The Experts below are selected from a list of 45138 Experts worldwide ranked by ideXlab platform
Damiaan Denys - One of the best experts on this subject based on the ideXlab platform.
-
Is Deep Brain Stimulation a treatment option for addiction?
Addiction, 2015Co-Authors: Judy Luigjes, Jens Kuhn, P. Richard Schuurman, Wim Van Den Brink, Damiaan DenysAbstract:Keywords: Addiction; Deep Brain Stimulation; feasibility; neuromodulation; recruitment; substance dependence
-
Neuroimaging Deep Brain Stimulation in psychiatric disorders.
Deep Brain Stimulation, 2012Co-Authors: Martijn Figee, P. Richard Schuurman, Pepijn Van Den Munckhof, Damiaan DenysAbstract:Neuroimaging may help us understand the mechanism of action of Deep Brain Stimulation for the treatment of psychiatric disorders at existing targets and to explore other targets. To this end, we discuss structural and functional imaging studies of obsessive–compulsive disorder, major depressive disorder, Tourette syndrome, and addiction, and the neuroanatomical changes in these disorders induced by Deep Brain Stimulation.
-
Deep Brain Stimulation in obsessive-compulsive disorder
Current psychiatry reports, 2009Co-Authors: Dan J. Stein, Damiaan DenysAbstract:Abstract The use of Deep Brain Stimulation in psychiatric disorders has received great interest owing to the small risk of the operation, the reversible nature of the technique, and the possibility of optimizing treatment postoperatively. Currently, Deep Brain Stimulation in psychiatry is investigated for obsessive–compulsive disorder, Gilles de la Tourette's syndrome, and major depression. This chapter reviews the application of Deep Brain Stimulation in obsessive–compulsive disorder. Preliminary results suggest that Deep Brain Stimulation in obsessive–compulsive disorder can effectuate a decrease of 40–60% in at least half of the patients. Although various side effects occur, most of these are transitory and linked to specific Stimulation parameters which can be changed. Because only a few studies have been performed with a limited number of patients in accordance with varying research protocols, appliance of Deep Brain Stimulation to obsessive–compulsive disorder is still at an experimental stage. The speed of the effect of Deep Brain Stimulation causes fundamental assumptions on the pathophysiology of obsessive–compulsive disorder.
Thomas Foltynie - One of the best experts on this subject based on the ideXlab platform.
-
efficacy and safety of Deep Brain Stimulation in tourette syndrome the international tourette syndrome Deep Brain Stimulation public database and registry
JAMA Neurology, 2018Co-Authors: Daniel Martinezramirez, Jens Kuhn, Fangang Meng, Joohi Jimenezshahed, James F Leckman, Mauro Porta, Domenico Servello, Daniel Huys, Juan Carlos Baldermann, Thomas FoltynieAbstract:IMPORTANCE Collective evidence has strongly suggested that Deep Brain Stimulation (DBS) is a promising therapy for Tourette syndrome.OBJECTIVE To assess the efficacy and safety of DBS in a multinat ...
-
Deep Brain Stimulation in the treatment of chorea
Movement Disorders, 2012Co-Authors: Thomas C Edwards, Patricia Limousin, Ludvic Zrinzo, Thomas FoltynieAbstract:Deep Brain Stimulation has been used as a means of reducing dyskinesias in various conditions, including Parkinson's disease and dystonia for many years. Recently, owing to the clinical similarities between L-dopa induced dyskinesia and chorea, Deep Brain Stimulation has now been implemented as a novel treatment method in both Huntington's disease and neuroacanthocytosis, and a paucity of case studies exist reporting its efficacy. This review will summarize the case studies of Deep Brain Stimulation in both Huntington's disease and neuroacanthocytosis, and discuss the possible implications and limitations associated with these reports. As both these disorders are often refractory to medication and difficult to treat, Deep Brain Stimulation may be a useful treatment option in the future.
-
Functional imaging of subthalamic nucleus Deep Brain Stimulation in Parkinson's disease.
