Abstract:
:Purpose: To depict the specific brain networks that are modulated by deep brain stimulation (DBS) of the subthalamic nucleus (STN) in Parkinson's disease (PD), using diffusion tensor imaging-based fibre tractography (DTI-FT).Materials and methods: Nine patients who received bilateral STN-DBS for PD were included. Electrodes were localized by co-registering preoperative magnetic resonance imaging and postoperative computed tomography. The volume of tissue activated (VTA) was estimated as an isotropic, spherical electric field distribution centred at each effective electrode contact's centroid coordinates, taking into account individual stimulation parameters (i.e. voltage, impedance). Brain connectivity analysis was undertaken using a deterministic DTI-FT method, seeded from a single region of interest corresponding to the VTA. The labelling of the reconstructed white matter fibre tracts relied on their path and (sub)cortical termination territories.Results: Six months after surgery, we observed a statistically significant reduction in both the Unified Parkinson Disease Rating Scale part III and L-dopa equivalent daily dose. Areas consistently connected to the VTA included the brainstem (100%), cerebellum (94%), dorsal (i.e. supplementary motor area) and lateral premotor cortex (94%), and primary motor cortex (72%). An involvement of the hyperdirect pathway (HDP) connecting the STN and the (pre)motor cortex was demonstrated.Conclusions: The connectivity patterns observed in this study suggest that the therapeutic effects of STN-DBS are mediated through the modulation of distributed, large-scale motor networks. Specifically, the depiction of projection neurons connecting the stimulated area/STN to the (pre)motor cortex, reinforce the growing evidence that the HDP might be a potential therapeutic target in PD. If further replicated, these findings could raise the possibility that DTI-FT reconstruction of the HDP may critically improve DBS targeting and stimulation parameters selection, through the development of programming tools that incorporate VTA modelling and patient-specific DTI-FT data.
journal_name
Br J Neurosurgjournal_title
British journal of neurosurgeryauthors
Vassal F,Dilly D,Boutet C,Bertholon F,Charier D,Pommier Bdoi
10.1080/02688697.2019.1701630subject
Has Abstractpub_date
2020-04-01 00:00:00pages
187-195issue
2eissn
0268-8697issn
1360-046Xjournal_volume
34pub_type
杂志文章abstract::Gliomatosis cerebri (GC), which mainly consists of oligodendroglial tumour cells, is rare and six cases have been documented to date. We present a new case of oligodendroglial gliomatosis cerebri with a favourable response to combination treatment using surgery, radiotherapy and chemotherapy. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.1080/02688690410001732823
更新日期:2004-06-01 00:00:00
abstract::A 72-year-old woman previously operated for a sphenoid-ridge meningioma, now presented with double vision. Histology showed a secretory meningioma with an epithelial-appearing, malignant component. Malignant transformation in a secretory meningioma is not known. This is the first report of such an occurrence. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690600875432
更新日期:2006-08-01 00:00:00
abstract:INTRODUCTION:Intraspinal tumours are rare and principally managed surgically. Laminectomy, employed for access to the spinal canal, destroys the posterior tension band leading to a risk of kyphosis. Hemilaminectomy as an alternative may be less destructive, potentially reducing the risk of deformity and causing less po...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2014.1003026
更新日期:2015-06-01 00:00:00
abstract::Multicentre gliomas are a well recognized entity but the occurrence of such tumours both above and below the tentorium remains uncommon. We report the case of an 11-year-old boy who underwent stereotactic biopsy of a brain stem ring enhancing tumour with histology of an anaplastic astrocytoma (Grade 3). Nine months fo...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699109002887
更新日期:1991-01-01 00:00:00
abstract::We report a secretory meningioma with metastasis from a pulmonary adenocarcinoma in a 48-year-old woman. Secretory meningioma can simulate metastatic disease both clinically and pathologically. Secretory meningioma and tumour-to-tumour metastasis are each rare, and we believe this to be the first report of their coinc...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/026886902753512646
更新日期:2002-02-01 00:00:00
