Electrical stimulation of therapeutic targests in waking dyskinetic patients

Alberts, W. Watson; Feinstein, B.; Levin, Grant; Wright, Elwood W.

doi:10.1016/0013-4694(66)90020-4

Cited by 26 publications

(6 citation statements)

References 8 publications

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“…Based partially on the notion that high-frequency stimulation could suppress extrapyramidal tremor during functional ablative neurosurgery (Hassler et al, 1960; Alberts et al, 1965, 1966), Benabid et al (1987) moved the field toward chronic stimulation with high-frequency continuous stimulation (130 Hz) of the thalamic nucleus ventralis intermedius for essential tremor and for parkinsonian tremor. He showed that DBS could be applied bilaterally without pseudobulbar and cognitive side-effects, an important observation as this was the major shortcoming of bilateral lesion therapy.…”

Section: Deep Brain Stimulationmentioning

confidence: 99%

“…The DBS leads are inserted by stereotactic surgery into the targeted brain structure, and an extension wire is subcutaneously tunneled to connect the implanted pulse generator (IPG) to the DBS lead (Oluigbo et al, 2012; Okun, 2014; Klooster et al, 2016). The IPG delivers adjustable pulses through the quadripolar electrodes and can be programmed to many settings based on voltage (or current in newer devices) amplitude, pulse width, and frequency (Hassler et al, 1960; Alberts et al, 1966; Benabid et al, 1991; Kuncel and Grill, 2004; Kringelbach et al, 2007; Brocker and Grill, 2013; Udupa and Chen, 2015). The DBS can be switched ON or OFF on demand (Oluigbo et al, 2012) in some paradigms.…”

Section: Deep Brain Stimulationmentioning

confidence: 99%

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Deep Brain Stimulation for Obesity: A Review and Future Directions

et al. 2019

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The global prevalence of obesity has been steadily increasing. Although pharmacotherapy and bariatric surgeries can be useful adjuvants in the treatment of morbid obesity, they may lose long-term effectiveness. Obesity result largely from unbalanced energy homeostasis. Palatable and densely caloric foods may affect the brain overlapped circuits involved with homeostatic hypothalamus and hedonic feeding. Deep brain stimulation (DBS) consists of delivering electrical impulses to specific brain targets to modulate a disturbed neuronal network. In selected patients, DBS has been shown to be safe and effective for movement disorders. We review all the cases reports and series of patients treated with DBS for obesity using a PubMed search and will address the following obesity-related issues: (i) the hypothalamic regulation of homeostatic feeding; (ii) the reward mesolimbic circuit and hedonic feeding; (iii) basic concepts of DBS as well as the rationale for obesity treatment; (iv) perspectives and challenges in obesity DBS. The small number of cases provides preliminary evidence for the safety and the tolerability of a potential DBS approach. The ventromedial ( n = 2) and lateral ( n = 8) hypothalamic nuclei targets have shown mixed and disappointing outcomes. Although nucleus accumbens ( n = 7) targets were more encouraging for the outcomes of body weight reduction and behavioral control for eating, there was one suicide reported after 27 months of follow-up. The authors did not attribute the suicide to DBS therapy. The identification of optimal brain targets, appropriate programming strategies and the development of novel technologies will be important as next steps to move DBS closer to a clinical application. The identification of electrical control signals may provide an opportunity for closed-loop adaptive DBS systems to address obesity. Metabolic and hormonal sensors such as glycemic levels, leptin, and ghrelin levels are candidate control signals for DBS. Focused excitation or alternatively inhibition of regions of the hypothalamus may provide better outcomes compared to non-selective DBS. Utilization of the NA delta oscillation or other physiological markers from one or multiple regions in obesity-related brain network is a promising approach. Experienced multidisciplinary team will be critical to improve the risk-benefit ratio for this approach.

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Section: Deep Brain Stimulationmentioning

confidence: 99%

Section: Deep Brain Stimulationmentioning

confidence: 99%

Deep Brain Stimulation for Obesity: A Review and Future Directions

et al. 2019

View full text Add to dashboard Cite

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“…Hassler et al [16] reported that the stimulation of the ventral lateral (subsequently referred to as the ventral intermediate nucleus of thalamus (VIM)) nucleus of the thalamus during stereotactic localization may terminate the tremor. Furthermore, Alberts et al [17] reported that dystonic symptoms improved following stimulation during stereotactic surgery. Delgado et al [18] introduced electrode implantation in human brains as a technique for chronic recording and brain stimulation, and Heath [19] initiated depth electrode studies for psychotic patients in the 1950s.…”

Section: Deep Brain Stimulation 21 Historical Reviewmentioning

confidence: 99%

Deep Brain Stimulation: The Perspective of Brain Connectivity

Kim¹

2016

From Bench to Bedside - Trauma, Tumors, Spine, Functional Neurosurgery

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Deep brain stimulation (DBS) has been demonstrated as a treatment option to alleviate patient symptoms in movement disorders, such as Parkinson's disease (PD) and dystonia, and has emerged as an alternative treatment for medically intractable epilepsy. However, complete understanding of the mechanism of DBS remains elusive despite recent human and nonhuman studies that have provided mechanistic clues. The precise mechanisms of action for DBS remain unclear. This review provides an up-to-date overview of the detailed procedures of DBS and reviews the actions of DBS on brain networks. Studies regarding the structural and functional connectivity of the brain are also reviewed.

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“…One such possible treatment is chronic stimulation of the GP. Early studies of PD tremor demonstrated that stimulation of the thalamus could elicit or inhibit tremor response as a function of the stimulation current [56,[76][77][78]. This response to chronic stimulation suggested that permanent indwelling electrodes might offer a method of influencing basal ganglia overactivity in a reversible manner, avoiding the risk of neural lesions' potential adverse effects [79][80][81].…”

Section: Future Directions Of Parkinson's Disease Treatmentmentioning

confidence: 99%

Use of Posteroventral Pallidotomy for Treatment of Parkinson’s Disease: Is Pallidotomy Still an Experimental Procedure?

Jacques

Eagle²,

Kopyov³

1998

Stereotact Funct Neurosurg

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Surgical interventions have been employed to alleviate symptoms of Parkinson’s disease (PD) for decades, with improving success. One such treatment has been pallidotomy, the lesioning of a portion of the globus pallidus. Early pallidotomy procedures have paved the way for more accurately targeted methods. Technological advancements in imaging and targeting have made modern pallidotomy a safe and well-tested means of treating PD patients that has reliably positive results. Numerous group studies in recent years have demonstrated effective relief of PD symptoms, and the neuroanatomical and physiological aspects which underlie its effects are being elucidated as well. Recent descriptions of pallidotomy as an experimental procedure must therefore be considered in light of these reports. This review will examine the development of the pallidotomy procedure and the neuroanatomical rationale which underlies it, and discuss recent studies of its efficacy in PD patients.

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Electrical stimulation of therapeutic targests in waking dyskinetic patients

Cited by 26 publications

References 8 publications

Deep Brain Stimulation for Obesity: A Review and Future Directions

Deep Brain Stimulation for Obesity: A Review and Future Directions

Deep Brain Stimulation: The Perspective of Brain Connectivity

Use of Posteroventral Pallidotomy for Treatment of Parkinson’s Disease: Is Pallidotomy Still an Experimental Procedure?

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