{"title":"Could systemic infections influence the effectiveness of deep brain stimulation therapy in patients with dystonia?","authors":"Valentino Rački , Mario Hero , Eliša Papić , Gloria Rožmarić , Marina Raguž , Darko Chudy , Olivio Perković , Vladimira Vuletić","doi":"10.1016/j.mehy.2024.111527","DOIUrl":null,"url":null,"abstract":"<div><div>Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions resulting from aberrant sensory integration, enhanced cortical plasticity, and lack of intracortical inhibition. Deep brain stimulation of the globus pallidus internus (GPi-DBS) effectively treats dystonia, reducing abnormal neural oscillations and improving motor function. However, systemic infections can significantly impact brain function, altering brain wave dynamics and cortical excitability. We hypothesize that dystonia patients treated with DBS exhibit altered cortical excitability and changes in brain wave dynamics during early recovery from systemic infections, necessitating DBS parameters adjustment to prevent symptoms exacerbation. We propose a two-year clinical study involving 15 dystonia patients with DBS capable of local field potential (LFP) recording to evaluate this hypothesis. The study will analyze brain activity patterns, symptom severity and infection impact on neural activity. Continuous and infection-triggered LFP recording will provide data for advanced analysis to identify LFP patterns associated with dystonia symptoms and the effects of infections. This paper underscored the importance of individualized and dynamic DBS management, especially post-infection. Systemic infections can induce neuroinflammation, disrupting neural circuits and increasing brain sensitivity to DBS. Timely DBS adjustments are crucial to mitigate overstimulation and optimize outcomes. Enhanced post-infection care, including thorough evaluations and parameter adjustments, is essential for managing dystonia patients with DBS. Future research into the neuroinflammatory mechanism and their effect on neural circuits will improve our understanding and treatment of dystonia in the context of systemic infections.</div></div>","PeriodicalId":18425,"journal":{"name":"Medical hypotheses","volume":"194 ","pages":"Article 111527"},"PeriodicalIF":2.1000,"publicationDate":"2024-11-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Medical hypotheses","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0306987724002706","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"MEDICINE, RESEARCH & EXPERIMENTAL","Score":null,"Total":0}
引用次数: 0
Abstract
Dystonia is a movement disorder characterized by sustained or intermittent muscle contractions resulting from aberrant sensory integration, enhanced cortical plasticity, and lack of intracortical inhibition. Deep brain stimulation of the globus pallidus internus (GPi-DBS) effectively treats dystonia, reducing abnormal neural oscillations and improving motor function. However, systemic infections can significantly impact brain function, altering brain wave dynamics and cortical excitability. We hypothesize that dystonia patients treated with DBS exhibit altered cortical excitability and changes in brain wave dynamics during early recovery from systemic infections, necessitating DBS parameters adjustment to prevent symptoms exacerbation. We propose a two-year clinical study involving 15 dystonia patients with DBS capable of local field potential (LFP) recording to evaluate this hypothesis. The study will analyze brain activity patterns, symptom severity and infection impact on neural activity. Continuous and infection-triggered LFP recording will provide data for advanced analysis to identify LFP patterns associated with dystonia symptoms and the effects of infections. This paper underscored the importance of individualized and dynamic DBS management, especially post-infection. Systemic infections can induce neuroinflammation, disrupting neural circuits and increasing brain sensitivity to DBS. Timely DBS adjustments are crucial to mitigate overstimulation and optimize outcomes. Enhanced post-infection care, including thorough evaluations and parameter adjustments, is essential for managing dystonia patients with DBS. Future research into the neuroinflammatory mechanism and their effect on neural circuits will improve our understanding and treatment of dystonia in the context of systemic infections.
期刊介绍:
Medical Hypotheses is a forum for ideas in medicine and related biomedical sciences. It will publish interesting and important theoretical papers that foster the diversity and debate upon which the scientific process thrives. The Aims and Scope of Medical Hypotheses are no different now from what was proposed by the founder of the journal, the late Dr David Horrobin. In his introduction to the first issue of the Journal, he asks ''what sorts of papers will be published in Medical Hypotheses? and goes on to answer ''Medical Hypotheses will publish papers which describe theories, ideas which have a great deal of observational support and some hypotheses where experimental support is yet fragmentary''. (Horrobin DF, 1975 Ideas in Biomedical Science: Reasons for the foundation of Medical Hypotheses. Medical Hypotheses Volume 1, Issue 1, January-February 1975, Pages 1-2.). Medical Hypotheses was therefore launched, and still exists today, to give novel, radical new ideas and speculations in medicine open-minded consideration, opening the field to radical hypotheses which would be rejected by most conventional journals. Papers in Medical Hypotheses take a standard scientific form in terms of style, structure and referencing. The journal therefore constitutes a bridge between cutting-edge theory and the mainstream of medical and scientific communication, which ideas must eventually enter if they are to be critiqued and tested against observations.