abstract::Traumatic pseudoaneurysms of the superficial temporal artery are uncommon. They present to a variety of specialities - orthopaedics, ear, nose and throat, neurosurgery, maxillofacial, plastic surgery, vascular surgery and dermatology. Experience managing these lesions is therefore limited and diluted. We present a cas...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690600777034
更新日期:2006-06-01 00:00:00
abstract::Chordomas constitute <5% of vertebral column tumours and a third of these arise in the upper cervical spine and tend to be clival - usually midline, with occasional eccentric extension. We report a case of cervical chordoma presenting as a lateral neck mass and discuss its origin, diagnosis and management. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2010.508959
更新日期:2011-08-01 00:00:00
abstract::Giant fusiform aneurysm is a rare vascular lesion which presents difficult management issues. We describe one such aneurysm in a middle cerebral artery branch (M2) that presented with subarachnoid haemorrhage and was managed operatively. Clinical, radiological and pathological presentations, as well as the different t...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699844466
更新日期:1998-12-01 00:00:00
abstract::We describe a sciatic schwannoma spanning the sciatic notch in a 39-year-old woman with persistent pelvic pain after caesarean delivery. The tumour was detected by pelvic CT scan and MRI. Anterior transabdominal surgery allowed the en bloc removal of both the pelvic and the buttock component of the tumour. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690600603776
更新日期:2006-02-01 00:00:00
abstract::We present a case of spontaneous 79% regression in the size of a vestibular schwannoma (VS). A 41-year-old lady with a large (36 mm) vestibular schwannoma underwent serial follow-up MRI scans which demonstrated the shrinkage over 9 years; the highest relative spontaneous regression recorded in the literature for vesti...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2019.1582749
更新日期:2019-03-04 00:00:00
abstract::The classical presentation of a ruptured intracranial aneurysm is subarachnoid haemorrhage (SAH). We present a rare case of a ruptured posterior communicating artery (PcomA) aneurysm presented solely with massive intraventricular haemorrhage (IVH) in a 53-year-old female. The aneurysm was coiled successfully and the o...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2017.1406451
更新日期:2019-10-01 00:00:00
abstract:AIM:To investigate inefficiencies during patients' stay in neurosurgical beds. METHODS:A prospective audit of neurosurgical inpatients was conducted over approximately 2 months. We recorded the causes and duration of inappropriate delays, defined as actions requiring more that 24 h from initiation until completion. R...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690701649488
更新日期:2007-12-01 00:00:00
abstract::The history of chronic subdural haematoma (CSH), spanning from its possibly earliest beginnings throughout the centuries until the early 1980s, was investigated within the context of four different epochs. In the 'era of uncertainty', successful trephination, the modem method of choice for the treatment of CSH, was de...
journal_title:British journal of neurosurgery
pub_type: 传,历史文章,杂志文章
doi:10.1080/02688690410001660418
更新日期:2004-02-01 00:00:00
abstract::Until recently, warfarin, clopidogrel and aspirin have provided the mainstay for prevention of thrombotic disease in cardiac patients. However, new classes of drugs have recently emerged that promise better clinical outcomes and lower risks. Use of such agents has increased, but increased risk and severity of intra-cr...
journal_title:British journal of neurosurgery
pub_type: 杂志文章,评审
doi:10.3109/02688697.2015.1029433
更新日期:2015-01-01 00:00:00
abstract::Tumor-to-tumor metastasis with schwannoma as a recipient tumor is very rare. There have been no reports on tumor to spinal schwannoma metastasis. We report a case of a 57-year-old woman who presented with neck pain and who turned out to have cervical spinal nerve schwannoma with breast carcinoma metastasis. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2014.997666
更新日期:2015-06-01 00:00:00
abstract::This paper proposes guidelines for good practice in the management of adults with malignant cerebral glioma. These guidelines were developed by a working group comprising representatives of the medical specialties involved in patient care, specialist nursing staff, purchasers, charitable bodies, and patient and relati...
