Subthalamic nucleus stimulation for attenuation of pain related to Parkinson disease

Oshima, Hideki; Katayama, Yoichi; Morishita, Takashi; Sumi, Koichiro; Otaka, Toshiharu; Kobayashi, Kazuhiko; Suzuki, Yutaka; Fukaya, Chikashi; Yamamoto, Takamitsu

doi:10.3171/2011.7.jns11158

Cited by 47 publications

(30 citation statements)

References 33 publications

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“…9) One of the reasons is considered to be the decreased threshold of pain due to abnormality of the dopaminergic system in the basal ganglia of PD patients. 5,10) Administration of anti-parkinsonian medication 5,14) or DBS 16,20,23) results in increased pain thresholds. Low back pain and leg pain are most commonly experienced pain symptoms in PD patients.…”

Section: Introductionmentioning

confidence: 99%

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Spinal Cord Stimulation for the Treatment of Abnormal Posture and Gait Disorder in Patients With Parkinson's Disease

Agari

Date

2012

Neurol. Med. Chir.(Tokyo)

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Patients with advanced Parkinson's disease (PD) often present with axial symptoms, including abnormal posture, postural instability, and gait disorder. Although spinal cord stimulation (SCS) is effective for pain, little is known about the effect of SCS on motor function in PD patients. The present study investigated the effect of SCS on posture and gait in 15 PD patients, 5 men and 10 women aged 63-79 years (mean 71.1 years), with low back pain and leg pain who received SCS. A visual analog scale (VAS) was used for pain evaluation pre-and postoperatively. The Unified Parkinson's Disease Rating Scale, Timed Up and Go tests, and Timed 10-Meter Walk tests were used to evaluate motor function and activities of daily living of patients. Preoperative mean VAS score was 8.9 (range 7.8-10), which showed significant postoperative improvement at 3 months to mean VAS score of 2.0 (range 0-3.3). The improvements in VAS scores persisted at 12 months after surgery with mean VAS score of 2.3 (range 0-4). Posture and postural stability motor subscores were improved at 3 months after SCS, and gait had significantly improved at 3 months and 1 year after surgery. Timed 10-Meter Walk tests also demonstrated that patient gait was significantly improved at 3 months and 12 months after surgery. Most advanced stage PD patients suffer considerable pain that causes abnormal posture and gait disturbance. SCS is expected to lead to both amelioration of pain and improvement of motor function in such patients.

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Section: Introductionmentioning

confidence: 99%

“…6,21) Treatment by medication or DBS is often ineffective for low back pain caused by postural deformity, and is also ineffective for radicular or peripheral neuropathic pain. 23) Because pain is an important factor that reduces the ADL and QOL of patients, the establishment of new and effective therapy is essential.…”

Section: Introductionmentioning

confidence: 99%

Spinal Cord Stimulation for the Treatment of Abnormal Posture and Gait Disorder in Patients With Parkinson's Disease

Agari

Date

2012

Neurol. Med. Chir.(Tokyo)

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“…4 This work and the increasing availability of biological markers of AD pathology have led to a proposed biological cascade model of AD 5 and reevaluation of diagnostic criteria for AD. 6 If one ascribes religiously to the concept that a large proportion of cognitive differences with age are driven by incipient disease, then one might expect that memory performance-a cognitive ability that changes most dramatically with age and is common to AD-would follow increasing levels of associated cerebral amyloid and be strongly associated with hippocampal atrophy. In their article, Jack et al 7 present new information that challenges the notion that amyloid accumulation explains memory performance across the entire age range.…”

Section: Charles Decarli MDmentioning

confidence: 99%

Deep Brain Stimulation of the Subthalamic Nucleus

Khemani

Dewey

2015

JAMA Neurol

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“…Curative electroconvulsive therapy (ECT) remains a very useful treatment, still irreplaceable for some specific rare cases especially with a psychiatric history, as long as other brain stimulation methods, such as transcranial magnetic stimulation, remain experimental [163]. DBS could successfully decrease inflammation, which is believed to be the direct source of the pain associated with Parkinson's [164]. The cell transplantation approach is promising in serving as an adept alternative therapy for DRE, because this strategy has shown the capability to curtail epileptogenesis when used soon after an initial precipitating brain injury, and to restrain spontaneous recurrent seizures and improve cognitive function when utilized after the occurrence of DRE [165].…”

Section: Perspectivesmentioning

confidence: 99%

Modulation of Immunity and the Inflammatory Response: A New Target for Treating Drug-resistant Epilepsy

Líu²,

Qin³

2013

Current Neuropharmacology

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Until recently, epilepsy medical therapy is usually limited to anti-epileptic drugs (AEDs). However, approximately 1/3 of epilepsy patients, described as drug-resistant epilepsy (DRE) patients, still suffer from continuous frequent seizures despite receiving adequate AEDs treatment of sufficient duration. More recently, with the remarkable progress of immunology, immunity and inflammation are considered to be key elements of the pathobiology of epilepsy. Activation of inflammatory processes in brain tissue has been observed in both experimental seizure animal models and epilepsy patients. Anti-inflammatory and immunotherapies also showed significant anticonvulsant properties both in clinical and in experimental settings. The above emerging evidence indicates that modulation of immunity and inflammatory processes could serve as novel specific targets to achieve potential anticonvulsant effects for the patients with epilepsy, especially DRE. Herein we review the recent evidence supporting the role of inflammation in the development and perpetuation of seizures, and also discuss the recent achievements in modulation of inflammation and immunotherapy applied to the treatment of epilepsy. Apart from medical therapy, we also discuss the influences of surgery, ketogenic diet, and electroconvulsive therapy on immunity and inflammation in DRE patients. Taken together, a promising perspective is suggested for future immunomodulatory therapies in the treatment of patients with DRE.

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Subthalamic nucleus stimulation for attenuation of pain related to Parkinson disease

Cited by 47 publications

References 33 publications

Spinal Cord Stimulation for the Treatment of Abnormal Posture and Gait Disorder in Patients With Parkinson's Disease

Spinal Cord Stimulation for the Treatment of Abnormal Posture and Gait Disorder in Patients With Parkinson's Disease

Deep Brain Stimulation of the Subthalamic Nucleus

Modulation of Immunity and the Inflammatory Response: A New Target for Treating Drug-resistant Epilepsy

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