Letter
Clinical Neurology
T. J. C. Zoon, V. Mathiopoulou, G. van Rooijen, P. van den Munckhof, D. A. J. P. Denys, P. R. Schuurman, R. M. A. de Bie, M. Bot
Summary: This study used subthalamic nucleus deep brain stimulation (STN DBS) and network analysis to investigate the relationship between the location of active DBS contact points and apathy in Parkinson's disease (PD) patients. The results showed that active contacts in apathy patients were more often positioned in the area with a high density of surrounding projections to associative cortex areas. The study provides insight into the anatomical connectivity substrate for apathy in DBS.
Review
Clinical Neurology
Thomas J. C. Zoon, Geeske van Rooijen, Georgina M. F. C. Balm, Isidoor O. Bergfeld, Joost G. Daams, Paul Krack, Damiaan A. J. P. Denys, Rob M. A. de Bie
Summary: This meta-analysis found that apathy is increased after STN DBS compared to the pre-operative state and medication only. The difference in severity of apathy remained significant after multiple analyses.
MOVEMENT DISORDERS
(2021)
Article
Neurosciences
Bernadette C. M. van Wijk, Wolf-Julian Neumann, Daniel Kroneberg, Andreas Horn, Friederike Irmen, Tilmann H. Sander, Qiang Wang, Vladimir Litvak, Andrea A. Kuehn
Summary: This study investigated the structural connectivity profile of the subthalamic nucleus (STN) using local field potential recordings and simultaneous magnetoencephalography. The results suggest the existence of a frequency-specific topography of cortico-STN coherence within the STN, with considerable spatial overlap between functional networks.
Review
Clinical Neurology
Francesca Mameli, Eleonora Zirone, Roberta Girlando, Elena Scagliotti, Giulia Rigamonti, Edoardo Nicolo Aiello, Barbara Poletti, Roberta Ferrucci, Nicola Ticozzi, Vincenzo Silani, Marco Locatelli, Sergio Barbieri, Fabiana Ruggiero
Summary: Deep brain stimulation (DBS) is an effective treatment for motor symptoms in Parkinson's disease (PD), but patients may experience psychological distress and social maladjustments after surgery. This review examines the role of patients' expectations regarding the outcomes of DBS and highlights the need for intervention to improve pre-operative patient education and post-operative psychosocial adjustment.
JOURNAL OF NEUROLOGY
(2023)
Article
Clinical Neurology
Maria Antonietta Volonte, Giacomo Clarizio, Sebastiano Galantucci, Pietro Giuseppe Scamarcia, Rosalinda Cardamone, Lina Raffaella Barzaghi, Monica Falautano, Pietro Mortini, Giancarlo Comi, Massimo Filippi
Summary: This study evaluated the long-term effectiveness of STN-DBS treatment on advanced PD patients over a span of 14 years. Results showed significant improvement in tremor, rigidity, and daily dopaminergic dose, but no lasting effect on axial symptoms and cognitive functions. STN-DBS remains an effective therapy for advanced PD patients, extending the period of acceptable quality of life despite disease progression.
JOURNAL OF NEUROLOGY
(2021)
Article
Clinical Neurology
Marisa DiMarzio, Radhika Madhavan, Ileana Hancu, Eric Fiveland, Julia Prusik, Suresh Joel, Michael Gillogly, Ilknur Telkes, Michael D. Staudt, Jennifer Durphy, Damian Shin, Julie G. Pilitsis
Summary: This study aimed to investigate the impact of altered frequencies on brain activation in PD patients. It was found that changing the frequency significantly affected the activation levels in regions such as the thalamus, globus pallidum externa, and cerebellum. Additionally, using fMRI signatures may be helpful in determining the optimal frequency for DBS programming.
Article
Clinical Neurology
Maidinamu Yakufujiang, Yoshinori Higuchi, Kyoko Aoyagi, Tatsuya Yamamoto, Toru Sakurai, Midori Abe, Yoji Okahara, Masaki Izumi, Osamu Nagano, Yoshitaka Yamanaka, Shigeki Hirano, Akihiro Shiina, Atsushi Murata, Yasuo Iwadate
Summary: This study found that preoperative evaluation using the Similarities and Object Assembly subtests in patients undergoing STN-DBS surgery may help predict cognitive declines postoperatively, especially in visuospatial functioning. A low score on the Similarities subtest may also predict future global cognitive deterioration.
