Article
Clinical Neurology
Josefine Waldthaler, Miriam Bopp, Nele Kuehn, Bugrahan Bacara, Merle Keuler, Marko Gjorgjevski, Barbara Carl, Lars Timmermann, Christopher Nimsky, David J. Pedrosa
Summary: This study compared changes in motor symptoms of Parkinson's Disease and the corresponding volume of the electrostatic field achieved by DBS programming using GUIDE XTTM versus standard-of-care clinical programming. The results showed that imaging-guided programming using GUIDE XTTM is as effective as clinical programming in controlling motor symptoms.
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.
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
Neuroimaging
Bethany R. Isaacs, Margot Heijmans, Mark L. Kuijf, Pieter L. Kubben, Linda Ackermans, Yasin Temel, Max C. Keuken, Birte U. Forstmann
Summary: The study found that neurosurgeons are stable in selecting the DBS target site across MRI field strength, MRI contrast, and repetitions. However, the analysis of coordinates in MNI space revealed that the actual selected location of the electrode is seemingly more ventral when using the 3 T scan compared to the 7 T scans.
NEUROIMAGE-CLINICAL
(2021)
Article
Neurosciences
Yingchuan Chen, Guanyu Zhu, Yuye Liu, Defeng Liu, Tianshuo Yuan, Xin Zhang, Yin Jiang, Tingting Du, Jianguo Zhang
Summary: The study found that changes in brain morphology are associated with the initial motor response to subthalamic nucleus deep brain stimulation in Parkinson's disease patients, and can be used to predict individual initial stimulation-related motor responses.
CNS NEUROSCIENCE & THERAPEUTICS
(2022)
Review
Behavioral Sciences
Chun-Hwei Tai
Summary: Understanding the pathophysiological mechanism of Parkinson's disease in the subthalamic nucleus is crucial for effective treatment through deep brain stimulation. STN burst firing is considered an electrophysiological signature of the cortico-basal ganglia circuit in PD patients, and plays a significant role in the motor symptoms of PD as well. This review explores the origins of STN bursts, factors influencing their formation, and the potential for interventions to alleviate PD symptoms.
NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS
(2022)
Review
Medicine, General & Internal
Marwan Hariz, Patric Blomstedtl
Summary: Parkinson's disease is a progressive neurodegenerative illness with motor and nonmotor symptoms. Deep brain stimulation is an effective symptomatic treatment that can be tailored to individual patients. DBS has significant effects on tremors, rigidity, and dyskinesias, but less responsive for axial symptoms. Specialized multidisciplinary teams are required for DBS in PD.
JOURNAL OF INTERNAL MEDICINE
(2022)
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
Medicine, General & Internal
Tianqi Hu, Hutao Xie, Yu Diao, Houyou Fan, Delong Wu, Yifei Gan, Fangang Meng, Yutong Bai, Jianguo Zhang
Summary: This study aimed to investigate the effects of STN-DBS on PD patients with different levels of depression and identify predictors of these effects. The results showed that patients with moderate depression had better improvement, and gender (female) and preoperative HAMA scores were predictors of the effects of STN-DBS on PD depression.
JOURNAL OF CLINICAL MEDICINE
(2022)
Article
Neurosciences
Zhe Zheng, Zhoule Zhu, Yuqi Ying, Hongjie Jiang, Hemmings Wu, Jun Tian, Wei Luo, Junming Zhu
Summary: Image-guided awake DBS with MER in subthalamic nucleus can accurately target Parkinson's disease. The majority of electrodes guided by preoperative MRI did not require adjustment, but a certain proportion needed repositioning. MER signals with a length <4mm may result in target deviation, thus requiring adjustment through MER and intraoperative testing.
JOURNAL OF PARKINSONS DISEASE
(2022)
Review
Clinical Neurology
Pepijn van den Munckhof, Maarten Bot, P. Richard Schuurman
Summary: Precise targeting of the dorsolateral motor part of the STN is crucial for maximizing clinical efficacy and minimizing side effects of DBS in Parkinson's disease patients. While recent advancements in MRI technology allow for direct visualization of the STN, there are discrepancies between MRI and electrophysiological STN borders that need further investigation. Further developments in imaging protocols and image fusion processes are necessary for optimizing DBS lead placement in the dorsolateral motor part of the STN.
NEUROLOGY AND THERAPY
(2021)
Article
Neurosciences
Martina Bockova, Eva Vytvarova, Martin Lamos, Petr Klimes, Pavel Jurak, Josef Halamek, Sabina Goldemundova, Marek Balaz, Ivan Rektor
Summary: The response to subthalamic nucleus deep brain stimulation (STN-DBS) varies individually and is difficult to predict. While most patients did not show changes in global network organization, suboptimal responders exhibited decreased global connectivity in the 1-8 Hz frequency range and regional node strength in frontal areas. The supplementary motor area was demonstrated to play an important role in the optimal response to DBS, with good responders showing increased node strength and eigenvector centrality in this brain region.
