scholarly journals Deep brain stimulation in the treatment of dyskinesia and dystonia

2004 ◽  
Vol 17 (1) ◽  
pp. 9-13 ◽  
Author(s):  
Hiroki Toda ◽  
Clement Hamani ◽  
Andres Lozano
Keyword(s):  
Deep Brain Stimulation ◽  
Basal Ganglia ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Improved Outcomes ◽  
Generalized Dystonia ◽  
Clinical Conditions ◽  
Better Than ◽  
Deep Brain

Deep brain stimulation (DBS) has become a mainstay of treatment for patients with movement disorders. This modality is directed at modulating pathological activity within basal ganglia output structures by stimulating some of their nuclei, such as the subthalamic nucleus (STN) and the globus pallidus internus (GPi), without making permanent lesions. With the accumulation of experience, indications for the use of DBS have become clearer and the effectiveness and limitations of this form of therapy in different clinical conditions have been better appreciated. In this review the authors discuss the efficacy of DBS in the treatment of dystonia and levodopa-induced dyskinesias. The use of DBS of the STN and GPi is very effective for the treatment of movement disorders induced by levodopa. The relative benefits of using the GPi as opposed to the STN as a target are still being investigated. Bilateral GPi stimulation is gaining importance in the therapeutic armamentarium for the treatment of dystonia. The DYT1 forms of generalized dystonia and cervical dystonias respond to DBS better than secondary dystonia does. Discrimination between the diverse forms of dystonia and a better understanding of the pathophysiological features of this condition will serve as a platform for improved outcomes.

Basal ganglia local field potentials: applications in the development of new deep brain stimulation devices for movement disorders

2007 ◽  
Vol 4 (5) ◽  
pp. 605-614 ◽  
Author(s):  
Sara Marceglia ◽  
Lorenzo Rossi ◽  
Guglielmo Foffani ◽  
AnnaMaria Bianchi ◽  
Sergio Cerutti ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Basal Ganglia ◽  
Local Field ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Local Field Potentials ◽  
Field Potentials ◽  
Deep Brain

Long-term follow-up of Huntington disease treated by bilateral deep brain stimulation of the internal globus pallidus

2008 ◽  
Vol 109 (1) ◽  
pp. 130-132 ◽  
Author(s):  
Brigitte Biolsi ◽  
Laura Cif ◽  
Hassan El Fertit ◽  
Santiago Gil Robles ◽  
Philippe Coubes
Keyword(s):  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Huntington Disease ◽  
Internal Globus Pallidus ◽  
Efficient Treatment ◽  
Deep Brain ◽  
Stimulation Of

Deep brain stimulation is now accepted as a safe and efficient treatment for movement disorders including selected types of dystonia and dyskinesia. Very little, however, is known about its effect on other movement disorders, particularly for “choreic” movements. Huntington disease is a fatal autosomal-dominant neurodegenerative disorder characterized by movement disorders, progressive cognitive impairment, and psychiatric symptoms. Bilateral chronic stimulation of the internal globus pallidus was performed to control choreic movements in a 60-year-old man with a 10-year history of Huntington disease. Chronic deep brain stimulation resulted in remarkable improvement of choreic movements. Postoperative improvement was sustained after 4 years of follow-up with a marked improvement in daily quality of life.

Freezing of Gait After Bilateral Globus Pallidus Interna Deep Brain Stimulation in Generalized Dystonia

2020 ◽  
pp. 105-108
Author(s):  
Mariana Moscovich
Keyword(s):  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Freezing Of Gait ◽  
Left Handed ◽  
Old Left ◽  
Generalized Dystonia ◽  
Walking Difficulty ◽  
Deep Brain

Deep brain stimulation (DBS) of the globus pallidus internus (GPi) is a safe and long-term effective treatment for medication-refractory dystonia. However, complications and side effects may occur. Freezing of gait (FOG) is a rare phenomenon in patients with dystonia, although very frequently this complication is observed in patients with Parkinson disease (PD). FOG can be disabling and may severely impair quality of life, even when episodic. This chapter reports on a case of a 49-year-old left-handed man presenting with FOG, impairment in balance, and walking difficulty. These issues emerged 3 years after successful bilateral GPi DBS for primary generalized dystonia.