WORLD NEUROSURGERY
(2021)
Article
Clinical Neurology
Jiping Li, Shanshan Mei, Xiaofei Jia, Yuqing Zhang
Summary: This study demonstrates that deep brain stimulation can effectively suppress levodopa-induced dyskinesia in Parkinson's disease patients without reducing levodopa dosage. The stimulation sites with good anti-dyskinesia effect are located above the subthalamic nucleus.
FRONTIERS IN NEUROLOGY
(2021)
Article
Clinical Neurology
Johannes Kahkola, Maija Lahtinen, Tuija Keinanen, Jani Katisko
Summary: This study utilized deterministic tractography to investigate the functional subdivisions of the subthalamic nucleus (STN) and the white matter connections with the medial frontal cortex in Parkinson's disease. The results suggest that stimulating the cluster located in the preSMA region of the STN may predict better treatment outcomes, including motor improvement and reduced levodopa equivalent daily dose.
Article
Clinical Neurology
Jiazhen Wang, Ru Pan, Ying Cui, Zhigang Wang, Qinghua Li
Summary: Compared to drug treatment, the verbal fluency of patients in the experimental group decreased significantly, especially phonemic fluency. Learning and memory abilities also showed a slight decline. Other neurocognitive functions were not significantly affected.
FRONTIERS IN NEUROLOGY
(2021)
Review
Medicine, General & Internal
Keying Zhu, Sun Peng, Yulun Wu, Yuanyuan Zhao, Zhonglei Lu
Summary: Deep brain stimulation (STN-DBS) improves sleep quality, motor function, and reduces medication usage in Parkinson disease (PD) patients.
Review
Medicine, General & Internal
Jae Meen Lee, Kyoungjune Pak
Summary: The efficacy of deep brain stimulation (DBS) in patients with young-onset Parkinson disease (YOPD) and late-onset Parkinson disease (LOPD) showed similar improvements in motor symptoms. Therefore, DBS should be considered regardless of the age at Parkinson disease onset.
Article
Engineering, Biomedical
James K. Trevathan, Anders J. Asp, Evan N. Nicolai, Jonathan M. Trevathan, Nicholas A. Kremer, Takashi D. Y. Kozai, David Cheng, Mike J. Schachter, Jonathan J. Nassi, Stephani L. Otte, Jones G. Parker, J. Luis Lujan, Kip A. Ludwig
Summary: This manuscript outlines an approach combining chronic behaving single-photon microendoscope recordings in a pathological mouse model with electrical stimulation of a common deep brain stimulation (DBS) target to study neuromodulation therapy. The authors present detailed steps necessary for this approach and discuss key considerations for extending it to other DBS targets. They also make recommendations based on their experience in implementing and validating the required procedures.
JOURNAL OF NEURAL ENGINEERING
(2021)
Article
Clinical Neurology
Abteen Mostofi, Francesca Morgante, Mark J. Edwards, Peter Brown, Erlick A. C. Pereira
Summary: Pain in Parkinson's disease is often untreated due to lack of understanding of its mechanisms. Deep brain stimulation of the subthalamic nucleus has shown potential in treating pain, but the exact type of pain it benefits and how it interferes with pain processing remain unclear.
Article
Neurosciences
Roxanne Lofredi, Cem-Georg Auernig, Siobhan Ewert, Friederike Irmen, Leon A. Steiner, Ute Scheller, Bernadette C. M. van Wijk, Simon Oxenford, Andrea A. Kuhn, Andreas Horn
Summary: Lead-DBS is a reliable and easy-to-use software tool for precise localization of deep brain stimulation electrodes. This study investigates the differences introduced by different raters and imaging types in the manual refinement process of electrode localization using Lead-DBS. The results show similar outcomes for all users, with an increase in variability when using postoperative MRI and standard space normalization. These findings contribute to the understanding of Lead-DBS and its potential use in formal training and imaging research in the field of deep brain stimulation.
Article
Clinical Neurology
Alberto Romagnolo, Roberta Balestrino, Gabriele Imbalzano, Giovannino Ciccone, Franco Riccardini, Carlo Alberto Artusi, Marco Bozzali, Bruno Ferrero, Elisa Montalenti, Elisa Montanaro, Mario Giorgio Rizzone, Giovanna Vaula, Maurizio Zibetti, Leonardo Lopiano
Summary: This study evaluated the prevalence of neurological comorbidities in COVID-19 patients and found that neurological comorbidity is associated with COVID-19 severity. Patients with cerebrovascular diseases and cognitive impairment are particularly at higher risk for severe COVID-19.