HUMAN BRAIN MAPPING
(2021)
Article
Clinical Neurology
Ahro Kim, Han-Joon Kim, Aryun Kim, Yoon Kim, Ahwon Kim, Jed Noel A. Ong, Hye Ran Park, Sun Ha Paek, Beomseok Jeon
Summary: This study aimed to investigate mortality and factors associated with mortality and causes of death after deep brain stimulation of the subthalamic nucleus in patients with Parkinson's disease. The results showed that 18.7% of patients died, with pneumonia being the most common cause of death. Older age, earlier disease onset, higher preoperative falling score while on medication, and higher preoperative total levodopa equivalent daily dose were associated with a higher risk of mortality.
FRONTIERS IN NEUROLOGY
(2023)
Article
Clinical Neurology
Jeanne Garcia, Cecile Hubsch, Ana Marques, Jean-Marc Gurruchaga, Cedric Lamirel, Emmanuel Roze, Antoine Moulignier
Summary: The study demonstrated that STN-DBS is a safe and effective treatment for PLHIV with Parkinson's disease, significantly improving symptoms without major adverse events; impulse control disorders were fully resolved after surgery.
EUROPEAN JOURNAL OF NEUROLOGY
(2022)
Article
Neurosciences
Lulu Jiang, Wanru Chen, Qiyu Guo, Chao Yang, Jing Gu, Wenbiao Xian, Yanmei Liu, Yifan Zheng, Jing Ye, Shaohua Xu, Yu Hu, Lei Wu, Jie Chen, Hao Qian, Xiaoli Fu, Jinlong Liu, Ling Chen
Summary: The long-term therapeutic efficacy of STN-DBS can be achieved in southern China with relatively low stimulation intensity and medication dosage, maintaining motor improvement and medication reduction through an 8-year follow-up, while improvement in quality of life lasts for only 3 years. No definite changes in nonmotor symptoms were found after STN-DBS.
CNS NEUROSCIENCE & THERAPEUTICS
(2021)
Article
Clinical Neurology
Eric Jackowiak, Amanda Cook Maher, Carol Persad, Vikas Kotagal, Kara Wyant, Amelia Heston, Parag G. Patil, Kelvin L. Chou
PARKINSONISM & RELATED DISORDERS
(2020)
Article
Health Care Sciences & Services
Noelle E. Carlozzi, Nicholas R. Boileau, Matthew W. Roche, Rebecca E. Ready, Joel S. Perlmutter, Kelvin L. Chou, Stacey K. Barton, Michael K. McCormack, Julie C. Stout, David Cella, Jennifer A. Miner, Jane S. Paulsen
QUALITY OF LIFE RESEARCH
(2020)
Article
Clinical Neurology
Hannah Ray, Amanda Cook Maher, Wilma MacKenzie, Laura Zeitlin, Kelvin L. Chou, Parag G. Patil, Carol C. Persad
PARKINSONISM & RELATED DISORDERS
(2020)
Article
Clinical Neurology
Galit Kleiner, Hubert H. Fernandez, Kelvin L. Chou, Alfonso Fasano, Kevin R. Duque, Diana Hengartner, Albie Law, Adam Margolius, Yu-Yan Poon, Michel Saenz Farret, Philip Saleh, Joaquin A. Vizcarra, Glenn T. Stebbins, Alberto J. Espay
Summary: The study validated a final version of a 27-item self-administered NoMoFA questionnaire, capable of effectively capturing both static and fluctuating non-motor symptoms in Parkinson's disease patients. The questionnaire showed good internal consistency, test-retest reliability, and concurrent validity, and underwent item reduction through a Delphi process, resulting in high acceptability.
MOVEMENT DISORDERS
(2021)
Article
Clinical Neurology
Connie Marras, Kelly A. Mills, Shirley Eberly, David Oakes, Kelvin L. Chou, Matthew Halverson, Sotirios A. Parashos, Christopher G. Tarolli, Jin-Shei Lai, Cindy J. Nowinsky, Oksana Suchowersky, Eric S. Farbman, Lisa M. Shulman, Tanya Simuni
Summary: The Neuro-QoL item banks showed limited utility as outcome measures in clinical trials for Parkinson's disease, indicating the need for more sensitive tools.
MOVEMENT DISORDERS
(2021)
Article
Clinical Neurology
Kelvin L. Chou, Justin Martello, Juliana Atem, Matt Elrod, Erin R. Foster, Karen Freshwater, Steven A. Gunzler, Hojoong Kim, Abhimanyu Mahajan, Harini Sarva, Glenn T. Stebbins, Erin Lee, Laurice Yang
Summary: Parkinson disease is the second most common neurodegenerative disorder globally, with increasing number of cases. Both motor and nonmotor symptoms contribute to decreased quality of life and neurologic disability.
