Optimal Geometry and Stimulating Mechanism of Deep‐brain Electrode—Role of Electrode Contact Geometry

2008 ◽  
Author(s):  
Qin Lian ◽  
Jue Wang ◽  
Hongzhong Liu ◽  
DiChen Li
Keyword(s):  
Contact Geometry ◽  
Optimal Geometry ◽  
Electrode Contact ◽  
Deep Brain

Deep brain stimulation in headache

Cephalalgia ◽  
2016 ◽  
Vol 36 (12) ◽  
pp. 1143-1148 ◽  
Author(s):  
Massimo Leone ◽  
Alberto Proietti Cecchini
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Chronic Cluster Headache ◽  
Hypothalamic Stimulation ◽  
Hypothalamic Area ◽  
Unilateral Headache ◽  
Randomised Controlled ◽  
Invasive Neurostimulation ◽  
Deep Brain

Background: Deep brain stimulation of the posterior hypothalamic area was first introduced in 2000 to treat drug-refractory chronic cluster headache (CH). Findings: So far, hypothalamic stimulation has been employed in 79 patients suffering from various forms of intractable short-lasting unilateral headache forms, mainly trigeminal autonomic cephalalgias. The majority were (88.6%) chronic CH, including one patient who suffered from symptomatic chronic CH-like attacks; the remaining were short-lasting unilateral neuralgiform headache attacks with conjunctival injection and tearing (SUNCT), one had paroxysmal hemicranias and one symptomatic trigeminal neuralgia. Overall, after a mean follow up of 2.2 years, 69.6% (55) hypothalamic-stimulated patients showed a ≥50% improvement. Conclusions: These observations need confirmation in randomised, controlled trials. A key role of the posterior hypothalamic area in the pathophysiology of unilateral short-lasting headaches, possibly by regulating the duration rather than triggering the attacks, can be hypothesised. Because of its invasiveness, hypothalamic stimulation can be proposed only after other, less-invasive, neurostimulation procedures have been tried.

Involvement of Subcortical Structures in the Preparation of Self-Paced Movement

2004 ◽  
Vol 18 (2/3) ◽  
pp. 130-139 ◽  
Author(s):  
Guillermo Paradiso ◽  
Danny Cunic ◽  
Robert Chen
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Basal Ganglia ◽  
Onset Time ◽  
Movement Planning ◽  
Movement Preparation ◽  
Subcortical Structures ◽  
Postoperative Mri ◽  
Deep Brain

Abstract Although it has long been suggested that the basal ganglia and thalamus are involved in movement planning and preparation, there was little direct evidence in humans to support this hypothesis. Deep brain stimulation (DBS) is a well-established treatment for movement disorders such as Parkinson's disease, tremor, and dystonia. In patients undergoing DBS surgery, we recorded simultaneously from scalp contacts and from electrodes surgically implanted in the subthalamic nucleus (STN) of 13 patients with Parkinson's disease and in the “cerebellar” thalamus of 5 patients with tremor. The aim of our studies was to assess the role of the cortico-basal ganglia-thalamocortical loop through the STN and the cerebello-thalamocortical circuit through the “cerebellar” thalamus in movement preparation. The patients were asked to perform self-paced wrist extension movements. All subjects showed a cortical readiness potential (RP) with onset ranging between 1.5 to 2s before the onset of movement. Subcortical RPs were recorded in 11 of 13 with electrodes in the STN and in 4 of 5 patients with electrodes in the thalamus. The onset time of the STN and thalamic RPs were not significantly different from the onset time of the scalp RP. The STN and thalamic RPs were present before both contralateral and ipsilateral hand movements. Postoperative MRI studies showed that contacts with maximum RP amplitude generally were inside the target nucleus. These findings indicate that both the basal ganglia and the cerebellar circuits participate in movement preparation in parallel with the cortex.

Modeling the influence of two terminal electrode contact geometry and sample dimensions in electro‐materials

2018 ◽  
Vol 102 (6) ◽  
pp. 3609-3622 ◽  
Author(s):  
Richard A. Veazey ◽  
Amy S. Gandy ◽  
Derek C. Sinclair ◽  
Julian S. Dean
Keyword(s):  
Contact Geometry ◽  
Electrode Contact

scholarly journals The medial forebrain bundle as a target for deep brain stimulation for obsessive-compulsive disorder

CNS Spectrums ◽  
2016 ◽  
Vol 22 (3) ◽  
pp. 282-289 ◽  
Author(s):  
Volker A. Coenen ◽  
Thomas E. Schlaepfer ◽  
Peter Goll ◽  
Peter C. Reinacher ◽  
Ulrich Voderholzer ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Major Depression ◽  
Brain Stimulation ◽  
Medial Forebrain Bundle ◽  
Reward System ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
Deep Brain

