Pub Date : 2024-12-09DOI: 10.1016/j.jdbs.2024.12.003
Chun-Hwei Tai , Sheng-Che Chou , Yen-Chen Lin , Ruey-Meei Wu , Chia-Jung Hsieh , Sheng-Hong Tseng
The purpose of research
We researched the beta power and other electrophysiological markers alterations during voluntary movement in Parkinson’s disease (PD) patients, in order to enhance the use of beta oscillations as a biomarker for currently developing closed-loop DBS (CL-DBS) system.
Methods
We recruited 24 patients with PD and recorded 120 sites in the subthalamic nucleus (STN) during micro-recording sessions during DBS implantation surgery. Both local field potentials (LFP) and single-units activities (SUA) were recorded concomitantly at one site during three consecutive phases: rest phase, voluntary movement phase, and post-movement rest phase. The electrophysiological data are then extracted and analyzed off-line to compare the alterations of these biomarkers during voluntary movement of the PD patients.
Results
Significant increases (17.53 % increase from baseline) in the beta oscillation power during voluntary movement (n = 208, p < 0.0001) was revealed. There was also an increase (6.79 % increase from baseline) in gamma power during voluntary movement (n = 208, p < 0.0001). Besides, there were also concomitant changes in the subthalamic spike rate and burst firing during voluntary movement.
Conclusions
The findings of alterations in beta and gamma oscillations power during voluntary movement of the PD patients will leverage the usefulness and effectiveness of these biomarkers for CL-DBS system.
{"title":"The responses of subthalamic beta oscillations during voluntary movement in patients with Parkinson’s disease","authors":"Chun-Hwei Tai , Sheng-Che Chou , Yen-Chen Lin , Ruey-Meei Wu , Chia-Jung Hsieh , Sheng-Hong Tseng","doi":"10.1016/j.jdbs.2024.12.003","DOIUrl":"10.1016/j.jdbs.2024.12.003","url":null,"abstract":"<div><h3>The purpose of research</h3><div>We researched the beta power and other electrophysiological markers alterations during voluntary movement in Parkinson’s disease (PD) patients, in order to enhance the use of beta oscillations as a biomarker for currently developing closed-loop DBS (CL-DBS) system.</div></div><div><h3>Methods</h3><div>We recruited 24 patients with PD and recorded 120 sites in the subthalamic nucleus (STN) during micro-recording sessions during DBS implantation surgery. Both local field potentials (LFP) and single-units activities (SUA) were recorded concomitantly at one site during three consecutive phases: rest phase, voluntary movement phase, and post-movement rest phase. The electrophysiological data are then extracted and analyzed off-line to compare the alterations of these biomarkers during voluntary movement of the PD patients.</div></div><div><h3>Results</h3><div>Significant increases (17.53 % increase from baseline) in the beta oscillation power during voluntary movement (n = 208, p < 0.0001) was revealed. There was also an increase (6.79 % increase from baseline) in gamma power during voluntary movement (n = 208, p < 0.0001). Besides, there were also concomitant changes in the subthalamic spike rate and burst firing during voluntary movement.</div></div><div><h3>Conclusions</h3><div>The findings of alterations in beta and gamma oscillations power during voluntary movement of the PD patients will leverage the usefulness and effectiveness of these biomarkers for CL-DBS system.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"8 ","pages":"Pages 6-13"},"PeriodicalIF":0.0,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098955","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-06DOI: 10.1016/j.jdbs.2024.12.001
Cihan Isler, Yildiz Degirmenci, Ersoy Kocabicak
{"title":"Editorial for special issue of Deep Brain Stimulation","authors":"Cihan Isler, Yildiz Degirmenci, Ersoy Kocabicak","doi":"10.1016/j.jdbs.2024.12.001","DOIUrl":"10.1016/j.jdbs.2024.12.001","url":null,"abstract":"","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"8 ","pages":"Page 14"},"PeriodicalIF":0.0,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143098515","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-05DOI: 10.1016/j.jdbs.2024.12.002
Faisal Alosaimi , Yasin Temel , Ali Jahanshahi
Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has become a standard surgical treatment option for Parkinson's disease. However, STN-DBS can cause mood-related side effects such as depression. Previous studies have shown that the inhibition of serotonergic cells in the dorsal raphe nucleus (DRN) is a potential cause of depressive-like behavior in rodents treated with STN-DBS. However, the exact anatomical circuitry behind this effect remains elusive. Given the absence of a direct anatomical connection between the STN and the DRN, relay nuclei such as the lateral habenula have been proposed to mediate those effects. Novel cell-type-specific viral tracing methods have recently unveiled a new connection from the STN to the DRN via the globus pallidus externa (GPe). To investigate whether this newly discovered anatomical connection relays the inhibitory effect of STN-DBS to the DRN, we used the designer receptors exclusively activated by the designer drug (DREADD) to inhibit the GPe. We utilized a cell-type-specific calcium indicator in transgenic 5-HT-Cre (ePet-Cre) mice to assess the activity of serotonergic cells in the DRN in STN-DBS mice while the GPe was challenged with DREADD. We observed that chemogenetic modulation of the GPe does not interfere with the suppression of DRN 5-HT neuronal activity caused by STN-DBS. These results suggest that the GPe may not serve as a relay for transmitting the suppressive effects of STN-DBS to the serotonergic neurons in the DRN or the DREADD modulation on the GPe was insufficient to counteract the effects of DBS in our study.
