Treatment results: Parkinson's disease

Pollak, Pierre; Fraix, Valérie; Krack, Paul; Moro, Elena; Mendes, Alexandre; Chabardès, Stéphan; Koudsié, Adnan; Benabid, Alim‐Louis

doi:10.1002/mds.10146

Cited by 163 publications

(105 citation statements)

References 107 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recently, this technique was approved by the Food and Drug Administration for the treatment of intractable motor disorders (tremor [20][21][22] and Parkinson's disease 23 ). The stimulating leads are connected via an extension wire to pulse generators typically placed in the chest (Figure).…”

Section: Deep Brain Stimulation and Neurosurgerymentioning

confidence: 99%

Brain Stimulation Techniques in the Treatment of Obsessive-Compulsive Disorder: Current and Future Directions

et al. 2005

View full text Add to dashboard Cite

Recent studies on the epidemiology of obsessive-compulsive disorder (OCD) estimate 50 million patients suffer from OCD worldwide, thus making it a global problem. The treatment of OCD has changed substantially over the last 2 decades following the introduction of selective serotonin reuptake inhibitors, which provide symptom improvement in ~60% of patients. However, some patients remain resistant to the standard pharmacologic and behavioral treatments. Although some Needs AssessmentIn the last decade, brain stimulation approaches to neuropsychiatric disorders have been increasingly investigated and are currently defining a "third way" of treatment besides the traditional ones, pharmacologic therapy and psychotherapy. Although some of these techniques are well-established treatments for specific conditions (ie, electroconvulsive therapy for severe depression or deep brain stimulation and transcranial magnetic stimulation in motor disorders) their efficacy in severe or treatment-resistant obsessive-compulsive disorder is still under investigation. Nevertheless, they represent a potential, helpful approach in this highly debilitating condition not only amongst the therapeutic approaches to obsessive-compulsive disorder but also as research means able to elucidate the specific dysfunctional neurocircuits underlying the clinical symptomatology. Learning ObjectivesAt the end of this activity, the participant should be able to:• Differentiate the specific techniques of brain stimulation investigated in the treatment of obsessive-compulsive disorder (OCD) in terms of efficacy, invasiveness, tolerability, and side effects.• Understand the main hypotheses through which these techniques might modify the dysfunctional circuits of OCD.• Understand the potential of these techniques in the field of treatment-resistant OCD, on one hand, and their current investigational state that requires further controlled clinical trials, on the other hand. Target Audience Neurologists and psychiatrists Accreditation StatementMount Sinai School of Medicine is accredited by the Accreditation Council for Continuing Medical Education to provide Continuing Medical Education for physicians.Mount Sinai School of Medicine designates this educational activity for a maximum of 3.0 Category 1 credit(s) toward the AMA Physician's Recognition Award. Each physician should claim only those credits that he/she actually spent in the educational activity.It is the policy of Mount Sinai School of Medicine to ensure fair balance, independence, objectivity and scientific rigor in all its sponsored activities. All faculty participating in sponsored activities are expected to disclose to the audience any real or apparent discussion of unlabeled or investigational use of any commercial product or device not yet approved in the United States.This activity has been peer-reviewed and approved by Eric Hollander, MD, professor of psychiatry, Mount Sinai School of Medicine. Review Date: November 1, 2005. To Receive Credit for This ActivityRead this article, and...

show abstract

Section: Deep Brain Stimulation and Neurosurgerymentioning

confidence: 99%

Brain Stimulation Techniques in the Treatment of Obsessive-Compulsive Disorder: Current and Future Directions

et al. 2005

View full text Add to dashboard Cite

show abstract

“…Olanow et al, 2000;Benabid et al, 2001b,c;Gross, 2001; The Deep Brain Stimulation for Parkinson's Disease Study Group, 2001;Pollak et al, 2002). The basic mechanisms underlying DBS remain mysterious, however.…”

Section: Introductionmentioning

confidence: 99%

High Frequency Stimulation of the Subthalamic Nucleus Eliminates Pathological Thalamic Rhythmicity in a Computational Model

2004

View full text Add to dashboard Cite

Abstract. Deep brain stimulation (DBS) of the subthalamic nucleus (STN) or the internal segment of the globus pallidus (GPi) has recently been recognized as an important form of intervention for alleviating motor symptoms associated with Parkinson's disease, but the mechanism underlying its effectiveness remains unknown. Using a computational model, this paper considers the hypothesis that DBS works by replacing pathologically rhythmic basal ganglia output with tonic, high frequency firing. In our simulations of parkinsonian conditions, rhythmic inhibition from GPi to the thalamus compromises the ability of thalamocortical relay (TC) cells to respond to depolarizing inputs, such as sensorimotor signals. High frequency stimulation of STN regularizes GPi firing, and this restores TC responsiveness, despite the increased frequency and amplitude of GPi inhibition to thalamus that result. We provide a mathematical phase plane analysis of the mechanisms that determine TC relay capabilities in normal, parkinsonian, and DBS states in a reduced model. This analysis highlights the differences in deinactivation of the low-threshold calcium T -current that we observe in TC cells in these different conditions. Alternative scenarios involving convergence of thalamic signals in the cortex are also discussed, and predictions associated with these results, including the occurrence of rhythmic rebound bursts in certain TC cells in parkinsonian states and their drastic reduction by DBS, are stated. These results demonstrate how DBS could work by increasing firing rates of target cells, rather than shutting them down.

show abstract

“…Common DBS targets for PD are the subthalamic nucleus (STN), the globus pallidus internus (GPi) and the ventralis intermedius nucleus (Vim) of the thalamus. Although no large controlled clinical trials comparing the different targets has yet been published, DBS in STN seems to give the most consistent alleviation of the majority of PD symptoms, and is at present the most common surgical therapy [2][3][4][5][6]. However, STN DBS is sometimes accompanied by postoperative adverse effects such as decrease in verbal fluency, depression and hypomania [7].…”

Section: Introductionmentioning

confidence: 99%

Method for patient-specific finite element modeling and simulation of deep brain stimulation

Åström

Zrinzo

Tisch

et al. 2008

Med Biol Eng Comput

View full text Add to dashboard Cite

Deep brain stimulation (DBS) is an established treatment for Parkinson's disease (PD). Success of DBS is highly dependent on electrode location and electrical parametersettings. The aim of this study was to develop a general method for setting up patient-specific 3D computer models of DBS, based on magnetic resonance images, and to demonstrate the use of such models for assessing the position of the electrode contacts and the distribution of the electric field in relation to individual patient anatomy. A software tool was developed for creating finite element DBS-models. The electric field generated by DBS was simulated in one patient and the result was visualized with isolevels and glyphs. The result was evaluated and corresponded well with reported effects and side effects of stimulation. It was demonstrated that patient-specific finite element models and simulations of DBS can be useful for increasing the understanding of the clinical outcome of DBS.

show abstract

Treatment results: Parkinson's disease

Cited by 163 publications

References 107 publications

Brain Stimulation Techniques in the Treatment of Obsessive-Compulsive Disorder: Current and Future Directions

Brain Stimulation Techniques in the Treatment of Obsessive-Compulsive Disorder: Current and Future Directions

High Frequency Stimulation of the Subthalamic Nucleus Eliminates Pathological Thalamic Rhythmicity in a Computational Model

Method for patient-specific finite element modeling and simulation of deep brain stimulation

Contact Info

Product

Resources

About