Deep brain stimulation (DBS) is a promising putative modality for the treatment of refractory psychiatric disorders such as major depression and obsessive-compulsive disorder (OCD). Several targets have been posited; however, a clear consensus on differential efficacy and possible modes of action remain unclear. DBS to the supero-lateral branch of the medial forebrain bundle (slMFB) has recently been introduced for major depression (MD). Due to our experience with slMFB stimulation for MD, and because OCD might be related to similar dysfunctions of the reward system, treatment with slMFB DBS seams meaningful. Here we describe our first 2 cases together with a hypothetical mode of action.We describe diffusion tensor imaging (DTI) fiber tractographically (FT)-assisted implantation of the bilateral DBS systems in 2 male patients. In a selected literature overview, we discuss the possible mode of action. Both patients were successfully implanted and stimulated. The follow-up time was 12 months. One patient showed a significant response (Yale–Brown Obsessive-Compulsive Scale [YBOCS] reduction by 35%); the other patient reached remission criteria 3 months after surgery (YBOCS<14) and showed mild OCD just above the remission criterion at 12 months follow-up.While the hypermetabolism theory for OCD involves the cortico–striato–thalamo–cortical (CSTC) network, we think that there is clinical evidence that the reward system plays a crucial role. Our findings suggest an important role of this network in mechanisms of disease development and recovery. In this uncontrolled case series, continuous bilateral DBS to the slMFB led to clinically significant improvements of ratings of OCD severity. Ongoing research focuses on the role of the reward system in OCD, and its yet-underestimated role in this underlying neurobiology of the disease.

Symptomatic Cystic Lesion Following Deep Brain Stimulation Surgery

2020 ◽  
pp. 37-40
Author(s):  
Vibhash D. Sharma ◽  
Shilpa Chitnis
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Rare Complication ◽  
Cyst Formation ◽  
Management Options ◽  
Unexplained Symptoms ◽  
The Common ◽  
Deep Brain Stimulation Surgery ◽  
Deep Brain

Deep brain stimulation therapy is an effective therapy for selected patients with movement disorders. The procedure is relatively safe, but complications related to the surgical procedure or implanted hardware can occur. The common complications include hemorrhage, infarct, infection, and confusion. Noninfectious cyst formation around the DBS lead is a rare but potential complication of this procedure, which can occur several weeks to months after DBS lead implantation. This chapter describes a case of noninfectious cyst formation at the tip of DBS lead in a patient with essential tremor. Clinical presentation, role of imaging, and the management options for this rare complication are discussed. This case also illustrates the importance of post-DBS imaging in suspected cases with new or unexplained symptoms.

Awake Craniotomy for Tumour, Epilepsy, and Functional Neurosurgery

2019 ◽  
pp. 235-244
Author(s):  
Lashmi Venkatraghavan ◽  
Pirjo Manninen
Keyword(s):  
Epilepsy Surgery ◽  
Brain Function ◽  
Anaesthetic Management ◽  
Awake Craniotomy ◽  
Epileptic Focus ◽  
Awake Patient ◽  
Functional Neurosurgery ◽  
Deep Brain Stimulator ◽  
Deep Brain

An awake craniotomy for tumour and epilepsy surgery allows for the mapping of eloquent brain function to minimize its injury and/or for the localization of an epileptic focus. The insertion of deep brain stimulators for the treatment of functional neurosurgical disorders is also frequently performed with an awake patient. The role of the anaesthetist is important in order to have a comfortable and cooperative patient, for the use of appropriate sedation to allow for mapping, and careful vigilance to rapidly diagnose and treat any complication. This chapter discusses the overall rationale for, and the anaesthetic management of, patients undergoing awake craniotomy for tumours, epilepsy surgery, or deep brain stimulator placement.

scholarly journals The Subthalamic Nucleus: Unravelling New Roles and Mechanisms in the Control of Action

2018 ◽  
Vol 25 (1) ◽  
pp. 48-64 ◽  
Author(s):  
Tora Bonnevie ◽  
Kareem A. Zaghloul
Keyword(s):  
Deep Brain Stimulation ◽  
Basal Ganglia ◽  
Subthalamic Nucleus ◽  
Action Control ◽  
Brain Disorders ◽  
Obsessive Compulsive ◽  
Compulsive Disorder ◽  
High Level ◽  
Deep Brain

How do we decide what we do? This is the essence of action control, the process of selecting the most appropriate response among multiple possible choices. Suboptimal action control can involve a failure to initiate or adapt actions, or conversely it can involve making actions impulsively. There has been an increasing focus on the specific role of the subthalamic nucleus (STN) in action control. This has been fueled by the clinical relevance of this basal ganglia nucleus as a target for deep brain stimulation (DBS), primarily in Parkinson’s disease but also in obsessive-compulsive disorder. The context of DBS has opened windows to study STN function in ways that link neuroscientific and clinical fields closely together, contributing to an exceptionally high level of two-way translation. In this review, we first outline the role of the STN in both motor and nonmotor action control, and then discuss how these functions might be implemented by neuronal activity in the STN. Gaining a better understanding of these topics will not only provide important insights into the neurophysiology of action control but also the pathophysiological mechanisms relevant for several brain disorders and their therapies.

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