scholarly journals Time for a New 3-D Image for Globus Pallidus Internus Deep Brain Stimulation Targeting and Programming

2021 ◽  
pp. 1-5
Author(s):  
Joshua K. Wong ◽  
Justin D. Hilliard ◽  
Vanessa M. Holanda ◽  
Aysegul Gunduz ◽  
Aparna Wagle Shukla ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Globus Pallidus Internus ◽  
The Past ◽  
Functional Zones ◽  
Spatial Boundary ◽  
Deep Brain

Deep brain stimulation (DBS) is an effective neuromodulatory therapy for Parkinson’s disease (PD). Early studies using globus pallidus internus (GPi) DBS for PD profiled the nucleus as having two functional zones. This concept disseminated throughout the neuromodulation community as the “GPi triangle”. Although our understanding of the pallidum has greatly evolved over the past 20 years, we continue to reference the triangle in our clinical decision-making process. We propose a new direction, termed the spatial boundary hypothesis, to build upon the 2-dimensional outlook on GPi DBS. We believe an updated 3-D GPi model can produce more consistent, positive patient outcomes.

Treatment of Persistent Hemiballism with Deep Brain Stimulation of the Globus Pallidus Internus: Case Report and Literature Review

2019 ◽  
Vol 132 ◽  
pp. 368-370
Author(s):  
Somnath V. Ganapa ◽  
Margish D. Ramani ◽  
Oladotun O. Ebunlomo ◽  
Raphia K. Rahman ◽  
Yehuda Herschman ◽  
...  
Keyword(s):  
Case Report ◽  
Deep Brain Stimulation ◽  
Literature Review ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Globus Pallidus Internus ◽  
Deep Brain ◽  
Stimulation Of

Tractography-Guided Deep Brain Stimulation of the Anteromedial Globus Pallidus Internus for Refractory Obsessive-Compulsive Disorder: Case Report

Neurosurgery ◽  
2019 ◽  
Author(s):  
Amit Azriel ◽  
Sarah Farrand ◽  
Maria Di Biase ◽  
Andrew Zalesky ◽  
Elaine Lui ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Obsessive Compulsive Disorder ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Surgical Planning ◽  
Globus Pallidus Internus ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Treatment Refractory ◽  
Deep Brain

AbstractBACKGROUND AND IMPORTANCEObsessive-compulsive disorder (OCD) is a disabling psychiatric disorder, mainly treated with psychotherapy and pharmacotherapy. Surgical intervention may be appropriate for patients with treatment-refractory OCD. Deep brain stimulation (DBS) is an alternative for previously common ablative surgical procedures. Tractography has been proposed as a method for individualizing DBS treatment and may have the potential to improve efficacy.CLINICAL PRESENTATIONWe present a patient with treatment-refractory OCD previously treated with bilateral leucotomies, who underwent DBS surgery with targeting informed by tractography. Preoperative tractography to identify suitable DBS targets was undertaken. Structural images were also utilized for standard stereotactic surgical planning. The anteromedial globus pallidus internus (amGPi) was chosen as the target bilaterally after consideration of white matter projections to frontal cortical regions and neurosurgical approach. Bilateral amGPi DBS surgery was undertaken without adverse events. At 16-mo follow-up, there was a 48.5% reduction in OCD symptom severity as measured by the Yale-Brown Obsessive Compulsive Scale.CONCLUSIONThe amGPi can be a successful DBS target for OCD. This is the first known case to report on DBS surgery postleucotomies for OCD and highlights the utility of tractography for surgical planning in OCD.

Treatment of idiopathic head drop (camptocephalia) by deep brain stimulation of the globus pallidus internus

2009 ◽  
Vol 110 (6) ◽  
pp. 1271-1273 ◽  
Author(s):  
Damianos E. Sakas ◽  
Ioannis G. Panourias ◽  
Efstathios J. Boviatsis ◽  
Marios S. Themistocleous ◽  
Lambis C. Stavrinou ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Globus Pallidus Internus ◽  
Number Of Patients ◽  
Chronic Electrical Stimulation ◽  
Lying Down ◽  
Deep Brain ◽  
Stimulation Of

Deep brain stimulation of the globus pallidus internus has been shown to be beneficial in a small number of patients suffering from axial dystonias. However, it has not yet been reported as an effective treatment for the alleviation of idiopathic head drop. The authors describe a 49-year-old woman with idiopathic cervical dystonia (camptocephalia) who was unable to raise her head > 30° when standing or sitting; her symptoms would abate when lying down. This disabling neurological condition was treated successfully with bilateral chronic electrical stimulation of the globus pallidus internus.

