Deep Brain Stimulation最新文献

{"title":"The correlation between motor improvement and disability in activities of daily living after DBS in Parkinson’s disease, tremor and dystonia","authors":"Yarit Wiggerts ,&nbsp;Annabel van der Weide ,&nbsp;Evan Markidis ,&nbsp;Joke M. Dijk ,&nbsp;Vincent J.J. Odekerken ,&nbsp;Maarten Bot ,&nbsp;Pepijn van den Munckhof ,&nbsp;P. Rick Schuurman ,&nbsp;Rob M.A. de Bie ,&nbsp;Martijn Beudel","doi":"10.1016/j.jdbs.2024.10.002","DOIUrl":"10.1016/j.jdbs.2024.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Deep brain stimulation (DBS) for Parkinson’s disease (PD), essential tremor (ET), and dystonia is a well-established treatment option. The correlation between motor symptom improvement and effect on disability is inconclusive.</div></div><div><h3>Objectives</h3><div>To assess the correlation between DBS-induced improvements of motor symptoms and disability for PD, ET and dystonia.</div></div><div><h3>Methods</h3><div>Disability and motor scores were obtained before and six to twelve months after surgery for 324 PD, 35 ET and 40 dystonia patients.</div></div><div><h3>Results</h3><div>There was a modest and significant correlation for PD (Rho=0.284, <em>p</em> &lt; 0.001), a substantial and significant correlation for ET (Rho=0.542, <em>p</em> &lt; 0.001) and no correlation for dystonia (Rho=0.238, <em>p</em> = 0.138) between motor score and disability improvement.</div></div><div><h3>Conclusions</h3><div>The effect of DBS on motor symptoms and disability is not uniformly for dystonia. Possible reasons for this are that the scales used might not be responsive or other symptoms than motor symptoms might have a greater impact on disability.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"6 ","pages":"Pages 29-33"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep brain stimulation for major depressive disorder: continued access or abandonment? Comment to Glannon [1]","authors":"Albert F.G. Leentjens ,&nbsp;Volker A. Coenen","doi":"10.1016/j.jdbs.2024.07.001","DOIUrl":"10.1016/j.jdbs.2024.07.001","url":null,"abstract":"","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"6 ","pages":"Pages 7-8"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949669124000071/pdfft?md5=827cea7a58bd7ff794b838513e2a8af6&pid=1-s2.0-S2949669124000071-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141707204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropsychological and social predictors of participation in a deep brain stimulation study of Parkinson’s disease and dystonia","authors":"Amelia Hahn ,&nbsp;Ann A. Lazar ,&nbsp;Stephanie Cernera ,&nbsp;Simon Little ,&nbsp;Sarah S. Wang ,&nbsp;Philip A. Starr ,&nbsp;Caroline A. Racine","doi":"10.1016/j.jdbs.2024.07.002","DOIUrl":"10.1016/j.jdbs.2024.07.002","url":null,"abstract":"<div><h3>Objectives</h3><p>Participation is essential to DBS research, yet circumstances that affect diverse participation remain unclear. Here we evaluate factors impacting participation in an adaptive DBS study of Parkinson’s disease (PD) and dystonia.</p></div><div><h3>Methods</h3><p>Twenty participants were implanted with a sensing-enabled DBS device (Medtronic Summit RC+S) that allows neural data streaming in naturalistic settings and encouraged to stream as much as possible for the first five months after surgery. Using standardized baseline data obtained through neuropsychological evaluation, we compared neuropsychological and social variables to streaming hours.</p></div><div><h3>Results</h3><p>Marital status and irritability significantly impacted streaming hours (estimate=136.7, bootstrapped (^<em>b</em>) <em>CI</em>^<em>b</em>=45.0 to 249.0, <em>p</em>^<em>b</em>=0.016, and estimate=−95.1, <em>CI</em>^<em>b</em>=−159.9 to −49.2, <em>p</em>^<em>b</em>=0.027, respectively). These variables remained significant after multivariable analysis. Composite scores on verbal memory evaluations predicted the number of hours of data streamed (<em>R</em>^<em>2</em>=0.284, estimate=67.7, <em>CI</em>^<em>b</em>=20.1 to 119.9, <em>p</em>^<em>b</em>=0.019).</p></div><div><h3>Discussion</h3><p>Verbal memory impairment, irritability, and lack of a caregiver may be associated with decreased participation. Further study of factors that impact research participation is critical to the sustained inclusion of diverse participants.