Tratamiento de un caso de distonía generalizada mediante estimulación subtalámica

Pastor-Gómez, J; Hernando-Requejo,; A, Luengo-Dos Santos; Pedrosa-Sánchez, Manuel; Rg, Sola

doi:10.33588/rn.3706.2003273

Cited by 7 publications

(2 citation statements)

References 10 publications

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“…It is also not known if targeting other brain structures, such as the subthalamic nucleus, could offer greater benefit in some types of dystonia. 9,33 Conclusions Microelectrode-guided placement of pallidal deep brain stimulators in patients with dystonia is a relatively safe procedure resulting in consistent electrode location in the posterior GPI. Spontaneous discharge characteristics of internal pallidal neurons in cases of dystonia differ considerably from those in cases of PD.…”

Section: Variability Of Clinical Outcomes After Gpi Dbs For Dystoniamentioning

confidence: 99%

Microelectrode-guided implantation of deep brain stimulators into the globus pallidus internus for dystonia: techniques, electrode locations, and outcomes

Starr

Turner

Rau

et al. 2006

JNS

239

215

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Physiologically guided implantation of DBS electrodes in patients with dystonia was technically feasible in the awake state in most patients, and the morbidity rate was low. Spontaneous discharge rates of GPI neurons in dystonia were similar to those of globus pallidus externus neurons, such that the two nuclei must be distinguished by neuronal discharge patterns rather than rates. Active electrode locations associated with robust improvement (> 70% decrease in BFMDRS score) were located near the intercommissural plane, at a mean distance from the pallidocapsular border of 3.6 mm.

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Section: Variability Of Clinical Outcomes After Gpi Dbs For Dystoniamentioning

confidence: 99%

Microelectrode-guided implantation of deep brain stimulators into the globus pallidus internus for dystonia: techniques, electrode locations, and outcomes

Starr

Turner

Rau

et al. 2006

JNS

239

215

View full text Add to dashboard Cite

show abstract

“…Deep brain stimulation, e.g. of the subthalamic nucleus (STN-DBS), may be effective in movement disorders 1,2,3 , such as in patients with primary dystonia manifestations [4][5][6] measured by the Burke-Fahn-Marsden Dystonia Rating Scale, and may improve their quality of life in terms of physical functioning, bodily pain, and mental health measured by the 36-Item Short-Form General Health Survey 4 . Improvement has been reported in patients with medically refractory isolated dystonia, even 12 and 36 months after STN-DB surgery 5 .…”

Section: Introductionmentioning

confidence: 99%

Safety of transcranial direct current stimulation in a patient with deep brain stimulation electrodes

Iannone

Allam

Brasil‐Neto

2019

Arq. Neuro-Psiquiatr.

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Background: Transcranial direct current stimulation (tDCS) has been investigated in movement disorders, making it a therapeutic alternative in clinical settings. However, there is still no consensus on the most appropriate treatment protocols in most cases, and the presence of deep brain stimulation (DBS) electrodes has been regarded as a contraindication to the procedure. We recently studied the effects of cerebellar tDCS on a female patient already undergoing subthalamic nucleus deep brain stimulation (STN-DBS) for generalized dystonia. She also presented with chronic pain and depression. With STN-DBS, there was improvement of dystonia, and botulinum toxin significantly reduced pain. However, depressive symptoms were worse after STN-DBS surgery. Methods: Neuromodulation with 2 mA anodal cerebellar tDCS was initiated, targeting both hemispheres in each daily 30 minute session: 15 minutes of left cerebellar stimulation followed by 15 minutes of right cerebellar stimulation. The DBS electrodes were in place and functional, but the current was turned off during tDCS. Results: Although our goal was to improve dystonic movements, after 10 tDCS sessions there was also improvement in mood with normalization of Beck Depression Inventory scores. There were no complications in spite of the implanted STN-DBS leads. Conclusion: Our results indicate that tDCS is safe in patients with DBS electrodes and may be an effective add-on neuromodulatory tool in the treatment of potential DBS partial efficacy in patients with movement disorders.

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Deep Brain Stimulation for Movement Disorders of Basal Ganglia Origin: Restoring Function or Functionality?

2016

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Deep brain stimulation (DBS) is highly effective for both hypo-and hyperkinetic movement disorders of basal ganglia origin. The clinical use of DBS is, in part, empiric, based on the experience with prior surgical ablative therapies for these disorders, and, in part, driven by scientific discoveries made decades ago. In this review, we consider anatomical and functional concepts of the basal ganglia relevant to our understanding of DBS mechanisms, as well as our current understanding of the pathophysiology of two of the most commonly DBS-treated conditions, Parkinson's disease and dystonia. Finally, we discuss the proposed mechanism(s) of action of DBS in restoring function in patients with movement disorders. The signs and symptoms of the various disorders appear to result from signature disordered activity in the basal ganglia output, which disrupts the activity in thalamocortical and brainstem networks. The available evidence suggests that the effects of DBS are strongly dependent on targeting sensorimotor portions of specific nodes of the basal gangliathalamocortical motor circuit, that is, the subthalamic nucleus and the internal segment of the globus pallidus. There is little evidence to suggest that DBS in patients with movement disorders restores normal basal ganglia functions (e.g., their role in movement or reinforcement learning). Instead, it appears that high-frequency DBS replaces the abnormal basal ganglia output with a more tolerable pattern, which helps to restore the functionality of downstream networks.

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Tratamiento de un caso de distonía generalizada mediante estimulación subtalámica

Cited by 7 publications

References 10 publications

Microelectrode-guided implantation of deep brain stimulators into the globus pallidus internus for dystonia: techniques, electrode locations, and outcomes

Microelectrode-guided implantation of deep brain stimulators into the globus pallidus internus for dystonia: techniques, electrode locations, and outcomes

Safety of transcranial direct current stimulation in a patient with deep brain stimulation electrodes

Deep Brain Stimulation for Movement Disorders of Basal Ganglia Origin: Restoring Function or Functionality?

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