{"title":"Assessing the role of globus pallidus externa in relaying the effect of subthalamic nucleus high-frequency stimulation on the dorsal raphe nucleus","authors":"Faisal Alosaimi , Yasin Temel , Ali Jahanshahi","doi":"10.1016/j.jdbs.2024.12.002","DOIUrl":"10.1016/j.jdbs.2024.12.002","url":null,"abstract":"<div><div>Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has become a standard surgical treatment option for Parkinson's disease. However, STN-DBS can cause mood-related side effects such as depression. Previous studies have shown that the inhibition of serotonergic cells in the dorsal raphe nucleus (DRN) is a potential cause of depressive-like behavior in rodents treated with STN-DBS. However, the exact anatomical circuitry behind this effect remains elusive. Given the absence of a direct anatomical connection between the STN and the DRN, relay nuclei such as the lateral habenula have been proposed to mediate those effects. Novel cell-type-specific viral tracing methods have recently unveiled a new connection from the STN to the DRN via the globus pallidus externa (GPe). To investigate whether this newly discovered anatomical connection relays the inhibitory effect of STN-DBS to the DRN, we used the designer receptors exclusively activated by the designer drug (DREADD) to inhibit the GPe. We utilized a cell-type-specific calcium indicator in transgenic 5-HT-Cre (ePet-Cre) mice to assess the activity of serotonergic cells in the DRN in STN-DBS mice while the GPe was challenged with DREADD. We observed that chemogenetic modulation of the GPe does not interfere with the suppression of DRN 5-HT neuronal activity caused by STN-DBS. These results suggest that the GPe may not serve as a relay for transmitting the suppressive effects of STN-DBS to the serotonergic neurons in the DRN or the DREADD modulation on the GPe was insufficient to counteract the effects of DBS in our study.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"8 ","pages":"Pages 1-5"},"PeriodicalIF":0.0,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143148880","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-20DOI: 10.1016/j.jdbs.2024.11.002
Luke Andrews , Ahmad M.S. Ali , Mohammed Elmolla , Simon S. Keller , Maneesh Bhojak , Jibril Osman-Farah , Antonella Macerollo
Background
Cervical dystonia is a movement disorder marked by involuntary head and neck muscle contractions. Deep brain stimulation (DBS) targeting the globus pallidus internus (GPi) is a recognised treatment, with directional DBS—enabling current steering—gaining traction in movement disorder management.
Objective
This study assessed clinical outcomes in cervical dystonia patients treated with directional DBS at our centre, compared to a matched group receiving conventional DBS, and examined challenges and research directions in directional DBS for dystonia.
Methods
Eleven patients with adult-onset isolated cervical dystonia received bilateral GPi stimulation with directional DBS systems, compared to a demographically matched cohort with conventional systems. Clinical outcomes and stimulation parameters were recorded at the latest follow-up, and electrode positioning was analysed using patient-specific volumes of tissue activated (VTA).
Results
Directional DBS significantly improved dystonia severity, pain, disability, and quality of life (p < 0.001), with no significant differences versus conventional DBS. Five patients utilised at least one directional electrode; six were set to bilateral “ring-mode” stimulation. Group VTA for directional DBS was positioned more medial and anterior than ring-mode or conventional DBS. Side effects were less frequent in directional DBS (20 %) than in ring-mode (83 %) or conventional DBS (36 %).
Conclusion
Directional DBS showed efficacy comparable to conventional DBS in managing cervical dystonia, with fewer side effects. Despite these benefits, its application in dystonia remains limited compared to other movement disorders, such as Parkinson’s disease and essential tremor, though advances in image-guided programming and biomarker discovery could support wider use in dystonia management.
