Clinical outcome of deep brain stimulation for dystonia: constant-current or constant-voltage stimulation? A non-randomized study

2014 ◽  
Vol 22 (6) ◽  
pp. 919-926 ◽  
Author(s):  
C. Lettieri ◽  
S. Rinaldo ◽  
G. Devigili ◽  
F. Pisa ◽  
M. Mucchiut ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Clinical Outcome ◽  
Brain Stimulation ◽  
Randomized Study ◽  
Constant Current ◽  
Constant Voltage ◽  
Deep Brain

Constant Current versus Constant Voltage Subthalamic Nucleus Deep Brain Stimulation in Parkinson's Disease

2015 ◽  
Vol 93 (2) ◽  
pp. 114-121 ◽  
Author(s):  
Fernando Ramirez de Noriega ◽  
Renana Eitan ◽  
Odeya Marmor ◽  
Adi Lavi ◽  
Eduard Linetzky ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Subthalamic Nucleus ◽  
Brain Stimulation ◽  
Constant Current ◽  
Constant Voltage ◽  
Deep Brain

Mapping efficacious deep brain stimulation for pediatric dystonia

2021 ◽  
pp. 1-11
Author(s):  
Ailish Coblentz ◽  
Gavin J. B. Elias ◽  
Alexandre Boutet ◽  
Jurgen Germann ◽  
Musleh Algarni ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Clinical Outcome ◽  
Brain Stimulation ◽  
Pediatric Patients ◽  
Rating Scale ◽  
Structural Connectivity ◽  
Response To Treatment ◽  
Internal Globus Pallidus ◽  
Probabilistic Map ◽  
Deep Brain

OBJECTIVEThe objective of this study was to report the authors’ experience with deep brain stimulation (DBS) of the internal globus pallidus (GPi) as a treatment for pediatric dystonia, and to elucidate substrates underlying clinical outcome using state-of-the-art neuroimaging techniques.METHODSA retrospective analysis was conducted in 11 pediatric patients (6 girls and 5 boys, mean age 12 ± 4 years) with medically refractory dystonia who underwent GPi-DBS implantation between June 2009 and September 2017. Using pre- and postoperative MRI, volumes of tissue activated were modeled and weighted by clinical outcome to identify brain regions associated with clinical outcome. Functional and structural networks associated with clinical benefits were also determined using large-scale normative data sets.RESULTSA total of 21 implanted leads were analyzed in 11 patients. The average follow-up duration was 19 ± 20 months (median 5 months). Using a 7-point clinical rating scale, 10 patients showed response to treatment, as defined by scores < 3. The mean improvement in the Burke-Fahn-Marsden Dystonia Rating Scale motor score was 40% ± 23%. The probabilistic map of efficacy showed that the voxel cluster most associated with clinical improvement was located at the posterior aspect of the GPi, comparatively posterior and superior to the coordinates of the classic GPi target. Strong functional and structural connectivity was evident between the probabilistic map and areas such as the precentral and postcentral gyri, parietooccipital cortex, and brainstem.CONCLUSIONSThis study reported on a series of pediatric patients with dystonia in whom GPi-DBS resulted in variable clinical benefit and described a clinically favorable stimulation site for this cohort, as well as its structural and functional connectivity. This information could be valuable for improving surgical planning, simplifying programming, and further informing disease pathophysiology.

scholarly journals Clinically Weighted Probabilistic Tractography Mapping of Therapeutic Thalamic Deep Brain Stimulation for Essential Tremor

Neurosurgery ◽  
2019 ◽  
Vol 66 (Supplement_1) ◽  
Author(s):  
Evangelia Tsolaki ◽  
Alon Kashanian ◽  
Nader Pouratian
Keyword(s):  
Deep Brain Stimulation ◽  
Clinical Outcome ◽  
Essential Tremor ◽  
Clinical Improvement ◽  
Brain Stimulation ◽  
Structural Connectivity ◽  
Precentral Gyrus ◽  
Probabilistic Tractography ◽  
Whole Brain ◽  
Deep Brain

Abstract INTRODUCTION Traditional targeting methods rely on indirect targeting with atlas-defined coordinates that induce interpatient anatomical and functional variability. Precise targeting is crucial for successful surgical intervention associated with improved surgical outcomes. Here, we use clinically weighted probabilistic tractography to investigate the connectivity from volume of tissue activated (VTA) to whole brain in order to evaluate the relationship between structural connectivity and clinical outcome of patients that underwent thalamic deep brain stimulation (DBS). METHODS Magnetic resonance imaging and clinical outcomes from 10 essential tremor (ET) patients who were treated by VIM-DBS at the University of California Los Angeles were evaluated. LeadBDS was used for the VTA calculation and FSL was used to evaluate the whole brain probabilistic tractography of VTA. Tractography maps were binarized and weighted based on the percent of clinical improvement using the Fahn-Tolosa-Martin Tremor Rating Score. The resulting clinically weighted maps were non-linearly fused to MNI space and averaged. These population maps provide a voxel-by-voxel map of the average clinical improvement observed when the VTA demonstrates structural connectivity to the whole brain. RESULTS The VTA connectivity to the whole brain was delineated. Superior clinical improvement was associated with connectivity to voxels connecting the thalamus to the precentral gyrus and to the brainstem/cerebellum. Also, the clinical efficacy map showed that patients with higher clinical improvement (>70%) presented stronger structural connectivity to the precentral gyrus and to the caudal projection to the cerebellum. CONCLUSION Stronger connectivity to the precentral gyrus and to brainstem/cerebellum is associated with superior clinical outcome in thalamic DBS for ET. In the future, rather than focusing on connectivity to predetermined targets, these clinically weighted tractography maps can be used with a reverse algorithm to identify the optimal region of the thalamus to provide clinically superior results.

scholarly journals Constant current stimulation may improve apraxia of eyelid opening induced by deep brain stimulation

2020 ◽  
Vol 19 ◽  
pp. 100565
Author(s):  
Katsuki Eguchi ◽  
Ichiro Yabe ◽  
Shinichi Shirai ◽  
Ikuko Iwata ◽  
Masaaki Matsushima ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Constant Current ◽  
Constant Current Stimulation ◽  
Deep Brain

scholarly journals Frameless stereotaxy in subthalamic deep brain stimulation: 3-year clinical outcome

2020 ◽  
Author(s):  
Carla Piano ◽  
Francesco Bove ◽  
Delia Mulas ◽  
Anna Rita Bentivoglio ◽  
Beatrice Cioni ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Clinical Outcome ◽  
Brain Stimulation ◽  
Frameless Stereotaxy ◽  
Deep Brain
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