Deep Brain Stimulation最新文献_第4页

Technological developments in electric-based DBS 基于电力的 DBS 技术发展

Deep Brain Stimulation Pub Date : 2023-12-13 DOI: 10.1016/j.jdbs.2023.12.001

Mehmet Tonge

引用次数: 0

Frameless and fiducial-less, O-arm assisted navigation for deep brain stimulation placement using the Nexframe®. A technical note 使用 Nexframe® 进行无框架、无靶标、O 型臂辅助导航以植入深部脑刺激物。技术说明。

Deep Brain Stimulation Pub Date : 2023-12-03 DOI: 10.1016/j.jdbs.2023.11.003

Mohammad Abolfotoh , Koroush Tavanaipour , Daryoush Tavanaipour

引用次数: 0

Postoperative infection problems in DBS applications DBS应用中的术后感染问题

Deep Brain Stimulation Pub Date : 2023-10-01 DOI: 10.1016/j.jdbs.2023.11.002

Ümit Akın Dere

{"title":"Postoperative infection problems in DBS applications","authors":"Ümit Akın Dere","doi":"10.1016/j.jdbs.2023.11.002","DOIUrl":"https://doi.org/10.1016/j.jdbs.2023.11.002","url":null,"abstract":"<div><p>Deep brain stimulation (DBS) is a significant neuromodulation method for treating neurological and psychiatric disorders. Despite its efficacy, complications, particularly infections, are a concern. This article reviews the prevalence, risk factors, pathogens, infection locations, timing, surgical approaches, prevention strategies, and treatment methods associated with infections following DBS procedures. DBS surgeries have gained popularity due to their adjustability, but infections pose challenges. Surgical site infections (SSIs) are common (0% to 24% cases) and extensively studied regarding patient groups, locations, timing, and pathogens. Expanding patient groups, including conditions like Tourette syndrome and epilepsy, have varying infection risks. Infections occur at burr-hole, extension, and implantable pulse generator (IPG) sites. Staphylococcus aureus is a primary pathogen, yet bacterial DNA on IPGs and colonization complicate understanding. Surgical approaches, staged or non-staged, show comparable infection rates. The influence of repetitive pulse generator replacements on infection rates is debated. Lead externalization, topical vancomycin powder, and other factors impact infection risk. Treating DBS-related infections often requires hardware extraction and antibiotic treatment. Innovations like ethylene oxide sterilization and hydrogen peroxide show potential. Algorithms suggest partial explantation for localized infections. Cost analyses favor starting with antibiotics. Infections persist despite progress; understanding risks, pathogens, and strategies is vital for optimal outcomes in DBS.</p></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"3 ","pages":"Pages 16-18"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2949669123000131/pdfft?md5=ed1c273bbc94b70e3ac2092dbe57b881&pid=1-s2.0-S2949669123000131-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138480409","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}

引用次数: 0

The role of the dorsal anterior cingulate cortex in obsessive-compulsive disorder 背前扣带皮层在强迫症中的作用

Deep Brain Stimulation Pub Date : 2023-10-01 DOI: 10.1016/j.jdbs.2023.07.001

Mégan M.G.H. van de Veerdonk , Tim A.M. Bouwens van der Vlis , Linda Ackermans , Koen R.J. Schruers , Yasin Temel , Albert F.G. Leentjens

{"title":"The role of the dorsal anterior cingulate cortex in obsessive-compulsive disorder","authors":"Mégan M.G.H. van de Veerdonk , Tim A.M. Bouwens van der Vlis , Linda Ackermans , Koen R.J. Schruers , Yasin Temel , Albert F.G. Leentjens","doi":"10.1016/j.jdbs.2023.07.001","DOIUrl":"https://doi.org/10.1016/j.jdbs.2023.07.001","url":null,"abstract":"<div><p>Despite extensive research efforts, the pathophysiology of obsessive-compulsive disorder (OCD) is still largely unknown. The dorsal anterior cingulate cortex (dACC) plays an important role in cognitive control and is therefore hypothesized to contribute to the pathogenesis of OCD. In this review, we aim to gain a wider understanding of the specific functions of the dACC and its role in the pathophysiology of OCD. The dACC is part of the cortico-basal ganglia-thalamo-cortical loop, where it forms connections between sensory input streams, cognitive and affective processing regions, and structures that regulate behaviour. This position facilitates a broad function for the dACC in multiple domains, which center on goal-directed behaviour and reward-based learning. When presented with a certain threatening stimulus, the dACC instructs downstream structures to select actions to respond to this particular stimulus, based on previous experiences We hypothesize that hyperactivity of the dACC may impair goal-directed behaviour in OCD patients which in turn may lead to obsessive-compulsive symptoms by creating an over-reliance on threatening stimuli and inadequate selection of neutralizing actions. The working mechanisms of cognitive behavioural therapy, serotonergic medication, repetitive transcranial magnetic stimulation and deep brain stimulation in OCD may be in part explained by the normalization of the activity of the dACC within the cortico-basal ganglia-thalamo-cortical (CBGTC) loop.</p></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"3 ","pages":"Pages 1-7"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49759526","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Ethical considerations in closed loop deep brain stimulation 闭环深部脑刺激的伦理考虑

