Abstract:
OBJECTIVES:Experimental data and case reports of patients with intractable epilepsy treated with deep brain stimulation (DBS) of the subthalamic nucleus (STN) suggest a considerable anticonvulsant effect. However, no satisfactory mechanisms of action have yet been elucidated. We investigated the putative therapeutic mechanisms of DBS from cerebral perfusion changes as measured by subtracting the SPECT image of the pre-DBS period from that of the chronic post-DBS state. METHODS:Two patients who had previous resective surgery on their right frontal cortices with or without anterior callosotomy were selected for DBS of the STN. Both of them showed frequent bilateral asymmetric tonic seizures (left > right) with rare drop attacks, and 1 patient's seizure frequency was more than 15/month during the pre-DBS period. They had both taken more than four antiepileptic agents for more than 10 years. After video-EEG monitoring, the irritative zones of the brain were delineated. The regional cerebral blood flow (rCBF) changes between the two SPECT images (pre-DBS and post-DBS after at least 6 months) were analyzed by SPECT subtraction with the volumetric MRI coregistration method using Analyze 5.0 software. RESULTS:After chronic STN DBS (18 months, case 1; 6 months, case 2), both patients experienced markedly reduced seizure frequencies (86.7% reduction in patient 1, 88.6% in patient 2). In patient 1, the increased rCBF was observed in the right frontal areas (dorsolateral and inferior frontal area), which corresponded to the irritative zones as confirmed by previous EEG recording. Unexpectedly, there was definite hyperperfusion in the right superior and inferior temporal areas as well as rCBF increase in the right superior frontal area (SMA) in patient 2. CONCLUSIONS:We demonstrated that the cerebral perfusion increase in the irritative zones of epilepsy patients is associated with favorable seizure reduction after STN DBS in 2 cases of frontal lobe epilepsy. Although the exact mechanism remains unknown, our findings suggest that the perfusion changes after STN DBS in frontal lobe epilepsy patients are quite different from those in subjects with Parkinson's disease. Our preliminary data suggest the clinical relevance of subtraction SPECT imaging in assessing the postprocedural outcome as well as the characteristics of SPECT perfusion patterns in other epilepsy syndromes.
journal_name
Stereotact Funct Neurosurgjournal_title
Stereotactic and functional neurosurgeryauthors
Shon YM,Lee KJ,Kim HJ,Chung YA,Ahn KJ,Kim YI,Yang DW,Kim BSdoi
10.1159/000086867keywords:
subject
Has Abstractpub_date
2005-01-01 00:00:00pages
84-90issue
2-3eissn
1011-6125issn
1423-0372pii
86867journal_volume
83pub_type
杂志文章abstract::Computed tomographic (CT), magnetic resonance (MR), MR angiographic and angiographic images, obtained after complete nidus obliteration had been angiographically confirmed, were reviewed in 9 patients who had undergone Gamma Knife treatment for cerebral arteriovenous malformations (AVMs). The period between angiograph...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098772
更新日期:1995-01-01 00:00:00
abstract::A Leksell Gamma Unit was commissioned and a Lars Leksell Center for Radiosurgery was established at the University of Virginia Health Sciences Center in March 1989. At that time a formal quality assurance program designed for the Leksell Gamma Unit was put into effect. This paper will review the components of suggeste...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099561
更新日期:1991-01-01 00:00:00
abstract::A computerized method of determining the focal point of electrical activity in the pallidum of parkinsonian patients was developed using on-line quantitative physiological data analysis. Thirty patients in a series of 70 were studied in depth. Neuronal activity was recorded from the pallidum using a semi-microelectrod...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000048378
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND/AIMS:Technological advancements had a serious impact on the evolution of robotic systems in stereotactic neurosurgery over the last three decades and may turn robot-assisted stereotactic neurosurgery into a sophisticated alternative to purely mechanical guiding devices. OBJECTIVES:To compare robot-assisted ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000494736
更新日期:2018-01-01 00:00:00
abstract::Six cases of acoustic neurinomas with macrocystic components are presented. In three cases the cystic portion was within the tumor, while in the other three, the cyst was peritumoral, in the form of a cul-de-sac within the arachnoid, in other words it was not a true tumor cyst. The six tumors are from a series of 74 a...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099775
更新日期:1996-01-01 00:00:00
abstract:BACKGROUND:Up to 60% of Parkinson's disease (PD) patients suffer from low back pain (LBP) during the course of their disease. How LBP affects daily functional status and how to manage this aspect of PD has not been adequately explored. METHODS:We examined 16 patients undergoing bilateral subthalamic nucleus deep brain...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000380827
