Stereotaktische Behandlung der Bewegungsstörungen

Ostertag, C. B.; Lücking, Carl Hermann; Mehdorn, H. M.; Deuschl, Günther

doi:10.1007/s001150050150

Cited by 14 publications

(6 citation statements)

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“…Nevertheless, stimulation techniques are considered to be safer and are reversible and therefore recommended in patients with substantial brain damage. 3,22 Interestingly, clear improvement occurred in the tremor as well as the associated dystonia in both patients following unilateral Vim stimulation, which represents a result yet to be described in the literature. This recovery was gradual in nature and added significant clinical benefit in the patients; that is, it facilitated the rehabilitation process in both patients and enabled a return to professional activities in one patient.…”

Section: Discussionmentioning

confidence: 78%

“…Current hypotheses involve neuroaugmentive and neurosuppressive effects on neural network functioning, including the concept of jamming. 3 Given that similar clinical responses occur after stereotactic lesioning and stimulation procedures, 13,21,22 the interpretation of the responsible mechanism becomes even more complex. Nevertheless, stimulation techniques are considered to be safer and are reversible and therefore recommended in patients with substantial brain damage.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Deep brain stimulation of the nucleus ventralis intermedius for Holmes (rubral) tremor and associated dystonia caused by upper brainstem lesions

Nikkhah¹,

Prokop²,

Hellwig³

et al. 2004

FOC

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Section: Discussionmentioning

confidence: 78%

Section: Discussionmentioning

confidence: 99%

Deep brain stimulation of the nucleus ventralis intermedius for Holmes (rubral) tremor and associated dystonia caused by upper brainstem lesions

Nikkhah¹,

Prokop²,

Hellwig³

et al. 2004

FOC

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“…Several reviews of the history of movement disorders surgery are available to the interested reader (13)(14)(15)(16)(17)(18)(19), as are recent reviews of the history of functional neurosurgery in general (20), psychosurgery (21,22), DBS for pain (23,24), and epilepsy (25). It must be pointed out that electrical stimulation of various brain structures for neurological and psychiatric conditions is not a new endeavor.…”

Section: Introduction and Historical Overviewmentioning

confidence: 99%

Neuropsychological Issues in Deep Brain Stimulation of Neurological and Psychiatric Disorders

Tröster

McTaggart

Heber

2008

Deep Brain Stimulation in Neurological and Psychiatric Disorders

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The past decade has seen an explosion in the number of medically refractory conditions and neuroanatomical structures targeted for DBS treatment. While a review of the literature and meta-analyses indicate DBS for movement disorders to be safe from a neurobehavioral standpoint it is also clear that a small subset of patients have experienced moderate or severe neurobehavioral morbidity. If one combines the various cognitive and psychiatric morbidities reported across studies, approximately 10% of patients with PD undergoing DBS have experienced one or another neurobehavioral adverse events. Furthermore, several small studies have indicated that improvements in motor symptoms and quality of life (QOL) may not necessarily translate into social readjustment. A greater role for ancillary health services, such as speech therapy, occupational and physical therapy, neuropsychology, and psychotherapy needs to be contemplated. Health care providers should not rely on subjective impression or spontaneous patient report to identify neurobehavioral and psychosocial issues. Recent consensus statements on patient selection, treatment, and outcome evaluation should facilitate greater uniformity in outcome reporting and identification of neurobehavioral risk.What has proved elusive is the identification of reliable predictors and risk factors for such neurobehavioral changes. Ethical concerns and methodological limitations hinder the initiation of more sophisticated, controlled, blinded, comparative trials with large numbers of subjects needed to isolate predictors of neurobehavioral and QOL outcomes. Similarly, it is difficult to conclude at present that stimulation alone is associated with neurobehavioral morbidity, though in some cases, there are replicable effects on mood and cognition when stimulation is turned on and off. In the case of PD, and likely many of the disorders for which DBS is beginning to be investigated, outcomes may be related to an interaction of the surgical procedure and stimulation as well as subsequent changes in medications, psychosocial factors and pre-operative vulnerability. Conclusions that DBS is neuropsychologically safe in conditions such as dystonia, depression, obsessive compulsive diorder (OCD), Tourette syndrome (TS), epilepsy, multiple sclerosis (MS) and others must be considered highly preliminary until NJ 400 A.I. Tröster et al.adequate controlled trials are completed. The emergence of cognitive and social neuroscience studies of DBS, particularly when accompanied by functional neuroimaging, are encouraging signs that DBS may be used as a vehicle to better understand the cognitive and behavioral roles of the basal ganglia.

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“…Einführung der speziellen Elektroden für intrazerebrale Implantation und die zunehmende Zahl der Patienten mit ausgeprägten Nebenwirkungen der medikamentösen Therapie haben in den letzten Jahren zu einer Renaissance der stereotaktischen Techniken geführt (2).…”

unclassified

Therapie mit L-Dopa und retardiertem L-Dopa bei Patienten unter tiefer Hirnstimulation

Korchounov¹,

Oechsner²

2004

psychoneuro

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Stereotaktische Behandlung der Bewegungsstörungen

Cited by 14 publications

References 0 publications

Deep brain stimulation of the nucleus ventralis intermedius for Holmes (rubral) tremor and associated dystonia caused by upper brainstem lesions

Deep brain stimulation of the nucleus ventralis intermedius for Holmes (rubral) tremor and associated dystonia caused by upper brainstem lesions

Neuropsychological Issues in Deep Brain Stimulation of Neurological and Psychiatric Disorders

Therapie mit L-Dopa und retardiertem L-Dopa bei Patienten unter tiefer Hirnstimulation

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