Abstract:
:We examined the direct effect of deep brain stimulation of the subthalamic nucleus (STN-DBS) on levodopa-induced peak-dose dyskinesia in 45 patients with Parkinson's disease (PD) without reducing the levodopa dosage during the early period after surgery. In 8 patients (18%), the dyskinesia was quickly attenuated by bipolar stimulation in an experimental trial (5 min) with the contacts placed within the area above the STN. In contrast, bipolar stimulation using contacts placed within the STN itself tended to provoke or exacerbate the dyskinesia, indicating that dyskinesia could be inhibited by stimulation of the areas above the STN rather than the STN itself. In an attempt to control the cardinal symptoms of PD and dyskinesia at the same time, we employed bipolar stimulation with a longer interpolar distance as a therapeutic procedure (2 weeks), using contacts within the STN as a cathode and contacts within the area above the STN as an anode. Bilateral STN-DBS significantly attenuated the dyskinesia as evaluated by the dyskinesia severity rating scale (p < 0.05). In 24 patients (53%), almost complete control of the dyskinesia was observed. The contacts used as an anode in these patients were located more dorsally compared to those of the remaining patients, suggesting again that the dyskinesia was inhibited by stimulation of the areas above the STN rather than the STN itself. In the area above the STN, pallidothalamic, pallidosubthalamic and subthalamopallidal fibers are densely distributed. It appears that stimulation of these fibers may cause effects similar to thalamic or pallidal DBS and therefore inhibit peak-dose dyskinesia. Bipolar STN-DBS with contacts placed within the area above the STN as an anode appears to represent a useful option for controlling both the cardinal symptoms of PD and peak-dose dyskinesia at the same time.
journal_name
Stereotact Funct Neurosurgjournal_title
Stereotactic and functional neurosurgeryauthors
Katayama Y,Oshima H,Kano T,Kobayashi K,Fukaya C,Yamamoto Tdoi
10.1159/000094957subject
Has Abstractpub_date
2006-01-01 00:00:00pages
176-9issue
4eissn
1011-6125issn
1423-0372pii
94957journal_volume
84pub_type
临床试验,杂志文章abstract::Out of 57 patients operated for intractable epilepsy of the central region, 8 harbored an indolent glioma (7 dysembryoplastic neuroepithelial tumors, 1 ganglioglioma). Mapping of the sensorimotor area with depth electrodes implanted for stereoelectroencephalographic exploration demonstrated no or abnormal motor respon...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099880
更新日期:1997-01-01 00:00:00
abstract:BACKGROUND:Balloon compression of the gasserian ganglion has been a well-established percutaneous treatment of trigeminal neuralgia since the 1980s. However, puncture of the foramen ovale by conventional single-plane fluoroscopy can be difficult in cases of local anatomic abnormalities. CASE PRESENTATION:We present th...
journal_title:Stereotactic and functional neurosurgery
pub_type:
doi:10.1159/000509821
更新日期:2020-09-16 00:00:00
abstract::The aim of the study was to investigate if laser Doppler perfusion monitoring (LDPM) can be used in order to differentiate between gray and white matter and to what extent microvascular perfusion can be recorded in the deep brain structures during stereotactic neurosurgery. An optical probe constructed to fit in the L...
