Tremor and Quality of Life in Patients With Advanced Essential Tremor Before and After Replacing Their Standard Deep Brain Stimulation With a Directional System

Krüger, Marie T.; Avecillas-Chasín, Josué M; Tamber, Mandeep S.; Heran, Manraj K. S.; Sandhu, Mini K; Polyhronopoulos, Nancy E; Sarai, Natasha; Honey, Christopher R.

doi:10.1111/ner.13301

Cited by 7 publications

(9 citation statements)

References 30 publications

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“…In recent years, with the advancement of DBS technology, directional leads [ 34 , 35 , 36 , 37 , 38 , 39 , 40 ] and adaptive DBS (aDBS) [ 41 ] have been developed and made clinically available. There are many reports showing the usefulness of directional leads not only in PD but also in essential tremor (ET) [ 34 , 35 , 36 , 37 , 38 , 39 , 40 ]. Directional leads can be particularly useful in optimizing STN-DBS stimulation to expand therapeutic windows and avoid stimulation-induced side effects [ 34 ].…”

Section: Advanced Treatmentsmentioning

confidence: 99%

“…This is the first publication to date that showed a clinical superiority of directional DBS. Thus, directional DBS may have high potential for patients with advanced symptoms [ 40 ]. aDBS is a technique that was developed to enable analysis of local field potentials from leads in STN and/or GPi, revealing that beta oscillations are associated with motor features of PD [ 41 ].…”

Section: Advanced Treatmentsmentioning

confidence: 99%

“…A multi-disciplinary medical team can be very helpful in advancing this treatment. In recent years, with the advancement of DBS technology, directional leads [34][35][36][37][38][39][40] and adaptive DBS (aDBS) [41] have been developed and made clinically available. There are many reports showing the usefulness of directional leads not only in PD but also in essential tremor (ET) [34][35][36][37][38][39][40].…”

Section: Levodopa-carbidopa Intestinal Gel (Lcig)mentioning

confidence: 99%

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Personalized Medicine in Parkinson’s Disease: New Options for Advanced Treatments

Mishima

Fujioka

Morishita

et al. 2021

JPM

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Parkinson’s disease (PD) presents varying motor and non-motor features in each patient owing to their different backgrounds, such as age, gender, genetics, and environmental factors. Furthermore, in the advanced stages, troublesome symptoms vary between patients due to motor and non-motor complications. The treatment of PD has made great progress over recent decades and has directly contributed to an improvement in patients’ quality of life, especially through the progression of advanced treatment. Deep brain stimulation, radiofrequency, MR–guided focused ultrasound, gamma knife, levodopa-carbidopa intestinal gel, and apomorphine are now used in the clinical setting for this disease. With multiple treatment options currently available for all stages of PD, we here discuss the most recent options for advanced treatment, including cell therapy in advanced PD, from the perspective of personalized medicine.

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Section: Advanced Treatmentsmentioning

confidence: 99%

Section: Advanced Treatmentsmentioning

confidence: 99%

Section: Levodopa-carbidopa Intestinal Gel (Lcig)mentioning

confidence: 99%

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Personalized Medicine in Parkinson’s Disease: New Options for Advanced Treatments

Mishima

Fujioka

Morishita

et al. 2021

JPM

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“…The additional stimulation options provided by directional DBS, however, are associated with an increase in the time required to program the leads, 10 especially in complex patients. 9 Imaging software can be used to facilitate programming, but require information regarding the orientation of the leads. Furthermore, sustained orientation is a prerequisite for longterm clinical efficacy.…”

Section: Introductionmentioning

confidence: 99%

“…Directional deep brain stimulation (DBS) leads have been shown to have theoretical benefits in newly implanted patients with Parkinson's disease [1][2][3][4][5] and essential tremor, 4,[6][7][8] while initial data indicate their clinical superiority in patients with advanced disease. 9 The use of directional leads is thus becoming increasingly relevant.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of the Rotational Stability of Directional Deep Brain Stimulation Leads: A Case Series and Systematic Review

Cavalloni,

Brugger,

Kägi

et al. 2023

J Neurol Surg A Cent Eur Neurosurg

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Background The rotational stability of directional deep brain stimulation leads is a major prerequisite for sustained clinical effects. Data on directional lead stability are limited and controversial. Methods We aimed to evaluate the long-term rotational stability of directional leads and define confounding factors in our own population and the current literature. We retrospectively evaluated the orientation of directional leads in patients with available postoperative computed tomography (CT; T1; day of surgery) and an additional postoperative image (T2; CT or rotational fluoroscopy) performed more than 7 days after the initial scan. The potential impact of intracranial air was assessed. We also reviewed the literature to define factors impacting stability. Results Thirty-six leads were evaluated. The mean follow-up between T1 and T2 was 413.3 (7–1,171) days. The difference in rotation between T1 and T2 was 2.444 ± 2.554 degrees (range: 0–9.0 degrees). The volume of intracranial air did not impact the rotation. The literature search identified one factor impacting the stability of directional leads, which is the amount of twist applied at implantation. Conclusion Directional leads for deep brain stimulation show stable long-term orientation after implantation. Based on our literature review, large amounts of twist during implantation can lead to delayed rotation and should thus be avoided.

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Deep Brain Stimulation for Tremor

Avantaggiato,

Isaias

2023

Contemporary Clinical Neuroscience

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Tremor and Quality of Life in Patients With Advanced Essential Tremor Before and After Replacing Their Standard Deep Brain Stimulation With a Directional System

Cited by 7 publications

References 30 publications

Personalized Medicine in Parkinson’s Disease: New Options for Advanced Treatments

Personalized Medicine in Parkinson’s Disease: New Options for Advanced Treatments

Evaluation of the Rotational Stability of Directional Deep Brain Stimulation Leads: A Case Series and Systematic Review

Deep Brain Stimulation for Tremor

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