Deep Brain Stimulation Pub Date : 2023-10-01 DOI: 10.1016/j.jdbs.2023.11.001

Sunderland Baker , Eliz Fenstermacher , Rachel A. Davis , Drew S. Kern , John A. Thompson , Gidon Felsen , Alexander J. Baumgartner

{"title":"Ethical considerations in closed loop deep brain stimulation","authors":"Sunderland Baker , Eliz Fenstermacher , Rachel A. Davis , Drew S. Kern , John A. Thompson , Gidon Felsen , Alexander J. Baumgartner","doi":"10.1016/j.jdbs.2023.11.001","DOIUrl":"https://doi.org/10.1016/j.jdbs.2023.11.001","url":null,"abstract":"<div><h3>Background</h3><p>Closed-loop deep brain stimulation (DBS) uses feedback to infer a clinical state and adjust stimulation accordingly. This novel mechanism has several potential advantages over conventional DBS including reducing stimulation-induced side effects, improving battery longevity, and alleviating symptoms not optimally treated with standard protocols. However, several ethical challenges may arise with the implementation of this technology, particularly with respect to clinical decision making.</p></div><div><h3>Objective</h3><p>To discuss potential ethical and clinical dilemmas encountered in using closed-loop DBS for neurological and psychiatric disorders.</p></div><div><h3>Methods</h3><p>The relevant literature is reviewed and supplemented with discussion of ethically challenging clinical scenarios. We outline an ethical framework for addressing these issues and provide practical recommendations for clinicians and researchers.</p></div><div><h3>Results</h3><p>Ethical considerations in closed-loop DBS revolve around five key principles: 1) risk/benefit analysis; 2) inclusion and exclusion criteria; 3) respect for patient autonomy; 4) quality of life and patient benefit; and 5) concerns associated with recording neural activity.</p></div><div><h3>Conclusion(s)</h3><p>Developing and implementing a pragmatic framework for ethical considerations in closed-loop DBS will be critical as this technology is utilized in patients with both neurologic and psychiatric indications.</p></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"3 ","pages":"Pages 8-15"},"PeriodicalIF":0.0,"publicationDate":"2023-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S294966912300012X/pdfft?md5=168abcc6e8af88c5de3585f384bca01b&pid=1-s2.0-S294966912300012X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134832941","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}

引用次数: 0

Deep brain stimulation of the subthalamic nucleus in Parkinson’s disease after 15 years: Clinical outcome and caregiver burden 帕金森病15年后丘脑底核深部脑刺激:临床结果和照顾者负担

Deep Brain Stimulation Pub Date : 2023-08-01 DOI: 10.1016/j.jdbs.2023.06.001

Lucas G. Westerink , Felix Gubler , Annelien Duits , Linda Ackermans , Anouk Smeets , Mark L. Kuijf , Yasin Temel

