Deep brain stimulation in Parkinson’s disease

Mehanna, Raja; Lai, Eugene C.

doi:10.1186/2047-9158-2-22

Cited by 44 publications

(32 citation statements)

References 126 publications

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“…UPDRS can not only judge the severity of symptoms in patients but also forecast the curative effect of STN-DBS surgery by comparing the differences between preoperative drug ''off'' stage and ''on'' stage and can objectively judge the effect of the surgery by comparing the preoperative and postoperative UPDRS score. The results of this study suggested that UPDRS can help select the patients who are suitable for the STN-DBS surgery, and the STN-DBS surgery can improve the motor function of Parkinson's Disease patients, improve the ability of daily life, and the curative effect is consistent with the results reported in the literature [3,4].…”

Section: Discussionsupporting

confidence: 85%

“…With the illness progress, the pesticide effect decreasing, and the deep brain stimulation (DBS)-subthalamic nuclei, stimulation (STN) surgery was gradually applied in the treatment of Parkinson's disease and obtained satisfactory curative effect [1][2][3][4]. The clinical manifestations of Parkinson's disease are as follows: static tremor, bradykinesia, and other dyskinesia symptoms; most patients presented with the non-movement symptoms of vegetative nervous system disorders, constipation, salivate, insomnia, and mental disorders [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Effect of Subthalamic Nuclei Electrical Stimulation in the Treatment of Parkinson’s Disease

Tao

Liang

2014

Cell Biochem Biophys

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The aim of this study was to evaluate the clinical efficacy of deep brain stimulation (DBS) and subthalamic nuclei stimulation (STN) in the treatment of Parkinson's disease. A total of 32 patients with Parkinson's disease who continuously treated in our hospital with STN-DBS from November 2011 to November 2013 were selected. All the patients received follow-up evaluation, psychological status questionnaire survey and analysis before surgery and 3 months after surgery using unified Parkinson's disease rating scale (UPDRS), Self-rating depression scale (SDS), and symptom checklist (SCL-90). After turned on the impulse generator (IPG), the daily activities and motor function of UPDRS in all the 32 cases of Parkinson's disease patients were in "turn off" state; the mean improvement rates were 51.7 and 60.9%; when the daily activities and motor function in the state of "turn on", the mean improvement rates were 21.4 and 22.3%. In 20 cases, the preoperative SDS > 50, the levels of depression, anxiety, somatization, interpersonal sensitivity, hostility, fear, and paranoia of SCL-90 were significant higher than the Chinese traditional levels (P < 0.05). Comparison of the preoperative and postoperative depression, somatization, fear, anxiety, and psychotic factor of SCL-90 found that there was negative correlation between preoperation and postoperation, and the differences were significant (P < 0.05), while there were no significant differences in interpersonal sensitivity and paranoia (P > 0.05). STN-DBS can improve the motor function and ability of daily life of Parkinson's disease patients and can significantly improve the psychological condition of the patients with Parkinson's disease and depression; it is a safe and effective method to the treatment of Parkinson's disease.

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Section: Discussionsupporting

confidence: 85%

Section: Introductionmentioning

confidence: 99%

Effect of Subthalamic Nuclei Electrical Stimulation in the Treatment of Parkinson’s Disease

Tao

Liang

2014

Cell Biochem Biophys

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“…The indirect pathway exerts surround inhibition to facilitate an excitatory drive to muscles responsible for a given movement and suppress unwanted motor activity not relevant to the primary movement (Mehanna & Jankovic, ). PD is thought to be of great concern to over‐activation of the indirect pathway (Mehanna & Lai, ). In our study, the connectivity of contacts with the thalamus and pallidum was found to be related to the therapeutic effects of STN‐DBS in PD, which might be explained by the inhibitory effects of DBS and the subthalamopallidal and pallidothalamic fibers surrounding the STN.…”

Section: Discussionmentioning

confidence: 99%

Brain connectivity markers for the identification of effective contacts in subthalamic nucleus deep brain stimulation

