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At least 721 records · Page 40Linked to original sources
PubMed1985

Sensory and motor responses to deep brain stimulation. Correlation with anatomical structures.

Motor and sensory responses induced by trial stimulation were examined before stereotaxically implanting a permanent stimulating electrode for pain relief in 11 patients with intractable pain of central origin. The total number of points eliciting a response when stimulated was 70. The points of stimulation were determined as exactly as possible from Schaltenbrand and Bailey's Atlas. Motor responses were detected upon stimulating 21 points, the majority of which were in the posterior third of the posterior limb of the internal capsule (IC). Stimulation of these 21 points was accompanied by pain relief in only two points (10%). Warm (22) or cool sensations (three) were provoked in the most posteromedial portion of the posterior limb of the IC, nucleus reticularis pulvinaris, and area triangularis, and seven (28%) of these 25 sensations were accompanied by pain relief. A burning sensation was found upon stimulation of 12 points, with stimulation in the mesencephalic lateral tegmental field eliciting the most severe burning pain. A tingling sensation was elicited at 12 points, in a distribution similar to that of the warm sensation. Five (42%) of these 12 points provided pain relief. The best stimulating point for pain relief is not in the center of the posterior limb of the IC, directly lateral to the posterior commissure, but rather in its most posteromedial part; that is, at the nucleus reticularis pulvinaris or area triangularis.

Adult↗
PubMed2004

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

Holmes tremor is caused by structural lesions in the perirubral area of the midbrain. Patients often present with associated symptoms such as dystonia and paresis, which are usually refractory to medical therapy. Here, the authors describe two patients in whom both tremor and associated dystonia improved markedly following unilateral stimulation of the thalamic nucleus ventralis intermedius.

Ataxia↗
PubMed2000

Changes in cerebral blood oxygenation induced by deep brain stimulation: study by near-infrared spectroscopy (NIRS).

Previous studies have demonstrated that neural activation causes changes in cerebral blood oxygenation (CBO), i.e. increases in tissue levels of oxy-Hb and total-Hb with a decrease in deoxy-Hb concentration. It is unclear, however, whether neural activation always induces the same pattern of CBO changes or not. In the present study, employing a near-infrared spectroscopy (NIRS), we investigated the CBO changes in the frontal lobe induced by direct stimulation of the thalamus (Vim) or globus pallidus (GPi) in patients with Parkinson's disease or essential tremor. The results indicated that under conditions of neural activation in the frontal lobe, oxy-Hb and total-Hb increased in all 6 cases. Deoxy-Hb decreased in 2 cases during GPi stimulation, and increased in 4 cases during low frequency stimulation of the Vim. The above findings suggest that neural activation induces various patterns of CBO change, especially in deoxy-Hb. This implies that functional MRI based on the BOLD contrast may not consistently detect the area of neural activation.

Cerebrovascular Circulation↗
PubMed2000

[Deep brain stimulation(DBS) therapy for parkkinson,s disease].

During the last decade, it has become increasingly clear that DBS represents a useful adjunct for therapies to control various symptoms of Parkinson's disease. The stimulation sites include the thalamic nucleus ventralis intermedius(Vim), globus pallidus internus(GPi) and subthalamic nucleus (STN). The clinical data of DBS therapy currently available from the literature, together with our own experience, are reviewed. The results of our double blinded evaluation of the effects of GPi and STN stimulation are also summarized. DBS therapy affords the best effect on tremor when the Vim is selected as the stimulation site. DBS therapy is also useful for controlling rigidity when the GPi or STN is stimulated. Improvement of bradykinesia may often be induced by DBS therapy involving the GPi or STN. Dopa-induced dyskinesia can be attenuated effectively by the direct and/or indirect effects of DBS therapy. Two advantages of GPi and STN stimulation were identified in our double blinded evaluation. Firstly, the stimulation can supplement a reduced action of levodopa during the off-period. It thus improves the patient's daily activities through attenuation of the motor fluctuations. Secondly, the stimulation can replace part of the action of levodopa during the on-period. It thus attenuates dopa-induced dyskinesia through a reduced dose of medication. More importantly, the stimulation improves the daily activities in dopa-intolerant patients who are being administered a small dose of levodopa because of unbearable side effects. In addition, GPi stimulation has its own inhibitory effect on dopa-induced dyskinesia.

Clinical Trials as Topic↗