Movement disorders : official journal of the Movement Disorder Society, 2011Co-Authors: Tessel M. Boertien, Patricia Limousin, Ludvic Zrinzo, Joshua Kahan, Marjan Jahanshahi, Marwan Hariz, Laura Mancini, Thomas FoltynieAbstract:Deep Brain Stimulation of the subtha- lamic nucleus is an accepted treatment for the motor complications of Parkinson's disease. The therapeutic mechanism of action remains incompletely understood. Although the results of Deep Brain Stimulation are similar to the results that can be obtained by lesional surgery, accumulating evidence from functional imaging and clini- cal neurophysiology suggests that the effects of subtha- lamic nucleus-Deep Brain Stimulation are not simply the result of inhibition of subthalamic nucleus activity. Posi- tron emission tomography/single-photon emission com- puted tomography has consistently demonstrated changes in cortical activation in response to subthalamic nucleus-Deep Brain Stimulation. However, the technique has limited spatial and temporal resolution, and therefore the changes in activity of subcortical projection sites of the subthalamic nucleus (such as the globus pallidus, substantia nigra, and thalamus) are not as clear. Clarify- ing whether clinically relevant effects from subthalamic nucleus-Deep Brain Stimulation in humans are mediated through inhibition or excitation of orthodromic or anti- dromic pathways (or both) would contribute to our understanding of the precise mechanism of action of Deep Brain Stimulation and may allow improvements in safety and efficacy of the technique. In this review we discuss the published evidence from functional imaging studies of patients with subthalamic nucleus-Deep Brain Stimulation to date, together with how these data inform the mechanism of action of Deep Brain Stimulation. V C 2011 Movement Disorder Society
Andres M. Lozano - One of the best experts on this subject based on the ideXlab platform.
-
Deep Brain Stimulation therapy.
BMJ (Clinical research ed.), 2012Co-Authors: Andres M. LozanoAbstract:Effectively treats movement disorders and could work in neuropsychiatric conditions Neurological and psychiatric illnesses continue to cause major disability despite currently available treatment options. With this background of unmet treatment need, important advances in structural and functional Brain imaging, the understanding of the circuitry of neurological disease, and neurosurgical techniques and equipment have led to the emergence of Deep Brain Stimulation (DBS) as an effective therapeutic option. Deep Brain Stimulation was first tested in animal experiments about 70 years ago and has been used in human subjects, mainly to treat movement disorders—particularly Parkinson’s disease—for the past 20 years. It is now available in most major medical centres. More than 80 000 patients have undergone such Stimulation to date,1 and 8000-10 000 new patients are treated each year. Deep Brain Stimulation involves implanting indwelling electrodes within specific Brain circuits to modulate the activity of those circuits, either to suppress pathological neuronal activity or to drive underactive output; an analogy would be moving the dial to a chosen radio station and adjusting the volume when the sound is too low …
-
Deep Brain Stimulation: emerging indications
Progress in brain research, 2011Co-Authors: Travis S. Tierney, Tejas Sankar, Andres M. LozanoAbstract:There are a number of emerging surgical indications for Deep Brain Stimulation. We have shown that modulation of activity within motor, mood, and cognitive circuits has beneficial effects in patients with Parkinson's disease, treatment-resistant depression, and perhaps Alzheimer's type dementia. We review the rationale, safety, and efficacy for each of these indications, focusing on disease mechanisms and relevant data that are necessary to document therapeutic value in each case. The review closes with some thoughts on possible future directions for Deep Brain Stimulation. It is likely that applications for Deep Brain Stimulation will continue to expand as accumulating data establish its safety and efficacy profile in these and other conditions.
-
Basal ganglia physiology and Deep Brain Stimulation.
Movement disorders : official journal of the Movement Disorder Society, 2010Co-Authors: Andres M. Lozano, Brian J Snyder, Clement Hamani, William D Hutchison, Jonathan O DostrovskyAbstract:Despite improvements in anatomic imaging of the basal ganglia, microelectrode recording is still an invaluable tool in locating appropriate targets for neurosurgical intervention. These recording also provide an unparalleled opportunity to study the pathophysiological aspects of diseases. This article reviews the principles of microelectrode recording in functional neurosurgery and discusses the pathologic neurophysiologic findings commonly encountered. It also highlights some of the potential mechanisms of action of both dopaminergic drugs and Deep Brain Stimulation. In addition we review the recent work on pedunculopontine nucleus neurophysiology and trials of Deep Brain Stimulation in that region for gait disturbances in Parkinson's disease.