{"title":"Directional deep brain stimulation for cervical dystonia: Outcomes, challenges and future directions","authors":"Luke Andrews , Ahmad M.S. Ali , Mohammed Elmolla , Simon S. Keller , Maneesh Bhojak , Jibril Osman-Farah , Antonella Macerollo","doi":"10.1016/j.jdbs.2024.11.002","DOIUrl":"10.1016/j.jdbs.2024.11.002","url":null,"abstract":"<div><h3>Background</h3><div>Cervical dystonia is a movement disorder marked by involuntary head and neck muscle contractions. Deep brain stimulation (DBS) targeting the globus pallidus internus (GPi) is a recognised treatment, with directional DBS—enabling current steering—gaining traction in movement disorder management.</div></div><div><h3>Objective</h3><div>This study assessed clinical outcomes in cervical dystonia patients treated with directional DBS at our centre, compared to a matched group receiving conventional DBS, and examined challenges and research directions in directional DBS for dystonia.</div></div><div><h3>Methods</h3><div>Eleven patients with adult-onset isolated cervical dystonia received bilateral GPi stimulation with directional DBS systems, compared to a demographically matched cohort with conventional systems. Clinical outcomes and stimulation parameters were recorded at the latest follow-up, and electrode positioning was analysed using patient-specific volumes of tissue activated (VTA).</div></div><div><h3>Results</h3><div>Directional DBS significantly improved dystonia severity, pain, disability, and quality of life (p < 0.001), with no significant differences versus conventional DBS. Five patients utilised at least one directional electrode; six were set to bilateral “ring-mode” stimulation. Group VTA for directional DBS was positioned more medial and anterior than ring-mode or conventional DBS. Side effects were less frequent in directional DBS (20 %) than in ring-mode (83 %) or conventional DBS (36 %).</div></div><div><h3>Conclusion</h3><div>Directional DBS showed efficacy comparable to conventional DBS in managing cervical dystonia, with fewer side effects. Despite these benefits, its application in dystonia remains limited compared to other movement disorders, such as Parkinson’s disease and essential tremor, though advances in image-guided programming and biomarker discovery could support wider use in dystonia management.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"7 ","pages":"Pages 7-13"},"PeriodicalIF":0.0,"publicationDate":"2024-11-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-13DOI: 10.1016/j.jdbs.2024.11.001
Chesney S. Oravec , Rebecca L. Calafiore , Sidish Venkataraman , Robert K. Townsend , Jacob Brendle , Muneera Kapadia , Carol A. Kittel , Mustafa S. Siddiqui , Adrian W. Laxton , Stephen B. Tatter , Amber Kimball-Hsu , Wesley Hsu
Background
We sought to determine if using clear masks in the operating room improves communication for patients undergoing awake deep brain stimulation (DBS) surgery.
Methods
This randomized, controlled study involved patients undergoing awake DBS receiving communication from the neurologist wearing a covered or clear mask for the intraoperative assessment, using a block randomization schedule. Adult patients (>18) undergoing DBS surgery between November 2021 and July 2023 were evaluated for inclusion. The primary outcome was a dichotomized response to the first question of a 10-question survey: “Did this provider explain things in a way that was easy to understand?”, answered using a Likert scale of 1–4. Secondary outcomes included differences in the responses to the remaining questions.
Results
104 patients were assessed for eligibility, 72 were enrolled, and 65 completed all questionnaires. More males than females (72.3 % versus 27.7 %) were enrolled, and most patients (64 %) underwent DBS for treatment of Parkinson’s disease. The primary outcome analysis showed 93.5 % positive response in the clear mask group compared to 85.3 % in the covered mask group (p = 0.502). There were no infections within 30 days or study-related adverse events in either population.
Discussion
This randomized controlled trial demonstrates that the use of clear masks in the setting of awake brain surgery has no difference on patient perception of communication compared to covered masks. There were no infections or mask-related adverse events. This suggests that clear masks are a safe and effective alternative to traditional masks in the operating room.