journal_title:Stereotactic and functional neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1159/000107360
更新日期:2007-01-01 00:00:00
abstract::There is no clear consensus regarding the optimal location for placing deep brain stimulation (DBS) electrodes within the subthalamic nucleus (STN) target region in Parkinson's disease. In cases of poor symptom control or adverse effects following lead placement, leads presumed to be inadequately positioned may be cor...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000230692
更新日期:2009-01-01 00:00:00
abstract::At the KUL University of Leuven a workstation for the planning of neurosurgical stereotactic procedures has been developed. Its benefits are illustrated in three exemplary cases. The CT and/or MR images, acquired under stereotactic conditions, are transmitted via a PACS network (picture archiving and communication sys...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100284
更新日期:1994-01-01 00:00:00
abstract::The correct explanation of the term 'stereotaxy' is linguistically not self-evident because the Greek term stereon means not spatial but 'hard' or 'solid'. The aim of our study was to clarify the term stereotaxy historically and linguistically. We carried out our study by reviewing the neurosurgical and ancient Greek ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 历史文章,杂志文章
doi:10.1159/000366490
更新日期:2015-01-01 00:00:00
abstract:INTRODUCTION:The primary goal of stereotactic systems in deep brain stimulation (DBS) surgery is accurate delivery of a DBS lead to a target identified on imaging. Thus, it is critical to understand the accuracy of the stereotactic systems and the factors which may be associated with a decrease in accuracy. METHODS:Ni...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000316761
更新日期:2010-01-01 00:00:00
abstract:OBJECTIVE:Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has evolved as a powerful therapeutic alternative for the treatment of Parkinson's disease (PD). Despite its clinical efficacy, the mechanisms of action have remained poorly understood. In addition to the immediate symptomatic effects, long-term ne...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000511121
更新日期:2020-11-05 00:00:00
abstract:BACKGROUND:Several subcortical structures have been targeted for surgical treatment of dystonia, including motor thalamus, internal segment of globus pallidus (GPi), and more recently, the subthalamic nucleus (STN). Deep brain stimulation of GPi is currently the preferred surgical treatment, but it is unclear if target...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000112428
更新日期:2008-01-01 00:00:00
abstract::A simple technique has been designed which identifies the gantry isocenter and aligns the laser beams to the isocenter of the gantry within 3-5 min with an error of less than 0.75 mm, depending upon the accuracy of gantry rotation. ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000099516
更新日期:1989-01-01 00:00:00
abstract::In this article, we use a case to illustrate and discuss some practically important learning points about programming subthalamic nucleus deep brain stimulation for Parkinson's disease patients and highlight clinically relevant issues resulting from anatomical and device-related anomalies. These include the phenomenon...
journal_title:Stereotactic and functional neurosurgery
pub_type:
doi:10.1159/000505701
更新日期:2020-01-01 00:00:00
abstract::Stereotactic radiosurgery under local anesthesia with the Leksell Gamma Knife can effectively treat some patients with recurrent tic douloureux after unsuccessful medical/surgical procedures. Seven of 12 patients have shown complete relief or improvement of their trigeminal neuralgia. No complications have been observ...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100663
更新日期:1993-01-01 00:00:00
abstract::Soon after its development, CT imaging, which provided direct visualization of neural structures, was used for stereotactic guidance. There has been progressive expansion of stereotactic methodology for image guided surgical intervention through minimally invasive corridors. Today, the development of high resolution M...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000066710
更新日期:2001-01-01 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:OBJECTIVES:We prospectively investigated the efficacy of corticosteroid medication in salvaging acute hearing deterioration after radiosurgery for vestibular schwannoma (VS) and analyzed prognostic factors for hearing preservation. METHODS:Forty-one patients with serviceable hearing treated with gamma knife radiosurge...
journal_title:Stereotactic and functional neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1159/000321913
更新日期:2011-01-01 00:00:00
abstract::We reviewed the initial experience with 331 consecutive patients treated during the first 2 years of operation of the University of Pittsburgh Gamma Unit. Among 178 patients with vascular malformations, 161 had angiographically demonstrable arteriovenous malformations, and 17 had angiographically occult malformations....