-
Deep Brain Stimulation for Tourette Syndrome
NEJM Journal Watch, 2008Co-Authors: Andres M. Lozano, FrcscAbstract:This is a report of experience with Deep Brain Stimulation (DBS) in 18 patients with severe Gilles de la Tourette syndrome that was refractory to
-
memory enhancement induced by hypothalamic fornix Deep Brain Stimulation
Annals of Neurology, 2008Co-Authors: Clement Hamani, Mary Pat Mcandrews, Melanie Cohn, Dominik Zumsteg, Colin M Shapiro, Richard Wennberg, Andres M. LozanoAbstract:Bilateral hypothalamic Deep Brain Stimulation was performed to treat a patient with morbid obesity. We observed, quite unexpectedly, that Stimulation evoked detailed autobiographical memories. Associative memory tasks conducted in a double-blinded “on” versus “off” manner demonstrated that Stimulation increased recollection but not familiarity-based recognition, indicating a functional engagement of the hippocampus. Electroencephalographic source localization showed that hypothalamic Deep Brain Stimulation drove activity in mesial temporal lobe structures. This shows that hypothalamic Stimulation in this patient modulates limbic activity and improves certain memory functions. Ann Neurol 2008;63:119–123
Patricia Limousin - One of the best experts on this subject based on the ideXlab platform.
-
Deep Brain Stimulation in the treatment of chorea
Movement Disorders, 2012Co-Authors: Thomas C Edwards, Patricia Limousin, Ludvic Zrinzo, Thomas FoltynieAbstract:Deep Brain Stimulation has been used as a means of reducing dyskinesias in various conditions, including Parkinson's disease and dystonia for many years. Recently, owing to the clinical similarities between L-dopa induced dyskinesia and chorea, Deep Brain Stimulation has now been implemented as a novel treatment method in both Huntington's disease and neuroacanthocytosis, and a paucity of case studies exist reporting its efficacy. This review will summarize the case studies of Deep Brain Stimulation in both Huntington's disease and neuroacanthocytosis, and discuss the possible implications and limitations associated with these reports. As both these disorders are often refractory to medication and difficult to treat, Deep Brain Stimulation may be a useful treatment option in the future.
-
shaping reversibility long term Deep Brain Stimulation in dystonia the relationship between effects on electrophysiology and clinical symptoms
Brain, 2011Co-Authors: Diane Ruge, Patricia Limousin, Marwan Hariz, Victoria Gonzalez, Xavier Vasques, Philippe Coubes, John C RothwellAbstract:Long-term results show that benefits from chronic Deep Brain Stimulation in dystonia are maintained for many years. Despite this, the neurophysiological long-term consequences of treatment and their relationship to clinical effects are not well understood. Previous studies have shown that transcranial magnetic Stimulation measures of abnormal long-term potentiation-like plasticity (paired associative Stimulation) and GABAa-ergic inhibition (short-interval intracortical inhibition), which are seen in dystonia, normalize after several months of Deep Brain Stimulation. In the present study, we examine the same measures in a homogenous group of 10 DYT1 gene-positive patients after long-term Deep Brain Stimulation treatment for at least 4.5 years. Recordings were made 'on' Deep Brain Stimulation and after stopping Deep Brain Stimulation for 2 days. The results show that: (i) on average, prior to discontinuing Deep Brain Stimulation, the paired associative Stimulation response was almost absent and short-interval intracortical inhibition was reduced compared with normal. This pattern differs from that in both healthy volunteers and from the typical pattern of enhanced plasticity and reduced inhibition seen in Deep Brain Stimulation-naive dystonia. It is similar to that seen in untreated Parkinson's disease and may relate to thus far unexplained clinical phenomena like parkinsonian symptoms that have sometimes been observed in patients treated with Deep Brain Stimulation. (ii) Overall, there was no change in average physiological or clinical status when Deep Brain Stimulation was turned off for 2 days, suggesting that Deep Brain Stimulation had produced long-term neural reorganization in the motor system. (iii) However, there was considerable variation between patients. Those who had higher levels of plasticity when Deep Brain Stimulation was 'on', had the best retention of clinical benefit when Deep Brain Stimulation was stopped and vice versa. This may indicate that better plasticity is required for longer term retention of normal movement when Deep Brain Stimulation is off. (iv) Patients with the highest plasticity 'on' Deep Brain Stimulation were those who had been receiving Stimulation with the least current drain. This suggests that it might be possible to 'shape' Deep Brain Stimulation of an individual patient to maximize beneficial neurophysiological patterns that have an impact on clinical status. The results are relevant for understanding long-term consequences and management of Deep Brain Stimulation in dystonia.