{"title":"Deep brain stimulation of the subthalamic nucleus in Parkinson’s disease after 15 years: Clinical outcome and caregiver burden","authors":"Lucas G. Westerink , Felix Gubler , Annelien Duits , Linda Ackermans , Anouk Smeets , Mark L. Kuijf , Yasin Temel","doi":"10.1016/j.jdbs.2023.06.001","DOIUrl":"https://doi.org/10.1016/j.jdbs.2023.06.001","url":null,"abstract":"<div><h3>Background and objectives</h3><p>To provide a detailed overview of motor and non-motor outcome of Parkinson disease (PD) patients with deep brain stimulation (DBS) of the Subthalamic nucleus (STN) 13–17 years after surgery. Little information on long-term follow-up (>10 years) after surgery is available yet, with a high percentage of loss to follow-up (FU).</p></div><div><h3>Methods</h3><p>In this observational cohort study data on motor, autonomic symptoms, cognitive outcome, mood, quality of life, activities of daily living, Unified Parkinson’s disease rating scale (UPDRS, version 1) scores and dopaminergic medication were collected average 15.1 years (± 1.5 standard deviation) after surgery. To limit the loss to FU, patients unable to visit the hospital have been evaluated at their place of residency (e.g. home or nursing home). Furthermore, caregiver burden was assessed.</p></div><div><h3>Results</h3><p>Fifteen (35%) of the 43 included patients survived follow-up, of which 9 patients were assessed at their institution. UPDRS I (1.46 vs. 6.7, p < 0.005), UPDRS II (10.5 vs. 30.5, p < 0.01) and UPDRS III (47.7 vs. 18.3, p = 0.005) significantly worsened compared to baseline with medication. Axial symptoms and bradykinesia were most severely affected of the UPDRS III score. New autonomic symptoms were dominant. One third (n = 5) of caregivers reported significant burden. EQ-5D was 0.43 and 4 patients (27%) showed signs of moderate to severe depression. Six patients (40%) met criteria of dementia.</p></div><div><h3>Conclusion</h3><p>Cognitive, axial, bradykinesia and autonomic symptoms are highly dominant after 15 years of follow-up, whereas tremor and rigidity show no significant worsening over time. This significantly affects health status, quality of life and caregiver burden.</p></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"2 ","pages":"Pages 20-25"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49750248","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Employing LFP recording to optimize stimulation location and amplitude in chronic DBS for Parkinson’s disease: A proof-of-concept pilot study 利用LFP记录优化帕金森病慢性DBS的刺激位置和振幅:一项概念验证的试点研究

Deep Brain Stimulation Pub Date : 2023-08-01 DOI: 10.1016/j.jdbs.2023.05.003

Bart E.K.S. Swinnen , Mariëlle J. Stam , Arthur W.G. Buijink , Martijn G.J. de Neeling , Peter R. Schuurman , Rob M.A. de Bie , Martijn Beudel

{"title":"Employing LFP recording to optimize stimulation location and amplitude in chronic DBS for Parkinson’s disease: A proof-of-concept pilot study","authors":"Bart E.K.S. Swinnen , Mariëlle J. Stam , Arthur W.G. Buijink , Martijn G.J. de Neeling , Peter R. Schuurman , Rob M.A. de Bie , Martijn Beudel","doi":"10.1016/j.jdbs.2023.05.003","DOIUrl":"https://doi.org/10.1016/j.jdbs.2023.05.003","url":null,"abstract":"<div><h3>Objectives</h3><p>Parkinson patients with chronic DBS routinely receive sensing-enabled implantable pulse generators upon battery replacement. Here we aimed to assess whether and/or how local field potential based reprogramming may be of use in this population.</p></div><div><h3>Methods</h3><p>In four Parkinson patients on chronic treatment with bilateral STN-DBS and implanted with the Percept™ PC implantable pulse generator, we employed an approach to select stimulation contacts and amplitudes based on beta-activity. When applicable, the effect of parameter adjustments on DBS effectiveness and DBS-induced side effects was assessed.</p></div><div><h3>Results</h3><p>In one out of eight electrodes, the LFP-guided contact was different from the clinically determined one. Beta-based therapeutic windows could be defined in five out of eight electrodes. LFP-guided parameter adjustments were performed in two patients, resulting in improved motor fluctuations and decreased stimulation-induced side effects respectively.</p></div><div><h3>Discussion</h3><p>LFP-guided DBS reprogramming has the potential to improve effectiveness and decrease side effects in selected cases. Prospective controlled research is required to assess the clinical usefulness of LFP-guided DBS reprogramming.</p></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"2 ","pages":"Pages 1-5"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49750521","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 2

Editorial Deep Brain Stimulation Issue 2 by Dr Yasin Temel & Dr Abdelhamid Benazzouz Yasin Temel博士和Abdelhamid Benazzouz博士撰写的深度脑刺激第2期社论

Deep Brain Stimulation Pub Date : 2023-08-01 DOI: 10.1016/j.jdbs.2023.08.001

Yasin Temel , Abdelhamid Benazzouz

引用次数: 0

An alternative electrode implantation and tethering approach for neuromodulation of non-cranial areas in freely moving rats 自由活动大鼠非颅区神经调节的替代电极植入和栓系方法

