Neuromodulation : journal of the International Neuromodulation Society
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Randomized Controlled Trial
The Effect of Uni- and Bilateral Thalamic Deep Brain Stimulation on Speech in Patients With Essential Tremor: Acoustics and Intelligibility.
Deep brain stimulation (DBS) of the ventral intermediate nucleus (VIM) is performed to suppress medically-resistant essential tremor (ET). However, stimulation induced dysarthria (SID) is a common side effect, limiting the extent to which tremor can be suppressed. To date, the exact pathogenesis of SID in VIM-DBS treated ET patients is unknown. ⋯ Our data confirms that SID is more pronounced under bilateral compared to unilateral stimulation. Laterally located electrodes are associated with more severe SID according to patient's self-ratings. We can confirm the relation between diadochokinetic rate and SID in that listener's tempo and intelligibility ratings can be predicted by measured syllable durations from DDK tasks.
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Randomized Controlled Trial
Subthalamic Nucleus Deep Brain Stimulation Alters Prefrontal Correlates of Emotion Induction.
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) improves motor symptoms in advanced Parkinson's disease. STN DBS may also affect emotion, possibly by impacting a parallel limbic cortico-striatal circuit. The objective of this study was to investigate changes in prefrontal cortical activity related to DBS during an emotion induction task. ⋯ These results suggest that STN stimulation influences the prefrontal cortical representation of positive and negative emotion induction.
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Spinal cord stimulation (SCS) is an effective method of treating chronic pain. Obese patients are overrepresented in chronic pain cases. We examine the effect of body mass index (BMI) on SCS success. ⋯ Each group experienced successful surgical outcomes. High BMI patients had less BDI improvement at six months and one year and less PCS improvement at one year. These data aid us in counseling our patients preoperatively.
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Observational Study
A Single Center Prospective Observational Study of Outcomes With Tonic Cervical Spinal Cord Stimulation.
Spinal cord stimulation (SCS) has been a valuable resource for the treatment of chronic, nonmalignant pain that persists in the face of maximal medical management. A recent study demonstrated efficacy of cervical SCS in a multicenter registry. Here, in our single center study, we are able to delve into patient specifics, explore outcomes with percutaneous vs. paddle implants, and examine impact of patient symptomatology. ⋯ We demonstrate that neck and arm pain can be improved with cervical SCS at six month and one-year follow-ups. Both percutaneous and paddle implants have benefit. We tend to place percutaneous implants for radicular pain and retrograde C1-2 paddles for axial pain that is ineffectively treated during the trial.