Editorial Material
Clinical Neurology
Kelvin L. Chou, David Charles
Article
Clinical Neurology
Asra Askari, Brandon J. Zhu, Xiru Lyu, Kelvin L. Chou, Parag G. Patil
Summary: The study found that STN DBS has differential effects on rigidity in upper and lower extremities in patients with Parkinson's disease. However, there was no significant difference in tremor or bradykinesia between the upper and lower extremities. Even though there were slight differences in the maximal-effect loci for stimulation between the upper and lower extremities, they were not statistically resolved.
PARKINSONISM & RELATED DISORDERS
(2022)
Article
Engineering, Biomedical
Akshay T. Rao, Charles W. Lu, Asra Askari, Karlo A. Malaga, Kelvin L. Chou, Parag G. Patil
Summary: This study derived a data-driven electrophysiological biomarker that predicts clinical DBS location and parameters, and consolidated this information into a quantitative score. The results suggest that biomarker-based trajectory selection and programming may lead to improved motor outcomes for patients undergoing STN DBS surgery.
JOURNAL OF NEURAL ENGINEERING
(2022)
Article
Neurosciences
Marit F. L. Ruitenberg, Vincent Koppelmans, Tina Wu, Bruno B. Averbeck, Kelvin L. Chou, Rachael D. Seidler
Summary: This study aimed to investigate the neural basis of impulsive, risky decision making in Parkinson's disease patients. Using an information-gathering task and fMRI, we found that impulse control disorders in Parkinson's disease are associated with differences in neural processing of risk-related information and outcomes.
EXPERIMENTAL BRAIN RESEARCH
(2022)
Article
Clinical Neurology
Sydney Spagna, Asra Askari, Kara J. Wyant, Laura Zeitlin, Taylor R. Schmitt, Carol C. Persad, Xiru Lyu, Parag G. Patil, Kelvin L. Chou
Summary: This study examined the change in perceived social support in PD patients before and after STN DBS surgery and its impact on clinical outcomes. The results showed that PD patients experienced a decrease in perceived social support after STN DBS, but baseline perceived social support did not affect clinical outcomes. Further research is needed to identify factors that may contribute to this perception of worsened social support.
JOURNAL OF NEURAL TRANSMISSION
(2022)
Article
Clinical Neurology
Kelvin L. Chou, Praveen Dayalu, Robert A. Koeppe, Sid Gilman, C. Chauncey Spears, Roger L. Albin, Vikas Kotagal
Summary: This study compared the serotoninergic innervation in patients with multiple system atrophy (MSA) and Parkinson's disease (PD) using serotonin transporter [C-11]3-amino-4-(2-dimethylaminomethyl-phenylsulfaryl)-benzonitrile positron emission tomography (PET). The results showed that MSA patients exhibited more severe deficits in brainstem and some forebrain subcortical regions compared to PD patients, and these deficits correlated with the severity of motor impairments in MSA.
MOVEMENT DISORDERS
(2022)
Article
Engineering, Biomedical
Akshay T. Rao, Kelvin L. Chou, Parag G. Patil
Summary: This study presents a computer algorithm that can accurately localize intraoperative microelectrode recording (MER) tracks on preoperative magnetic resonance imaging (MRI) in real-time, thereby predicting deviation between the surgical plan and the MER trajectories. The algorithm integrates a random forest model that can distinguish between gray and white matter regions along MER trajectories. It improves the accuracy of electrode position estimation during subthalamic nucleus deep brain stimulation (STN DBS) surgery.
JOURNAL OF NEURAL ENGINEERING
(2023)
Article
Clinical Neurology
Karen J. Kluin, James M. Mossner, Joseph T. Costello, Kelvin L. Chou, Parag G. Patil
Summary: This study investigated the effects of STN DBS on motor speech in PD patients and the potential of intraoperative testing to predict outcomes. Intraoperative motor speech testing was found to strongly predict postoperative outcomes, and distinct stimulation sites were identified for motor speech deterioration and motor improvement as measured by MDS-UPDRS.
JOURNAL OF NEUROSURGERY
(2021)
Article
Neuroimaging
Karlo A. Malaga, Joseph T. Costello, Kelvin L. Chou, Parag G. Patil
Summary: The optimal regions for STN DBS treatment in Parkinson's disease were found to be located medial, posterior, and dorsal to the STN centroid, extending towards the caudal zona incerta (cZI). Therapeutic stimulation spread notably more in the dorsal and posterior directions, with significant linear relationships between the amount of dorsal and posterior stimulation and motor improvement. The variability in STN anatomy, active contact position, and VTA location among patients highlights the importance of individualized modeling techniques for optimizing DBS outcomes.
NEUROIMAGE-CLINICAL
(2021)