Physiological Observations in Stereotaxic Operations in Extrapyramidal Motor Disturbances

Häßler, R.; Riechert, T; Mundinger, F.; Umbach, W; Ganglberger, J. A.

doi:10.1093/brain/83.2.337

Cited by 326 publications

(170 citation statements)

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“…In generalized dystonia, compared with thalamotomy, only a few small series of pallidotomies were published during the ®rst era of functional surgery (Guiot and Brion, 1952;Hassler et al, 1960;Cooper, 1969;Burzaco, 1985). Pallidotomies were also rarely performed in cervical dystonia (Hassler and Riechert, 1954;Mundinger et al, 1972;Bertrand et al, 1978).…”

Section: Pallidotomy For Dystoniamentioning

confidence: 99%

“…Interestingly, an old report had mentioned that low frequency (4±8 Hz) stimulation of the pallidum in torsion dystonia and athetosis could elicit abnormal movements, whilst higher stimulus frequencies applied to the same target may eventually suppress them (Hassler et al, 1960). However, little was inferred from this observation, and so far there are only a few reports of the eects of pallidal DBS in dystonia (Coubes et al, 1999(Coubes et al, , 2000aKrauss et al, 1999;Kumar et al, 1999;Loher et al, 2000;Tronnier and Fogel, 2000;Gill et al, 2000;Kulisevsky et al, 2000;Liu et al, 2000;Parkin et al, 2001).…”

Section: Pallidal Dbsmentioning

confidence: 99%

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Mirthful laughter induced by subthalamic nucleus stimulation

et al. 2001

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Copper salts, which are abundant, relatively inexpensive and possess low toxicity, have long been used as versatile catalysts for various reactions in organic synthesis. Recently, the development of Cu‐catalyzed or ‐mediated CH functionalization reactions has gained significant attention. Since the pioneering work of Daugulis on the introduction of 8‐aminoquinoline and picolinic acid auxiliaries as removable directing groups in transition metal‐catalyzed CH bond activations, the combination of copper salts with these bidentate directing groups has emerged as an innovative strategy for the construction of carbon‐carbon or carbon‐heteroatom bonds through CH bond cleavage. In addition to the 8‐aminoquinoline and picolinamide systems, several other bidentate directing groups including the 2‐aminophenyloxazoline group by Yu and Dai and the PIP system by Shi, have been developed as well. This review intends to cover most of the recent advances on copper‐catalyzed or ‐mediated direct sp2 and sp3 CH bond functionalizations assisted by these bidentate directing groups. The major achievements in this area are discussed and catalogued by the type of bonds formed (CC, CO, CN, CS, CP etc.). Special attention is paid to the reaction mechanisms. Selected examples of substrates are listed as well. In addition, a personal outlook is given at the end.

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Section: Pallidotomy For Dystoniamentioning

confidence: 99%

Section: Pallidal Dbsmentioning

confidence: 99%

Mirthful laughter induced by subthalamic nucleus stimulation

et al. 2001

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“…4,5 Intraoperative electrical stimulation was recognized early on as an important prelesion targeting tool, capable of augmenting or suppressing motor signs depending on the frequency and amplitude of stimulation. In 1960, Hassler et al 6 reported that low-frequency stimulation (Ͻ25 Hz) in the globus pallidus elicited contralateral tremor in parkinsonian patients, whereas high-frequency stimulation (25 Hz-100 Hz) applied to the same location suppressed tremor. Since then, similar stimulation-dependent effects have been reported in other nuclei and for other clinical indications (FIG.…”

Section: Introductionmentioning

confidence: 99%

Mechanisms and Targets of Deep Brain Stimulation in Movement Disorders

et al. 2008

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Summary:Chronic electrical stimulation of the brain, known as deep brain stimulation (DBS), has become a preferred surgical treatment for medication-refractory movement disorders. Despite its remarkable clinical success, the therapeutic mechanisms of DBS are still not completely understood, limiting opportunities to improve treatment efficacy and simplify selection of stimulation parameters. This review addresses three questions essential to understanding the mechanisms of DBS. 1) How does DBS affect neuronal tissue in the vicinity of the active electrode or electrodes? 2) How do these changes translate into therapeutic benefit on motor symptoms? 3) How do these effects depend on the particular site of stimulation? Early hypotheses proposed that stimulation inhibited neuronal activity at the site of stimulation, mimicking the outcome of ablative surgeries. Recent studies have challenged that view, suggesting that although somatic activity near the DBS electrode may exhibit substantial inhibition or complex modulation patterns, the output from the stimulated nucleus follows the DBS pulse train by direct axonal excitation. The intrinsic activity is thus replaced by high-frequency activity that is time-locked to the stimulus and more regular in pattern. These changes in firing pattern are thought to prevent transmission of pathologic bursting and oscillatory activity, resulting in the reduction of disease symptoms through compensatory processing of sensorimotor information. Although promising, this theory does not entirely explain why DBS improves motor symptoms at different latencies. Understanding these processes on a physiological level will be critically important if we are to reach the full potential of this powerful tool.

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“…During this same period, it was observed that the high-frequency stimulation used for targeting during lesioning of the thalamus significantly reduced tremor and that tremor recurred once the stimulation was discontinued. 6 Further research in the 1980s 7 provided additional evidence that deep brain stimulation (DBS) of the Vim of the thalamus significantly reduced tremor, which set the groundwork for the approval of DBS of the thalamus for the treatment of essential and parkinsonian tremor in 1997. Several studies have demonstrated that DBS of the thalamus has comparable control of tremor with fewer side effects, compared with thalamotomy, especially with bilateral procedures, and DBS is therefore currently the treatment of choice for medication-resistant tremor.…”

Section: Introductionmentioning

confidence: 99%

Deep Brain Stimulation and Tremor

2008

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Summary: Deep brain stimulation (DBS) has been used to treat various tremor disorders for several decades. Medicationresistant, disabling essential tremor (ET) is the most common tremor disorder treated with DBS. The treatment has been consistently reported to result in significant benefit in upper extremity, as well as head and voice tremor, all of which were improved more dramatically with bilateral procedures. These benefits have been demonstrated to be sustained for up to 7 years. DBS has also been shown to be beneficial for the tremor associated with multiple sclerosis and post-traumatic tremor; however, fewer cases have been reported and the benefit is less consistent, less dramatic, and more transient than that seen with ET. The ventral intermediate nucleus of the thalamus is the most common DBS target for tremor disorders, but more recent studies have demonstrated benefits in tremor from DBS of the subthalamic area, primarily the zona incerta. Surgical complications are relatively uncommon and are generally less frequent than those seen with thalamotomy. Stimulation-related effects are usually mild and resolve with adjustment of stimulation parameters. DBS is thus a relatively safe and effective treatment for tremor disorders, particularly for medication-resistant, disabling ET, but may also have some role in medicationresistant, disabling tremor associated with multiple sclerosis and traumatic head injury.

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Physiological Observations in Stereotaxic Operations in Extrapyramidal Motor Disturbances

Cited by 326 publications

References 0 publications

Mirthful laughter induced by subthalamic nucleus stimulation

Mirthful laughter induced by subthalamic nucleus stimulation

Mechanisms and Targets of Deep Brain Stimulation in Movement Disorders

Deep Brain Stimulation and Tremor

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