Subthalamic nucleus deep brain stimulation improves motor symptoms and quality of life in advanced Parkinson's disease. We sought to determine the suicide rate following Subthalamic nucleus deep brain stimulation for Parkinson's disease by conducting an international multicentre retrospective survey of movement disorder and surgical centres. Mortality in the first year following Subthalamic nucleus deep brain stimulation has been reported at 0.4%. Suicide is thus one of the most important potentially preventable risks for mortality following Subthalamic nucleus deep brain stimulation for Parkinson's disease. 
We recorded LFPs from the Subthalamic nucleus (STN) deep brain stimulation (DBS) lead in the operating room in 22 cases from 16 subjects with Parkinson's disease (PD) who were off medication.
Deep brain stimulation (DBS) of the Subthalamic nucleus (STN) has been shown to be an effective treatment for Parkinson's disease (PD).
Patients and Methods: Data of 20 consecutive patients, treated for Parkinson's disease by implantation of deep brain stimulators into the Subthalamic nucleus, were collected prospectively.
Improvement in motor function of PD patients has been established with Subthalamic nucleus (STN) deep brain stimulation (DBS).
In order to evaluate the specific interactions between cortical oscillations and basal ganglia-spiking activity under normal and parkinsonian conditions, we examined the relationship between frontal cortex electroencephalographic (EEG) signals and simultaneously recorded neuronal activity in the internal and external segments of the pallidum or the Subthalamic nucleus (STN) in 3 rhesus monkeys.
Deep brain stimulation (DBS) is a surgical procedure that has been shown effective in improving the cardinal motor signs of advanced Parkinson's disease, however, declines in cognitive function have been associated with bilateral Subthalamic nucleus (STN) DBS.
Lesions directly involving the Subthalamic nucleus (STN) are the cause of a minority of cases but are usually associated with poor prognosis.
The globus pallidus and Subthalamic nucleus was not identified, and the putamen and thalamus were dysplasic.
The Subthalamic nucleus (STN), a major relay in the indirect striatofugal pathway, plays an important role in extrapyramidal motor control.
The metabolic activity of the nucleus accumbens, the Subthalamic nucleus, the corpus amygdaloideum and the red nucleus was normal.
In 1997, again under the guidance of Professor Benabid, we commenced bilateral Subthalamic nucleus stimulation (STN) for patients with severe Parkinson's disease.
We studied the involvement of the electrophysiological localization of the Subthalamic nucleus (NST) using a multi-unit recording technique by means of semi-microelectrode in a set of thirty Parkinson's patients who benefited from a bilateral stimulation of the NST and who were operated on under local or general anesthesia.
The activity of the Subthalamic nucleus (STN) is intimately related to movement and is generated, in part, by voltage-dependent Na(+) (Nav) channels that drive autonomous firing.
From their stereotactic coordinates, electrodes were placed behind the Subthalamic nucleus..
the globus pallidus (GP) and the Subthalamic nucleus (STN) following 6-OHDA lesion of the medial forebrain bundle (MFB) or the striatum.
RESULTS: Opioid-dependent subjects, but not control subjects, showed significant increases in activation in hippocampal region and subcortical limbic structures in response to heroin-related stimuli with a significant groupxstimulus interaction effect for the Subthalamic nucleus (STN).
Using c-Fos expression as a high-resolution marker of neuronal activation, congenic mice demonstrated significantly less neuronal activity associated with ethanol withdrawal than background strain mice in the substantia nigra pars reticulata (SNr), Subthalamic nucleus (STN), rostromedial lateral globus pallidus, and ventral pallidum.
The multi-target approach we have encouraged since the late nineties has allowed the combined implantation of a standard target (the Subthalamic nucleus-STN or the internal pallidus-GPi) plus an innovative one (CM/Pf) in well-identified Parkinson's disease (PD) patients; hence, it is possible to study, in the same PD patients, the specific target-mediated effects on different clinical signs.
