scholarly journals Deep Brain Stimulation Effects on Olfactory Dysfunction of Parkinson’s Disease - A Meta-Analysis

2020 ◽  
Author(s):  
Chao Li ◽  
Xue-lian Chu ◽  
Min Tian ◽  
Feng Li ◽  
Shu-jun Xu ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Publication Bias ◽  
Therapeutic Effect ◽  
Brain Stimulation ◽  
Early Stage ◽  
Meta Analysis ◽  
Olfactory Function ◽  
Efficient Treatment ◽  
Stimulation Parameters ◽  
Deep Brain

Abstract Background: Non-motor symptoms in PD usually arise at very early stage and suffer the damage decades from diagnose. Deep brain stimulation (DBS) is considered as a highly efficient treatment option for PD’s motor function. However, the effect of DBS on NMS, especially hyposmia, has not been fully understood and there are contradictory data among different researches.Objective: The objective of this study was to evaluate the therapeutic effect of DBS on hyposmia in PD patients with a cohort study and identified whether the olfactory function scores influence the final surgery effect.Methods: A meta-analysis including six studies with 326 patients were conducted to evaluate the exact therapeutic effect of DBS on hyposmia in PD. Sub-group analyses based on sample size, gender, stimulation parameters were carried out to distinguish the difference. Sensitivity analysis was conducted to evaluate studies’ heterogeneity and stability. Potential publication bias were evaluated by Egger’s tests and the funnel plots.Results: Our study showed that DBS had clearly improved olfactory function in Parkinson patients (P < 0.0001) and the group heterogeneity as well as the publication bias advocate the convince of the result (Heterogeneity: Chi² = 6.39, df = 5 (P = 0.38); I² = 22%). Subgroup analysis also found that different groups of gender, education level or stimulation parameters have no obvious discrepancy on olfactory function improvement except age groups.Conclusion: In summary, this article summarize studies about DBS and hyposmia and offer evidences for the notion that DBS has authentic therapeutic value on the hyposmia in PD.

scholarly journals Impact of Subthalamic Deep Brain Stimulation on Hyposmia in Patients With Parkinson's Disease Is Influenced by Constipation and Dysbiosis of Microbiota

2021 ◽  
Vol 12 ◽  
Author(s):  
Chao Li ◽  
Ying Hou ◽  
Xu Wang ◽  
Yue-xuan Li ◽  
Feng Li ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Therapeutic Effect ◽  
Brain Stimulation ◽  
Early Stage ◽  
Olfactory Function ◽  
Efficient Treatment ◽  
Qilu Hospital ◽  
Potential Factors ◽  
The Relationship ◽  
Deep Brain

Background: Non-motor symptoms in PD usually arise at very early stage and vary during the whole disease progression. Deep brain stimulation (DBS) is considered as a highly efficient treatment option for PD's motor function. However, the effect of DBS on NMS, especially hyposmia, has not been fully understood and the deep connection between different NMS such as hyposmia and constipation is still unknown.Objective: The objective of this study was to evaluate the therapeutic effect of DBS on hyposmia in PD patients with or without constipation and find potential factors which might influence the efficacy.Methods: A retrospective analysis of 65 PD patients accepted STN-DBS operation in Qilu Hospital during 2019–2020 were conducted to evaluate the exact therapeutic effect of DBS on hyposmia in PD. Sub-group analyses about the relationship between hyposmia and constipation were carried out. Analysis of flora in nasal mucosa was also conducted to evaluate the abundance and variety in different PD groups.Results: Our study showed that DBS had clearly improved olfactory function in Parkinson patients (P = 0.012) and subgroup analysis found that PD patients with constipation have lower olfactory function scores (25.27 ± 3.44 vs. 33.90 ± 6.633, p = 0.014) and worse improvement after DBS operation (ΔTDI 12.11 ± 3.2 vs. 8.78 ± 2.91, p = 0.0072). Analysis of flora indicated the obvious discrepancy on olfactory function scores and degree of improvement might be related to the abundance and dysbiosis of microbiota.Conclusion: In summary, this article presents a study on PD with hyposmia and constipation after DBS operation, explored the relationship between different NMS and offer a potential explanation on why PD patients with constipation usually have worse olfactory function for the less abundance and variety of microbiota.

