deep brain stimulation
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2022 ◽  
Vol 3 (1) ◽  
pp. 101054
Author(s):  
Qi Wang ◽  
Bin Tang ◽  
Jianrong Tang

2022 ◽  
Vol 7 (4) ◽  
pp. 281-286
Author(s):  
Venkateshwarla Rama Raju

Deep brain stimulation of the subthalamic nucleus (STN) is a highly effective treatment for motor symptoms of Parkinson’s disease. Sub thalamic nucleus deep brain stimulation (STN-DBS) is a therapeutic surgical procedure for reducing the symptoms Parkinson’s and restoring and increasing the motor functioning. However, precise intraoperative edge or perimeter detection of STN remains a procedural challenge. In this study, we present the micro electrode signals recordings (MER) of STNs and local field potentials (LFPs) were acquired from deep brain stimulation macro electrodes during trajectory towards STN, in Parkinson patients. The frequency versus intensity atlas of field potential activity was obtained and further than investigated in distinct sub band’s, to explore whether field potentials activity can be employed for STN edge detection. STN perimeter detections by means of L F Ps were evaluated to edge predictions by way of the functional stereotactic DBS neurosurgeon, based on micro electrode derived, single unit recordings (M E R – S N A of S T Ns). The findings show variation amongst M E R – S N A and macro electrode L F P-signals gathering through MER-system pertaining to the d o r s a l S T N b o r d e r of -1.00±0.85mm plus -0.42±1.08 mm in the and frequencies, correspondingly. For these sub band`s, root mean square of the voids was found to be 1.27milli meters and 1.07milli meters. The Assessment of other sub band`s didn`t set a limit for differentiating the posterior (c a u d a l) point of sub-thalamic nuclei. We may infer that In conclusion, macro electrode signal acquisitions of STNs derived L F P gatherings might offer an unconventional methodology in the direction of m e r – s n a, for detecting the aimed target subthalamic nucleus borders during DBS-surgery.


2022 ◽  
Vol 15 ◽  
Author(s):  
Tao Xie ◽  
Mahesh Padmanaban ◽  
Adil Javed ◽  
David Satzer ◽  
Theresa E. Towle ◽  
...  

Tremor of the upper extremity is a significant cause of disability in some patients with multiple sclerosis (MS). The MS tremor is complex because it contains an ataxic intentional tremor component due to the involvement of the cerebellum and cerebellar outflow pathways by MS plaques, which makes the MS tremor, in general, less responsive to medications or deep brain stimulation (DBS) than those associated with essential tremor or Parkinson's disease. The cerebellar component has been thought to be the main reason for making DBS less effective, although it is not clear whether it is due to the lack of suppression of the ataxic tremor by DBS or else. The goal of this study was to clarify the effect of DBS on cerebellar tremor compared to non-cerebellar tremor in a patient with MS. By wearing an accelerometer on the index finger of each hand, we were able to quantitatively characterize kinetic tremor by frequency and amplitude, with cerebellar ataxia component on one hand and that without cerebellar component on the other hand, at the beginning and end of the hand movement approaching a target at DBS Off and On status. We found that cerebellar tremor surprisingly had as good a response to DBS as the tremor without a cerebellar component, but the function control on cerebellar tremor was not as good due to its distal oscillation, which made the amplitude of tremor increasingly greater as it approached the target. This explains why cerebellar tremor or MS tremor with cerebellar component has a poor functional transformation even with a good percentage of tremor control. This case study provides a better understanding of the effect of DBS on cerebellar tremor and MS tremor by using a wearable device, which could help future studies improve patient selection and outcome prediction for DBS treatment of this disabling tremor.


Author(s):  
Yang Wu ◽  
Yang-yang Xu ◽  
Yuan Gao ◽  
Jia-ming Li ◽  
Xiao-wei Liu ◽  
...  

2022 ◽  
Vol 8 (1) ◽  
Author(s):  
Luigi Albano ◽  
Federica Agosta ◽  
Silvia Basaia ◽  
Camilla Cividini ◽  
Tanja Stojkovic ◽  
...  

