scholarly journals Kinematic Adaptive Deep Brain Stimulation for Resting Tremor in Parkinson's Disease

2016 ◽  
Vol 31 (3) ◽  
pp. 426-428 ◽  
Author(s):  
Mahsa Malekmohammadi ◽  
Jeffrey Herron ◽  
Anca Velisar ◽  
Zack Blumenfeld ◽  
Megan H. Trager ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Resting Tremor ◽  
Deep Brain

scholarly journals Independently together: subthalamic theta and beta opposite roles in predicting Parkinson’s tremor

2020 ◽  
Vol 2 (2) ◽  
Author(s):  
Nir Asch ◽  
Yehuda Herschman ◽  
Rotem Maoz ◽  
Carmel R Auerbach-Asch ◽  
Dan Valsky ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Negative Correlation ◽  
Brain Stimulation ◽  
Significant Negative Correlation ◽  
Positive Correlation ◽  
Resting Tremor ◽  
Non Linear ◽  
Deep Brain

Abstract Tremor is a core feature of Parkinson’s disease and the most easily recognized Parkinsonian sign. Nonetheless, its pathophysiology remains poorly understood. Here, we show that multispectral spiking activity in the posterior-dorso-lateral oscillatory (motor) region of the subthalamic nucleus distinguishes resting tremor from the other Parkinsonian motor signs and strongly correlates with its severity. We evaluated microelectrode-spiking activity from the subthalamic dorsolateral oscillatory region of 70 Parkinson’s disease patients who underwent deep brain stimulation surgery (114 subthalamic nuclei, 166 electrode trajectories). We then investigated the relationship between patients’ clinical Unified Parkinson’s Disease Rating Scale score and their peak theta (4–7 Hz) and beta (13–30 Hz) powers. We found a positive correlation between resting tremor and theta activity (r = 0.41, P < 0.01) and a non-significant negative correlation with beta activity (r = −0.2, P = 0.5). Hypothesizing that the two neuronal frequencies mask each other’s relationship with resting tremor, we created a non-linear model of their proportional spectral powers and investigated its relationship with resting tremor. As hypothesized, patients’ proportional scores correlated better than either theta or beta alone (r = 0.54, P < 0.001). However, theta and beta oscillations were frequently temporally correlated (38/70 patients manifested significant positive temporal correlations and 1/70 exhibited significant negative correlation between the two frequency bands). When comparing theta and beta temporal relationship (r θ β) to patients’ resting tremor scores, we found a significant negative correlation between the two (r = −0.38, P < 0.01). Patients manifesting a positive correlation between the two bands (i.e. theta and beta were likely to appear simultaneously) were found to have lower resting tremor scores than those with near-zero correlation values (i.e. theta and beta were likely to appear separately). We therefore created a new model incorporating patients’ proportional theta–beta power and r θ βscores to obtain an improved neural correlate of resting tremor (r = 0.62, P < 0.001). We then used the Akaike and Bayesian information criteria for model selection and found the multispectral model, incorporating theta–beta proportional power and their correlation, to be the best fitting model, with 0.96 and 0.89 probabilities, respectively. Here we found that as theta increases, beta decreases and the two appear separately—resting tremor is worsened. Our results therefore show that theta and beta convey information about resting tremor in opposite ways. Furthermore, the finding that theta and beta coactivity is negatively correlated with resting tremor suggests that theta–beta non-linear scale may be a valuable biomarker for Parkinson’s resting tremor in future adaptive deep brain stimulation techniques.

scholarly journals Deep Brain Stimulation in Sub-Thalamic Nucleus in idiopathic Parkinson’s disease – our initial experience in four cases

2019 ◽  
Vol 9 (1) ◽  
pp. 78-83
Author(s):  
Md Zahid Raihan ◽  
Tipu Zahed Aziz
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Thalamic Nucleus ◽  
Idiopathic Parkinson’S Disease ◽  
Parkinsonian Tremor ◽  
Resting Tremor ◽  
Idiopathic Parkinson's Disease ◽  
Deep Brain

Parkinson’s Disease ( PD ) is a chronic neurodegenerative disease . It’s cardinal features are resting tremor, Rigidity, Akinesia and postural instability. Idiopathic Parkinson’s disease develops mainly due to degeneration of Dopaminergic neurons of Substantia Nigra. The role of Subthalamic Nucleus ( STN ) in the development of Parkinsonian Tremmor and other cardinal features is not completely understood yet. However previous studies in monkeys , administration of MPTP ( 1-methyl-4-phenyl- 1.2.3.6.-tetrahydropyridine ) proved that sub thalamic nucleus has a direct role in the development of Parkinsonian tremor and other features. We used no Micro Electrode Recording (MER) system,only studied clinically that Parkinsonian tremor stopped immediately after placement of electrode and same thing happened after micro stimulation of the sensorymotor region of the sub thalamic nucleus .Then high frequency deep brain stimulation ( DBS ) of these same four patients were assessed six months after surgery which led to a significant reduction of Parkinsonian tremor as well as other cardinal features of PD ( p< 0.001 ) . Both postural and resting tremor disappeared completely in three cases and significantly reduced in one case Bang. J Neurosurgery 2019; 9(1): 78-83

Influence of deep brain stimulation and levodopa on signs and symptoms in Parkinson's disease

2009 ◽  
Vol 36 (S 02) ◽  
Author(s):  
J Gierthmühlen ◽  
P Arning ◽  
G Wasner ◽  
A Binder ◽  
J Herzog ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Signs And Symptoms ◽  
Deep Brain

Visual Effects of Deep Brain Stimulation in a Patient with Parkinson’s Disease

2019 ◽  
pp. 158-173
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Visual System ◽  
Brain Stimulation ◽  
Neurodegenerative Disorder ◽  
Initial Examination ◽  
Before And After ◽  
Deep Brain ◽  
Cover Test

Background: Parkinson’s disease (PD) is a progressive neurodegenerative disorder caused by a dopamine deficiency that presents with motor symptoms. Visual disorders can occur concomitantly but are frequently overlooked. Deep brain stimulation (DBS) has been an effective treatment to improve tremors, stiffness and overall mobility, but little is known about its effects on the visual system. Case Report: A 75-year-old Caucasian male with PD presented with longstanding binocular diplopia. On baseline examination, the best-corrected visual acuity was 20/25 in each eye. On observation, he had noticeable tremors with an unsteady gait. Distance alternating cover test showed exophoria with a right hyperphoria. Near alternating cover test revealed a significantly larger exophoria accompanied by a reduced near point of convergence. Additional testing with a 24-2 Humphrey visual field and optical coherence tomography (OCT) of the nerve and macula were unremarkable. The patient underwent DBS implantation five weeks after initial examination, and the device was activated four weeks thereafter. At follow up, the patient still complained of intermittent diplopia. There was no significant change in the manifest refraction or prism correction. On observation, the patient had remarkably improved tremors with a steady gait. All parameters measured were unchanged. The patient was evaluated again seven months after device activation. Although vergence ranges at all distances were improved, the patient was still symptomatic for intermittent diplopia. OCT scans of the optic nerve showed borderline but symmetric thinning in each eye. All other parameters measured were unchanged. Conclusion: The case found no significant changes on ophthalmic examination after DBS implantation and activation in a patient with PD. To the best of the authors’ knowledge, there are no other cases in the literature that investigated the effects of DBS on the visual system pathway in a patient with PD before and after DBS implantation and activation.

Sign in / Sign up

Export Citation Format

Share Document