scholarly journals Optimal Parameters of Deep Brain Stimulation in Essential Tremor: A Meta-Analysis and Novel Programming Strategy

2020 ◽  
Vol 9 (6) ◽  
pp. 1855
Author(s):  
I. Daria Bogdan ◽  
Teus van Laar ◽  
D.L. Marinus Oterdoom ◽  
Gea Drost ◽  
J. Marc C. van Dijk ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Side Effects ◽  
Essential Tremor ◽  
Brain Stimulation ◽  
Meta Analysis ◽  
Stimulation Parameters ◽  
Novel Approach ◽  
Patient Reported ◽  
Tremor Suppression ◽  
Deep Brain

The programming of deep brain stimulation (DBS) parameters for tremor is laborious and empirical. Despite extensive efforts, the end-result is often suboptimal. One reason for this is the poorly understood relationship between the stimulation parameters’ voltage, pulse width, and frequency. In this study, we aim to improve DBS programming for essential tremor (ET) by exploring a new strategy. At first, the role of the individual DBS parameters in tremor control was characterized using a meta-analysis documenting all the available parameters and tremor outcomes. In our novel programming strategy, we applied 10 random combinations of stimulation parameters in eight ET-DBS patients with suboptimal tremor control. Tremor severity was assessed using accelerometers and immediate and sustained patient-reported outcomes (PRO’s), including the occurrence of side-effects. The meta-analysis showed no substantial relationship between individual DBS parameters and tremor suppression. Nevertheless, with our novel programming strategy, a significantly improved (accelerometer p = 0.02, PRO p = 0.02) and sustained (p = 0.01) tremor suppression compared to baseline was achieved. Less side-effects were encountered compared to baseline. Our pilot data show that with this novel approach, tremor control can be improved in ET patients with suboptimal tremor control on DBS. In addition, this approach proved to have a beneficial effect on stimulation-related complications.

Deep brain stimulation for multiple sclerosis tremor: A systematic review and meta-analysis

2021 ◽  
Vol 56 ◽  
pp. 103256
Author(s):  
Alireza Zali ◽  
Reza Jalili Khoshnood ◽  
Mahsa Motavaf ◽  
Alireza Salimi ◽  
Meisam Akhlaghdoust ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Systematic Review ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Meta Analysis ◽  
Deep Brain

Effects of deep brain stimulation on sleep-wake disturbances in patients with Parkinson's disease: A narrative review

2021 ◽  
Vol 19 ◽  
Author(s):  
Yu Jin Jung ◽  
Han-Joon Kim ◽  
Sun Ha Paek ◽  
Beomseok Jeon
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Early Stage ◽  
Motor Symptoms ◽  
Specific Effects ◽  
The Impact ◽  
Non Motor Symptoms ◽  
Deep Brain

: Sleep-wake disturbances (SWD) are one of the most common non-motor symptoms in Parkinson's disease (PD) and can appear in the early stage even before the onset of motor symptoms. Deep brain stimulation (DBS) is an established treatment for the motor symptoms in patients with advanced PD. However, the effect of DBS on SWD and its specific mechanisms are not widely understood and remain controversial. In addition to the circuit-mediated direct effect, DBS may improve SWD by an indirect effect such as the resolution of nocturnal motor complications and a reduction of dopaminergic medication. Here, the authors review the recent literatures regarding the impact of DBS on SWD in patients with PD. Furthermore, the selection of the DBS targets and the specific effects of applying DBS to each target on SWD in PD are also discussed.

scholarly journals iHandU: A Novel Quantitative Wrist Rigidity Evaluation Device for Deep Brain Stimulation Surgery