The caudal intralaminar nuclei, in particular the Centrum-Medianum Parafascicularis (CM-Pf) nucleus complex, are involved in various functions, particularly in pain processing and in motor control, through their projections to the Subthalamic nucleus and their afferents from the pallidum internus (GPi) (or entopeduncular nucleus in the rat).
INTRODUCTION: Rest tremor, one of the main symptoms in Parkinson's disease (PD), is dramatically improved following Subthalamic nucleus stimulation (STN). AIM: The aim of this work was to investigate the role of Subthalamic nucleus stimulation in the appearance of parkinsonian rest tremor.
The role of the Subthalamic nucleus must be considered at different scales.
Subthalamic nucleus deep brain stimulation (STN-DBS) was recently introduced to treat advanced PD.
CM/Pf lesion prevented the changes produced by the dopamine denervation in the components of the indirect pathway connecting the striatum to the output structures (striatopallidal neurons, globus pallidus, Subthalamic nucleus), and among the output structures, in the entopeduncular nucleus. These data, which provide substrates for the potential of CM/Pf surgery in the treatment of movement disorders, are discussed in comparison with the effects of lesion or deep brain stimulation of the Subthalamic nucleus, the currently preferred target for the surgical treatment of PD..
OBJECTIVE: The optimal imaging modality for preoperative targeting of the Subthalamic nucleus (STN) for high-frequency stimulation is controversially discussed.
OBJECTIVE: To evaluate the benefits and adverse effects of bilateral Subthalamic nucleus stimulation in the treatment of Parkinson's disease (PD) by systematically reviewing the published literature. Only articles that included original, nonduplicated descriptions of patients with PD treated with bilateral Subthalamic nucleus stimulation were selected for further analysis. The outcomes for 471 patients with PD treated with bilateral Subthalamic nucleus stimulation were assessed according to the Unified Parkinson's Disease Rating Scale in both on-medication and off-medication conditions. At 12 months of Subthalamic nucleus stimulation, the mean improvement in tremor was 81%, in rigidity was 63%, in bradykinesia was 52%, in gait was 64%, and in postural instability was 69% when compared with preoperative off-medication subscores. CONCLUSION: Bilateral Subthalamic nucleus stimulation is effective in the treatment of PD.
OBJECTIVE: The success of Subthalamic nucleus (STN) surgery for Parkinson's disease depends on accuracy in target determination.
The vast majority of patients have been implanted with bilateral electrodes, and the targets were the Subthalamic nucleus, the thalamus and the internal segment of globus pallidus.
BACKGROUND: The term basal ganglia usually includes the striatum, globus pallidus, substantia nigra and the Subthalamic nucleus.
High-frequency stimulation of around 130 Hz delivered to the Subthalamic nucleus (STN-DBS [ deep brain stimulation]) is an effective treatment of Parkinson's disease (PD), but the mechanisms of its therapeutic effect remain obscure.
In contrast, two key structures of the basal ganglia, the globus pallidus internus and the Subthalamic nucleus, were not found to be engaged in these processes.
Subthalamic nucleus deep brain stimulation (STN-DBS) is particularly effective in improving limb symptoms in Parkinson's disease.
High-frequency stimulation (HFS) of the Subthalamic nucleus (STN) or internal segment of the globus pallidus is a clinically successful treatment for the motor symptoms of Parkinson's disease.
OBJECTIVE: To study the effects of Subthalamic nucleus (STN) stimulation on motor cortex excitability in Parkinson's disease (PD).
Although the striatum remains the main functional target of dopamine, it is now appreciated that there is dopaminergic innervation of the pallidum, Subthalamic nucleus, and substantia nigra.
The motor circuit of the BG has two entry points, the striatum and the Subthalamic nucleus (STN), and an output, the globus pallidus pars interna (GPi), which connects to the cortex via the motor thalamus.
