scholarly journals Can the Executive Control Network be Used to Diagnose Parkinson’s Disease and as an Efficacy Indicator of Deep Brain Stimulation?

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Wenwen Dong ◽  
Chang Qiu ◽  
Xu Jiang ◽  
Bo Shen ◽  
Li Zhang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Inferior Frontal Gyrus ◽  
Imaging Biomarker ◽  
Posterior Lobe ◽  
Left Inferior Frontal Gyrus ◽  
Before And After ◽  
Deep Brain

Objective. The aim of this work was to investigate whether there are differences in the executive control network (ECN) between patients with Parkinson’s disease (PD) before and after deep brain stimulation (DBS) surgery and to explore how deep brain stimulation (DBS) surgery affects ECN connectivity in patients with PD. Methods. Resting-state magnetic resonance imaging (MRI) data were obtained from 23 patients with Parkinson’s disease preoperatively (pre-PD) and postoperatively (post-PD) and 14 normal controls (CN). The right dorsolateral prefrontal cortex (DLPFC) was used as the seed region of interest (ROI) to study the characteristics of the functional connectivity of the ECN in these subjects. Results. There were differences in the ECN among PD patients before and after surgery and between the CN. Compared with the CN group, the pre-PD patients showed significantly reduced functional connectivity (FC) between the DLPFC and the left inferior frontal gyrus, left precuneus, left cerebellum posterior lobe, right middle frontal gyrus, right inferior parietal gyrus, right posterior central gyrus, right precuneus, and right inferior frontal gyrus. Compared to the CN group, the post-PD patients showed significantly reduced FC between the DLPFC and left inferior frontal gyrus, left precuneus, left cerebellum posterior lobe, right middle frontal gyrus, right inferior frontal gyrus, and right parietal lobule. There is no difference in the ECN between the pre-PD patients and the post-PD patients. Conclusions. The FC of ECN in PD patients was different from that in normal controls, but the FC of the ECN in patients with PD may not be altered by DBS. This suggests that the ECN may be considered an imaging biomarker for the identification of PD but may not be a good imaging biomarker for the evaluation of DBS efficacy.

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.

scholarly journals Personality Changes after Deep Brain Stimulation in Parkinson’s Disease

2015 ◽  
Vol 2015 ◽  
pp. 1-7 ◽  
Author(s):  
Uyen Pham ◽  
Anne-Kristin Solbakk ◽  
Inger-Marie Skogseid ◽  
Mathias Toft ◽  
Are Hugo Pripp ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Sensation Seeking ◽  
Eysenck Personality Questionnaire ◽  
Personality Changes ◽  
Before And After ◽  
Stn Dbs ◽  
Deep Brain

Objectives. Deep brain stimulation of the subthalamic nucleus (STN-DBS) is a recognized therapy that improves motor symptoms in advanced Parkinson’s disease (PD). However, little is known about its impact on personality. To address this topic, we have assessed personality traits before and after STN-DBS in PD patients.Methods. Forty patients with advanced PD were assessed with the Temperament and Character Inventory (TCI): the Urgency, Premeditation, Perseverance, Sensation Seeking impulsive behaviour scale (UPPS), and the Neuroticism and Lie subscales of the Eysenck Personality Questionnaire (EPQ-N, EPQ-L) before surgery and after three months of STN-DBS. Collateral information obtained from the UPPS was also reported.Results. Despite improvement in motor function and reduction in dopaminergic dosage patients reported lower score on the TCI Persistence and Self-Transcendence scales, after three months of STN-DBS, compared to baseline (P=0.006;P=0.024). Relatives reported significantly increased scores on the UPPS Lack of Premeditation scale at follow-up (P=0.027).Conclusion. STN-DBS in PD patients is associated with personality changes in the direction of increased impulsivity.

Trading Vulnerabilities: Living with Parkinson’s Disease before and after Deep Brain Stimulation

2021 ◽  
Vol 30 (4) ◽  
pp. 623-630
Author(s):  
Sara Goering ◽  
Anna Wexler ◽  
Eran Klein
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Medical Devices ◽  
Brain Stimulation ◽  
Health Needs ◽  
Insulin Pumps ◽  
Before And After ◽  
Implanted Medical Devices ◽  
Deep Brain

AbstractImplanted medical devices—for example, cardiac defibrillators, deep brain stimulators, and insulin pumps—offer users the possibility of regaining some control over an increasingly unruly body, the opportunity to become part “cyborg” in service of addressing pressing health needs. We recognize the value and effectiveness of such devices, but call attention to what may be less clear to potential users—that their vulnerabilities may not entirely disappear but instead shift. We explore the kinds of shifting vulnerabilities experienced by people with Parkinson’s disease (PD) who receive therapeutic deep brain stimulators to help control their tremors and other symptoms of PD.