Sensors ◽  
2020 ◽  
Vol 20 (2) ◽  
pp. 331 ◽  
Author(s):  
Elodie Múrias Lopes ◽  
Maria do Carmo Vilas-Boas ◽  
Duarte Dias ◽  
Maria José Rosas ◽  
Rui Vaz ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Lessons Learned ◽  
Wrist Flexion ◽  
Stimulation Parameters ◽  
Average Accuracy ◽  
Gyroscope Sensor ◽  
Work Done ◽  
Deep Brain Stimulation Surgery ◽  
Deep Brain

Deep brain stimulation (DBS) surgery is the gold standard therapeutic intervention in Parkinson’s disease (PD) with motor complications, notwithstanding drug therapy. In the intraoperative evaluation of DBS’s efficacy, neurologists impose a passive wrist flexion movement and qualitatively describe the perceived decrease in rigidity under different stimulation parameters and electrode positions. To tackle this subjectivity, we designed a wearable device to quantitatively evaluate the wrist rigidity changes during the neurosurgery procedure, supporting physicians in decision-making when setting the stimulation parameters and reducing surgery time. This system comprises a gyroscope sensor embedded in a textile band for patient’s hand, communicating to a smartphone via Bluetooth and has been evaluated on three datasets, showing an average accuracy of 80%. In this work, we present a system that has seen four iterations since 2015, improving on accuracy, usability and reliability. We aim to review the work done so far, outlining the iHandU system evolution, as well as the main challenges, lessons learned, and future steps to improve it. We also introduce the last version (iHandU 4.0), currently used in DBS surgeries at São João Hospital in Portugal.

scholarly journals A Meta-Analysis of the Effect of Subthalamic Nucleus-Deep Brain Stimulation in Parkinson's Disease-Related Pain

2021 ◽  
Vol 15 ◽  
Author(s):  
Yu Diao ◽  
Yutong Bai ◽  
Tianqi Hu ◽  
Zixiao Yin ◽  
Huangguang Liu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Meta Analysis ◽  
Motor Symptom ◽  
Stn Dbs ◽  
Deep Brain

Pain from Parkinson's disease (PD) is a non-motor symptom affecting the quality of life and has prevalence of 20–80%. However, it is unclear whether subthalamic nucleus deep brain stimulation (STN–DBS), a well-established treatment for PD, is effective forPD-related pain. Thus, the objective of this meta-analysis was to investigate the efficacy of STN-DBS on PD-related pain and explore how its duration affects the efficacy of STN-DBS. A systematic search was performed using PubMed, Embase, and the Cochrane Library. Nine studies included numerical rating scale (NRS), visual analog scale (VAS), or non-motor symptom scale (NMSS) scores at baseline and at the last follow-up visit and therefore met the inclusion criteria of the authors. These studies exhibited moderate- to high-quality evidence. Two reviewers conducted assessments for study eligibility, risk of bias, data extraction, and quality of evidence rating. Random effect meta-analysis revealed a significant change in PD-related pain as assessed by NMSS, NRS, and VAS (P &lt;0.01). Analysis of the short and long follow-up subgroups indicated delayed improvement in PD-related pain. These findings (a) show the efficacy of STN-DBS on PD-related pain and provide higher-level evidence, and (b) implicate delayed improvement in PD-related pain, which may help programming doctors with supplement selecting target and programming.Systematic Review Registration: This study is registered in Open Science Framework (DOI: 10.17605/OSF.IO/DNM6K).

Subthalamic nucleus deep brain stimulation: Summary and meta-analysis of outcomes

2006 ◽  
Vol 21 (S14) ◽  
pp. S290-S304 ◽  
Author(s):  
Galit Kleiner-Fisman ◽  
Jan Herzog ◽  
David N. Fisman ◽  
Filippo Tamma ◽  
Kelly E. Lyons ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Meta Analysis ◽  
Deep Brain
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