Article
Neurosciences
Hutao Xie, Quan Zhang, Yin Jiang, Yutong Bai, Jianguo Zhang
Summary: This study found that Parkinson's disease patients with mild cognitive impairment (MCI) have a lower risk of cognitive decline after subthalamic nucleus deep brain stimulation (STN-DBS) compared to patients with normal cognitive function.
FRONTIERS IN HUMAN NEUROSCIENCE
(2022)
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
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
Clinical Neurology
Carlo Alberto Artusi, Leonardo Lopiano
Summary: Parkinson's disease (PD) patients with glucosylceramidase beta 1 (GBA1) gene mutations often have an earlier onset and more aggressive disease course, with increased neuropsychological issues. Deep brain stimulation (DBS) is a common therapeutic option for PD patients with disabling motor fluctuations and no dementia, showing good outcomes in terms of daily living activities and quality of life improvement. However, studies suggest that PD patients with GBA1 variants may have a worse DBS outcome due to accelerated cognitive decline. This summary highlights the current literature, identifies knowledge gaps, and proposes suggestions for further research and clinical practice in using DBS for PD patients with GBA1 variants.
FRONTIERS IN NEUROLOGY
(2023)
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
Danilo Genovese, Francesco Bove, Leonardo Rigon, Tommaso Tufo, Alessandro Izzo, Paolo Calabresi, Anna Rita Bentivoglio, Carla Piano
Summary: This study assessed the clinical safety and efficacy of frameless bilateral subthalamic nucleus deep brain stimulation (STN-DBS) in Parkinson's disease (PD) patients at 5 years after surgery. The results demonstrate that this technique is safe and well-tolerated, with sustained motor efficacy at 5 years post-surgery.
NEUROLOGICAL SCIENCES
(2023)
Article
Clinical Neurology
Jan Hirschmann, Alexandra Steina, Jan Vesper, Esther Florin, Alfons Schnitzler
Summary: This study demonstrates for the first time that neuronal oscillations are predictive of deep brain stimulation (DBS) outcome. Coherence between subthalamic and parietal oscillations are particularly informative.
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)
Editorial Material
Medicine, General & Internal
Gabriella Gruden, Sara Bernardi, Michela Scandella, Francesca Arietti, Giuseppe Gargiulo, Claudia Papa, Guglielmo Beccuti, Mario Giorgio Rizzone, Vincenzo Villari, Paolo Cavallo Perin, Marilena Durazzo
INTERNAL AND EMERGENCY MEDICINE
(2022)
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)
Article
Clinical Neurology
Fabrizio Vallelonga, G. Sobrero, A. Merola, M. Valente, M. Giudici, C. Di Stefano, V. Milazzo, J. Burrello, A. Burrello, F. Veglio, A. Romagnolo, S. Maule
Summary: This study aimed to investigate the accuracy of a machine learning algorithm applied to 24-hour ambulatory blood pressure monitoring (ABPM) as a tool for diagnosing autonomic failure (AF) in Parkinson's disease (PD) patients. The results showed that the Linear Discriminant Analysis (LDA) model based on ABPM parameters had a higher accuracy in predicting AF compared to individual ABPM variables. This study provides a new method for more accessible and accurate diagnosis of AF.
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
Clinical Neurology
Katherine Longardner, Aristide Merola, Irene Litvan, Alberto Maria De Stefano, Simona Maule, Fabrizio Vallelonga, Leonardo Lopiano, Alberto Romagnolo
Summary: Cardiovascular dysautonomia was associated with a sevenfold higher risk of developing dementia and a fivefold higher risk of falls in PD patients, as well as significantly higher impairment in ADLs and HRQoL. No relevant associations were found between the other autonomic domains and these outcomes.
JOURNAL OF NEUROLOGY
(2022)
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
Clinical Neurology
Gabriele Imbalzano, Domiziana Rinaldi, Giovanna Calandra-Buonaura, Manuela Contin, Federica Amato, Giulia Giannini, Luisa Sambati, Claudia Ledda, Alberto Romagnolo, Gabriella Olmo, Pietro Cortelli, Maurizio Zibetti, Leonardo Lopiano, Carlo Alberto Artusi
Summary: This study aimed to explore the challenges in treating FoG and other PD axial symptoms and analyze the effects of progressively increasing levodopa doses on the resistance of FoG, posture, speech, and altered gait features. The results showed that in a short-term evaluation, increasing LCIG dose can improve dopa-resistant FoG and gait issues in most advanced PD patients with good overall control of motor symptoms.
EUROPEAN JOURNAL OF NEUROLOGY
(2023)
Article
Clinical Neurology
Gurleen Vilkhu, Clarisse Goas, Jacob A. Miller, Scott M. Kelly, Kelsey J. McDonald, Anna J. Tsai, Alok Dviwedi, Brian D. Dalm, Aristide Merola
Summary: This study investigates whether electrode visualization tools (EVT) can accurately predict the selection of optimal Deep Brain Stimulation (DBS) electrode contacts in patients with Parkinson's disease. The results show a high concordance between EVT and standard DBS programming, demonstrating that EVT can save time and effort in selecting electrode contacts and accurately predict side effects.
PARKINSONISM & RELATED DISORDERS
(2023)
Article
Clinical Neurology
Anna Covolo, Gabriele Imbalzano, Carlo Alberto Artusi, Elisa Montanaro, Claudia Ledda, Marco Bozzali, Mario Giorgio Rizzone, Maurizio Zibetti, Tiziana Martone, Leonardo Lopiano, Alberto Romagnolo
Summary: This case report describes the very long-term outcome of a Parkinson's disease patient with PRKN gene mutations after more than 15 years of deep brain stimulation treatment. The patient experienced significant improvement in motor symptoms and fluctuations, although he developed some cognitive impairments. However, his overall quality of life was better compared to before the surgery.
NEUROLOGICAL SCIENCES
(2023)
Editorial Material
Clinical Neurology
Helen Bronte-Stewart, Aristide Merola
PARKINSONISM & RELATED DISORDERS
(2023)
Letter
Clinical Neurology
Alberto Romagnolo, Margherita Fabbri, Carlo Alberto Artusi, Maurizio Zibetti, Leonardo Lopiano, Elisa Montanaro
MOVEMENT DISORDERS CLINICAL PRACTICE
(2023)
Article
Clinical Neurology
Rajesh Pahwa, Aristide Merola, Michael Soileau, Ali Alobaidi, A. Simon Pickard, Prasanna L. Kandukuri, Yanjun Bao, John Strezewski, Julia Oddsdottir, Weiwei Xu, David Standaert
Summary: This study aims to compare the cost, quality-adjusted life years (QALY), and cost-effectiveness of Carbidopa/levodopa enteral suspension (CLES) and the standard-of-care (SoC) for Parkinson's disease (PD) patients in the US. The results showed that although CLES is associated with incremental costs, it provides greater QALY gain, making it a cost-effective treatment option for PD patients with medication-resistant motor fluctuations.
MOVEMENT DISORDERS
(2023)