scholarly journals Impact of deep brain stimulation on people with Parkinson’s disease: A mixed methods feasibility study exploring lifespace and community outcomes

2019 ◽  
Vol 32 (2) ◽  
pp. 97-107
Author(s):  
Jacki Liddle ◽  
Amreetaa Sundraraj ◽  
David Ireland ◽  
Sally Bennett ◽  
Tereza Stillerova ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Mixed Methods ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Qualitative Data ◽  
Structured Interviews ◽  
Before And After ◽  
Community Outcomes ◽  
Deep Brain

Background Deep brain stimulation is a surgical treatment for Parkinson’s disease. Its impacts on motor symptoms are widely reported; however, little is known about the broader impact of deep brain stimulation on the community lives of people with Parkinson’s disease. Lifespace is a measure of lived community mobility, providing an indication of community access and participation. Aims This pilot study explored the feasibility of remotely monitoring the qualitative and quantitative community outcomes related to deep brain stimulation. Methods A longitudinal mixed methods study with a convergent design was undertaken exploring the lifespace, quality of life, life satisfaction and lived experiences of people with Parkinson’s disease before and after deep brain stimulation. Data were collected through questionnaires, semi-structured interviews and a smartphone-based application which collected geolocation data. Results Quantitative and qualitative data from eight participants living with Parkinson’s disease were analysed and integrated. At baseline, participants had a median age of 68 years and a median Hoehn and Yahr score of 2. Measuring a range of community-based outcomes indicated different change trajectories for individuals across outcomes. Key content areas were developed from the qualitative data: participation in occupations and travel and home. This study indicates the potential value of including geolocation data-based lifespace collection in metropolitan and regional areas. Conclusions Monitoring lifespace in conjunction with subjective measures provides insights into the complex and individually varied experiences. Further research could explore the impacts of deep brain stimulation on occupations and community participation to gain a deeper understanding of the related needs and support clinical approaches.

Comparison of dysphagia before and after deep brain stimulation in Parkinson's disease

2012 ◽  
Vol 27 (14) ◽  
pp. 1763-1768 ◽  
Author(s):  
Alice K. Silbergleit ◽  
Peter LeWitt ◽  
Fred Junn ◽  
Lonni R. Schultz ◽  
Denise Collins ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Before And After ◽  
Deep Brain

scholarly journals Sleep electroencephalographic asymmetry in Parkinson's disease patients before and after deep brain stimulation

2021 ◽  
Vol 132 (4) ◽  
pp. 857-863
Author(s):  
Georgia Sousouri ◽  
Christian R. Baumann ◽  
Lukas L. Imbach ◽  
Reto Huber ◽  
Esther Werth
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Before And After ◽  
Deep Brain

scholarly journals Subthalamic stimulation impairs stopping of ongoing movements

Brain ◽  
2020 ◽  
Author(s):  
Roxanne Lofredi ◽  
Georg Cem Auernig ◽  
Friederike Irmen ◽  
Johanna Nieweler ◽  
Wolf-Julian Neumann ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Right Hemisphere ◽  
Inferior Frontal Gyrus ◽  
Motor Area ◽  
Subthalamic Stimulation ◽  
The Right ◽  
Deep Brain

Abstract The subthalamic nucleus is part of a global stopping network that also includes the presupplementary motor area and inferior frontal gyrus of the right hemisphere. In Parkinson’s disease, subthalamic deep brain stimulation improves movement initiation and velocity, but its effect on stopping of ongoing movement is unknown. Here, we examine the relation between movement stopping and connectivity of stimulation volumes to the stopping network. Stop and go times were collected in 17 patients with Parkinson’s disease on and off subthalamic stimulation during visually cued initiation and termination of continuous, rotational movements. Deep brain stimulation contacts were localized; the stimulation volume computed and connectivity profiles estimated using an openly available, normative structural connectome. Subthalamic stimulation significantly increased stop times, which correlated with the connectivity of the stimulation volume to presupplementary motor area and inferior frontal gyrus of the right hemisphere. The robustness of this finding was validated using three separate analysis streams: voxel-wise whole-brain connectivity, region of interest connectivity and a tract-centred method. Our study sheds light on the role of the fronto-subthalamic inhibitory triangle in stopping of ongoing movements and may inspire circuit based adaptive stimulation strategies for control of stopping impairment, possibly reflected in stimulation-induced dyskinesia.

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