Deep brain stimulation of the Subthalamic nucleus (DBS/STN) is an effective treatment for motor symptoms in advanced Parkinson's disease (PD).
INTRODUCTION: The purpose of this study was to assess the usefulness of signs ("Sukeroku sign" and "dent internal-capsule sign") for the recognition of Subthalamic nucleus (STN).
OBJECTIVE : To evaluate neuropsychiatric symptoms in PD patients submitted to bilateral deep brain stimulation of the Subthalamic nucleus (DBS-STN) by comparison with a control group of PD patients not treated with DBS.
Similar entrainment was also observed in GPe efferents, a majority of which have been shown to project through GPi en route to the Subthalamic nucleus (STN).
Despite the relatively frequent involvement of the basal ganglia and Subthalamic nucleus by multiple sclerosis (MS) plaques, movement disorders (MD), other than tremor secondary to cerebellar or brainstem lesions, are uncommon clinical manifestations of MS.
Deep brain stimulation (DBS) of the Subthalamic nucleus (STN) in individuals with Parkinson's disease (PD) has often been associated with reduced verbal fluency performance.
Besides limb shaking, that seems to reflect a transient diffuse ischemia of the frontosubcortical motor pathway, lesions are described at all levels of the frontosubcortical motor circuit including the sensorimotor frontoparietal cortex, the striatum, the pallidum, the thalamic nuclei, the Subthalamic nucleus, the substantia nigra, the cerebellum, the brainstem and their interconnecting pathways, as ischemic or hemorrhagic strokes.
We have previously shown that in patients with Parkinson's disease (PD), high-frequency stimulation (HFS) of the Subthalamic nucleus (STN) modifies spinal excitability via subcortical reticulospinal routes.
Although motor function can be improved with Subthalamic nucleus (STN) DBS, the long-term risks of living with implanted hardware should be carefully evaluated for patients with diminishing cognitive capacity.
Because deep brain stimulation (DBS) of the posterior Subthalamic nucleus (STN), which modulates the sensorimotor BG network, is beneficial in movement disorders, stimulation of the anterior, limbic STN might improve intractable behavioral disorders.
Part I of The Subthalamic nucleus (volume 198) (STN) accentuates the gap between experimental animal and human information concerning subthalamic development, cytology, topography and connections.The light and electron microscopical cytology focuses on the open nucleus concept and the neuronal types present in the STN. This monograph (Part II of the two volumes) on the Subthalamic nucleus (STN) starts with a systemic model of the basal ganglia to evaluate the position of the STN in the direct, indirect and hyperdirect pathways.
This monograph (Part I of two volumes) on the Subthalamic nucleus (STN) accentuates the gap between experimental animal and human information concerning subthalamic development, cytology, topography and connections. Part II of the two volumes (volume 199) on the Subthalamic nucleus (STN) starts with a systemic model of the basal ganglia to evaluate the position of the STN in the direct, indirect and hyperdirect pathways.
In PD, objective clinical improvements in parkinsonism correlate with dopaminergic activation of the striatum, documented by PET and with changes in cell firings of the Subthalamic nucleus documented by single cell recordings.
We recorded resting state neuronal activity from the human Subthalamic nucleus during functional stereotactic surgeries.
Deep brain stimulation of the Subthalamic nucleus (STN DBS) improves motor symptoms in idiopathic Parkinson's disease, yet the mechanism of action remains unclear.
Modulation of the activity of the Subthalamic nucleus (STN) using deep brain stimulation (DBS) in patients with advanced Parkinson's disease is the most common procedure performed today by functional neurosurgeons.
We report the case of a psychiatrically healthy Parkinson's disease patient who presented acute transient depressive states related to high frequency stimulation (HFS) of the Subthalamic nucleus (STN) and its neighbouring anatomical structures, i.e.
BACKGROUND: Although deep brain stimulation of the Subthalamic nucleus (STN DBS) in Parkinson disease (PD) improves motor function, it has variable effects on working memory (WM) and response inhibition (RI) performance.
