Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2014
Case Reports Comparative StudyDeep brain stimulation for obsessive-compulsive disorder: is the side relevant?
Deep brain stimulation for obsessive-compulsive disorder (OCD) has targeted several subcortical nuclei, including the subthalamic nucleus (STN) and the nucleus accumbens. While the most appropriate target is still being looked for, little attention has been given to the side of the stimulated hemisphere in relationship to outcome. ⋯ Some reports suggest that lesion stimulation or stimulation of only the right side relieves OCD symptoms. However, anatomical and functional studies are not conclusive as to which side is most affected in OCD. Possibly, each OCD patient has an individualized optimal side to stimulate.
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Stereotact Funct Neurosurg · Jan 2014
Clinical TrialSimultaneous trial of deep brain and motor cortex stimulation in chronic intractable neuropathic pain.
Both motor cortex stimulation (MCS) and deep brain stimulation (DBS) of the ventralis caudalis (Vc) thalamus have been shown to be effective in chronic neuropathic pain, and the modulation of thalamic and thalamocortical activity is regarded as a possible mechanism. Although Vc DBS and MCS have a common analgesic mechanism, the application of MCS and DBS is still considered empirical, and there is no consensus on which method is better. ⋯ Considering the initial success rate and the less invasive nature of epidural MCS compared with DBS, we think that MCS would be a more reasonable initial means of treatment for chronic intractable neuropathic pain.
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Stereotact Funct Neurosurg · Jan 2014
Single-institution retrospective series of gamma knife radiosurgery in the treatment of multiple sclerosis-related trigeminal neuralgia: factors that predict efficacy.
Gamma knife radiosurgery (GKRS) has been reported as a treatment option for multiple sclerosis (MS)-related trigeminal neuralgia. ⋯ GKRS is a viable noninvasive treatment option for MS-related trigeminal neuralgia.
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Stereotact Funct Neurosurg · Jan 2014
Reuse of internal pulse generator in cases of infection after deep brain stimulation surgery.
Hardware-related infection after deep brain stimulation (DBS) is one of the most serious complications and may need additional interventions. ⋯ Management of hardware-related infections can be challenging. The medical and economic costs associated with these infections are enormous. The IPG can often be saved in infected patients. Thus, a significant cost burden is eliminated. Properly executed, reuse of IPG should markedly reduce the costs of these devices.
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Stereotact Funct Neurosurg · Jan 2014
Case ReportsHuman striatum remodelling after neurotransplantation in Huntington's disease.
Restoration of functions in Huntington's disease (HD) by neurotransplantation stems from the formation of a striatum-like structure capable of establishing host connections as a result of grafted striatal neuroblast maturation. For the first time, we demonstrated some developmental steps accomplished by progenitor cells in the brain of an HD patient and analysed the molecular asset of the human primordium. ⋯ The striatal primordium grew into the host brain and this process was associated with metabolic change and some clinical benefit. The study suggests the plasticity and reparative potential of un-manipulated primordium in an era where promising cell-based therapies are still in their infancy.