</p></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"6 ","pages":"Pages 1-6"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949669124000083/pdfft?md5=73140f5ac8529d60f93fa7fbf69eed21&pid=1-s2.0-S2949669124000083-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141952851","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cervical dystonia patients with psychiatric classification: Despite dystonia improvement less improvement in other domains after DBS surgery","authors":"Annabel van der Weide ,&nbsp;Anjum Aarifa Khanom ,&nbsp;Yarit Wiggerts ,&nbsp;Yasmin Namavar ,&nbsp;Joke Dijk ,&nbsp;Maarten Bot ,&nbsp;Pepijn van den Munckhof ,&nbsp;Rick Schuurman ,&nbsp;Rob M.A. de Bie ,&nbsp;Jibril Osman Farah ,&nbsp;Antonella Macerollo ,&nbsp;Martijn Beudel","doi":"10.1016/j.jdbs.2024.09.001","DOIUrl":"10.1016/j.jdbs.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Patient satisfaction of deep brain stimulation (DBS) for cervical dystonia (CD) is heterogeneous. A high prevalence of psychiatric disorders in patients with CD is well-established. The presence of psychiatric classification in CD may affect the outcomes of DBS treatment.</div></div><div><h3>Methods</h3><div>A cohort of 49 patients with CD and GPi-DBS was retrospectively studied in two centers. Psychiatric history was obtained from patient records. Pre- and post-operative Toronto Western Spasmodic Torticollis Rating Scores (TWSTRS, range 0–85) were compared between patients with and those without psychiatric classification. The TWSTRS disability and pain sub-scores were combined to evaluate non-motor improvement. The severity sub-score was used to assess motor improvement.</div></div><div><h3>Results</h3><div>Twenty (40.8 %) patients had a psychiatric classification, predominantly major depressive disorder and anxiety disorders. Following DBS treatment, the overall mean (± SD) improvement on the TWSTRS was 38.0 ± 29.2 %. Significantly, patients with a psychiatric classification experienced less improvement in the non-motor domain than the patients without a psychiatric classification (29.1 ± SD 38.2 % [range −41.7 to 96.6 %] vs. 51.9 ± 33.6 % [range −8.6 to 100.0 %]; <em>p</em> = 0.02).</div></div><div><h3>Conclusion</h3><div>Our findings indicate that CD patients with psychiatric classifications experience less non-motor improvement following DBS. Psychiatric comorbidities could influence the lacking experience of successful DBS treatment despite good motor outcome. Therefore, it is important to establish these comorbidities in CD patients undergoing DBS with respect to expectation management and treatment if necessary.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"6 ","pages":"Pages 23-28"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the cognitive implications of traditional and novel subthalamic nucleus deep brain stimulation paradigms in Parkinson’s disease","authors":"Anouk Wolters ,&nbsp;Yasin Temel ,&nbsp;Hans Clusmann ,&nbsp;Sarah-Anna Hescham","doi":"10.1016/j.jdbs.2024.07.003","DOIUrl":"10.1016/j.jdbs.2024.07.003","url":null,"abstract":"<div><p>Parkinson's disease (PD) is a prevalent neurodegenerative disorder primarily affecting the motor system. However, it is also accompanied by significant non-motor symptoms such as sleep disturbances, cognitive impairment, and mood disorders. While dopaminergic deficits in the substantia nigra pars compacta are linked to motor symptoms, cognitive decline and non-motor symptoms may involve other neurotransmitter systems, including cholinergic pathways. This review investigates the cognitive implications of traditional and novel subthalamic nucleus (STN) deep brain stimulation (DBS) paradigms in PD. Recognising the growing significance of cognitive function in the management of PD, our study aims to analyse comprehensively how different DBS approaches impact cognitive outcomes. By reviewing existing literature, we examine the cognitive domains of PD patients undergoing traditional STN DBS and explore the effects of novel stimulation paradigms. The findings from these studies may enhance our understanding of the cognitive consequences associated with STN DBS and inform therapeutic strategies to optimize patient outcomes in PD management.