Deep brain stimulation (DBS) of the Subthalamic nucleus (STN) is a clinically effective neurosurgical treatment for Parkinson disease.
OBJECT: The authors of this preliminary study investigated the outcome and feasibility of intraoperative microelectrode recording (MER) in patients with Parkinson disease (PD) undergoing deep brain stimulation of the Subthalamic nucleus (STN) after anesthetic inhalation.
The current transplantation paradigm for Parkinson's disease that places foetal dopaminergic cells in the striatum neither normalizes neuronal activity in basal ganglia structures such as the substantia nigra (SN) and Subthalamic nucleus (STN) nor leads to complete functional recovery.
BACKGROUND: Deep brain stimulation (DBS) of the Subthalamic nucleus (STN) gained general acceptance in the treatment of Parkinson's disease (PD).
MATERIAL AND METHODS: Five patients underwent deep brain stimulation of the Subthalamic nucleus due to levodopa-induced motor complications in Parkinson's disease.
This inverted U-shaped profile was mirrored by a VP output structure, the medial Subthalamic nucleus (mSTN).
It is unclear how Subthalamic nucleus activity is modulated by the cerebral cortex. We studied nine patients with Parkinson's disease (PD) to test whether cortical stimulation can modulate synchronized oscillations in the human Subthalamic nucleus. Motor cortical stimulation suppressed beta activity in the Subthalamic nucleus from approximately 0.2 to 0.6 s after TMS (repeated measures anova; main effect of time, P < 0.01; main effect of side, P = 0.03), regardless of intensity.
The LCBF increase in the somatosensory cortex, ventrobasal and anterior thalamic nuclei, hypothalamus, Subthalamic nucleus, piriform, entorhinal and perirhinal cortex, amygdala, CA2 region of hippocampus, and substantia nigra was statistically significantly larger in stimulated GAERS compared to stimulated NEC rats.
METHODS: We measured the regional normalized resting cerebral metabolic rate of glucose (nCMRGlc) with 18-fluorodeoxyglucose (FDG) and PET in 12 patients with Parkinson disease (PD) and bilateral DBS of the Subthalamic nucleus (STN) compared to 10 age-matched controls. We conclude that Subthalamic nucleus DBS has predominant excitatory properties and does, therefore, fundamentally differ from lesional neurosurgery..
In PD EMCS is less efficacious than bilateral Subthalamic nucleus (STN) stimulation, but it may be safely employed in patients not eligible for deep brain stimulation (DBS).
The effects of Subthalamic nucleus (STN) stimulation on cognition and mood have not been well established. The authors estimated cognitive and mood effects of bilateral Subthalamic nucleus deep brain stimulation (STN DBS) in patients with Parkinson's disease (PD) at 6 months and 1 year postoperatively.
Deep brain stimulation (DBS) of the Subthalamic nucleus has been used extensively in the treatment of Parkinson's disease.
The Subthalamic nucleus (STN) which is part of the basal ganglia is of particular interest, since deep brain stimulation of the STN is an effective treatment for PD including Parkinsonian tremor.
By recording local field potentials (LFPs) in the Subthalamic nucleus (STN) while stimulating the nucleus ventralis intermedius thalami (VIM), information of the stimulation effects should be gained.
Parkinson's disease is treated pharmacologically with dopamine replacement medication and, more recently, by stimulating basal-ganglia nuclei such as the Subthalamic nucleus (STN). We recorded local field potentials (LFPs) from the Subthalamic nucleus of patients with Parkinson's disease (PD) after surgery to implant deep brain stimulating electrodes while they were on and off dopaminergic medication.
Based on these initial findings, we proposed that: (a) D2-like receptors in the dorsal striatum are responsible for attenuating kappa-opioid-induced locomotor activity, and (b) the effects of D2-like receptor stimulation are mediated by the indirect pathway, which extends from the dorsal striatum to the SNPR via the globus pallidus (GP) and Subthalamic nucleus (STN).
