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
Fabian J. David, Yessenia M. Rivera, Tara K. Entezar, Rishabh Arora, Quentin H. Drane, Miranda J. Munoz, Joshua M. Rosenow, Sepehr B. Sani, Gian D. Pal, Leonard Verhagen-Metman, Daniel M. Corcos
Summary: This study investigated the effects of encoding type, medication, and subthalamic nucleus deep brain stimulation (STN-DBS) on memory-guided movements in Parkinson's disease (PD). The findings revealed that encoding type influenced reaching performance and deficits in PD, medication had differential effects depending on the encoding type, and STN-DBS was superior to medication in increasing amplitude and velocity. The study provides valuable insights into the understanding of memory-guided movements in PD and the effects of different treatments.
FRONTIERS IN NEUROLOGY
(2022)
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
Neurosciences
Miranda J. Munoz, Rishabh Arora, Yessenia M. Rivera, Quentin H. Drane, Gian D. Pal, Leo Verhagen Metman, Sepehr B. Sani, Joshua M. Rosenow, Lisa C. Goelz, Daniel M. Corcos, Fabian J. David
Summary: This study found that medication worsens saccade performance and benefits reaching performance, while STN-DBS benefits both saccade and reaching performance. These findings suggest potential physiological changes due to treatment.
FRONTIERS IN HUMAN NEUROSCIENCE
(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
Neurosciences
Kilian Hett, Ilwoo Lyu, Paula Trujillo, Alexander M. Lopez, Megan Aumann, Kathleen E. Larson, Peter Hedera, Benoit Dawant, Bennett A. Landman, Daniel O. Claassen, Ipek Oguz
Summary: In this study, a texture-based approach was proposed to identify structural differences in the cerebellum between patients with Parkinson's disease and essential tremor. The results showed anatomical differences localized to the inferior part of the cerebellar cortex and highlighted the complementary information provided by T1-weighted intensity and texture-based methods. Texture analysis demonstrated high sensitivity for gray matter differences, while T1-weighted intensity was sensitive for white matter differences.
HUMAN BRAIN MAPPING
(2021)
Article
Clinical Neurology
Spyros Papapetropoulos, Margaret S. Lee, Stacey Versavel, Evan Newbold, Hyder A. Jinnah, Rajesh Pahwa, Kelly E. Lyons, Rodger Elble, William Ondo, Theresa Zesiewicz, Peter Hedera, Adrian Handforth, Jenna Elder, Mark Versavel
Summary: The study evaluated the efficacy of CX-8998 in essential tremor, showing some improvement in certain assessments despite not meeting the primary endpoint. Adverse events with CX-8998 included dizziness, headache, euphoric mood, and insomnia.
MOVEMENT DISORDERS
(2021)
Article
Oncology
Mohamed H. Khattab, Anthony J. Cmelak, Alexander D. Sherry, Guozhen Luo, Li Wang, Hong Yu, Peter Hedera, Fenna T. Phibbs, Christopher J. Lindsell, Joseph Neimat, Austin N. Kirschner
Summary: This study aimed to determine whether a noninvasive, frameless radiosurgical thalamotomy could improve objective measures of refractory essential or parkinsonian tremor without added toxicity. A pilot observational trial was conducted with adult patients, and the results at the 1-year follow-up showed promising improvements in tremor symptoms with short-term safety. Further long-term studies are needed to assess the long-term effectiveness and safety of this treatment.
INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS
(2022)
Editorial Material
Clinical Neurology
Peter Hedera
Article
Clinical Neurology
Derek E. Neilson, Michael Zech, Robert B. Hufnagel, Jesse Slone, Xinjian Wang, Shelli Homan, Lisa M. Gutzwiller, Elizabeth J. Leslie, Nancy D. Leslie, Jianfeng Xiao, Peter Hedera, Mark S. LeDoux, Brian Gebelein, Friederike Wilbert, Matthias Eckenweiler, Juliane Winkelmann, Donald L. Gilbert, Taosheng Huang
Summary: Using whole exome sequencing and linkage analysis, a genetic variant related to autosomal dominant spastic paraplegia and dystonia was identified in a family, which was not found in other cases, reducing mitochondrial complex V activity.
MOVEMENT DISORDERS
(2022)
Editorial Material
Clinical Neurology
Muhammad Yousaf, Talita D'Aguiar Rosa, Victoria N. Holiday, Peter Hedera
Article
Neurosciences
Jessi M. Kane, Jessica L. McDonnell, Joseph S. Neimat, Peter Hedera, Wery P. M. van den Wildenberg, Fenna T. Phibbs, Elise B. Bradley, Scott A. Wylie, Nelleke C. van Wouwe
Summary: This study found that essential tremor (ET) patients have impaired conflict control proficiency compared to healthy controls (HCs). ET patients showed slower and less accurate responses, especially on non-corresponding conflict trials. An analysis of fast impulsive response rates revealed that ET patients made more fast errors compared to HCs. These findings suggest deficiencies in the cerebello-thalamocortical networks and cortico-striatal pathways in ET patients, which may contribute to their impaired conflict control.
