Deep Brain Stimulation最新文献_第6页

Patient Selection Criteria for Deep Brain Stimulation for Parkinson Disease 帕金森病深部脑刺激的患者选择标准

Deep Brain Stimulation Pub Date : 2020-06-01 DOI: 10.1093/med/9780190647209.003.0008

Laura S. Surillo Dahdah, P. O'Suilleabhain, Hrishikesh Dadhich, Mazen T Elkurd, Shilpa Chitnis, R. Dewey

{"title":"Patient Selection Criteria for Deep Brain Stimulation for Parkinson Disease","authors":"Laura S. Surillo Dahdah, P. O'Suilleabhain, Hrishikesh Dadhich, Mazen T Elkurd, Shilpa Chitnis, R. Dewey","doi":"10.1093/med/9780190647209.003.0008","DOIUrl":"https://doi.org/10.1093/med/9780190647209.003.0008","url":null,"abstract":"Patient selection is critical for optimizing clinical outcomes after deep brain stimulation (DBS) surgery. Patient expectations need to be addressed before DBS surgery to avoid disappointment. There are generally accepted criteria for DBS candidacy for treatment of Parkinson disease (PD), essential tremor (ET), and dystonia. For PD, selection criteria include a diagnosis of idiopathic PD and the presence of disabling or troubling motor symptoms such as motor fluctuations or dyskinesia (despite optimized pharmacologic treatment). Medication-resistant tremor is also an indication. The response of problematic motor symptoms to dopaminergic drugs is an important predictor of DBS response, favoring selection of patients for whom levodopa substantially improves tremor, bradykinesia, and rigidity. Rarely, gait is improved with DBS, and in some cases freezing can improve, although this is not a predictable post-DBS feature. Exclusion criteria include serious medical comorbidities, uncontrolled psychiatric illness (thought and mood disorders), and dementia. Preoperative magnetic resonance imaging with extensive white matter changes, vascular malformations, severe cerebral atrophy, or hydrocephalus can also be exclusions. The patient should clearly understand the risks and benefits of DBS, which should be assessed using a preoperative multidisciplinary evaluation (neurology, neurosurgery, neuropsychology, psychiatry, and rehabilitation). Use of a social worker and/or nutritionist can also be helpful in select cases.","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81459196","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: 1

Genetic Mutations and Deep Brain Stimulation 基因突变和深部脑刺激

Deep Brain Stimulation Pub Date : 2020-06-01 DOI: 10.1093/med/9780190647209.003.0011

J. T. Hinkle, A. Butala, V. Parfenov, Kelly A. Mills, Z. Mari

引用次数: 0

Deep Brain Stimulation Targeting the Ventral Intermediate Nucleus of the Thalamus for Parkinsonian Tremor and Later Adding the Globus Pallidus Interna for Parkinson Disease Features 针对丘脑腹侧中间核的深部脑刺激治疗帕金森性震颤，随后加入内苍白球治疗帕金森病特征

Deep Brain Stimulation Pub Date : 2020-06-01 DOI: 10.1093/med/9780190647209.003.0033

Qiang Zhang, T. Thomsen

{"title":"Deep Brain Stimulation Targeting the Ventral Intermediate Nucleus of the Thalamus for Parkinsonian Tremor and Later Adding the Globus Pallidus Interna for Parkinson Disease Features","authors":"Qiang Zhang, T. Thomsen","doi":"10.1093/med/9780190647209.003.0033","DOIUrl":"https://doi.org/10.1093/med/9780190647209.003.0033","url":null,"abstract":"Deep brain stimulation (DBS) targeting the ventral intermediate (Vim) nucleus of thalamus has been established as an effective therapy for patients with debilitating essential tremor. However, some patients initially diagnosed with essential tremor (ET) later develop idiopathic Parkinson disease (PD), and Vim DBS is not as effective for other PD-related symptoms, including bradykinesia, rigidity, and dyskinesia. This chapter describes a patient with PD who initially presented with debilitating right-dominant tremor that was misdiagnosed as ET. He received bilateral Vim DBS with good tremor control. Two years later, he received bilateral globus pallidus internus (GPi) DBS for progression of his PD, and he has been reporting adequate relief of his PD symptoms. For patients with debilitating tremor, but relatively mild or no parkinsonian symptoms on presentation, after medical trials have been administered, a Vim DBS is a reasonable option for tremor relief. A second DBS placement targeting the GPi or subthalamic nucleus (STN) may be considered if more parkinsonian symptoms evolve and progress.","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83682658","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