Lin

Peng

Zhang

et al. 2020

Human Brain Mapping

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The clinical benefit of deep brain stimulation (DBS) for Parkinson's disease (PD) is relevant to the tracts adjacent to the stimulation site, but it remains unclear what connectivity pattern is associated with effective DBS. The aim of this study was to identify clinically effective electrode contacts on the basis of brain connectivity markers derived from diffusion tensor tractography. We reviewed 77 PD patients who underwent bilateral subthalamic nucleus DBS surgery. The patients were assigned into the training (n = 58) and validation (n = 19) groups. According to the therapeutic window size, all contacts were classified into effective and ineffective groups. The whole-brain connectivity of each contact's volume of tissue activated was estimated using tractography with preoperative diffusion tensor data. Extracted connectivity features were put into an all-relevant feature selection procedure within cross-validation loops, to identify features with significant discriminative power for contact classification. A total of 616 contacts on 154 DBS leads were discriminated, with 388 and 228 contacts being classified as effective and ineffective ones, respectively. After the feature selection, the connectivity of contacts with the thalamus, pallidum, hippocampus, primary motor area, supplementary motor area and superior frontal gyrus was identified to significantly contribute to contact classification. Based on these relevant features, the random forest model constructed from the training group achieved an accuracy of 84.9% in the validation group, to discriminate effective contacts from the ineffective. Our findings advanced the understanding of the specific brain connectivity patterns associated with clinical effective electrode contacts, which potentially guided postoperative DBS programming. K E Y W O R D S brain connectivity, DBS programming, deep brain stimulation, Parkinson's disease, subthalamic nucleus Hai Lin and Peng Na contributed equally to this study.

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“…Deep brain stimulation (DBS) of the subthalamic nucleus (STN) and ventral intermediate nucleus (VIM) has been shown to effectively reduce PD tremor severity . STN and VIM are structurally and functionally connected to the motor cortex through the dentatorubro‐thalamic tract and the cerebello‐thalamo‐cortical (CTC) circuit, which play an important role in PD tremor .…”

Section: Introductionmentioning

confidence: 99%

Dentate nucleus iron deposition is a potential biomarker for tremor‐dominant Parkinson's disease

Huang

Ling

et al. 2016

NMR in Biomedicine

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Parkinson disease (PD) is a heterogeneous neurodegenerative disorder with variable clinicopathologic phenotypes and underlying neuropathologic mechanisms. Each clinical phenotype has a unique set of motor symptoms. Tremor is the most frequent initial motor symptom of PD and is the most difficult symptom to treat. The dentate nucleus (DN) is a deep iron rich nucleus in the cerebellum and may be involved in PD tremor. In this study, we test the hypothesis that DN iron may be elevated in tremor dominant PD patients using quantitative susceptibility mapping. Forty-three patients with PD [19 tremor dominant (TD)/24 akinetic-rigid dominant (AR)] and 48 healthy gender- and age-matched controls were recruited. Multi-echo gradient echo data were collected for each subject on a 3.0 T MR system. Inter-group susceptibility differences in bilateral DN were investigated and correlations of clinical features with susceptibility were also examined. In contrast to the AR group, the TD group was found to have increased susceptibility in the bilateral DN, when compared to healthy controls. In addition, susceptibility was positively correlated with tremor score in drug naive PD patients. These findings indicate that iron load within DN may make an important contribution to motor phenotypes in PD. Moreover, our results suggest that TD and AR phenotypes of PD can be differentiated on the basis of the susceptibility of the DN at least on the group level.

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Deep brain stimulation in Parkinson’s disease

Cited by 44 publications

References 126 publications

Effect of Subthalamic Nuclei Electrical Stimulation in the Treatment of Parkinson’s Disease

Effect of Subthalamic Nuclei Electrical Stimulation in the Treatment of Parkinson’s Disease

Brain connectivity markers for the identification of effective contacts in subthalamic nucleus deep brain stimulation

Dentate nucleus iron deposition is a potential biomarker for tremor‐dominant Parkinson's disease

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