Globus pallidus deep brain stimulators for a case of severe neuroleptic-related dystonia and dyskinesia

2007 ◽  
Vol 24 (4) ◽  
pp. 159-160
Author(s):  
Stephen McWilliams ◽  
Nick de Pennington ◽  
Tipu Z Aziz ◽  
Justin Brophy
Keyword(s):  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Globus Pallidus Internus ◽  
Clinical Implications ◽  
Deep Brain

AbstractWe report a 45 year old man with neuroleptic-induced dyskinesia for whom deep brain stimulators (DBS) were implanted in the globus pallidus internus (GPi). We describe a significant improvement in his symptoms. Lastly, we review briefly the success of deep brain stimulation to date, and discuss the clinical implications for individuals who develop movement disorders during neuroleptic use.

scholarly journals Common therapeutic mechanisms of pallidal deep brain stimulation for hypo- and hyperkinetic movement disorders

2015 ◽  
Vol 114 (4) ◽  
pp. 2090-2104 ◽  
Author(s):  
Kevin W. McCairn ◽  
Atsushi Iriki ◽  
Masaki Isoda
Keyword(s):  
Deep Brain Stimulation ◽  
Basal Ganglia ◽  
Brain Stimulation ◽  
Movement Disorders ◽  
Information Transfer ◽  
Motor Behavior ◽  
Global Network ◽  
Symptom Profiles ◽  
Stimulus Effect ◽  
Deep Brain

Abnormalities in cortico-basal ganglia (CBG) networks can cause a variety of movement disorders ranging from hypokinetic disorders, such as Parkinson's disease (PD), to hyperkinetic conditions, such as Tourette syndrome (TS). Each condition is characterized by distinct patterns of abnormal neural discharge (dysrhythmia) at both the local single-neuron level and the global network level. Despite divergent etiologies, behavioral phenotypes, and neurophysiological profiles, high-frequency deep brain stimulation (HF-DBS) in the basal ganglia has been shown to be effective for both hypo- and hyperkinetic disorders. The aim of this review is to compare and contrast the electrophysiological hallmarks of PD and TS phenotypes in nonhuman primates and discuss why the same treatment (HF-DBS targeted to the globus pallidus internus, GPi-DBS) is capable of ameliorating both symptom profiles. Recent studies have shown that therapeutic GPi-DBS entrains the spiking of neurons located in the vicinity of the stimulating electrode, resulting in strong stimulus-locked modulations in firing probability with minimal changes in the population-scale firing rate. This stimulus effect normalizes/suppresses the pathological firing patterns and dysrhythmia that underlie specific phenotypes in both the PD and TS models. We propose that the elimination of pathological states via stimulus-driven entrainment and suppression, while maintaining thalamocortical network excitability within a normal physiological range, provides a common therapeutic mechanism through which HF-DBS permits information transfer for purposive motor behavior through the CBG while ameliorating conditions with widely different symptom profiles.

Serial 1H-MRS of thalamus during deep brain stimulation of bilateral globus pallidus internus for primary generalized dystonia

2008 ◽  
Vol 50 (12) ◽  
pp. 1055-1059 ◽  
Author(s):  
Mikhail F. Chernov ◽  
Taku Ochiai ◽  
Takaomi Taira ◽  
Yuko Ono ◽  
Ryoichi Nakamura ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Globus Pallidus Internus ◽  
1H Mrs ◽  
Generalized Dystonia ◽  
Deep Brain ◽  
Stimulation Of

scholarly journals Excitatory Deep Brain Stimulation Quenches Parkinsonian Signs in the Basal Ganglia and Thalamus

2020 ◽  
Author(s):  
Seyed Mojtaba Alavi ◽  
Amin Mirzaei ◽  
Alireza Valizadeh ◽  
Reza Ebrahimpour
Keyword(s):  
Deep Brain Stimulation ◽  
Basal Ganglia ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Experimental Studies ◽  
Underlying Mechanism ◽  
Neuronal Population ◽  
Motor Deficits ◽  
Synaptic Coupling ◽  
Deep Brain

Parkinson's disease (PD) is associated with abnormal β band oscillations (13-30 Hz) in the cortico-basal ganglia circuits. Abnormally increased striato-pallidal inhibition and strengthening the synaptic coupling between subthalamic nucleus (STN) and globus pallidus externa (GPe), due to the loss of dopamine, are considered as the potential sources of β oscillations in the basal ganglia. Deep brain stimulation (DBS) of the basal ganglia subregions is known as a way to reduce the pathological β oscillations and motor deficits related to PD. Despite the success of the DBS, its underlying mechanism is poorly understood and, there is controversy about the inhibitory or excitatory role of the DBS in the literature. Here, we utilized a computational network model of basal ganglia which consists of STN, GPe, globus pallidus interna (GPi), and thalamic neuronal population. This model can reproduce healthy and pathological β oscillations similar to what has been observed in experimental studies. Using this model, we investigated the effect of DBS to understand whether its effect is excitatory or inhibitory. Our results show that the excitatory DBS (EDBS) is able to quench the pathological synchrony and β oscillations, while, applying inhibitory DBS (IDBS) failed to quench the PD signs. In light of simulation results, we conclude that the effect of the DBS on its target is excitatory.

Globus pallidus deep brain stimulation for generalized dystonia: Clinical and PET investigation

Neurology ◽  
1999 ◽  
Vol 53 (4) ◽  
pp. 871-871 ◽  
Author(s):  
R. Kumar ◽  
A. Dagher ◽  
W. D. Hutchison ◽  
A. E. Lang ◽  
A. M. Lozano
Keyword(s):  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Generalized Dystonia ◽  
Deep Brain
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