Stereotactic and functional neurosurgery
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Stereotact Funct Neurosurg · Jan 2009
Comparative StudyPrognostic factors of subthalamic stimulation in Parkinson's disease: a comparative study between short- and long-term effects.
Bilateral subthalamic nucleus deep brain stimulation (STN-DBS) has been shown to have long-term benefits in Parkinson's disease (PD). Through analyzing different variables, this study identified prognostic factors for the short- and long-term effects of STN-DBS. ⋯ The prognostic factors for STN-DBS benefit were different for short- and long-term follow-ups. Good prognostic factors for long-term STN-DBS for PD patients were good cognitive function and tremor dominance. Poor prognostic factors were related to older age and non-dopaminergic-responsive axial disability.
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Stereotact Funct Neurosurg · Jan 2009
Clinical TrialSpectral analysis of field potential recordings by deep brain stimulation electrode for localization of subthalamic nucleus in patients with Parkinson's disease.
Spectral analysis of local field potential (LFP) recorded by deep brain stimulation (DBS) electrode around the subthalamic nucleus (STN) in patients with Parkinson's disease was performed. ⋯ A spectral power analysis of LFP recording by DBS electrode helps with the final confirmation of the dorsal and ventral borders of the STN of Parkinson's disease in DBS implantation surgery.
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Stereotact Funct Neurosurg · Jan 2008
Comparative StudyEffects of bilateral deep brain stimulation of the subthalamic nucleus on olfactory function in Parkinson's disease patients.
The goal of the present study was to evaluate the effects of bilateral deep brain stimulation (DBS) of the subthalamic nucleus (STN) on olfaction in patients with Parkinson's disease (PD). ⋯ STN DBS can significantly improve olfactory cognitive function in PD patients. The possible mechanisms include an improvement in striatal metabolism and neuronal activity in the orbitofrontal cortex mediated by STN DBS, as well as increased glucose metabolism in the striatum, midbrain, cingulate gyrus, and motor and higher-order somatosensory association cortices.
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Stereotact Funct Neurosurg · Jan 2008
Comparative StudyModeling parkinsonian circuitry and the DBS electrode. II. Evaluation of a computer simulation model of the basal ganglia with and without subthalamic nucleus stimulation.
Treatment with deep brain stimulation (DBS) for Parkinson's disease (PD) has become routine over the past decade, particularly using the subthalamic nucleus (STN) as a target and utilizing microelectrode recordings to ensure accurate placement of the stimulating electrodes. The clinical changes seen with DBS in the STN for PD are consistently beneficial, but there continues to be only marginal understanding of the mechanisms by which DBS achieves these results. Using an analytical model of the typical DBS 4-contact electrode and software developed to simulate individual neurons and neural circuitry of the basal ganglia we compare the results of the model to those of data obtained during DBS surgery of the STN. Firing rate, interspike intervals and regularity analyses were performed on the simulated data and compared to results in the literature.
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Stereotact Funct Neurosurg · Jan 2008
Case ReportsSuccessful bilateral subthalamic nucleus stimulation for segmental dystonia after unilateral pallidotomy.
Several subcortical structures have been targeted for surgical treatment of dystonia, including motor thalamus, internal segment of globus pallidus (GPi), and more recently, the subthalamic nucleus (STN). Deep brain stimulation of GPi is currently the preferred surgical treatment, but it is unclear if targeting other structures would yield better results. Patients who have already had a pallidotomy yet continue to experience dystonic symptoms may be limited in further treatment options. ⋯ This result supports the efficacy of STN deep brain stimulation in dystonia patients, even those with prior pallidotomy.