Nucleus ventralis oralis deep brain stimulation in postanoxic dystonia

Constantoyannis, Constantine; Kagadis, George C.; Ellul, John; Kefalopoulou, Zinovia; Chroni, Elisabeth

doi:10.1002/mds.22350

Cited by 17 publications

(15 citation statements)

References 11 publications

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“…Tasker and others94, 95 showed that standard radiofrequency thalamotomy (Voa/Vop) significantly improves contralateral limb movement in patients with secondary dystonia, but axial and truncal symptoms often remain refractory. Similar outcomes have been reported in single cases in which chronic high‐frequency thalamic stimulation has been attempted for secondary dystonia 29, 32. In patients with dystonia secondary to cerebral palsy, Murat et al96 found that additional lesions placed in the subthalamic region achieved better symptomatic control compared with thalamotomy or pallidotomy alone.…”

Section: Surgically Intractable Secondary Dystonia: Importance Of Anasupporting

confidence: 53%

“…While class 1 evidence now shows that bilateral high‐frequency pallidal stimulation significantly improves motor performance and quality of life for patients with primary generalized and segmental dystonia,10–13 no similar high‐level data have yet been published for secondary dystonia. Stimulation of nonpallidal sites, including the thalamus29–32 and subthalamic nucleus,33–35 has shown some promising preliminary results in selected cases of secondary dystonia, but again no prospective comparisons have yet appeared. As discussed further below under ‘DBS Targets’, these neighboring targets may be considered when a preoperative pallidal lesion is present or when dystonia remains refractory to prior pallidal interventions.…”

Section: General Therapy For Secondary Dystoniamentioning

confidence: 99%

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Surgical treatment for secondary dystonia

Tierney

Lozano

2012

Movement Disorders

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Surgical therapy for the secondary dystonias is generally perceived to be less effective than for primary disease. However, a number of case reports and small open series have recently appeared describing quite favorable outcomes following surgery for some nonprimary dystonias. We discuss surgical treatment options for this group of diverse conditions, including tardive dystonia, dystonic cerebral palsy, and certain heredodegenerative diseases in which deep brain stimulation and ablative lesions of the posteroventral pallidum have been shown to be effective. Other types of secondary dystonia respond less well to pallidal surgery, particularly when anatomical lesions of the basal ganglia are prominent on preoperative imaging. For these conditions, central baclofen delivery and botulinum toxin denervation may be considered. With optimal medical and surgical care, some patients with secondary dystonia have achieved reductions in disability and pain that approach those documented for primary dystonia.

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Section: Surgically Intractable Secondary Dystonia: Importance Of Anasupporting

confidence: 53%

Section: General Therapy For Secondary Dystoniamentioning

confidence: 99%

Surgical treatment for secondary dystonia

Tierney

Lozano

2012

Movement Disorders

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“…, 2008), and postanoxic dystonia with damaged GPi (Ghika et al. , 2002; Constantoyannis et al. , 2009; Katsakiori et al.…”

Section: Thalamusmentioning

confidence: 99%

Probing basal ganglia functions by saccade eye movements

Watanabe

Munoz

2011

Eur J of Neuroscience

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The basal ganglia (BG) are a group of subcortical structures involved in diverse functions, such as motor, cognition and emotion. However, the BG do not control these functions directly, but rather modulate functional processes occurring in structures outside the BG. The BG form multiple functional loops, each of which controls different functions with similar architectures. Accordingly, to understand the modulatory role of the BG, it is strategic to uncover the mechanisms of signal processing within specific functional loops that control simple neural circuits outside the BG, and then extend the knowledge to other BG loops. The saccade control system is one of the best-understood neural circuits in the brain. Furthermore, sophisticated saccade paradigms have been used extensively in clinical research in patients with BG disorders as well as in basic research in behaving monkeys. In this review, we describe recent advances of BG research from the viewpoint of saccade control. Specifically, we account for experimental results from neuroimaging and clinical studies in humans based on the updated knowledge of BG functions derived from neurophysiological experiments in behaving monkeys by taking advantage of homologies in saccade behavior. It has become clear that the traditional BG network model for saccade control is too limited to account for recent evidence emerging from the roles of subcortical nuclei not incorporated in the model. Here, we extend the traditional model and propose a new hypothetical framework to facilitate clinical and basic BG research and dialogue in the future.

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“…We tested each contact point of GPi DBS with various parameters; however, no GPi DBS setting improved his symptoms. According to our previous report, the thalamic nucleus ventrooralis as described by Hassler, which is called the VLa nucleus in recent publications [11,12,13], could be an effective target for DBS therapy for generalized and focal dystonia [14,15,16]. Thus, we chose to stimulate the thalamic VLa as the primary target in our patient.…”

Section: Case Reportmentioning

confidence: 99%

Deep Brain Stimulation of the Thalamic Ventral Lateral Anterior Nucleus for DYT6 Dystonia

Mure

Morigaki

Koizumi

et al. 2014

Stereotact Funct Neurosurg

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Background: A missense mutation of the THAP1 gene results in DYT6 primary dystonia. While deep brain stimulation (DBS) of the internal globus pallidus (GPi) is effective in treating primary dystonia, recent reports indicate that GPi DBS is only mildly effective for DYT6 dystonia. Objective: To describe a patient with DYT6 dystonia who underwent thalamic ventral lateral anterior (VLa) nucleus DBS. Patient: A 35-year-old Japanese man had been experiencing upper limb dystonia and spasmodic dysphonia since the age of 15. His dystonic symptoms progressed to generalized dystonia. He was diagnosed as having DYT6 dystonia with mutations in the THAP1 gene. Because his dystonic symptoms were refractory to pharmacotherapy and pallidal DBS, he underwent thalamic VLa DBS. Results: Continuous bilateral VLa stimulation with optimal parameter settings ameliorated the patient's dystonic symptoms. At the 2-year follow-up, his Burke-Fahn-Marsden Dystonia Rating Scale total score decreased from 71 to 11, an improvement of more than 80%. Conclusions: The thalamic VLa nucleus could serve as an alternative target in DBS therapy for DYT6 dystonia.

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Nucleus ventralis oralis deep brain stimulation in postanoxic dystonia

Cited by 17 publications

References 11 publications

Surgical treatment for secondary dystonia

Surgical treatment for secondary dystonia

Probing basal ganglia functions by saccade eye movements

Deep Brain Stimulation of the Thalamic Ventral Lateral Anterior Nucleus for DYT6 Dystonia

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