Stimulation and Destruction of and around the Interstitial Nucleus of Cajal in Man

Sano, Keiji; Yoshioka, Masumi; Mayanagi, Yoshiaki; Sekino, Hiroaki; Yoshimasu, Norio; Tsukamoto, Youichi

doi:10.1159/000103405

Cited by 23 publications

(17 citation statements)

References 1 publication

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The authors suggested that disorders which affect the bilateral balance of INC activity, either by direct damage or by imbalance of input, could be involved in the pathophysiology of CD. These findings are reminding of the human studies in the 1970s by Sano et al [50] who tried to use the INC as a target for treatment of CD. INC lesioning appeared to be beneficial in some patients but it was abandoned later on.…”

Section: Future Perspectivesmentioning

confidence: 54%

Deep Brain Stimulation for Dystonia in Adults

Krauss

2002

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

The renaissance of functional neurosurgery in the treatment of Parkinson’s disease has sparked also the interest in other movement disorders which are refractory to medical treatment. Deep brain stimulation (DBS) has been used only since a few years in dystonia patients. This review summarizes the available data on pallidal and thalamic DBS for various dystonic syndromes. The major advantage of DBS as compared to radiofrequency lesioning is that it allows performing contemporaneous bilateral surgery with relatively low morbidity in these patients. The posteroventral lateral globus pallidus internus (GPi) has been the preferred target in most instances, thus far. While phasic dystonic movements may improve early after surgery, the response of tonic dystonic movements to chronic stimulation may be delayed. The most beneficial results have been achieved in patients with primary genetic generalized and segmental dystonia, myoclonic dystonia, and complex cervical dystonia. Outcome has been varied in patients with other dystonic disorders, in particular those with secondary dystonia. Most studies have reported on relatively short follow-up periods, on single cases, or were retrospective. Pallidal DBS has been shown to be effective in complex cervical dystonia yielding both symptomatic and functional benefit for up to 2.5 years of follow-up. Dramatic improvement has been obtained in children and in adults with DYT1 positive dystonia. Also, patients with non DYT1 genetic dystonia achieved sustained benefit for up to 2 years of follow-up. Preliminary experience indicates that choreoathetosis in patients with cerebral palsy responds less well to pallidal DBS, and that it may not be effective at all in some patients. In single instances unilateral pallidal DBS has been shown to yield valuable benefit in patients with hemidystonia. The experience with DBS for treatment of Meige syndrome and other focal dystonias has been explored only recently. There is much less experience with thalamic DBS for dystonia. Thalamic DBS has been shown to be effective in single cases with posttraumatic dystonia, postanoxic dystonia and paroxysmal nonkinesigenic dystonia. Future perspectives of DBS for treatment of dystonia include the development of new technology, the evaluation of the possible role of other targets, and carefully planned studies to further establish the role of surgery.

show abstract

Section: Future Perspectivesmentioning

confidence: 54%

Deep Brain Stimulation for Dystonia in Adults

Krauss

2002

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

show abstract

“…A survey of the studies on ablative stereotactic surgery for treatment of CD is shown in table 2 [20,31,33,[36][37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54]. Some studies did not clearly differentiate between focal or segmental dystonia, while others included patients with both CD and generalized dystonia.…”

Section: Review Of Clinical Results Of Ablative Surgerymentioning

confidence: 99%

“…In 1970, Sano et al [31] reported their experience with stimulation and destruction of the INC in patients with CD. They found a close juxtaposition of points causing anteflexion or retroflexion of the patient's head in the interstitial region.…”

Section: Other Pathophysiological Conceptsmentioning

confidence: 99%

See 1 more Smart Citation

Functional Stereotactic Surgery for Treatment of Cervical Dystonia: Review of the Experience from the Lesional Era

Loher

Pohle

Krauss

2004

Stereotact Funct Neurosurg

View full text Add to dashboard Cite

Background: Functional stereotactic neurosurgery has been rediscovered as a powerful tool to treat various manifestations of medically refractory dystonia. The purpose of this study was to provide the first systematic review of previous experience with thalamic and basal ganglia surgery in the treatment of cervical dystonia (CD). Methods: A comprehensive review of the literature published between 1950 and 1990 was performed. In addition, data from an unpublished doctoral thesis on 162 patients with CD operated on by Mundinger between 1972 and 1986 were analyzed. Results: Overall, there is published documentation of experience with more than 300 patients with CD who underwent functional stereotactic surgery between the late 1950s and the early 1980s. In general, amelioration of CD was achieved in about 50–70% of patients in most studies. Bilateral surgery generally provided better outcomes than unilateral surgery. Postoperative benefit was reported to become evident only after a delay in several studies. Some reports demonstrated sustained benefit after follow-up of more than 5 years. Bilateral procedures, in particular bilateral thalamotomies, were clearly associated with a higher rate of postoperative side effects, such as dysarthria, dysphagia and ataxia, ranging from 20 to 70%. In the first decade after its introduction, thalamotomy was the preferred procedure. Later, the subthalamic area was targeted more frequently in order to affect pallidal outflow. Experience with targeting the pallidum proper was limited. Functional stereotactic surgery for CD was abandoned in the late 1970s for several reasons, including the general decline in movement disorder surgery at that time, the introduction of selective peripheral denervation and the widespread and beneficial use of botulinum toxin soon thereafter. Conclusions: Functional stereotactic surgery for treatment of CD has a rich history. There are several lessons to be learned from review of earlier experience. Contemporary techniques have led to a significant improvement in the benefit to risk ratio, in particular regarding bilateral surgery.

show abstract

“…71,72 There were even attempts to eliminate torticollis with stereotaxic lesions of this region in humans. 73,74 A recent study in nonhuman primates created an animal model of cervical dystonia by showing that altering INC activity disrupted sensorimotor integration of head information. 75 As with the early study, 71 Klier et al 75 found that microstimulation of INC produced ipsiversive head rotations.…”

Section: Spasmodic Torticollismentioning

confidence: 99%

Animal models of focal dystonia

Evinger

2005

Neurotherapeutics

View full text Add to dashboard Cite

Summary: Animal models indicate that the abnormal movements of focal dystonia result from disordered sensorimotor integration. Sensorimotor integration involves a comparison of sensory information resulting from a movement with the sensory information expected from the movement. Unanticipated sensory signals identified by sensorimotor processing serve as signals to modify the ongoing movement or the planning for subsequent movements. Normally, this process is an effective mechanism to modify neural commands for ongoing movement or for movement planning. Animal models of the focal dystonias spasmodic torticollis, writer's cramp, and benign essential blepharospasm reveal different dysfunctions of sensorimotor integration through which dystonia can arise. Animal models of spasmodic torticollis demonstrate that modifications in a variety of regions are capable of creating abnormal head postures. These data indicate that disruption of neural signals in one structure may mutate the activity pattern of other elements of the neural circuits for movement. The animal model of writer's cramp demonstrates the importance of abnormal sensory processing in generating dystonic movements. Animal models of blepharospasm illustrate how disrupting motor adaptation can produce dystonia. Together, these models show mechanisms by which disruptions in sensorimotor integration can create dystonic movements.

show abstract

Stimulation and Destruction of and around the Interstitial Nucleus of Cajal in Man

Cited by 23 publications

References 1 publication

Deep Brain Stimulation for Dystonia in Adults

Deep Brain Stimulation for Dystonia in Adults

Functional Stereotactic Surgery for Treatment of Cervical Dystonia: Review of the Experience from the Lesional Era

Animal models of focal dystonia

Contact Info

Product

Resources

About