Julia Steinhardt, Simone Zittel, Vera Tadic, Volker Tronnier, Christian Moll, Tobias Bäumer, Alexander Münchau, Dirk Rasche, Norbert Brüggemann
{"title":"GPi/GPe 边界--深部脑刺激治疗亨廷顿舞蹈症的潜在甜蜜点？","authors":"Julia Steinhardt, Simone Zittel, Vera Tadic, Volker Tronnier, Christian Moll, Tobias Bäumer, Alexander Münchau, Dirk Rasche, Norbert Brüggemann","doi":"10.1186/s42466-024-00316-5","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>Pallidal deep brain stimulation (GPi-DBS) has been considered as an effective treatment option for medication-refractory Huntington's disease (HD).</p><p><strong>Objectives: </strong>To identify stimulation-dependent effects on motor symptoms and to determine if these alterations are associated with the local impact of DBS on different pallidal parcellations.</p><p><strong>Methods: </strong>We prospectively evaluated the effects of bilateral GPi-DBS within one year in 5 HD patients. We evaluated the effects of GPi-DBS on choreatic symptoms and UHDRS. Electrode placement in the pallidum was localized, and the local impact of DBS was estimated.</p><p><strong>Results: </strong>The chorea subscore (p < 0.001) and UHDRS total motor score was significantly reduced postoperatively (p = 0.019). Pallidal DBS did not improve other motor symptoms. Activation of the lateral GPi/GPe was associated with improvement in choreatic symptoms (p = 0.048; r = 0.90).</p><p><strong>Conclusions: </strong>Our findings indicate that stimulation of the lateral GPi has a stable effect on choreatic symptoms. The modulation of the electrical field is relevant for motor outcome.</p>","PeriodicalId":94156,"journal":{"name":"Neurological research and practice","volume":"6 1","pages":"28"},"PeriodicalIF":4.0000,"publicationDate":"2024-05-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11112842/pdf/","citationCount":"0","resultStr":"{\"title\":\"GPi/GPe borderland- a potential sweet spot for deep brain stimulation for chorea in Huntington's disease?\",\"authors\":\"Julia Steinhardt, Simone Zittel, Vera Tadic, Volker Tronnier, Christian Moll, Tobias Bäumer, Alexander Münchau, Dirk Rasche, Norbert Brüggemann\",\"doi\":\"10.1186/s42466-024-00316-5\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>Pallidal deep brain stimulation (GPi-DBS) has been considered as an effective treatment option for medication-refractory Huntington's disease (HD).</p><p><strong>Objectives: </strong>To identify stimulation-dependent effects on motor symptoms and to determine if these alterations are associated with the local impact of DBS on different pallidal parcellations.</p><p><strong>Methods: </strong>We prospectively evaluated the effects of bilateral GPi-DBS within one year in 5 HD patients. We evaluated the effects of GPi-DBS on choreatic symptoms and UHDRS. Electrode placement in the pallidum was localized, and the local impact of DBS was estimated.</p><p><strong>Results: </strong>The chorea subscore (p < 0.001) and UHDRS total motor score was significantly reduced postoperatively (p = 0.019). Pallidal DBS did not improve other motor symptoms. Activation of the lateral GPi/GPe was associated with improvement in choreatic symptoms (p = 0.048; r = 0.90).</p><p><strong>Conclusions: </strong>Our findings indicate that stimulation of the lateral GPi has a stable effect on choreatic symptoms. The modulation of the electrical field is relevant for motor outcome.</p>\",\"PeriodicalId\":94156,\"journal\":{\"name\":\"Neurological research and practice\",\"volume\":\"6 1\",\"pages\":\"28\"},\"PeriodicalIF\":4.0000,\"publicationDate\":\"2024-05-23\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11112842/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Neurological research and practice\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.1186/s42466-024-00316-5\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neurological research and practice","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.1186/s42466-024-00316-5","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"Medicine","Score":null,"Total":0}
GPi/GPe borderland- a potential sweet spot for deep brain stimulation for chorea in Huntington's disease?
Background: Pallidal deep brain stimulation (GPi-DBS) has been considered as an effective treatment option for medication-refractory Huntington's disease (HD).
Objectives: To identify stimulation-dependent effects on motor symptoms and to determine if these alterations are associated with the local impact of DBS on different pallidal parcellations.
Methods: We prospectively evaluated the effects of bilateral GPi-DBS within one year in 5 HD patients. We evaluated the effects of GPi-DBS on choreatic symptoms and UHDRS. Electrode placement in the pallidum was localized, and the local impact of DBS was estimated.
Results: The chorea subscore (p < 0.001) and UHDRS total motor score was significantly reduced postoperatively (p = 0.019). Pallidal DBS did not improve other motor symptoms. Activation of the lateral GPi/GPe was associated with improvement in choreatic symptoms (p = 0.048; r = 0.90).
Conclusions: Our findings indicate that stimulation of the lateral GPi has a stable effect on choreatic symptoms. The modulation of the electrical field is relevant for motor outcome.
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