EXPERIMENTAL BRAIN RESEARCH
(2022)
Article
Neurosciences
Holly N. Cukier, Hyunjin Kim, Anthony J. Griswold, Simona G. Codreanu, Lisa M. Prince, Stacy D. Sherrod, John A. McLean, Derek M. Dykxhoorn, Kevin C. Ess, Peter Hedera, Aaron B. Bowman, M. Diana Neely
Summary: By analyzing cellular, genetic, and metabolomic data from two brothers, we identified genetic differences that could potentially contribute to the discordant clinical presentation of Parkinson's Disease (PD) in these individuals. These differences may be related to neurodevelopment, dopamine metabolism, and glutathione homeostasis.
NPJ PARKINSONS DISEASE
(2022)
Article
Neurosciences
Diksha Mohanty, Philipp Schmitt, Laura Dixon, Victoria Holiday, Peter Hedera
Summary: This study surveyed the attitudes of caregivers and patients with Huntington's disease towards telemedicine. The results showed that telemedicine was favored by both groups and could improve the convenience of treatment without impacting patient-provider communication.
JOURNAL OF HUNTINGTONS DISEASE
(2022)
Article
Genetics & Heredity
Karen M. Bailey, Navdeep Sahota, Uyen To, Peter Hedera
Summary: This qualitative study aims to understand the wider patient and physician experience of the diagnosis and management of Wilson disease (WD) in the US. Through interviews with 12 patients and 7 specialist physicians, the study found issues in diagnosis journey, multidisciplinary approach, medication, the role of insurance, and education, awareness, and support. The study emphasizes the importance of easy access to reliable and up-to-date information for physicians, patients, and their caregivers, as well as general community outreach programs.
ORPHANET JOURNAL OF RARE DISEASES
(2023)
Article
Clinical Neurology
Mallory L. Hacker, Michael G. Tramontana, Kian Pazira, Jacqueline C. Meystedt, Maxim Turchan, Kelly A. Harper, Run Fan, Fei Ye, Thomas L. Davis, Peter E. Konrad, David Charles
Summary: This study examined the long-term neuropsychological outcomes of deep brain stimulation (DBS) in early-stage Parkinson's disease (PD) patients. The results showed no significant differences between DBS plus optimal drug therapy (DBS + ODT) and optimal drug therapy alone (ODT) groups after five and eleven years. However, there was a significant decline in cognitive processing speed and motor control for all PD patients. More research is needed to understand the long-term effects of early DBS on neuropsychological outcomes in PD.
PARKINSONISM & RELATED DISORDERS
(2023)
Article
Clinical Neurology
Erin Furr Stimming, Daniel Claassen, Elise Kayson, Jody Goldstein, Raja Mehanna, Hui Zhang, Grace S. Liang, Dietrich Haubenberger
Summary: Valbenazine was evaluated as a treatment for chorea associated with Huntington's disease, and it was found to be more effective than placebo in improving chorea symptoms and well tolerated.
Article
Medicine, General & Internal
Muhammad Ismail Khalid Yousaf, Mohammad Ravi Ghani, Talita D'Aguiar Rosa, Victoria Holiday, Martin Brown, Peter Hedera
Summary: Myokymia is a condition characterized by hyperexcitability of muscle fibers due to repetitive spontaneous contractions of motor units. This study reports two cases of continuous myokymia, which were effectively treated with botulinum toxin.
SAGE OPEN MEDICAL CASE REPORTS
(2022)
Article
Clinical Neurology
Guozhen Luo, Brent D. Cameron, Li Wang, Hong Yu, Joseph S. Neimat, Peter Hedera, Fenna Phibbs, Elise B. Bradley, Anthony J. Cmelak, Austin N. Kirschner
Summary: This study evaluated the optimal SRS treatment target within the thalamic ventral intermediate nucleus (VIM) and determined the location of the optimal SRS target by correlation between early responders and nonresponders.
JOURNAL OF NEUROSURGERY
(2022)
Article
Medicine, General & Internal
Kevin G. Buell, Brian P. Vickers, Karen C. Bloch, Amy E. Brown, Peter Hedera, Walter Jermakowicz, Peter E. Konrad, E. Wesley Ely
Summary: The case involves a 31-year-old immunocompetent male with altered mental status and agitation, ultimately diagnosed with cryptococcal meningitis. Despite unsuccessful pharmacologic options, he underwent a successful unilateral pallidotomy targeting the posterior-ventral pallidum, leading to significant improvement in choreiform movements within 48 hours post-operatively.
CUREUS JOURNAL OF MEDICAL SCIENCE
(2021)