Abstract:
OBJECTIVE:To create a data-driven computational model that identifies brain regions most frequently influenced by successful deep brain stimulation (DBS) of the globus pallidus (GP) for advanced, medication-resistant, generalized dystonia. METHODS:We studied a retrospective cohort of 21 DYT1 primary dystonia patients treated for at least 1 year with bilateral pallidal DBS. We first created individual volume of tissue activation (VTA) models utilizing neuroimaging and postoperative stimulation and clinical data. These models were then combined into a standardized probabilistic dystonia stimulation atlas (DSA). Finally, we constructed a candidate target volume from electrodes demonstrating at least 75% improvement in contralateral symptoms, utilizing voxels stimulated by least 75% of these electrodes. RESULTS:Pallidal DBS resulted in a median contralateral hemibody improvement of 90% (mean = 83%, standard deviation [SD] = 20) after 1 year of treatment. Individual VTA models of the 42 active electrodes included in the study demonstrated a mean stimulation volume of 501mm ([SD] = 284). The resulting DSA showed that areas most frequently stimulated were located squarely in the middle of the posterior GP, with a common target volume measuring 153mm(3) . INTERPRETATION:Our results provide a map of the region of influence of therapeutic DBS for dystonia and represent a potential target to refine current methods of surgical planning and stimulation parameters selection. Based on their role in alleviating symptoms, these regions may also provide anatomical and physiological information relevant to disease models of dystonia. Further experimental and clinical studies will be needed to validate their importance.
journal_name
Ann Neuroljournal_title
Annals of neurologyauthors
Cheung T,Noecker AM,Alterman RL,McIntyre CC,Tagliati Mdoi
10.1002/ana.24187subject
Has Abstractpub_date
2014-07-01 00:00:00pages
22-30issue
1eissn
0364-5134issn
1531-8249journal_volume
76pub_type
杂志文章abstract::We here report the second and third mutations in alphaB-crystallin causing myofibrillar myopathy. Two patients had adult-onset muscle weakness. Patient 1 had cervical, limb girdle, and respiratory muscle weakness and died of respiratory failure. Patient 2 had proximal and distal leg muscle weakness. Both had myopathic...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.10767
更新日期:2003-12-01 00:00:00
abstract::Cytogenetic analysis has become an important part of the diagnostic evaluation of most hematological neoplasms. However, there is limited information on the value of cytogenetic analysis in most solid tumors, including cerebral astrocytomas. This report summarizes a prospective cytogenetic study of 99 human cerebral a...
journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410310512
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abstract::Freezing of gait (FOG) is a common and debilitating, but largely mysterious, symptom of Parkinson disease. In this review, we will discuss the cerebral substrate of FOG focusing on brain physiology and animal models. Walking is a combination of automatic movement processes, afferent information processing, and intenti...
journal_title:Annals of neurology
pub_type: 杂志文章,评审
doi:10.1002/ana.24778
更新日期:2016-11-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410380422
更新日期:1995-10-01 00:00:00
abstract::To investigate the potential role of drug therapy in preventing or exacerbating seizure-related brain injury in the prepubescent brain, we administered kainic acid to rats at postnatal day 35. Therapy with daily phenobarbital was started directly before or 1 day after kainic acid was administered, and was continued th...
journal_title:Annals of neurology
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doi:10.1002/ana.410360314
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journal_title:Annals of neurology
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journal_title:Annals of neurology
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更新日期:2014-05-01 00:00:00
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journal_title:Annals of neurology
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更新日期:2015-02-01 00:00:00
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journal_title:Annals of neurology
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doi:
更新日期:2000-04-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410100604
更新日期:1981-12-01 00:00:00
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pub_type: 杂志文章
doi:10.1002/ana.22164
更新日期:2010-12-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410100610
更新日期:1981-12-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.20798
更新日期:2006-04-01 00:00:00
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pub_type: 杂志文章
doi:10.1002/ana.10505
更新日期:2003-03-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410160402
更新日期:1984-10-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410350212
更新日期:1994-02-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.410110307
更新日期:1982-03-01 00:00:00
abstract::A patient with longstanding Mollaret's meningitis had an increased number of circulating natural killer cells during an acute attack, as evidenced by 73% large granular lymphocytes and 80% Leu-11a-positive peripheral mononuclear cells. Numbers of large granular lymphocytes and Leu-11a-positive cells returned to normal...
journal_title:Annals of neurology
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doi:10.1002/ana.410200315
更新日期:1986-09-01 00:00:00
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pub_type: 临床试验,杂志文章
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更新日期:1996-12-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章,评审
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更新日期:1992-01-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.22110
更新日期:2011-01-01 00:00:00
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pub_type: 杂志文章
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更新日期:2001-02-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.10210
更新日期:2002-06-01 00:00:00
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journal_title:Annals of neurology
pub_type: 杂志文章
doi:10.1002/ana.21528
更新日期:2008-11-01 00:00:00
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journal_title:Annals of neurology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:
更新日期:2000-01-01 00:00:00
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journal_title:Annals of neurology
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doi:10.1002/ana.410210407
更新日期:1987-04-01 00:00:00
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journal_title:Annals of neurology
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doi:10.1002/ana.24907
更新日期:2017-04-01 00:00:00