Neuronal activity of the zona incerta in Parkinson's disease patients

Merello, Marcelo; Tenca, Eduardo; Cerquetti, Daniel

doi:10.1002/mds.20834

Cited by 39 publications

(28 citation statements)

References 19 publications

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“…Low-amplitude signals below this point were recorded for the next 5-6 mm. Thereafter, midsized units were recorded at the mesencephalic level in the area marked substantia Q of Sano, as previously reported [23,24,25] (see online suppl. video).…”

Section: Resultsmentioning

confidence: 99%

Optimizing Prelemniscal Radiations as a Target for Motor Symptoms in Parkinson's Disease Treatment

Castro

Carrillo-Ruíz²,

Salcido³

et al. 2015

Stereotact Funct Neurosurg

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Objective: To better define prelemniscal radiations (Raprl) as a target for the control of tremor and rigidity in Parkinson's disease (PD). Methods: A total of 36 deep brain stimulation (DBS) electrodes were stereotactically implanted in Raprl contralateral to the extremities to be treated. Effects on symptoms were evaluated using UPDRS-III before and after DBS, and significance was determined using the Wilcoxon test. The location of DBS contacts in cases with optimum versus suboptimum results was evaluated using Student's t test and percentage improvement correlated through a bivariable Pearson test. The power and percentage of spike components for microelectrode recordings were statistically compared between the target point and structures located above and below. Results: Raprl-DBS improved tremor and rigidity (p < 0.01). The potency of microelectrode recordings indicated that the target was formed by fibers. There was no correlation between demographic characteristics and clinical outcome, and there were no significant differences in stereotactic placement between cases with optimum and suboptimum results. Tremor and rigidity were selectively improved in cases with suboptimum results. Conclusion: Raprl-DBS is an effective treatment for the motor symptoms of PD. Selective improvement of symptoms suggests that the target has different fiber components related to either tremor or rigidity, and variations in improvement between cases may derive from individual variations of the location of these fibers.

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Section: Resultsmentioning

confidence: 99%

Optimizing Prelemniscal Radiations as a Target for Motor Symptoms in Parkinson's Disease Treatment

Castro

Carrillo-Ruíz²,

Salcido³

et al. 2015

Stereotact Funct Neurosurg

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“…Methods for visualization of the rZI allowing direct stereotactic targeting have recently been reported [33, 34]. In addition, intraoperative microelectrode recordings may aide in direct targeting of the ZI as this region reveals a low amplitude background and a sparse cell density, as well as a lack of proprioceptive responses, which help to distinguish it from surrounding areas [24]. Furthermore, as one of the greatest limitations of increasing stimulation are unwanted adverse effects, studies aimed at assessing the response to titration of stimulation as well as immediate and potential delayed side effects need to be performed.…”

Section: Discussionmentioning

confidence: 99%

Interleaving Stimulation in Parkinson’s Disease, Tremor, and Dystonia

Kern

Picillo

Thompson

et al. 2018

Stereotact Funct Neurosurg

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Background/Aims: Interleaving stimulation (ILS) in deep brain stimulation (DBS) provides individualized stimulation of 2 contacts delivered in alternating order. Currently, limited information on the utility of ILS exists. The aims of this study were to determine the practical applications and outcomes of ILS DBS in Parkinson’s disease (PD), tremor, and dystonia. Methods: We performed a single-center, unblinded, retrospective chart review of all patients with DBS attempted on ILS at our referral center assessing for rationale and outcomes. Results: Fifty patients (PD, n = 27; tremor, n = 7; dystonia, n = 16 patients) tried ILS for 2 rationales: management of adverse effects (n = 29) and to improve clinical efficacy (n = 21). A total of 19 patients demonstrated improvement with ILS for adverse effect management predominately for the treatment of dyskinesias (n = 12). In the vast majority of dyskinetic patients, a contact added into the rostral zona incerta with ILS was performed. Nine out of 21 patients demonstrated improved clinical efficacy with ILS with all 6 PD patients who tried ILS for this rationale demonstrating benefit. Conclusions: In PD, ILS provided benefits for dyskinesias and parkinsonism, with minimal improvement of other adverse effects. In tremor and dystonia, marginal effects in terms of mitigation of adverse effects and improvement of clinical outcomes were evident.

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“…Loss of this dopaminergic projection causes the STN to become increasingly responsive to its glutamatergic afferents and become hyperactive, adopting a burst-like firing pattern 9 27. The same pattern of burst firing is seen in the ZI28 29 and probably involves a similar mechanism.…”

Section: Support For the Hypothesismentioning

confidence: 87%