-
Functional imaging of subthalamic nucleus Deep Brain Stimulation in Parkinson's disease.
Movement disorders : official journal of the Movement Disorder Society, 2011Co-Authors: Tessel M. Boertien, Patricia Limousin, Ludvic Zrinzo, Joshua Kahan, Marjan Jahanshahi, Marwan Hariz, Laura Mancini, Thomas FoltynieAbstract:Deep Brain Stimulation of the subtha- lamic nucleus is an accepted treatment for the motor complications of Parkinson's disease. The therapeutic mechanism of action remains incompletely understood. Although the results of Deep Brain Stimulation are similar to the results that can be obtained by lesional surgery, accumulating evidence from functional imaging and clini- cal neurophysiology suggests that the effects of subtha- lamic nucleus-Deep Brain Stimulation are not simply the result of inhibition of subthalamic nucleus activity. Posi- tron emission tomography/single-photon emission com- puted tomography has consistently demonstrated changes in cortical activation in response to subthalamic nucleus-Deep Brain Stimulation. However, the technique has limited spatial and temporal resolution, and therefore the changes in activity of subcortical projection sites of the subthalamic nucleus (such as the globus pallidus, substantia nigra, and thalamus) are not as clear. Clarify- ing whether clinically relevant effects from subthalamic nucleus-Deep Brain Stimulation in humans are mediated through inhibition or excitation of orthodromic or anti- dromic pathways (or both) would contribute to our understanding of the precise mechanism of action of Deep Brain Stimulation and may allow improvements in safety and efficacy of the technique. In this review we discuss the published evidence from functional imaging studies of patients with subthalamic nucleus-Deep Brain Stimulation to date, together with how these data inform the mechanism of action of Deep Brain Stimulation. V C 2011 Movement Disorder Society
-
Deep Brain Stimulation for Parkinson's disease: surgical issues.
Movement Disorders, 2006Co-Authors: Ali Rezai, Patricia Limousin, Ashwini Sharan, Brian Kopell, Robert Gross, Jerrold Vitek, Alim-louis BenabidAbstract:Numerous factors need to be taken into account when implanting Deep Brain Stimulation (DBS) systems into patients with Parkinson's disease. The surgical procedure itself can be divided into immediate preoperative, intraoperative, and immediate postoperative phases. Preoperative considerations include medication withdrawal issues, stereotactic equipment choices, imaging modalities, and targeting strategy. Intraoperative considerations focus on methods for physiological confirmation of a given target for DBS electrode deployment. Terms such as microelectrode recording, microStimulation, and macroStimulation will be defined to clarify inconsistencies in the literature. Advantages and disadvantages of each technique will be addressed. Furthermore, operative decisions such as staging, choice of electrode and implantable pulse generator, and methods of device fixation will be outlined. Postoperative issues include imaging considerations, including magnetic resonance safety, device-device interactions, and immediate surgical complications pertaining to the DBS procedure. This report outlines answers to a series of questions developed to address all aspects of the DBS surgical procedure and decision-making with a systematic overview of the literature (until mid-2004) and by the expert opinion of the authors. This is a report from the Consensus on Deep Brain Stimulation for Parkinson's Disease, a project commissioned by the Congress of Neurological Surgeons and the Movement Disorder Society. It outlines answers to a series of questions developed to address all surgical aspects of Deep Brain Stimulation.