{"title":"Read my lips: Clear versus standard masks during awake deep brain stimulation surgery – A randomized clinical trial","authors":"Chesney S. Oravec , Rebecca L. Calafiore , Sidish Venkataraman , Robert K. Townsend , Jacob Brendle , Muneera Kapadia , Carol A. Kittel , Mustafa S. Siddiqui , Adrian W. Laxton , Stephen B. Tatter , Amber Kimball-Hsu , Wesley Hsu","doi":"10.1016/j.jdbs.2024.11.001","DOIUrl":"10.1016/j.jdbs.2024.11.001","url":null,"abstract":"<div><h3>Background</h3><div>We sought to determine if using clear masks in the operating room improves communication for patients undergoing awake deep brain stimulation (DBS) surgery.</div></div><div><h3>Methods</h3><div>This randomized, controlled study involved patients undergoing awake DBS receiving communication from the neurologist wearing a covered or clear mask for the intraoperative assessment, using a block randomization schedule. Adult patients (>18) undergoing DBS surgery between November 2021 and July 2023 were evaluated for inclusion. The primary outcome was a dichotomized response to the first question of a 10-question survey: “Did this provider explain things in a way that was easy to understand?”, answered using a Likert scale of 1–4. Secondary outcomes included differences in the responses to the remaining questions.</div></div><div><h3>Results</h3><div>104 patients were assessed for eligibility, 72 were enrolled, and 65 completed all questionnaires. More males than females (72.3 % versus 27.7 %) were enrolled, and most patients (64 %) underwent DBS for treatment of Parkinson’s disease. The primary outcome analysis showed 93.5 % positive response in the clear mask group compared to 85.3 % in the covered mask group (p = 0.502). There were no infections within 30 days or study-related adverse events in either population.</div></div><div><h3>Discussion</h3><div>This randomized controlled trial demonstrates that the use of clear masks in the setting of awake brain surgery has no difference on patient perception of communication compared to covered masks. There were no infections or mask-related adverse events. This suggests that clear masks are a safe and effective alternative to traditional masks in the operating room.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"7 ","pages":"Pages 1-6"},"PeriodicalIF":0.0,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142703367","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-15DOI: 10.1016/j.jdbs.2024.10.002
Yarit Wiggerts , Annabel van der Weide , Evan Markidis , Joke M. Dijk , Vincent J.J. Odekerken , Maarten Bot , Pepijn van den Munckhof , P. Rick Schuurman , Rob M.A. de Bie , Martijn Beudel
Background
Deep brain stimulation (DBS) for Parkinson’s disease (PD), essential tremor (ET), and dystonia is a well-established treatment option. The correlation between motor symptom improvement and effect on disability is inconclusive.
Objectives
To assess the correlation between DBS-induced improvements of motor symptoms and disability for PD, ET and dystonia.
Methods
Disability and motor scores were obtained before and six to twelve months after surgery for 324 PD, 35 ET and 40 dystonia patients.
Results
There was a modest and significant correlation for PD (Rho=0.284, p < 0.001), a substantial and significant correlation for ET (Rho=0.542, p < 0.001) and no correlation for dystonia (Rho=0.238, p = 0.138) between motor score and disability improvement.
Conclusions
The effect of DBS on motor symptoms and disability is not uniformly for dystonia. Possible reasons for this are that the scales used might not be responsive or other symptoms than motor symptoms might have a greater impact on disability.
{"title":"The correlation between motor improvement and disability in activities of daily living after DBS in Parkinson’s disease, tremor and dystonia","authors":"Yarit Wiggerts , Annabel van der Weide , Evan Markidis , Joke M. Dijk , Vincent J.J. Odekerken , Maarten Bot , Pepijn van den Munckhof , P. Rick Schuurman , Rob M.A. de Bie , Martijn Beudel","doi":"10.1016/j.jdbs.2024.10.002","DOIUrl":"10.1016/j.jdbs.2024.10.002","url":null,"abstract":"<div><h3>Background</h3><div>Deep brain stimulation (DBS) for Parkinson’s disease (PD), essential tremor (ET), and dystonia is a well-established treatment option. The correlation between motor symptom improvement and effect on disability is inconclusive.</div></div><div><h3>Objectives</h3><div>To assess the correlation between DBS-induced improvements of motor symptoms and disability for PD, ET and dystonia.</div></div><div><h3>Methods</h3><div>Disability and motor scores were obtained before and six to twelve months after surgery for 324 PD, 35 ET and 40 dystonia patients.</div></div><div><h3>Results</h3><div>There was a modest and significant correlation for PD (Rho=0.284, <em>p</em> < 0.001), a substantial and significant correlation for ET (Rho=0.542, <em>p</em> < 0.001) and no correlation for dystonia (Rho=0.238, <em>p</em> = 0.138) between motor score and disability improvement.</div></div><div><h3>Conclusions</h3><div>The effect of DBS on motor symptoms and disability is not uniformly for dystonia. Possible reasons for this are that the scales used might not be responsive or other symptoms than motor symptoms might have a greater impact on disability.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"6 ","pages":"Pages 29-33"},"PeriodicalIF":0.0,"publicationDate":"2024-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142528231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-05DOI: 10.1016/j.jdbs.2024.10.001
Chiara van der Kuy , Pieter L. Kubben , Linda Ackermans , Mayke Oosterloo , Mark L. Kuijf , Marcus L.F. Janssen
Dystonia is a neurological disorder characterized by intermittent muscle contractions or abnormal movements. The pathophysiology and pathogenetic variations are increasingly better understood, but their translation into appropriate treatment is still largely lacking. We present a case of a woman suffering from a dystonic tremor of the upper limbs and head. Both the patient treated with DBS and her sister carry a novel mutation in the VPS16 gene. Treatment proved to be successful through deep brain stimulation targeting the ventral intermediate nucleus of the thalamus.