更新日期:2015-01-01 00:00:00
abstract:BACKGROUND:Gamma knife surgery (GKS) is used at subnecrotic doses for temporal lobe epilepsy (TLE) treatment. Rat models of TLE have been used to probe the mechanisms underlying GKS. Previous GKS studies on rats have used the Leksell GammaPlan (LGP) treatment planning system to determine the irradiation time to achieve...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000314355
更新日期:2010-01-01 00:00:00
abstract::Electric stimulation applied to the posterior surface of the spinal cord (SCS) is an established treatment in certain chronic pain syndromes resistant to conventional therapeutic procedures. Despite the clinical value of SCS, the mechanisms behind the efficacy of the method are largely unknown. Several neurotransmitte...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100634
更新日期:1993-01-01 00:00:00
abstract::Fifty-eight patients, 36 with essential tremor (ET) and 22 with Parkinson's disease (PD), received deep brain stimulation (DBS) in the thalamic ventral intermediate (Vim) nucleus. The mean follow-up was 17 months for ET and 21 months for PD patients. Stimulation parameters were adjusted as needed, at various intervals...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000029728
更新日期:1999-01-01 00:00:00
abstract::The purpose of this study was to analyze the feasibility and utility of 3D imaging to help lead positioning during a deep brain stimulation (DBS) procedure. A bilateral subthalamic DBS procedure was conducted in 2 patients for idiopathic Parkinson's disease. Subthalamic nucleus targeting was based on preoperative ster...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000280823
更新日期:2010-01-01 00:00:00
abstract:BACKGROUND:Writer's cramp is a specific movement disorder with hand muscle cramps in writing, being classified into focal and action-specific dystonia. Stereotactic surgery, such as thalamotomy and deep brain stimulation (DBS), has been reported for writer's cramp; however, the number of reported cases is still scarce ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000366004
更新日期:2014-01-01 00:00:00
abstract::The diagnostic yield of stereotactic biopsies depends upon safely sampling the most representative regions of masses. Potentially, localization information presently available from CT and MR scans might be improved by considering regional levels of cerebral metabolism by PET. In 10 selected stereotactic biopsies of in...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098986
更新日期:1992-01-01 00:00:00
abstract:BACKGROUND/AIMS:Stereotactic postoperative imaging is essential for verification of the position of electrodes implanted for deep brain stimulation (DBS). MRI offers superior visualisation of the DBS targets relative to CT, but previous adverse incidents have heightened concerns about risks of postoperative MRI. Preope...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000225973
更新日期:2009-01-01 00:00:00
abstract:BACKGROUND/AIMS:In subthalamic nucleus (STN) deep brain stimulation (DBS) lead implantation, it is still controversial whether it is more appropriate to employ indirect or direct methods in magnetic resonance imaging (MRI)-based tentative targeting and to select single- or multiple-track recording in electrophysiologic...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000120430
更新日期:2008-01-01 00:00:00
abstract::Autologous transplantation of the superior cervical ganglion (SCG) into the caudate nuclei of 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine-induced parkinsonian monkey was studied in regard to animal behavior and catecholamine (CA) metabolites in cerebrospinal fluid. Monkeys which had undergone autotransplantation of t...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100231
更新日期:1990-01-01 00:00:00
abstract:OBJECTIVE:We have developed an overlaid three-dimensional image (Volumegraph)-guided navigation system that allows navigation during operative procedures. The three-dimensional image is superimposed on the patient's head and body via a semi-transparent mirror. The Volumegraph can display three-dimensional images in the...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099897
更新日期:1997-01-01 00:00:00
abstract:OBJECTIVE:We compared bilateral globus pallidus internus (GPi) deep brain stimulation (DBS) with bilateral GPi DBS plus ventralis oralis (Vo) thalamotomy to analyze the effect of the combined Vo thalamotomy. METHODS:Between March 2003 and December 2008, 10 patients underwent DBS and/or Vo thalamotomy for treatment of ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000338093
更新日期:2012-01-01 00:00:00
abstract::Microrecordings were performed during pallidotomy and thalamotomy for Parkinson's disease (PD). Neuronal activity in globus pallidus (GP) was in general agreement with previous studies of human and primate models of PD. Neuronal activity, where frequency of tremor appeared to oscillate independently from peripheral in...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000029643