journal_title:British journal of neurosurgery
pub_type: 指南,杂志文章,实务指引
doi:10.1080/02688699746104
更新日期:1997-08-01 00:00:00
abstract:BACKGROUND:Nowadays the endoscopic endonasal approach is increasingly being used to remove craniopharyngiomas, tuberculum sellae meningiomas and other presellar and parasellar lesions and its value in anterior skull base surgery is undisputed. Herein, we assess the relative advantages, disadvantages and feasibility of ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2018.1480748
更新日期:2018-10-01 00:00:00
abstract::A 48-year-old man with a cystic craniopharyngioma developed hypersomnia, personality changes, memory impairment and thermal dysfunction following intracystic administration of bleomycin through an Ommaya reservoir after partial removal of the tumour. The patient's neurological deterioration was thought to be related t...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699409101192
更新日期:1994-01-01 00:00:00
abstract::The authors report the rare and first documented case of intracranial collision tumour occurrence in a previously evacuated intracerebral haematoma site. Surgery trauma could predispose to collision tumour occurrence. Research efforts should try to reveal the possible pathogenesis of this condition. ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2012.697220
更新日期:2012-12-01 00:00:00
abstract::Objective: Mixed growth hormone (GH) and prolactin (PRL) secreting adenomas are the most common type of plurihormonal pituitary adenomas. We assessed the clinical presentations and impacts of transsphenoidal surgery (TS) on patients with mixed GH and PRL adenomas including surgical outcomes, complications, and prognos...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1713989
更新日期:2020-04-01 00:00:00
abstract::Intracerebral metastasis in osteosarcoma is extremely rare. A 14-year-old girl who had previously been operated upon for osteosarcoma of the femur presented with seizures and left hemiparesis. A right parietal lesion with calcification and brain oedema was found. After resection of the mass, pathology revealed an oste...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2011.581771
更新日期:2012-02-01 00:00:00
abstract:OBJECTIVE:The aim of our study is to investigate the influence of caspase-9 and tumour necrosis factor alpha (TNFα) in the grade of lumbar disc herniation. We determined the strength of different predictors such as age, gender, disc grading, caspase-9 and TNFα. METHODS:We retrospectively reviewed 84 patients who had d...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1817314
更新日期:2020-09-14 00:00:00
abstract::An obese woman with benign intracranial hypertension had been managed for several years with lumbo-peritoneal shunting. Following a bilopancreatic procedure performed for management of her obesity dense peritoneal adhesions caused repeated shunt failure. The shunt system was successfully converted to a lumbo-atrial sy...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690601127460
更新日期:2006-12-01 00:00:00
abstract::We report our experience with five lesions exclusively involving the entire cavernous sinus in which an essentially extradural surgical approach was used. There were two cases of cavernous haemangioma, two cases of meningioma and one case of fungal granuloma. The dural cover of the superior orbital fissure, and mandib...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688699746483
更新日期:1997-04-01 00:00:00
abstract::Background: Posterior fossa decompression both with and without duraplasty are accepted treatments for symptomatic adult patients with Chiari Malformations Type 1 (CM-1). There is still debate of the superiority of one technique over the other. The purpose of this study was to determine the clinical and craniometrical...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2019.1617407
更新日期:2019-10-01 00:00:00
abstract::Among 344 patients with posterior fossa tumours treated from 1979 to 1986 a ventriculoperitoneal, or, less commonly, a ventriculatrial shunt was inserted in 164 cases pre-operatively. Haematoma following the insertion of a shunt was found to be an important cause of deterioration. While the occurrence of cerebrospinal...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688699008992760
更新日期:1990-01-01 00:00:00
abstract:BACKGROUND:Some patients with lumbar spine stenosis (LSS) have severe low back pain (LBP) with only mild leg symptoms. The effects of decompression surgery for such patients remain unknown. METHODS:Of 818 patients with LSS who underwent surgical treatment in our institution from 2011 to 2019, eight patients had a nume...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688697.2020.1868402
更新日期:2021-01-19 00:00:00
abstract::We report the case of a 32-year-old woman with a left frontal ganglioglioma (WHO grade I). Quantitative analysis based on three dimensional magnetic resonance images revealed a threefold increase of growth rate during pregnancy as compared to pre-pregnancy, causing neurological deterioration and leading to prompt surg...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2012.703356
更新日期:2013-02-01 00:00:00
abstract:OBJECTIVE:Decompressive craniectomy is often emergently performed in an effort to reduce intracranial hypertension. After this urgent intervention, brain-injured patients often start rehabilitation programs but are left with a skull defect. Cranioplasty is often performed in these situations in order to repair this def...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.3109/02688697.2012.692838
更新日期:2012-12-01 00:00:00
abstract::Survivors of head injury are often left with varying degrees of disability and complex and varied needs, necessitating prolonged periods of rehabilitation and continuing care. Advances have been made in the acute management of these patients, but continuing management in terms of rehabilitation remains deficient with ...
journal_title:British journal of neurosurgery
pub_type: 杂志文章
doi:10.1080/02688690903078874
更新日期:2009-01-01 00:00:00