</p></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"6 ","pages":"Pages 9-18"},"PeriodicalIF":0.0,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949669124000095/pdfft?md5=7f8ea55dc32157755f3cf14ac43f3099&pid=1-s2.0-S2949669124000095-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141850901","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local field potentials: Therapeutic implications for DBS in dystonia including adaptive DBS for dystonia","authors":"David Ledingham ,&nbsp;Mark Baker ,&nbsp;Nicola Pavese","doi":"10.1016/j.jdbs.2024.03.003","DOIUrl":"https://doi.org/10.1016/j.jdbs.2024.03.003","url":null,"abstract":"<div><p>Local field potentials (LFPs) are signals generated primarily by the result of the synchronous discharge of post-synaptic potentials. Detection of LFPs from intracranial electrodes sited within the basal ganglia has led to the recognition that there are specific features of the LFP that could serve as neurophysiological biomarkers of different disease states. For example, in Parkinson’s disease peaks in the beta frequency range of the power spectrum are known to correlate with the degree of bradykinesia and rigidity, whereas low frequency, alpha-theta peaks are increasingly considered a biomarker of dystonic activity. The introduction of newer deep brain stimulation (DBS) devices capable of simultaneous stimulation and LFP detection creates opportunities to investigate new strategies for treating patients with dystonia. This review aims to summarise the LFP findings seen in patients with dystonia undergoing DBS with a particular focus on the potential implications for future clinical practice and the development of adaptive DBS systems.</p></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"5 ","pages":"Pages 4-19"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949669124000058/pdfft?md5=f0df3b5152f7c21dc6b707e654b98e8d&pid=1-s2.0-S2949669124000058-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140350893","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Neuropalliative care in deep brain stimulation for Parkinson’s disease: Potential impactful areas of care","authors":"Caroline T. Goldin ,&nbsp;Christina L. Vaughan ,&nbsp;Brian Hoyt ,&nbsp;Drew S. Kern","doi":"10.1016/j.jdbs.2024.03.001","DOIUrl":"10.1016/j.jdbs.2024.03.001","url":null,"abstract":"<div><p>Neuropalliative care (NPC) is a relatively new subspeciality of neurology. Recent studies have demonstrated efficacy of NPC in Parkinson’s disease (PD). However, the implementation of NPC in deep brain stimulation (DBS) has yet to be addressed. Patients with PD being evaluated for and having undergone DBS potentially have unmet needs that may be best assessed and managed by neuropalliative neurologist. Specific areas include an in-depth psychosocial evaluation, exploration of patient and caregiver expectations, addressing caregiver needs, providing spiritual and marital support, and discussing advance directives.</p></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"5 ","pages":"Pages 1-3"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949669124000034/pdfft?md5=6ba0644fe6c68775affa756ec1db54e6&pid=1-s2.0-S2949669124000034-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140090706","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Local field potential journey into the Basal Ganglia","authors":"Eitan E. Asher ,&nbsp;Maya Slovik ,&nbsp;Rea Mitelman ,&nbsp;Hagai Bergman ,&nbsp;Shlomo Havlin ,&nbsp;Shay Moshel","doi":"10.1016/j.jdbs.2024.03.002","DOIUrl":"https://doi.org/10.1016/j.jdbs.2024.03.002","url":null,"abstract":"<div><p>Local field potentials (LFP) in the basal ganglia (BG) have attracted considerable research and clinical interest. The genesis of these signals has been a topic of extensive discourse, focusing on whether they are a manifestation of local synaptic activity or result from the propagation of electrical signals through tissue, as described by the Maxwell equations (volume conduction). To investigate this, we conducted simultaneous recordings of LFPs from two cortical areas— the dorsolateral prefrontal cortex (DLPFC) and the primary motor cortex (M1)—and various sites within the BG nuclei in an awake, non-task-engaged non-human primate (NHP). Employing innovative analytical techniques, we discerned significant cross-correlations indicative of potential connections, while filtering out non-significant correlations. This allowed us to differentiate between synaptic inputs and volume conduction. Our findings indicate two distinct propagation pathways of BG field potentials emanating from the M1 and the DLPFC, each characterized by different temporal delays. The results imply that these anatomical pathways are differentially influenced by the mechanisms of volume conduction and synaptic transmission. Notably, the M1 exhibits more functional links with non-zero-time delays to the BG structures, while the DLPFC-BG connections are marked by zero-time delays, suggesting a predominance of volume conduction effects. Consequently, investigations into the origins of BG LFP should account for the distinct anatomical pathways linking the cortex and the BG, as they differentially represent information flow and volume conductance.