Deep Brain Stimulation Pub Date : 2023-08-01 DOI: 10.1016/j.jdbs.2023.05.001

Aryo Zare , Gommert A. van Koeveringe , Celine Meriaux , Yasin Temel , Ali Jahanshahi

{"title":"An alternative electrode implantation and tethering approach for neuromodulation of non-cranial areas in freely moving rats","authors":"Aryo Zare , Gommert A. van Koeveringe , Celine Meriaux , Yasin Temel , Ali Jahanshahi","doi":"10.1016/j.jdbs.2023.05.001","DOIUrl":"https://doi.org/10.1016/j.jdbs.2023.05.001","url":null,"abstract":"<div><p>Electrical stimulation and recording from non-cranial areas in freely moving rodents often require tethered devices for monitoring from a distant location. Inspired by our experience in electrode implantation for deep brain stimulation (DBS), we developed an implantation approach, which allows for performing electrical modulation of the urinary bladder. In order to prevent the wires from being damaged by rats in freely moving conditions and compromising animal welfare, we guided the wires subcutaneously toward the nape to reach a plug, which was mounted on the skull. No complications such as infection, gastrointestinal tract injury, or inflammation occurred during or after surgery. The device allowed easy plugging and unplugging throughout the bladder stimulation and behavioral testing sessions undertaken in freely moving animals. This method enables modulation of peripheral organs in combination with DBS in freely moving rodents and can encompass many procedures such as electrical stimulation and recording, drug delivery, or electromyography.</p></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"2 ","pages":"Pages 15-19"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49750243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of preoperative computed tomography image slice thickness on the planning of deep brain stimulation surgery: A phantom study 术前计算机断层成像层厚度对深部脑刺激手术计划的影响:一项幻象研究

Deep Brain Stimulation Pub Date : 2023-08-01 DOI: 10.1016/j.jdbs.2023.05.004

Felix S. Gubler , Onur Alptekin , Linda Ackermans , Pieter L. Kubben , Mark L. Kuijf , Ersoy Kocabicak , Yasin Temel

{"title":"Impact of preoperative computed tomography image slice thickness on the planning of deep brain stimulation surgery: A phantom study","authors":"Felix S. Gubler , Onur Alptekin , Linda Ackermans , Pieter L. Kubben , Mark L. Kuijf , Ersoy Kocabicak , Yasin Temel","doi":"10.1016/j.jdbs.2023.05.004","DOIUrl":"https://doi.org/10.1016/j.jdbs.2023.05.004","url":null,"abstract":"<div><h3>Background</h3><p>Preoperative Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) coregistration is often applied to perform deep brain stimulation (DBS) surgeries. Thin sliced (high dose) CT is used and recommended because of the high reported accuracy but there are no comparative studies. Thin sliced CT could lead to a higher radiation exposure for the patient in contrast to thicker sliced CT (low dose) due to a longer scanning time. In this study we investigated if the preoperative CT slice thickness had an effect on the registration accuracy in a preoperative simulated DBS setting.</p></div><div><h3>Material and methods</h3><p>An implanted phantom, a Citrullus lanatus (watermelon), was used to acquire an MRI data set (2 millimeter (mm) T2) with a fixed reference point. Two observers targeted the reference point independently and they recorded and compared the coordinates, ring, and arc angles from all coregistered series with different CT slice thicknesses of 0.5 mm, 1 mm, 1.5 mm, 2 mm, 3 mm, 4 mm, and 5 mm. Separately, both MRI and CT were used as reference series for coregistration and analysis. Lastly, inter-observer reliability was calculated with Kendall’s coefficient of concordance (W). With W> 0.9 defined as very good.</p></div><div><h3>Results</h3><p>Our results show no relevant effect on the preoperative registration accuracies for the different CT’s with all absolute differences in mm for the stereotactic coordinates< 0.5 and angles in degrees< 0.4. Additionally, the inter-observer reliability was high (W 0.991).</p></div><div><h3>Conclusion</h3><p>We found no relevant effect of increased slice thickness of preoperative CT on the preoperative registration accuracy in a simulated DBS setting.</p></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"2 ","pages":"Pages 6-14"},"PeriodicalIF":0.0,"publicationDate":"2023-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49750595","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0