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100269
更新日期:1990-01-01 00:00:00
abstract::Peacock is a 3-D conformal treatment planning and delivery system for conformal radiation therapy which delivers intensity-modulated fields. A group of 13 patients were treated between March and February, 1995. Patient age ranged from 10 to 74. Six of the patients had previously received radiation therapy. Target volu...
journal_title:Stereotactic and functional neurosurgery
pub_type: 临床试验,杂志文章
doi:10.1159/000099664
更新日期:1996-01-01 00:00:00
abstract::A 25-year-old woman with a large acoustic schwannoma underwent surgical excision 18 months after Gamma Knife radiosurgery because of transient expansion of the tumor causing ataxia. Histopathologial investigation by the TUNEL method revealed the presence of some apoptotic cells. The findings were compared with finding...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000056411
更新日期:1998-10-01 00:00:00
abstract::At the 1989 meeting of the World Society for Stereotactic and Functional Neurosurgery in Maebashi, the authors presented the concept and design of a stereotactic neurosurgical robot. The first prototype has now been completed and has entered clinical testing. The characteristics are as follows. The robot is positioned...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000100300
更新日期:1994-01-01 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:OBJECT:To estimate the efficacy of Gamma Knife radiosurgery (GKR) especially as a primary surgical treatment for hypersecreting pituitary adenomas. METHODS:274 patients were treated with GKR. The mean tumor volume was 1.86 cm(3). The mean peripheral dose was 28.7 Gy. RESULTS:223 patients were followed up for an avera...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000048393
更新日期:2000-01-01 00:00:00
abstract:BACKGROUND:Among the neuropsychiatric symptoms in Parkinson's disease (PD) patients, hallucination can result from the disease itself or medical treatment. Hallucination associated with subthalamic nucleus stimulation (STN-DBS) has been reported; however, it is still unclear whether PD patients with a history of halluc...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000195719
更新日期:2009-01-01 00:00:00
abstract::Experimental studies indicate that deafferentation results in reorganization of the somatosensory map at various levels of the CNS, such that the representation of a body part adjacent to a region that is denervated expands into the deafferented area. Recent data suggest that in the human this occurs at the cortical l...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098612
更新日期:1994-01-01 00:00:00
abstract:BACKGROUND:The goal of this study is to retrieve the attention to the treatment opportunities for this cohort of intractable bitemporal epilepsy patients who in most cases are not considered optimal candidates for surgery. OBJECTIVES:The purpose of this study is to demonstrate that electrophysiologically guided precis...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000343198
更新日期:2013-01-01 00:00:00
abstract::In this study, we investigated the efficacy of brachytherapy in the treatment of 138 patients with intracranial neoplasms of the CNS. Of the total number of patients, 50 presented with glioblastoma multiforme, 45 presented with low-grade glioma, 19 presented with anaplastic astrocytoma, 23 presented with metastases an...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000075100
更新日期:2003-01-01 00:00:00
abstract::The longevity of batteries in internal pulse generators (IPGs) used clinically for deep brain stimulation is not known. We conducted a study to assess the life span of these batteries. From 1993 to 2000, 163 single-channel batteries were surgically implanted in our institution. The electrical settings utilized in pati...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000075161
更新日期:2003-01-01 00:00:00
abstract::We identified 35 patients who had undergone stereotactic radiosurgery (SRS) for their biochemically proven Cushing's disease in order to assess the efficacy of SRS with regard to control of hypercortisolism, improvement of clinical features and prevention of tumor progression, and subsequent incidence of hypopituitari...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000083476
更新日期:2004-01-01 00:00:00
abstract:BACKGROUND:In nonresectable glioblastoma (GBM), stereotactic biopsies are performed to retrieve tissue for diagnostic purposes. The analysis of O6-methylguanine-DNA methyltransferase (MGMT) promoter methylation adds prognostic and predictive information. OBJECTIVES:The aim of the study was to detect confounding factor...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000360582
更新日期:2014-01-01 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::Paresthesia-producing (PP), but not periventricular grey (PVG) deep brain stimulation (DBS) proved effective in steady neuropathic pain in 25 patients receiving both, regardless of the PP site stimulated, but PVG-DBS suppressed allodynia or hyperpathia in 3 cases of stroke-induced pain. In patients with stroke-induced...
journal_title:Stereotactic and functional neurosurgery
pub_type: 杂志文章
doi:10.1159/000098682
更新日期:1995-01-01 00:00:00