</p></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"5 ","pages":"Pages 20-29"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949669124000046/pdfft?md5=0860751b57ed52a679b69d6665e7eba4&pid=1-s2.0-S2949669124000046-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140543471","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep brain stimulation for major depressive disorder: Continued access or abandonment?","authors":"Walter Glannon","doi":"10.1016/j.jdbs.2024.05.001","DOIUrl":"10.1016/j.jdbs.2024.05.001","url":null,"abstract":"<div><p>Participants in DBS clinical trials for major depressive and other psychiatric disorders may not have access to post-trial neuromodulation. Some commentators have claimed that this would be unfair to trial participants and effectively abandon them. Continued access to these devices could be justified only if there were a statistically significant difference in outcomes between active and sham stimulation and participants responded positively to active DBS. Clinicians and investigators have post-trial obligations to provide appropriate care and psychosocial support to patients and trial participants. Depending on trial outcomes and patient responses, lack of access to continued DBS may not be unfair to them or a form of abandonment.</p></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"5 ","pages":"Pages 30-32"},"PeriodicalIF":0.0,"publicationDate":"2024-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294966912400006X/pdfft?md5=d8164a13fc48a5d2d63f1bd7417ed526&pid=1-s2.0-S294966912400006X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141033971","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Deep brain stimulation-related experiences for obsessive-compulsive disorder: In-depth interviews with operated patients and relatives","authors":"Samantha Baldi ,&nbsp;Emma Vandenberk ,&nbsp;Jeanine Bors ,&nbsp;Liesbet Goossens ,&nbsp;Klara de Cort ,&nbsp;Linda Ackermans ,&nbsp;Albert F.G. Leentjens ,&nbsp;David E.J. Linden ,&nbsp;Annelien A. Duits ,&nbsp;Yasin Temel ,&nbsp;Angelique de Rijk ,&nbsp;Bart Nuttin ,&nbsp;Chris Bervoets ,&nbsp;Laura Luyten ,&nbsp;Koen R.J. Schruers","doi":"10.1016/j.jdbs.2023.12.003","DOIUrl":"https://doi.org/10.1016/j.jdbs.2023.12.003","url":null,"abstract":"<div><h3>Background</h3><p>Deep brain stimulation (DBS) is an effective intervention for refractory obsessive-compulsive disorder (OCD). Although treatment success is measured by a decrease in the severity of core symptoms, this procedure can have broader psychological and physical effects. The field regrettably still lacks knowledge and tools allowing an adequate understanding and assessment of the full range of experiences that accompany DBS treatment. We aimed to describe possible side effects of DBS treatment as experienced by patients, beyond specific changes in OCD core symptoms.</p></div><div><h3>Methods</h3><p>We interviewed 16 patients and 7 of their relatives from two independent cohorts, receiving stimulation in different anatomical locations. We conducted semi-structured interviews, then transcribed at verbatim. Inductive content analysis was performed to code and group common themes.</p></div><div><h3>Results</h3><p>We categorized a variety of psychological and physical experiences. Patients frequently reported long-lasting changes often manifesting as improved mood and calmer behavior, but also as impaired memory, concentration, and sleep problems. Further, a wide range of individual experiences were described, suggesting that patients can feel and behave significantly different towards themselves and others, feeling more sensitive, more or less emotional, more impulsive, more irritable, more talkative.</p></div><div><h3>Conclusions</h3><p>We stress the importance of accumulating knowledge of the full range of DBS-related experiences, to improve shared decision making between patients and treating clinicians, and to facilitate comprehensive monitoring throughout the course of treatment.</p></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"4 ","pages":"Pages 1-8"},"PeriodicalIF":0.0,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949669123000167/pdfft?md5=860cd0e6a2b5d8d7b45c8848f1af7876&pid=1-s2.0-S2949669123000167-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138839884","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}