (S1) ◽  
pp. S323-S323
Author(s):  
S. Raymaekers ◽  
Z. Van Duppen ◽  
K. Demyttenaere ◽  
L. Luyten ◽  
L. Gabriels ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Well Being ◽  
Structured Interviews ◽  
Obsessive Compulsive ◽  
Research Education ◽  
Compulsive Disorder ◽  
The Brain ◽  
Anterior Capsulotomy ◽  
Deep Brain

IntroductionIn carefully selected treatment-refractory patients with obsessive compulsive disorder (OCD), deep brain stimulation (DBS) or anterior capsulotomy (AC) might be considered as a possible treatment. However, the direct intervention in the brain can raise questions about autonomy. Do patients still feel like they are in control of their actions when their behavior is changed by a surgical intervention?Objective/aimsTo examine in both AC and DBS patients whether these intervention influenced perception of autonomy. We aimed to discover any differences in these perceptions when comparing AC and DBS patients.MethodsWe conducted semi-structured interviews with AC and DBS patients. Interviews were recorded digitally and transcribed verbatim. We analyzed interviews in an iterative process based on grounded theory principles.ResultsWe interviewed 10 DBS patients and 6 AC patients. Sense of agency (the awareness that one is the author of his/her own actions) did not seem to be diminished by AC or DBS. However, especially DBS patients are aware of their dependency on a device for their well-being. Another important theme is authenticity (in how far patients perceive their actions and thoughts as matching their self-concept). Feelings of authenticity can be disturbed especially in cases of induced hypomania (for DBS) or apathy (for AC). OCD itself also has an impact on autonomy as patients describe a lack of freedom due to their disorder.ConclusionDespite extensive changes in emotions, behavior and even personal identity after DBS or AC surgery, perceived autonomy was not greatly altered in these OCD patients.Disclosure of interestMedtronic provided grants for research, education, and traveling to B. Nuttin and L. Gabriëls, who hold the Medtronic Chair for Stereotactic Neurosurgery in Psychiatric Disorders at KU Leuven. S. Raymaekers is supported by this Chair. B. Nuttin co-owns a patent on DBS in OCD.

Principles of deep brain stimulation

2019 ◽  
pp. 865-872
Author(s):  
Erlick A.C Pereira ◽  
Alexander L Green ◽  
Tipu Z Aziz
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Diffusion Tensor ◽  
Electrode Placement ◽  
Obsessive Compulsive ◽  
Randomized Controlled Clinical Trials ◽  
Medication Side ◽  
Deep Brain

Deep brain stimulation (DBS) is a minimally invasive targeted neurosurgical intervention that enables structures deep in the brain to be stimulated electrically by an implanted pacemaker. It has become the treatment of choice in Parkinson’s disease patients with either disabling medication side effects, on-off fluctuations, or tremor. Its efficacy in Parkinson’s disease has been demonstrated robustly by randomized controlled clinical trials, with numerous brain areas having been targeted in the last two decades for indications including dystonia and tremor in movement disorders; depression, obsessive-compulsive disorder, and Tourette’s syndrome in psychiatry; epilepsy, cluster headache, and chronic pain. The principles of framed stereotactic surgery enabling DBS electrode placement are reviewed here, before describing the putative mechanisms underlying DBS and its action upon individual neurons. Recent and future developments in DBS technology such as segmented, directional leads, and smart, adaptive stimulation are then discussed alongside related technological advances such as diffusion tensor imaging, robotic surgery, and molecular and cellular therapies. The role of stereotactic lesions in the era of DBS and the different modalities of lesioning are then summarized.

scholarly journals Prediction of Deep Brain Stimulation Outcome in Parkinson’s Disease With Connectome Based on Hemispheric Asymmetry

2021 ◽  
Vol 15 ◽  
Author(s):  
Jingqi Wang ◽  
Ruihong Shang ◽  
Le He ◽  
Rongsong Zhou ◽  
Zhensen Chen ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Motor Function ◽  
Brain Stimulation ◽  
Precentral Gyrus ◽  
True Value ◽  
The Brain ◽  
Stn Dbs ◽  
Deep Brain

Parkinson’s disease (PD) is a neurodegenerative disease that is associated with motor and non-motor symptoms and caused by lack of dopamine in the substantia nigra of the brain. Subthalamic nucleus deep brain stimulation (STN-DBS) is a widely accepted therapy of PD that mainly inserts electrodes into both sides of the brain. The effect of STN-DBS was mainly for motor function, so this study focused on the recovery of motor function for PD after DBS. Hemispherical asymmetry in the brain network is considered to be a potential indicator for diagnosing PD patients. This study investigated the value of hemispheric brain connection asymmetry in predicting the DBS surgery outcome in PD patients. Four types of brain connections, including left intra-hemispheric (LH) connection, right intra-hemispheric (RH) connection, inter-hemispheric homotopic (Ho) connection, and inter-hemispheric heterotopic (He) connection, were constructed based on the resting state functional magnetic resonance imaging (rs-fMRI) performed before the DBS surgery. We used random forest for selecting features and the Ridge model for predicting surgical outcome (i.e., improvement rate of motor function). The functional connectivity analysis showed that the brain has a right laterality: the RH networks has the best correlation (r = 0.37, p = 5.68E-03) between the predicted value and the true value among the above four connections. Moreover, the region-of-interest (ROI) analysis indicated that the medioventral occipital cortex (MVOcC)–superior temporal gyrus (STG) and thalamus (Tha)–precentral gyrus (PrG) contributed most to the outcome prediction model for DBS without medication. This result provides more support for PD patients to evaluate DBS before surgery.

Brain stimulation therapies

2013 ◽  
Author(s):  
Daniel W. O’Connor ◽  
Chris Plakiotis
Keyword(s):  
Cognitive Impairment ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Magnetic Stimulation ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Treatment Of Depression ◽  
Electrical Impulses ◽  
The Brain ◽  
Deep Brain

Electroconvulsive therapy (ECT), transcranial magnetic stimulation (TMS) and deep brain stimulation (DBS) all entail the delivery of electrical impulses to the brain with the aim of relieving mental disorders. ECT is an effective treatment of depression, mania and catatonia and, to a lesser extent, of schizophrenia. Its side effects, principally cognitive impairment, are mitigated through the use of individually tailored, unilateral delivery. TMS is more convenient but of lesser effectiveness. DBS, while reversible and thus safer than lesional surgery, is a major undertaking that is reserved at present for profoundly disabling depression, obsessive-compulsive disorder and Tourette’s syndrome.

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