Postural Instability and Gait Disorder After Subthalamic Nucleus Deep Brain Stimulation 丘脑下核深部脑刺激后的姿势不稳定和步态障碍

Deep Brain Stimulation Pub Date : 2020-06-01 DOI: 10.1093/med/9780190647209.003.0024

M. Kurtis, J. R. Pérez-Sánchez

引用次数: 0

Freezing of Gait After Bilateral Globus Pallidus Interna Deep Brain Stimulation in Generalized Dystonia 广泛性肌张力障碍患者双侧苍白球深部脑刺激后步态冻结的研究

Deep Brain Stimulation Pub Date : 2020-06-01 DOI: 10.1093/med/9780190647209.003.0021

M. Moscovich

引用次数: 0

Acute Neuropsychiatric Symptoms and Impulse Control Disorders After Subthalamic Nucleus Deep Brain Stimulation 丘脑下核深部脑刺激后的急性神经精神症状和冲动控制障碍

Deep Brain Stimulation Pub Date : 2020-06-01 DOI: 10.1093/med/9780190647209.003.0031

A. Ramirez-Zamora

{"title":"Acute Neuropsychiatric Symptoms and Impulse Control Disorders After Subthalamic Nucleus Deep Brain Stimulation","authors":"A. Ramirez-Zamora","doi":"10.1093/med/9780190647209.003.0031","DOIUrl":"https://doi.org/10.1093/med/9780190647209.003.0031","url":null,"abstract":"Neuropsychiatric symptoms, including impulse control disorders and mood changes, are common nonmotor features across all Parkinson disease (PD) stages. Subthalamic nucleus (STN) deep brain stimulation (DBS) is a safe and well-established treatment for the management of refractory motor fluctuations in PD; however, it has been associated with worsening neuropsychiatric symptoms in the short and long term. Recognizing the occurrence of stimulation-induced behavioral symptoms is critical to implement effective and timely treatment. Most reports indicate that stimulation of the ventral and medial region within the STN and surrounding structures, including the substantia nigra, might account for the occurrence of acute impulsive behaviors and hypomania, requiring adopting different programming strategies aimed at limiting behavioral side effects while reducing parkinsonism. Stimulation of the most dorsal and lateral contacts can mitigate behavioral side effects after STN DBS, but specific treatment needs to be applied based on the patient’s individual neuropsychiatric and motor presentations and specific imaging-based brain localization of DBS lead contacts.","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"68 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87805416","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: 1

4 Intraoperative Imaging-Based Lead Implantation 术中基于成像的导联植入

Deep Brain Stimulation Pub Date : 2019-01-01 DOI: 10.1055/b-0039-168475

引用次数: 0

8 Parkinson’s Disease Application 8帕金森病的应用

Deep Brain Stimulation Pub Date : 2019-01-01 DOI: 10.1055/b-0039-168479

引用次数: 0

Index 指数

Deep Brain Stimulation Pub Date : 2019-01-01 DOI: 10.1055/b-0039-168490

引用次数: 0

17 Deep Brain Stimulation: Techniques and Practice for Pediatrics Indications 脑深部刺激:儿科适应症的技术与实践

Deep Brain Stimulation Pub Date : 2019-01-01 DOI: 10.1055/b-0039-168488

引用次数: 0