Deep Brain Stimulation in Huntington’s Disease—Preliminary Evidence on Pathophysiology, Efficacy and Safety

Wojtecki, Lars; Groiss, Stefan Jun; Hartmann, Christian; Elben, Saskia; Omlor, Sonja; Schnitzler, Alfons; Vesper, Jan

doi:10.3390/brainsci6030038

Cited by 46 publications

(33 citation statements)

References 84 publications

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“…On the other hand, DBS of the GPe, although not currently used in clinical practice, has been indicated as a potential target for treatment given that it reduces discharge rate and bursting in GPi and STN in MPTP‐treated monkeys . Moreover, a PET study on patients with Huntington's disease revealed that bilateral GPe‐DBS modulated connectivity within the basal ganglia/thalamo‐cortical circuits and sensorimotor and default mode networks, promoting integration across these networks and therefore suggesting its potential role as a therapeutic target …”

Section: Discussionmentioning

confidence: 99%

“…77 Moreover, a PET study on patients with Huntington's disease revealed that bilateral GPe-DBS modulated connectivity within the basal ganglia/thalamocortical circuits and sensorimotor and default mode networks, promoting integration across these networks and therefore suggesting its potential role as a therapeutic target. [78][79][80] In this framework, segmentation of the GP, based on multimodal structural and functional imaging in the setting of DBS, could improve patient outcome minimizing side effects. For example, Middlebrooks and colleagues showed that when a DBS electrode is located within the GP sensorimotor territory, the increase of volume tissue activated in the sensorimotor territory is correlated with improvement in the UPDRS.…”

Section: Pathophysiological Implications In Movement Disordersmentioning

confidence: 99%

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Structural connectivity‐based topography of the human globus pallidus: Implications for therapeutic targeting in movement disorders

et al. 2019

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Background Understanding the topographical organization of the cortico‐basal ganglia circuitry is of pivotal importance because of the spreading of techniques such as DBS and, more recently, MR‐guided focused ultrasound for the treatment of movement disorders. A growing body of evidence has described both direct cortico‐ and dento‐pallidal connections, although the topographical organization in vivo of these pathways in the human brain has never been reported. Objective To investigate the topographical organization of cortico‐ and dento‐pallidal pathways by means of diffusion MRI tractography and connectivity based parcellation. Methods High‐quality data from 100 healthy subjects from the Human Connectome Project repository were utilized. Constrained spherical deconvolution–based tractography was used to reconstruct structural cortico‐ and dento‐pallidal connectivity. Connectivity‐based parcellation was performed with a hypothesis‐driven approach at three different levels: functional regions (limbic, associative, sensorimotor, and other), lobes, and gyral subareas. Results External globus pallidus segregated into a ventral associative cluster, a dorsal sensorimotor cluster, and a caudal “other” cluster on the base of its cortical connectivity. Dento‐pallidal connections clustered only in the internal globus pallidus, where also associative and sensorimotor clusters were identified. Lobar parcellation revealed the presence in the external globus pallidus of dissociable clusters for each cortical lobe (frontal, parietal, temporal, and occipital), whereas in internal globus pallidus only frontal and parietal clusters were found out. Conclusion We mapped the topographical organization of both internal and external globus pallidus according to cortical and cerebellar connections. These anatomical data could be useful in DBS, radiosurgery and MR‐guided focused ultrasound targeting for treating motor and nonmotor symptoms in movement disorders. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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Section: Discussionmentioning

confidence: 99%

Section: Pathophysiological Implications In Movement Disordersmentioning

confidence: 99%

Structural connectivity‐based topography of the human globus pallidus: Implications for therapeutic targeting in movement disorders

et al. 2019

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“…DBS of the fornix (Lozano et al , ; Fig A) and the nucleus basalis of Meynert (Hardenacke et al , ) is being explored as a treatment for Alzheimer's. Combined stimulation of GPi and GPe (Fig B) is currently being explored for treating Huntington's disease to reduce the amount of choreatic movements and cognitive decline (Wojtecki et al , ).…”

Section: Current and Future Developmentsmentioning

confidence: 99%

“…DBS of the fornix ; Fig 7A) and the nucleus basalis of Meynert (Hardenacke et al, 2013) is being explored as a treatment for Alzheimer's. Combined stimulation of GPi and GPe ( Fig 7B) is currently being explored for treating Huntington's disease to reduce the amount of choreatic movements and cognitive decline (Wojtecki et al, 2016). As the traditional indication for DBS therapy, movement disorders continually see new developments to improve effectiveness or efficiency.…”

Section: Dbs Targets In Coronal Viewmentioning

confidence: 99%

Cellular, molecular, and clinical mechanisms of action of deep brain stimulation—a systematic review on established indications and outlook on future developments

et al. 2019

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Deep brain stimulation ( DBS ) has been successfully used to treat movement disorders, such as Parkinson's disease, for more than 25 years and heralded the advent of electrical neuromodulation to treat diseases with dysregulated neuronal circuits. DBS is now superseding ablative techniques, such as stereotactic radiofrequency lesions. While serendipity has played a role in developing DBS as a therapy, research during the past two decades has shown that electrical neuromodulation is far more than a functional lesion that can be switched on and off. This understanding broadens the field to enable new types of stimulation, clinical indications, and research. This review highlights the complex effects of DBS from the single cell to the neuronal network. Specifically, we examine the electrical, cellular, molecular, and neurochemical mechanisms of DBS as applied to Parkinson's disease and other emerging applications.

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“…Bei tardiven Syndromen und Stimulation des GPi oder des STN zeigten sich in einem Review von 117 Patienten Verbesserungen um mehr als 50 % [17]. Für die Chorea bei Morbus Huntington gibt es erste positive Ergebnisse bei der Stimulation des GPi [18].…”

Section: Merkeunclassified

Tiefe Hirnstimulation

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2019

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Deep Brain Stimulation in Huntington’s Disease—Preliminary Evidence on Pathophysiology, Efficacy and Safety

Cited by 46 publications

References 84 publications

Structural connectivity‐based topography of the human globus pallidus: Implications for therapeutic targeting in movement disorders

Structural connectivity‐based topography of the human globus pallidus: Implications for therapeutic targeting in movement disorders

Cellular, molecular, and clinical mechanisms of action of deep brain stimulation—a systematic review on established indications and outlook on future developments

Tiefe Hirnstimulation

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