Neurohistopathological Findings at the Electrode–Tissue Interface in Long-Term Deep Brain Stimulation: Systematic Literature Review, Case Report, and Assessment of Stimulation Threshold Safety

DiLorenzo, Daniel J.; Jankovic, Joseph; Simpson, Richard K.; Takei, Hiroyuki; Powell, Suzanne Zein-Eldin

doi:10.1111/ner.12192

Cited by 33 publications

(24 citation statements)

References 41 publications

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“…Instead, haematoxylin-eosin stained sections from these animals revealed a thin layer of infiltrating cells immediately surrounding the lead trajectory ( Figure 4C, F), consistent with the expected glial encapsulation of the DBS leads based on histopathological reports from PD patient specimens [45][46][47][48]. Overall, no remarkable health complications were observed in 8 of the 11 chronically-implanted sheep.…”

Section: Feasibility Of Routine Dbs Targeting the Sheep Stnsupporting

confidence: 68%

Motor behaviors in the sheep evoked by electrical stimulation of the subthalamic nucleus

Lentz

Zhao

Kelly

et al. 2015

Experimental Neurology

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Section: Feasibility Of Routine Dbs Targeting the Sheep Stnsupporting

confidence: 68%

Motor behaviors in the sheep evoked by electrical stimulation of the subthalamic nucleus

Lentz

Zhao

Kelly

et al. 2015

Experimental Neurology

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“…Third, it may be questioned whether white matter tract atlas in Tractotron software constitute a relevant quantitative imaging techniques to detect microlesion following electrodes trajectories. Few histopathological studies reported the pathological findings in brain of a PD patient treated by DBS (DiLorenzo, Jankovic, Simpson, Takei, & Powell, ). Mostly, authors concluded that surgical procedure causes minimal damage such as mild neuronal loss, mild to severe gliosis and spongiosis around the electrode tracts (Capparos‐Lefebvre, Ruchoux, Blond, Petit, & Percheron, ; Haberler et al, ; Jarraya et al, ).…”

Section: Discussionmentioning

confidence: 99%

White matter tracts lesions and decline of verbal fluency after deep brain stimulation in Parkinson's disease

Costentin

Derrey

Gérardin

et al. 2019

Human Brain Mapping

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Decline of verbal fluency (VF) performance is one of the most systematically reported neuropsychological adverse effects after subthalamic nucleus deep brain stimulation (STN‐DBS). It has been suggested that this worsening of VF may be related to a microlesion due to the electrode trajectories. We describe the disruption of surrounding white matter tracts following electrode implantation in Parkinson's disease (PD) patients with STN‐DBS and assess whether damage of fiber pathways is associated with VF impairment after surgery. We retrospectively analyzed 48 PD patients undergoing bilateral STN DBS. The lesion mask along the electrode trajectory transformed into the MNI 152 coordinate system, was compared with white matter tract atlas in Tractotron software, which provides a probability and proportion of fibers disconnection. Combining tract‐ and atlas‐based analysis reveals that the trajectory of the electrodes intersected successively with the frontal aslant tract, anterior segment of arcuate tract, the long segment of arcuate tract, the inferior longitudinal fasciculus, the superior longitudinal fasciculus, the anterior thalamic radiation, and the fronto striatal tract. We found no association between the proportion fiber disconnection and the severity of VF impairment 6 months after surgery. Our findings demonstrated that microstructural injury associated with electrode trajectories involved white matter bundles implicated in VF networks.

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“…The increase in TEED 1sec after 7 years of VIM‐DBS after a stable period of several years may be the consequence of increasing stimulation parameters to try to improve the progression of clinically disabling tremor. Gliosis around the placement of the electrodes, although it cannot be completely ruled out, seems an unlikely cause for the late decline of VIM‐DBS efficacy in this study.…”

Section: Discussionmentioning

confidence: 99%

Long‐term Thalamic Deep Brain Stimulation for Essential Tremor: Clinical Outcome and Stimulation Parameters

Cruz

Vargas

Fernández-Carballal

et al. 2016

Movement Disord Clin Pract

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Background: The reasons underlying the loss of efficacy of deep brain stimulation (DBS) of the thalamic nucleus ventralis intermedius (VIM-DBS) over time in patients with essential tremor are not well understood. Methods: Long-term clinical outcome and stimulation parameters were evaluated in 14 patients with essential tremor who underwent VIM-DBS. The mean AE standard deviation postoperative follow-up was 7.7 AE 3.8 years. At each visit (every 3-6 months), tremor was assessed using the Fahn-Tolosa-Marin tremor rating scale (FTM-TRS) and stimulation parameters were recorded (contacts, voltage, frequency, pulse width, and total electrical energy delivered by the internal generator [TEED 1sec ]). Results: The mean reduction in FTM-TRS score was 73.4% at 6 months after VIM-DBS surgery (P < 0.001) and 50.1% at the last visit (P < 0.001). The gradual worsening of FTM-TRS scores over time fit a linear regression model (coefficient of determination [R 2 ] = 0.887; P < 0.001). Stimulation adjustments to optimize tremor control required a statistically significant increase in voltage (P = 0.01), pulse width (P = 0.01), frequency (P = 0.02), and TEED 1sec (P = 0.008). TEED 1sec fit a third-order polynomial curve model throughout the followup period (R 2 = 0.966; P < 0.001). The initial exponential increase (first 4 years of VIM-DBS) was followed by a plateau and a further increase from the seventh year onward. Conclusions: The current findings suggest that the waning effect of VIM-DBS over time in patients with essential tremor may be the consequence of a combination of factors. Superimposed on the progression of the disease, tolerance can occur during the early years of stimulation.

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Neurohistopathological Findings at the Electrode–Tissue Interface in Long-Term Deep Brain Stimulation: Systematic Literature Review, Case Report, and Assessment of Stimulation Threshold Safety

Cited by 33 publications

References 41 publications

Motor behaviors in the sheep evoked by electrical stimulation of the subthalamic nucleus

Motor behaviors in the sheep evoked by electrical stimulation of the subthalamic nucleus

White matter tracts lesions and decline of verbal fluency after deep brain stimulation in Parkinson's disease

Long‐term Thalamic Deep Brain Stimulation for Essential Tremor: Clinical Outcome and Stimulation Parameters

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