scholarly journals Case Report: Bilateral Deep Brain Stimulation Implantation on Different Targets for a Parkinson's Disease Patient With a Bullet in the Brain

2022 ◽  
Vol 15 ◽  
Author(s):  
Yu Tian ◽  
Jiaming Wang ◽  
Xin Shi ◽  
Zhaohai Feng ◽  
Lei Jiang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Right Hemisphere ◽  
Disease Patient ◽  
Long Term Effects ◽  
History Of ◽  
The Right ◽  
Deep Brain

Patients requiring deep brain stimulation due to intracerebral metallic foreign substances have not been reported elsewhere in the world. Additionally, the long-term effects of metallic foreign bodies on deep brain stimulation (DBS) are unknown. A 79-year-old man with a 5-year history of Parkinson's disease (PD) reported that, 40 years ago, while playing with a pistol, a metallic bullet was accidentally discharged into the left brain through the edge of the left eye, causing no discomfort other than blurry vision in the left eye. DBS was performed due to the short duration of efficacy for oral medication. Because the bullet was on the left subthalamic nucleus (STN) electrode trajectory and the patient's right limb was primarily stiff, the patient received globus pallidus interna (GPi)-DBS implantation in the left hemisphere and STN-DBS implantation in the right hemisphere. During a 6-month postoperative follow-up, the patient's PD symptoms were effectively managed with no noticeable discomfort.

scholarly journals Subthalamic stimulation impairs stopping of ongoing movements

Brain ◽  
2020 ◽  
Author(s):  
Roxanne Lofredi ◽  
Georg Cem Auernig ◽  
Friederike Irmen ◽  
Johanna Nieweler ◽  
Wolf-Julian Neumann ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Right Hemisphere ◽  
Inferior Frontal Gyrus ◽  
Motor Area ◽  
Subthalamic Stimulation ◽  
The Right ◽  
Deep Brain

Abstract The subthalamic nucleus is part of a global stopping network that also includes the presupplementary motor area and inferior frontal gyrus of the right hemisphere. In Parkinson’s disease, subthalamic deep brain stimulation improves movement initiation and velocity, but its effect on stopping of ongoing movement is unknown. Here, we examine the relation between movement stopping and connectivity of stimulation volumes to the stopping network. Stop and go times were collected in 17 patients with Parkinson’s disease on and off subthalamic stimulation during visually cued initiation and termination of continuous, rotational movements. Deep brain stimulation contacts were localized; the stimulation volume computed and connectivity profiles estimated using an openly available, normative structural connectome. Subthalamic stimulation significantly increased stop times, which correlated with the connectivity of the stimulation volume to presupplementary motor area and inferior frontal gyrus of the right hemisphere. The robustness of this finding was validated using three separate analysis streams: voxel-wise whole-brain connectivity, region of interest connectivity and a tract-centred method. Our study sheds light on the role of the fronto-subthalamic inhibitory triangle in stopping of ongoing movements and may inspire circuit based adaptive stimulation strategies for control of stopping impairment, possibly reflected in stimulation-induced dyskinesia.

scholarly journals Continuous subcutaneous apomorphine infusion allowing awake deep brain stimulation in a Parkinson’s disease patient

2021 ◽  
Vol 7 (S1) ◽  
Author(s):  
Francesca Spagnolo ◽  
Francesco Romeo ◽  
Piermassimo Proto ◽  
Augusto Maria Rini ◽  
Emanuela Leopizzi ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Perioperative Complications ◽  
Disease Patient ◽  
Continuous Administration ◽  
Subcutaneous Apomorphine ◽  
The Right ◽  
Deep Brain

Abstract Background Subthalamic Deep Brain Stimulation (DBS) have demonstrated in the last decades to determine an important clinical improvement in advanced and selected Parkinson’s disease (PD) patients. However, only a minority of parkinsonian patients meet the criteria to undergo DBS, and the surgical procedure itself is often stressful, especially for patients experiencing severe OFF state. Subcutaneous Apomorphine continuous administration is suitable as an adjunctive therapy capable of improving a suboptimal DBS result. Here we hypothesize a possible role for subcutaneous apomorphine infusion to alleviate severe OFF state in parkinsonian patients undergoing DBS, thus allowing intraoperative microrecording and patient’s collaboration during clinical testing. Case presentation A 68-year-old man, suffering from a very long PD-history, characterized by a severe akinetic status and dramatic non-motor features while in OFF, underwent Subthalamic-DBS keeping a slight but continuous apomorphine infusion (1.8 mg/hour), able to guarantee the right degree of patient’s collaboration without interfering with microelectrode recordings. There were no intra or perioperative complications and after the procedure he experienced a marked clinical benefit, being able to stop apomorphine administration. Conclusions Here we described the first Subthalamic DBS procedure performed with a low and stable dopaminergic stimulation guaranteed by subcutaneous Apomorphine continuous infusion. For its rapidity of action and prompt reversibility, apomorphine could be particularly suitable for use during difficult surgical procedures in PD, allowing more therapeutic opportunities for patients who would otherwise be excluded from the DBS option.

Alleviation of dysphagia after deep brain stimulation: results from a Parkinson's disease patient

2011 ◽  
Vol 27 (2) ◽  
pp. 325-326 ◽  
Author(s):  
Takashi Asahi ◽  
Yukichi Inoue ◽  
Nakamasa Hayashi ◽  
Kazutomi Araki ◽  
Shunro Endo
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Disease Patient ◽  
Deep Brain

Subthalamic Deep Brain Stimulation for a Parkinson's Disease Patient With Duplication ofSNCA

2013 ◽  
Vol 17 (1) ◽  
pp. 102-103 ◽  
Author(s):  
Yasushi Shimo ◽  
Shihoko Natori ◽  
Genko Oyama ◽  
Madoka Nakajima ◽  
Hisato Ishii ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Disease Patient ◽  
Deep Brain

scholarly journals Syncope Associated with Subthalamic Nucleus Deep Brain Stimulation in a Patient with Parkinson’s Disease

2013 ◽  
Vol 2013 ◽  
pp. 1-2
Author(s):  
Dursun Aygun ◽  
Ersoy Kocabicak ◽  
Onur Yildiz ◽  
Musa Kazim Onar ◽  
Hatice Guz ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Early Period ◽  
Motor Symptoms ◽  
The Right ◽  
Stn Dbs ◽  
Deep Brain

In advanced Parkinson's disease (PD), deep brain stimulation (DBS) may be an alternative option for the treatment of motor symptoms. Side effects associated with subthalamic nucleus (STN) DBS in patients with PD are emerging as the most frequent sensory and motor symptoms. DBS-related syncope is reported as extremely rare. We wanted to discuss the mechanisms of syncope associated with STN DBS in a patient with Parkinson's disease.Case report.Sixty-three-year-old female patient is followed up with diagnosis of idiopathic Parkinson's disease for 6 years in our clinic. The patient has undergone STN DBS due to painful dystonia and drug resistant tremor. During the operation, when the left STN was stimulated at 5 milliampere (mAmp), the patient developed presyncopal symptoms. However, when the stimulation was stopped symptoms improved. During the early period after the operation, when the right STN was stimulated at 1.3 millivolts (mV), she developed the pre-yncopal symptoms and then syncope. Our case shows that STN DBS may lead to directly autonomic symptoms resulting in syncope during stimulation-on (stim-on).

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