JOURNAL OF NEUROLOGY
(2021)
Article
Clinical Neurology
Andrea Sturchio, Alok K. Dwivedi, Luca Marsili, Aaron Hadley, Gabriele Sobrero, Dustin Heldman, Simona Maule, Leonardo Lopiano, Cristoforo Comi, Maurizio Versino, Alberto J. Espay, Aristide Merola
Summary: Kinematic evaluations were more accurate in predicting falls in PD patients with OH compared to clinical assessments. There was a trend for higher risk of falls in patients with orthostatic mean arterial pressure <= 75 mmHg.
JOURNAL OF NEUROLOGY
(2021)
Article
Clinical Neurology
Marina Picillo, Raffaele Palladino, Roberto Erro, Rossella Alfano, Carlo Colosimo, Roberto Marconi, Angelo Antonini, Paolo Barone
Summary: In women, prodromal constipation is associated with attention/memory complaints and apathy symptoms. In older patients, prodromal constipation is linked to lower cognitive scores and higher apathy scores.
JOURNAL OF NEUROLOGY
(2021)
Article
Clinical Neurology
Elisa Montanaro, Carlo Alberto Artusi, Cristina Rosano, Carlotta Boschetto, Gabriele Imbalzano, Alberto Romagnolo, Marco Bozzali, Mario Giorgio Rizzone, Maurizio Zibetti, Leonardo Lopiano
Summary: During the COVID-19 outbreak, a higher prevalence of anxiety and depression was observed in APD patients and their caregivers, with main worries including infection risk, interruption of treatments, clinic closures, and PD complications related to COVID-19. Specific interventions are necessary to effectively manage these psychological distresses.
NEUROLOGICAL SCIENCES
(2022)
Article
Clinical Neurology
Margherita Fabbri, Federico Natale, Carlo Alberto Artusi, Alberto Romagnolo, Marco Bozzali, Giovanni Giulietti, Isabel Guimaraes, Mario Giorgio Rizzone, Anna Accornero, Leonardo Lopiano, Maurizio Zibetti
Summary: In a pilot cross-sectional study, STN-DBS patients with low speech intelligibility benefited from a 30PW stimulation trial at a higher amplitude. The beneficial effect of 30PW on speech clarity was confirmed by both automatic analysis and patients' perception, indicating potential for improved application of recent DBS hardware advances.
PARKINSONISM & RELATED DISORDERS
(2021)
Article
Clinical Neurology
Carlo Alberto Artusi, Alberto Romagnolo, Gabriele Imbalzano, Elisa Montanaro, Maurizio Zibetti, Mario Giorgio Rizzone, Leonardo Lopiano
Summary: In patients with Parkinson's Disease, those at the malignant end of the spectrum have a higher risk of losing independence in daily living after DBS surgery compared to benign patients, despite similar improvements in motor symptoms and fluctuations.
PARKINSONISM & RELATED DISORDERS
(2021)
Article
Clinical Neurology
Elisa Montanaro, Alberto Romagnolo, Margherita Fabbri, Carlo Alberto Artusi, Gabriele Imbalzano, Mario Giorgio Rizzone, Leonardo Lopiano, Maurizio Zibetti
Summary: In advanced PD patients, sleep disturbances selectively correlate with specific neuropsychological functions and not with short-term memory and consolidation. It is suggested to consider treatment of sleep disturbances to minimize their potential impact on cognition.
JOURNAL OF NEUROLOGY
(2022)
Review
Clinical Neurology
Giuseppe Cosentino, Micol Avenali, Antonio Schindler, Nicole Pizzorni, Cristina Montomoli, Giovanni Abbruzzese, Angelo Antonini, Filippo Barbiera, Marco Benazzo, Eduardo Elias Benarroch, Giulia Bertino, Emanuele Cereda, Pere Clave, Pietro Cortelli, Roberto Eleopra, Chiara Ferrari, Shaheen Hamdy, Maggie-Lee Huckabee, Leonardo Lopiano, Rosario Marchese Ragona, Stefano Masiero, Emilia Michou, Antonio Occhini, Claudio Pacchetti, Ronald F. Pfeiffer, Domenico A. Restivo, Mariangela Rondanelli, Giovanni Ruoppolo, Giorgio Sandrini, Anthony H. Schapira, Fabrizio Stocchi, Eduardo Tolosa, Francesca Valentino, Mauro Zamboni, Roberta Zangaglia, Mario Zappia, Cristina Tassorelli, Enrico Alfonsi
Summary: Parkinson's disease is a neurodegenerative disorder characterized by motor and non-motor dysfunction, with dysphagia being a common yet often underdiagnosed symptom. A multinational group of experts conducted a systematic review and consensus conference to provide guidance on the screening, diagnosis, and impact of dysphagia on the prognosis and quality of life of PD patients. The consensus statements offer a framework for timely detection and accurate diagnosis of dysphagia in PD.
JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Michele Tinazzi, Mirta Fiorio, Alfredo Berardelli, Bruno Bonetti, Domenico Marco Bonifati, Alessandro Burlina, Annachiara Cagnin, Francesca Calabria, Maurizio Corbetta, Pietro Cortelli, Bruno Giometto, Silvia Vittoria Guidoni, Leonardo Lopiano, Gianluigi Mancardi, Fabio Marchioretto, Maria Pellegrini, Francesco Teatini, Gioacchino Tedeschi, Lucia Tesolin, Emanuele Turinese, Mario Zappia, Angela Marotta
Summary: The study investigated Italian neurologists' knowledge and clinical experience in managing patients with Functional Neurological Disorders (FND). Results showed that neurologists preferred using the term FND over other psychological or descriptive terms when communicating with patients, and were more inclined to refer patients to psychologists rather than psychiatrists. Some believed in the usefulness of physiotherapy and psychiatric interventions, while others thought patients may simulate their symptoms. Overall, the study suggests that understanding of scientific advances in FND is somewhat lacking, and there is a need for professional education to improve patient management.
JOURNAL OF NEUROLOGY
(2022)
Article
Clinical Neurology
Mario Giorgio Rizzone, Francesca Mancini, Carlo Alberto Artusi, Roberta Balestrino, Salvatore Bonvegna, Margherita Fabbri, Gabriele Imbalzano, Elisa Montanaro, Alberto Romagnolo, Maurizio Zibetti, Leonardo Lopiano
Summary: We evaluated the effect of Safinamide as adjunctive therapy in PD patients still experiencing motor fluctuations and dyskinesias after STN-DBS.
NEUROLOGICAL SCIENCES
(2022)
Article
Environmental Sciences
Irene Rechichi, Antonella Iadarola, Maurizio Zibetti, Alessandro Cicolin, Gabriella Olmo
Summary: This study aims to automatically detect REM sleep disorders and evaluate the level of impairment by implementing an automatic detection of REM Sleep Without Atonia (RSWA) and proposing a continuous index (the Dissociation Index) to assess the level of dissociation between REM sleep stage and atonia. Machine Learning models were used to classify RSWA and non-RSWA subjects, achieving high accuracy, sensitivity and precision. The Dissociation Index showed potential in measuring the impairment level of patients.
INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH
(2022)
Article
Neurosciences
Pietro Zeppa, Raffaele De Marco, Matteo Monticelli, Armando Massara, Andrea Bianconi, Giuseppe Di Perna, Stefania Greco Crasto, Fabio Cofano, Antonio Melcarne, Michele Maria Lanotte, Diego Garbossa
Summary: This study compared the use of 5-ALA and SF in GBM patients and found no significant differences in terms of resection extent and postoperative functional status. However, the concomitant use of both fluorophores may improve overall survival.
Review
Clinical Neurology
Gabriele Imbalzano, Claudia Ledda, Carlo Alberto Artusi, Alberto Romagnolo, Elisa Montanaro, Mario Giorgio Rizzone, Leonardo Lopiano, Maurizio Zibetti
Summary: This study describes two cases of Parkinson's disease patients who experienced worsening of symptoms after receiving the COVID-19 vaccine, but eventually recovered with treatment modifications. A short review of similar cases in the literature also suggests that these side effects are transient and manageable. Patients should not be overly concerned.
NEUROLOGICAL SCIENCES
(2022)
Article
Neurosciences
Pietro Zeppa, Marco Fraccalvieri, Chiara Fronda, Enrico Lo Bue, Laura Rizzi, Virginia Caliendo, Michele Maria Lanotte
Summary: Skin erosion is a common complication of deep brain stimulation (DBS), which can be managed conservatively or with invasive surgical techniques. In some cases, a flap can be used to cover the implant, but removal of the implant may still be necessary, leading to worsening of symptoms. The treatment of skin erosion requires careful consideration.
Letter
Clinical Neurology
Alberto Romagnolo, Margherita Fabbri, Carlo Alberto Artusi, Maurizio Zibetti, Leonardo Lopiano, Elisa Montanaro
MOVEMENT DISORDERS CLINICAL PRACTICE
(2023)