{"title":"Deep brain stimulation in a patient with dystonic tremor with a novel familial VPS16 gene mutation","authors":"Chiara van der Kuy , Pieter L. Kubben , Linda Ackermans , Mayke Oosterloo , Mark L. Kuijf , Marcus L.F. Janssen","doi":"10.1016/j.jdbs.2024.10.001","DOIUrl":"10.1016/j.jdbs.2024.10.001","url":null,"abstract":"<div><div>Dystonia is a neurological disorder characterized by intermittent muscle contractions or abnormal movements. The pathophysiology and pathogenetic variations are increasingly better understood, but their translation into appropriate treatment is still largely lacking. We present a case of a woman suffering from a dystonic tremor of the upper limbs and head. Both the patient treated with DBS and her sister carry a novel mutation in the VPS16 gene. Treatment proved to be successful through deep brain stimulation targeting the ventral intermediate nucleus of the thalamus.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"6 ","pages":"Pages 20-22"},"PeriodicalIF":0.0,"publicationDate":"2024-10-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421273","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-09-30DOI: 10.1016/j.jdbs.2024.09.001
Annabel van der Weide , Anjum Aarifa Khanom , Yarit Wiggerts , Yasmin Namavar , Joke Dijk , Maarten Bot , Pepijn van den Munckhof , Rick Schuurman , Rob M.A. de Bie , Jibril Osman Farah , Antonella Macerollo , Martijn Beudel
Background
Patient satisfaction of deep brain stimulation (DBS) for cervical dystonia (CD) is heterogeneous. A high prevalence of psychiatric disorders in patients with CD is well-established. The presence of psychiatric classification in CD may affect the outcomes of DBS treatment.
Methods
A cohort of 49 patients with CD and GPi-DBS was retrospectively studied in two centers. Psychiatric history was obtained from patient records. Pre- and post-operative Toronto Western Spasmodic Torticollis Rating Scores (TWSTRS, range 0–85) were compared between patients with and those without psychiatric classification. The TWSTRS disability and pain sub-scores were combined to evaluate non-motor improvement. The severity sub-score was used to assess motor improvement.
Results
Twenty (40.8 %) patients had a psychiatric classification, predominantly major depressive disorder and anxiety disorders. Following DBS treatment, the overall mean (± SD) improvement on the TWSTRS was 38.0 ± 29.2 %. Significantly, patients with a psychiatric classification experienced less improvement in the non-motor domain than the patients without a psychiatric classification (29.1 ± SD 38.2 % [range −41.7 to 96.6 %] vs. 51.9 ± 33.6 % [range −8.6 to 100.0 %]; p = 0.02).
Conclusion
Our findings indicate that CD patients with psychiatric classifications experience less non-motor improvement following DBS. Psychiatric comorbidities could influence the lacking experience of successful DBS treatment despite good motor outcome. Therefore, it is important to establish these comorbidities in CD patients undergoing DBS with respect to expectation management and treatment if necessary.
