Refractory epilepsy and deep brain stimulation

Pereira, Erlick A. C.; Green, Alexander L.; Stacey, Richard; Aziz, Tipu Z.

doi:10.1016/j.jocn.2011.03.043

Cited by 36 publications

(16 citation statements)

References 76 publications

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“…These studies are subject to several reviews [29][30][31][32][33]. SANTE trial reported median of 56% seizure reduction in a group of 81 patients at two years with a 54% responder rate (>50% seizure reduction) [11] and 69% seizure reduction with 68% responder rate at five years [12].…”

Section: Discussionmentioning

confidence: 99%

Outcome based definition of the anterior thalamic deep brain stimulation target in refractory epilepsy

et al. 2016

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Section: Discussionmentioning

confidence: 99%

Outcome based definition of the anterior thalamic deep brain stimulation target in refractory epilepsy

et al. 2016

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“…Deep brain stimulation (DBS) is an effective treatment option for movement disorders, including Parkinson disease (PD), essential tremor, and dystonia, 1,2 and its applications are expanding to other neurological and neuropsychiatric disorders such as epilepsy, 3 chronic pain, 4 obsessive-compulsive disorder, 5 Tourette’s syndrome, 6 and major depression. 7 …”

Section: Introductionmentioning

confidence: 99%

Motor and Nonmotor Circuitry Activation Induced by Subthalamic Nucleus Deep Brain Stimulation in Patients With Parkinson Disease

Knight

Testini

Min

et al. 2015

Mayo Clinic Proceedings

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Objective To test the hypothesis suggested by previous studies that subthalamic nucleus (STN) deep brain stimulation (DBS) in patients with PD would affect the activity of both motor and non-motor networks, we applied intraoperative fMRI to patients receiving DBS. Patients and Methods Ten patients receiving STN DBS for PD underwent intraoperative 1.5T fMRI during high frequency stimulation delivered via an external pulse generator. The study was conducted between the dates of January 1, 2013 and September 30, 2014. Results We observed blood oxygen level dependent (BOLD) signal changes (FDR<.001) in the motor circuitry, including primary motor, premotor, and supplementary motor cortices, thalamus, pedunculopontine nucleus (PPN), and cerebellum, as well as in the limbic circuitry, including cingulate and insular cortices. Activation of the motor network was observed also after applying a Bonferroni correction (p<.001) to our dataset, suggesting that, across subjects, BOLD changes in the motor circuitry are more consistent compared to those occurring in the non-motor network. Conclusions These findings support the modulatory role of STN DBS on the activity of motor and non-motor networks, and suggest complex mechanisms at the basis of the efficacy of this treatment modality. Furthermore, these results suggest that, across subjects, BOLD changes in the motor circuitry are more consistent compared to those occurring in the non-motor network. With further studies combining the use of real time intraoperative fMRI with clinical outcomes in patients treated with DBS, functional imaging techniques have the potential not only to elucidate the mechanisms of DBS functioning, but also to guide and assist in the surgical treatment of patients affected by movement and neuropsychiatric disorders.

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“…Functional brain surgery aimed at modulation of subcortical brain structures, named deep brain stimulation (DBS), has provided a unique window of opportunity to apply electrochemical methods for monitoring changes in the neuronal milieu. DBS has demonstrated clinical efficacy in a multitude of neurological and psychiatric conditions including Parkinson’s disease[1-3], dystonia[4-6], essential tremor[7-9], chorea[10, 11], epilepsy[12-14], chronic pain[15, 16], depression[17, 18], obsessive compulsive disorder[19-21], and Tourette’s syndrome[22-25]. Although previously confined to animal research models, electrochemical methods have recently been successfully applied in humans to monitor real-time neurochemical changes during functional neurosurgery[26].…”

Section: Introductionmentioning

confidence: 99%

Wireless Neurochemical Monitoring in Humans

Kasasbeh¹,

Lee²,

Bieber³

et al. 2013

Stereotact Funct Neurosurg

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Electrochemical techniques have long been utilized to investigate chemical changes in the neuronal microenvironment. Preclinical models have demonstrated the successful monitoring of changes in various neurotransmitter systems in vivo with high temporal and spatial resolution. The expansion of electrochemical recording to humans is a critical yet challenging goal to elucidate various aspects of human neurophysiology and to create future therapies. We have designed a novel device named the WINCS (Wireless Instantaneous Neurotransmitter Concentration Sensing) system that combines rapid scan voltammetry with wireless telemetry for highly resolved electrochemical recording and analysis. WINCS utilizes fast-scan cyclic voltammetry and fixed potential amperometry for in vivo recording and has demonstrated high temporal and spatial resolution in detecting changes in extracellular levels of a wide range of analytes including dopamine, adenosine, glutamate, serotonin, and histamine. Neurochemical monitoring in humans represents a new approach to understanding the neurophysiology of the central nervous system, the neurobiology of numerous diseases, and the underlying mechanism of various neurosurgical therapies. This article addresses the current understanding of electrochemistry, its application in humans, and future directions.

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Refractory epilepsy and deep brain stimulation

Cited by 36 publications

References 76 publications

Outcome based definition of the anterior thalamic deep brain stimulation target in refractory epilepsy

Outcome based definition of the anterior thalamic deep brain stimulation target in refractory epilepsy

Motor and Nonmotor Circuitry Activation Induced by Subthalamic Nucleus Deep Brain Stimulation in Patients With Parkinson Disease

Wireless Neurochemical Monitoring in Humans

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