Effects of Relative Low-Frequency Bilateral Globus Pallidus Internus Stimulation for Treatment of Cervical Dystonia

2012 ◽  
Vol 90 (1) ◽  
pp. 30-36 ◽  
Author(s):  
Joo Pyung Kim ◽  
Won Seok Chang ◽  
Young Seok Park ◽  
Jin Woo Chang
Keyword(s):  
Globus Pallidus ◽  
Cervical Dystonia ◽  
Low Frequency ◽  
Globus Pallidus Internus

Location of Active Contacts in Patients with Primary Dystonia Treated with Globus Pallidus Deep Brain Stimulation

2008 ◽  
Vol 62 (suppl_1) ◽  
pp. ONS217-ONS225 ◽  
Author(s):  
Clement Hamani ◽  
Elena Moro ◽  
Cindy Zadikoff ◽  
Yu-Yan Poon ◽  
Andres M. Lozano
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Cervical Dystonia ◽  
Rating Scale ◽  
Globus Pallidus Internus ◽  
Generalized Dystonia ◽  
Deep Brain

Abstract Objective: Deep brain stimulation of the globus pallidus internus has been used for the treatment of various forms of dystonia, but the factors influencing postoperative outcomes remain unknown. We compared the location of the contacts being used for stimulation (active contacts) in patients with cervical dystonia, generalized dystonia, and Parkinson's disease and correlated the results with clinical outcome. Methods: Postoperative magnetic resonance scans of 13 patients with cervical dystonia, six patients with generalized dystonia, and five patients with Parkinson's disease who underwent globus pallidus internus deep brain stimulation were analyzed. We assessed the location of the active contacts relative to the midcommisural point and in relation to the anteroposterior and mediolateral boundaries of the pallidum. Postoperative outcome was measured with the Toronto Western Spasmodic Torticollis Rating Scale (for cervical dystonia) and the Burke-Fahn-Marsden Dystonia Rating Scale (for generalized dystonia) during the last follow-up. Results: We found that the location of the active contacts relative to the midcom-misural point and the internal boundaries of the pallidum was similar across the groups. In our series, the contacts used for stimulation were clustered in the posterolateral region of the pallidum. Within that region, we found no correlation between the location of the contacts and postoperative outcome. Conclusion: The location of the active contacts used for globus pallidus internus deep brain stimulation was similar in patients with cervical dystonia, generalized dystonia, and Parkinson's disease.

scholarly journals Functional Neural Changes after Low-Frequency Bilateral Globus Pallidus Internus Deep Brain Stimulation for Post-Hypoxic Cortical Myoclonus: Voxel-Based Subtraction Analysis of Serial Positron Emission

2020 ◽  
Vol 10 (10) ◽  
pp. 730
Author(s):  
Myung Ji Kim ◽  
So Hee Park ◽  
Kyoung Heo ◽  
Jin Woo Chang ◽  
Joong Il Kim ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Globus Pallidus ◽  
Brain Stimulation ◽  
Statistical Parametric Mapping ◽  
Low Frequency ◽  
Globus Pallidus Internus ◽  
Hypoxic Event ◽  
Positron Emission ◽  
Study Results ◽  
Deep Brain

Post-hypoxic myoclonus (PHM) and Lance–Adams syndrome (LAS) are rare conditions following cardiopulmonary resuscitation. The aim of this study was to identify functional activity in the cerebral cortex after a hypoxic event and to investigate alterations that could be modulated by deep brain stimulation (DBS). A voxel-based subtraction analysis of serial positron emission tomography (PET) scans was performed in a 34-year-old woman with chronic medically refractory PHM that improved with bilateral globus pallidus internus (Gpi) DBS implanted three years after the hypoxic event. The patient required low-frequency stimulation to show myoclonus improvement. Using voxel-based statistical parametric mapping, we identified a decrease in glucose metabolism in the prefrontal lobe including the dorsolateral, orbito-, and inferior prefrontal cortex, which was suspected to be the origin of the myoclonus from postoperative PET/magnetic resonance imaging (MRI) after DBS. Based on the present study results, voxel-based subtraction of PET appears to be a useful approach for monitoring patients with PHM treated with DBS. Further investigation and continuous follow-up on the use of PET analysis and DBS treatment for patients with PHM are necessary to help understanding the pathophysiology of PHM, or LAS.

scholarly journals Neuronal Firing Rates and Patterns in the Globus Pallidus Internus of Patients With Cervical Dystonia Differ From Those With Parkinson's Disease

2007 ◽  
Vol 98 (2) ◽  
pp. 720-729 ◽  
Author(s):  
Joyce K. H. Tang ◽  
Elena Moro ◽  
Neil Mahant ◽  
William D. Hutchison ◽  
Anthony E. Lang ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Firing Rate ◽  
Globus Pallidus ◽  
Cervical Dystonia ◽  
Neuronal Firing ◽  
Globus Pallidus Internus ◽  
Motor Symptoms ◽  
Firing Rates ◽  
Irregular Pattern

Cervical dystonia (CD) is a movement disorder that involves involuntary turning and twisting of the neck caused by abnormal muscle contraction. Deep brain stimulation (DBS) in the globus pallidus internus (GPi) is used to treat both CD and the motor symptoms of Parkinson's disease (PD). It has been suggested that the differing motor symptoms in CD and PD may arise from a decreased GPi output in CD and elevation of output in PD. To test this hypothesis, extracellular recordings of GPi neuronal activity were obtained during stereotactic surgery for the implantation of DBS electrodes in seven idiopathic CD and 14 PD patients. The mean GPi neuronal firing rate recorded from CD patients was lower than that in PD patients ( P < 0.001; means ± SE: 71.4 ± 2.2 and 91.7 ± 3.0 Hz, respectively). Furthermore, GPi neurons fired in a more irregular pattern consisting of more frequent and longer pauses in CD compared with PD patients. When comparisons were done based on locations of recordings, these differences in firing rates and patterns were limited to the ventral portion of the GPi. In contrast, no difference in firing rate or pattern was observed in the globus pallidus externus between the two groups. These findings suggest that alterations in both firing rate and firing pattern may underlie the differing motor symptoms associated with these two movement disorders.

Long-term follow-up study of chronic globus pallidus internus stimulation for posttraumatic hemidystonia

2000 ◽  
Vol 92 (3) ◽  
pp. 457-460 ◽  
Author(s):  
Thomas J. Loher ◽  
Mustafa G. Hasdemir ◽  
Jean-Marc Burgunder ◽  
Joachim K. Krauss
Keyword(s):  
Globus Pallidus ◽  
Right Hemisphere ◽  
Low Frequency ◽  
Globus Pallidus Internus ◽  
Content Type ◽  
First Case ◽  
Long Term Follow Up ◽  
The Right

✓ The authors report the first case of chronic globus pallidus internus (GPi) stimulation for treatment of medically intractable hemidystonia for which long-term follow-up data are available. The patient had developed left-sided low-frequency tremor and hemidystonia after a severe head trauma sustained at 15 years of age. He experienced relief of the tremor but not of the hemidystonia after a thalamotomy was performed in the right hemisphere 3 years postinjury. When the patient was 24 years old, the authors performed a magnetic resonance-guided stereotactic implantation of a monopolar electrode in the right-sided posteroventral GPi. Chronic deep brain stimulation resulted in remarkable improvement of dystonia-associated pain, phasic dystonic movements, and dystonic posture, which was accompanied by functional gain. Postoperative improvement was sustained after 4 years of follow up. Chronic GPi stimulation appears to be a valuable treatment option for posttraumatic dystonia.

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