背景深部脑刺激（DBS）治疗颈性肌张力障碍（CD）的患者满意度参差不齐。CD 患者中精神障碍的高患病率已得到证实。方法对两个中心的 49 名 CD 和 GPi-DBS 患者进行了回顾性研究。从患者病历中获取精神病史。比较了有精神病分类和无精神病分类患者的术前和术后多伦多西方痉挛性皮肌痉挛评分（TWSTRS，范围 0-85）。将 TWSTRS 残疾和疼痛子分数合并，以评估非运动改善情况。结果20 名（40.8%）患者有精神病分类，主要是重度抑郁症和焦虑症。接受 DBS 治疗后，TWSTRS 的总体平均（± SD）改善率为 38.0 ± 29.2%。值得注意的是，与无精神分类的患者相比，有精神分类的患者在非运动领域的改善较少（29.1 ± SD 38.2 % [范围-41.7至96.6 %] vs. 51.9 ± 33.6 % [范围-8.6至100.0 %]; p = 0.02）。我们的研究结果表明，患有精神疾病的 CD 患者在接受 DBS 治疗后，非运动功能的改善较少。尽管运动功能改善良好，但精神疾病合并症可能会影响 DBS 治疗的成功率。因此，必须确定接受 DBS 治疗的 CD 患者是否有这些合并症，以便在必要时进行预期管理和治疗。
{"title":"Cervical dystonia patients with psychiatric classification: Despite dystonia improvement less improvement in other domains after DBS surgery","authors":"Annabel van der Weide , Anjum Aarifa Khanom , Yarit Wiggerts , Yasmin Namavar , Joke Dijk , Maarten Bot , Pepijn van den Munckhof , Rick Schuurman , Rob M.A. de Bie , Jibril Osman Farah , Antonella Macerollo , Martijn Beudel","doi":"10.1016/j.jdbs.2024.09.001","DOIUrl":"10.1016/j.jdbs.2024.09.001","url":null,"abstract":"<div><h3>Background</h3><div>Patient satisfaction of deep brain stimulation (DBS) for cervical dystonia (CD) is heterogeneous. A high prevalence of psychiatric disorders in patients with CD is well-established. The presence of psychiatric classification in CD may affect the outcomes of DBS treatment.</div></div><div><h3>Methods</h3><div>A cohort of 49 patients with CD and GPi-DBS was retrospectively studied in two centers. Psychiatric history was obtained from patient records. Pre- and post-operative Toronto Western Spasmodic Torticollis Rating Scores (TWSTRS, range 0–85) were compared between patients with and those without psychiatric classification. The TWSTRS disability and pain sub-scores were combined to evaluate non-motor improvement. The severity sub-score was used to assess motor improvement.</div></div><div><h3>Results</h3><div>Twenty (40.8 %) patients had a psychiatric classification, predominantly major depressive disorder and anxiety disorders. Following DBS treatment, the overall mean (± SD) improvement on the TWSTRS was 38.0 ± 29.2 %. Significantly, patients with a psychiatric classification experienced less improvement in the non-motor domain than the patients without a psychiatric classification (29.1 ± SD 38.2 % [range −41.7 to 96.6 %] vs. 51.9 ± 33.6 % [range −8.6 to 100.0 %]; <em>p</em> = 0.02).</div></div><div><h3>Conclusion</h3><div>Our findings indicate that CD patients with psychiatric classifications experience less non-motor improvement following DBS. Psychiatric comorbidities could influence the lacking experience of successful DBS treatment despite good motor outcome. Therefore, it is important to establish these comorbidities in CD patients undergoing DBS with respect to expectation management and treatment if necessary.</div></div>","PeriodicalId":100359,"journal":{"name":"Deep Brain Stimulation","volume":"6 ","pages":"Pages 23-28"},"PeriodicalIF":0.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142421272","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-07-18DOI: 10.1016/j.jdbs.2024.07.003
Anouk Wolters , Yasin Temel , Hans Clusmann , Sarah-Anna Hescham
Parkinson's disease (PD) is a prevalent neurodegenerative disorder primarily affecting the motor system. However, it is also accompanied by significant non-motor symptoms such as sleep disturbances, cognitive impairment, and mood disorders. While dopaminergic deficits in the substantia nigra pars compacta are linked to motor symptoms, cognitive decline and non-motor symptoms may involve other neurotransmitter systems, including cholinergic pathways. This review investigates the cognitive implications of traditional and novel subthalamic nucleus (STN) deep brain stimulation (DBS) paradigms in PD. Recognising the growing significance of cognitive function in the management of PD, our study aims to analyse comprehensively how different DBS approaches impact cognitive outcomes. By reviewing existing literature, we examine the cognitive domains of PD patients undergoing traditional STN DBS and explore the effects of novel stimulation paradigms. The findings from these studies may enhance our understanding of the cognitive consequences associated with STN DBS and inform therapeutic strategies to optimize patient outcomes in PD management.
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