AbstractThis study aimed to identify functional neuroimaging patterns anticipating the clinical indication for deep brain stimulation (DBS) in patients with Parkinson’s disease (PD). A cohort of prospectively recruited patients with PD underwent neurological evaluations and resting-state functional MRI (RS-fMRI) at baseline and annually for 4 years. Patients were divided into two groups: 19 patients eligible for DBS over the follow-up and 41 patients who did not meet the criteria to undergo DBS. Patients selected as candidates for DBS did not undergo surgery at this stage. Sixty age- and sex-matched healthy controls performed baseline evaluations. Graph analysis and connectomics assessed global and local topological network properties and regional functional connectivity at baseline and at each time point. At baseline, network analysis showed a higher mean nodal strength, local efficiency, and clustering coefficient of the occipital areas in candidates for DBS over time relative to controls and patients not eligible for DBS. The occipital hyperconnectivity pattern was confirmed by regional analysis. At baseline, a decreased functional connectivity between basal ganglia and sensorimotor/frontal networks was found in candidates for DBS compared to patients not eligible for surgery. In the longitudinal analysis, patient candidate for DBS showed a progressively decreased topological brain organization and functional connectivity, mainly in the posterior brain networks, and a progressively increased connectivity of basal ganglia network compared to non-candidates for DBS. RS-fMRI may support the clinical indication to DBS and could be useful in predicting which patients would be eligible for DBS in the earlier stages of PD.


Author(s):  
Gabriel Gonzalez-Escamilla ◽  
Nabin Koirala ◽  
Manuel Bange ◽  
Martin Glaser ◽  
Bogdan Pintea ◽  
...  

2022 ◽  
Vol 16 (1) ◽  
Author(s):  
Andrea Giorni ◽  
Terry Coyne ◽  
Peter A. Silburn ◽  
George D. Mellick ◽  
Pankaj Sah ◽  
...  

Abstract Background The globus pallidus internus is the main target for the treatment of dystonia by deep brain stimulation. Unfortunately, for some genetic etiologies, the therapeutic outcome of dystonia is less predictable. In particular, therapeutic outcomes for deep brain stimulation in craniocervical and orolaryngeal dystonia in DYT6-positive patients are poor. Little is known about the neurophysiology of the globus pallidus internus in DYT6-positive dystonia, and how symptomatic treatment affects the neural activity of this region. Case presentation We present here the case of a 55-year-old Caucasian female DYT6-dystonic patient with blepharospasm, spasmodic dysphonia, and oromandibular dystonia where single-unit and local field potential activity was recorded from the globus pallidus internus during two deep brain stimulation revision surgeries 4 years apart with no symptomatic improvement. Botulinum toxin injections consistently improved dysphonia, while some of the other symptoms were only inconsistently or marginally improved. Neural activity in the globus pallidus internus during both revision surgeries were compared with previously published results from an idiopathic dystonic cohort. Single-cell firing characteristics and local field potential from the first revision surgery showed no differences with our control group. However, during the second revision surgery, the mean firing rate of single units and local field potential power in the gamma range were lower than those present during the first revision surgery or the control group. Conclusions Symptoms related to facial movements were greatly improved by botulinum toxin treatment between revision surgeries, which coincided with lower discharge rate and changes in gamma local field oscillations.


2022 ◽  
Vol 12 (1) ◽  
pp. 86
Author(s):  
Mevlüt Yalaz ◽  
Nicholas Maling ◽  
Günther Deuschl ◽  
León M. Juárez-Paz ◽  
Markus Butz ◽  
...  

Background: Current approaches to detect the positions and orientations of directional deep-brain stimulation (DBS) electrodes rely on radiative imaging data. In this study, we aim to present an improved version of a radiation-free method for magnetic detection of the position and the orientation (MaDoPO) of directional electrodes based on a series of magnetoencephalography (MEG) measurements and a possible future solution for optimized results using emerging on-scalp MEG systems. Methods: A directional DBS system was positioned into a realistic head–torso phantom and placed in the MEG scanner. A total of 24 measurements of 180 s each were performed with different predefined electrode configurations. Finite element modeling and model fitting were used to determine the position and orientation of the electrode in the phantom. Related measurements were fitted simultaneously, constraining solutions to the a priori known geometry of the electrode. Results were compared with the results of the high-quality CT imaging of the phantom. Results: The accuracy in electrode localization and orientation detection depended on the number of combined measurements. The localization error was minimized to 2.02 mm by considering six measurements with different non-directional bipolar electrode configurations. Another six measurements with directional bipolar stimulations minimized the orientation error to 4°. These values are mainly limited due to the spatial resolution of the MEG. Moreover, accuracies were investigated as a function of measurement time, number of sensors, and measurement direction of the sensors in order to define an optimized MEG device for this application. Conclusion: Although MEG introduces inaccuracies in the detection of the position and orientation of the electrode, these can be accepted when evaluating the benefits of a radiation-free method. Inaccuracies can be further reduced by the use of on-scalp MEG sensor arrays, which may find their way into clinics in the foreseeable future.


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