Directional Stimulus-Evoked Pallidal Electrophysiology in Primary Dystonia.

IF 2.5 Q2 CLINICAL NEUROLOGY Tremor and Other Hyperkinetic Movements Pub Date : 2024-09-18 eCollection Date: 2024-01-01 DOI:10.5334/tohm.916

Aditya V Boddu, Sarah Brinkerhoff, Adam E Bashir, Camerron M Crowder, Mohammed Awad, Christopher L Gonzalez, Harrison C Walker

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Abstract

Background: Deep brain stimulation for dystonia improves motor symptoms but variable and delayed responses challenge patient selection, targeting, and device programming.

Case report: Here we studied intracranial electrophysiology in a patient with primary dystonia and observed evoked resonant neural activity (ERNA) in the globus pallidus interna. These local stimulus-evoked potentials displayed refractory periods and paired-pulse facilitation at clinically relevant interstimulus intervals. Sensing from directional DBS contacts localized ERNA to an effective stimulation site in the ventral posterolateral portion of the pallidum.

Discussion: To the best of our knowledge, this is the first observation of ERNA in the globus pallidus interna in a patient with primary dystonia. Stimulus-evoked activity could eventually guide both directional and adaptive stimulation for dystonia and other complex neuropsychiatric disorders.

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原发性肌张力障碍的定向刺激诱发苍白球电生理学

背景：脑深部刺激治疗肌张力障碍可改善运动症状，但不同的延迟反应对患者选择、目标定位和设备编程提出了挑战：在此，我们研究了一名原发性肌张力障碍患者的颅内电生理学，并观察到了球状苍白肌间隙的诱发共振神经活动（ERNA）。这些局部刺激诱发电位显示了临床相关的刺激间期的折射期和配对脉冲促进。定向 DBS 触点的感应将 ERNA 定位在苍白球腹侧后外侧的有效刺激部位：据我们所知，这是首次在原发性肌张力障碍患者的苍白球间期观察到ERNA。刺激诱发的活动最终可为肌张力障碍和其他复杂神经精神疾病的定向和适应性刺激提供指导。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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