Successful bilateral deep brain stimulation of the globus pallidus internus for persistent status dystonicus and generalized chorea

2010 ◽  
Vol 113 (3) ◽  
pp. 634-638 ◽  
Author(s):  
Diana Apetauerova ◽  
Clemens M. Schirmer ◽  
Jay L. Shils ◽  
Janet Zani ◽  
Jeffrey E. Arle
Keyword(s):  
Deep Brain Stimulation ◽  
Movement Disorder ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Globus Pallidus Internus ◽  
Battery Life ◽  
Status Dystonicus ◽  
Hyperkinetic Movement Disorder ◽  
Deep Brain ◽  
Stimulation Of

The authors report the cases of 2 young male patients (aged 16 and 26 years) with dystonic cerebral palsy of unknown origin, who developed status dystonicus, an acute and persistent combination of generalized dystonia and chorea. Both patients developed status dystonicus after undergoing general anesthesia, and in 1 case, after administration of metoclopramide. In attempting to control this acute hyperkinetic movement disorder, multiple medication trials failed in both cases and patients required prolonged intubation and sedation with propofol. Bilateral deep brain stimulation of the globus pallidus internus (4 and 2 months after the onset of symptoms in the first and second case, respectively) produced immediate resolution of the hyperkinetic movement disorder in each case. Deep brain stimulation provided persistent suppression of the dystonic movement potential after a follow-up of 30 and 34 months, respectively, as demonstrated by the reemergence of severe dystonia during the end of battery life of the implantable pulse generators that was readily controlled by exchange of the generators in each case.

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 Globus Pallidus Internus Deep Brain Stimulation for Disabling Diabetic Hemiballism/Hemichorea

2017 ◽  
Vol 2017 ◽  
pp. 1-5 ◽  
Author(s):  
Byung-chul Son ◽  
Jin-gyu Choi ◽  
Hak-cheol Ko
Keyword(s):  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Globus Pallidus Internus ◽  
Glucose Levels ◽  
Magnetic Resonance Imaging Mri ◽  
T1 Hyperintensity ◽  
The Right ◽  
Almost All ◽  
Deep Brain

Unilateral hemichorea/hemiballism (HH) associated with contralateral neuroimaging abnormalities of the basal ganglia, which is characterized by T1 hyperintensity on magnetic resonance imaging (MRI) and is secondary to diabetic nonketotic hyperglycemia, is a rare and unique complication of poorly controlled diabetes mellitus (DM). Although almost all prior reports have documented rapid resolution of HH within days after normalization of blood glucose levels, medically refractory persistent HH has been noted. The experience of surgical intervention for persistent HH is limited. A 46-year-old, right-handed female patient with type 2 DM presented with refractory diabetic HH on the left side of 6 months’ duration despite DM control and neuroleptic medication usage. Image-guided deep brain stimulation (DBS) on the right globus pallidus internus (GPi) was performed. A mechanical micropallidotomy effect was observed and chronic stimulation of GPi was quite effective in symptomatic control of diabetic HH until a 16-month follow-up visit. DBS of the GPi can be an effective treatment for medically refractory diabetic HH.

Using imaging to identify psychogenic parkinsonism before deep brain stimulation surgery

2012 ◽  
Vol 116 (1) ◽  
pp. 114-118 ◽  
Author(s):  
Michael H. Pourfar ◽  
Chris C. Tang ◽  
Alon Y. Mogilner ◽  
Vijay Dhawan ◽  
David Eidelberg
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Metabolic Networks ◽  
Clinical Decision Making ◽  
Clinical Decision ◽  
Number Of Patients ◽  
Normal Expression ◽  
Deep Brain Stimulation Surgery ◽  
Deep Brain

The frequency with which patients with atypical parkinsonism and advanced motor symptoms undergo deep brain stimulation (DBS) procedures is unknown. However, the potential exposure of these patients to unnecessary surgical risks makes their identification critical. As many as 15% of patients enrolled in recent early Parkinson disease (PD) trials have been found to lack evidence of a dopaminergic deficit following PET or SPECT imaging. This suggests that a number of patients with parkinsonism who are referred for DBS may not have idiopathic PD. The authors report on 2 patients with probable psychogenic parkinsonism who presented for DBS surgery. They found that both patients had normal caudate and putamen [18F]-fluorodopa uptake on PET imaging, along with normal expression of specific disease-related metabolic networks for PD and multiple system atrophy, a common form of atypical neurodegenerative parkinsonism. The clinical and PET findings in these patients highlight the role of functional imaging in assisting clinical decision making when the diagnosis is uncertain.

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