Tipu Z. Aziz - One of the best experts on this subject based on the ideXlab platform.
-
Deep Brain Stimulation and multiple sclerosis: Therapeutic applications
Multiple sclerosis and related disorders, 2014Co-Authors: Holly A. Roy, Tipu Z. AzizAbstract:Deep Brain Stimulation is a neurosurgical technique that can be used to alleviate symptoms in a growing number of neurological conditions through modulating activity within Brain networks. Certain applications of Deep Brain Stimulation are relevant for the management of symptoms in multiple sclerosis. In this paper we discuss existing treatment options for tremor, facial pain and urinary dysfunction in multiple sclerosis and discuss evidence to support the potential use of Deep Brain Stimulation for these symptoms.
-
switching off micturition using Deep Brain Stimulation at midBrain sites
Annals of Neurology, 2012Co-Authors: Alexande L Gree, Tipu Z. Aziz, Ella Stone, Holly Sitsapesa, Enjami W Turney, J H Coote, Jonny A Hyam, Thelma A. LovickAbstract:Most of the time the bladder is locked in storage mode, switching to voiding only when it is judged safe and/or socially appropriate to urinate. Here we show, in humans and rodents, that Deep Brain Stimulation in the periaqueductal gray matter can rapidly and reversibly manipulate switching within the micturition control circuitry, to defer voiding and maintain urinary continence, even when the bladder is full. Manipulation of neural continence pathways by Deep Brain Stimulation may offer new avenues for the treatment of urinary incontinence of central origin. Ann Neurol 2012;72:144–147
-
Deep Brain Stimulation: indications and evidence.
Expert review of medical devices, 2007Co-Authors: Erlick A. C. Pereira, Alexander L. Green, Dipankar Nandi, Tipu Z. AzizAbstract:Deep Brain Stimulation is a minimally invasive targeted neurosurgical intervention that enables structures Deep in the Brain to be stimulated electrically by an implanted pacemaker. It has become the treatment of choice for Parkinson's disease, refractory to, or complicated by, drug therapy. Its efficacy has been demonstrated robustly by randomized, controlled clinical trials, with multiple novel Brain targets having been discovered in the last 20 years. Multifarious clinical indications for Deep Brain Stimulation now exist, including dystonia and tremor in movement disorders; depression, obsessive-compulsive disorder and Tourette's syndrome in psychiatry; epilepsy, cluster headache and chronic pain, including pain from stroke, amputation, trigeminal neuralgia and multiple sclerosis. Current research argues for novel indications, including hypertension and orthostatic hypotension. The development, principles, indications and effectiveness of the technique are reviewed here. While Deep Brain Stimulation is a standard and widely accepted treatment for Parkinson's disease after 20 years of experience, in chronic pain it remains restricted to a handful of experienced, specialist centers willing to publish outcomes despite its use for over 50 years. Reasons are reviewed and novel approaches to appraising clinical evidence in functional neurosurgery are suggested.
-
Deep Brain Stimulation for neuropathic pain.
Neuromodulation : journal of the International Neuromodulation Society, 2006Co-Authors: Sarah L. F. Owen, Alexander L. Green, Dipankar Nandi, Richard G. Bittar, Shouyan Wang, Tipu Z. AzizAbstract:Objectives. To determine whether Deep Brain Stimulation is an effective treatment for neuropathic pain of varied etiology. Material and Methods. Thirty-four patients with intractable neuropathic pain were prospectively studied using visual analog scores, McGill Pain Questionnaire, and Quality of Life Questionnaires (EUROQOL EQ-5D VAS, and SF-36 v-2). Patients had either Deep Brain Stimulation of either the periventricular gray or ventroposterolateral nucleus of the thalamus, or both. Results. Seventy-six percent of patients underwent permanent implantation. Overall reduction of pain intensity was 54%. The burning component of pain improved by 77%. Health-related quality of life improved by 38%. Conclusions. Deep Brain Stimulation is an effective treatment for neuropathic pain. The factors that influence outcome, including etiology and site of Stimulation, are discussed.