更新日期:1998-01-01 00:00:00
abstract:BACKGROUND/AIMS:Postoperative cerebral edema around a deep brain stimulation (DBS) electrode is an uncommon reported complication. The goal of this study was to identify instances of postoperative edema based on clinical presentation, and to remark on their management. METHODS:A retrospective chart review was performe...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000454892
更新日期:2017-01-01 00:00:00
abstract::The first Gamma Knife was installed in Stockholm in 1968 after nearly two decades of development. Following the opening of the Gamma Knife facility in Pittsburgh in 1987, radiosurgery has seen an explosive expansion. Along with this expansion there has been a development of alternative technologies, of which the most ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:
更新日期:1993-01-01 00:00:00
abstract::The possible influence of painful stimulation and morphine analgesia on hypothalamic met-enkephalin levels, and the possible correlation between this biochemical parameter and animal behaviour was studied. The results indicate that both painful stimulation and morphine treatment induce an increase in hypothalamic mete...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100635
更新日期:1993-01-01 00:00:00
abstract::We describe the Zamorano-Dujovny localizing unit which consists of a ring-shaped headholder held on the patient's head by three or four variably placed fixation pins, thereby avoiding interference with the flap sites or craniotomy. The base ring is mounted intraoperatively on a special adapter that allows any patient ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100290
更新日期:1994-01-01 00:00:00
abstract:INTRODUCTION:Evidence has been provided that the subiculum may play an important role in the generation of seizures. Electrical stimulation at this target has been reported to have anticonvulsive effects in kindling and pilocarpine rat models, while in a clinical study of hippocampal deep brain stimulation (DBS), conta...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000510295
更新日期:2020-10-28 00:00:00
abstract:PURPOSE:To evaluate the imaging and pathological correlates of successful or risk-related stereotactic radiosurgery (SR). Methods and Materials. The ten-year Gamma Knife experience in 2,344 patients at the University of Pittsburgh was reviewed. In addition, the results or radiosurgery primate, rat, and mouse models wer...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000056401
更新日期:1998-10-01 00:00:00
abstract::With the recent approval of reimbursement for positron emission tomography (PET), it has become important to clarify the utility of this diagnostic study. We evaluated the utility of PET to distinguish radiation necrosis from recurrent tumor in a retrospective review of patients with primary glial neoplasms. Fifteen p...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000029743
更新日期:1999-01-01 00:00:00
abstract::We report a case of induced oscillopsia caused by deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN). Recent reports have described involuntary oscillopsia during DBS of the PPN that patients have described as trembling vision. Here we substantiate this observation using infra-red eye tracking. It has ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000335871
更新日期:2012-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Neuronavigation devices have progressed over the past 2 decades, but logistical limitations remain for many stereotactic procedures. We describe our technique and accuracy for a novel miniature optical tracking system which overcomes these limitations. METHOD:The minioptical tracking system us...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000354819
更新日期:2014-01-01 00:00:00
abstract::Interstitial hyperthermia of malignant brain tumors has been produced by a heated ferromagnetic implant with a low Curie point. Induction heating of the implant, which is stereotactically implanted in a tumor, is obtained by eddy currents in a high-frequency magnetic field. Safe, repeated and long-term treatment of 35...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098928
更新日期:1992-01-01 00:00:00
abstract::The true accuracy of MRI scanners utilized for target acquisition in functional stereotaxis remains undefined. We have performed pallidotomies at the Loma Linda University Medical Center using both MRI and MRI concomitant with positive contrast ventriculography. A retrospective study of 33 cases revealed significant d...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098897
更新日期:1995-01-01 00:00:00
abstract:BACKGROUND:In well-designed multicenter studies, the protocol of continuing motor cortex stimulation (MCS) temporarily for 3-6 weeks was employed with rehabilitation therapy, and these studies showed some recovery of motor weakness in post-stroke patients. OBJECTIVES:We aimed to clarify the effects of long-term MCS an...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000332060
更新日期:2011-01-01 00:00:00