The Subthalamic nucleus (STN) of the basal ganglia is an important element of motor control.
Despite the clinical importance of the question, a number of methodological issues have limited firm conclusions regarding the cognitive safety of deep brain stimulation (DBS) of the Subthalamic nucleus (STN) in Parkinson's disease (PD).
After dopamine loss, synchronous oscillatory activity emerges in the Subthalamic nucleus and substantia nigra pars reticulata in phase with cortical slow oscillations.
It has been shown that stimulation of the Subthalamic nucleus (STN), a small subcortical structure located within the basal ganglia, can help ameliorate the motor symptoms associated with Parkinson's disease (PD).
Manic symptoms have been reported as adverse effects of bilateral deep brain stimulation (DBS) of the Subthalamic nucleus (STN) in patients with Parkinson's disease.
Flexion movements of the wrist were studied in a patient who showed signs of hemiballismus following a unilateral infarction, which damaged the region neighboring the Subthalamic nucleus.
We report the successful treatment of an episode of major depression with psychotic features with electroconvulsive therapy (ECT) in a 78-year-old woman with advanced Parkinson disease who had a left Subthalamic nucleus deep-brain stimulator (DBS) in place.
OBJECTIVE: To test the hypothesis that emotion recognition and apathy share the same functional circuit involving the Subthalamic nucleus (STN).
The aim of this study was to investigate personality, by means of the Rorschach Psychodiagnostic test, in a consecutive series of fourteen patients with Parkinson's disease (PD) submitted to bilateral deep brain stimulation of the Subthalamic nucleus (DBS STN).
BACKGROUND: Reversible changes in Subthalamic nucleus (STN) activity, detected by microelectrode recording (MER), are reported in three patients who received an intravenous betablocker, metoprolol, during deep brain stimulation (DBS) for Parkinson's disease (PD).
METHODS: We compared the gain and latency of visually triggered eye and head movements in 12 patients bilaterally implanted into the Subthalamic nucleus (STN) for severe PD and six age-matched control subjects.
Bilateral symptoms and signs of Parkinson's disease (PD) are often improved by unilateral Subthalamic nucleus deep brain stimulation (STN-DBS).
Ten of the 24 patients had T(1)-weighted image high signal intensity in the Subthalamic nucleus and appeared as normal intensity in the region for the T(2)-weighted images.
Several lines of evidence have implicated the Subthalamic nucleus (STN) in behaviors that require precise temporal control.
BACKGROUND: Stereotactic implantation of electrodes for deep brain stimulation (DBS) in the Subthalamic nucleus (STN) is a well-established treatment for Parkinson's disease.
We investigated by a computational model of the basal ganglia the different network effects of deep brain stimulation (DBS) for Parkinson's disease (PD) in different target sites in the Subthalamic nucleus (STN), the globus pallidus pars interna (GPi), and the globus pallidus pars externa (GPe).
BACKGROUND/AIMS/METHODS: In order to explore the usefulness and long-term result of Subthalamic nucleus (STN) stimulation for the treatment of essential tremor (ET), we evaluated 3 groups of patients undergoing deep brain stimulation (DBS) for ET.
High-frequency stimulation (HFS) of the Subthalamic nucleus (STN) is a well-established therapy for patients with severe Parkinson's disease (PD), but its mechanism of action is unclear.
The globus pallidus (GP), the rodent homologue of the primate GPe, is the main central nucleus of the basal ganglia, affecting the striatum, the Subthalamic nucleus (STN), and BG output structures.
Neuronal burst firing in the Subthalamic nucleus (STN) is one of the hallmarks of dopamine depletion in Parkinson's disease.
The Subthalamic nucleus (STN), a major component of the basal ganglia (BG), plays a crucial role in motor activity and cognitive functions.
BACKGROUND: Deep brain stimulation (DBS) of the Subthalamic nucleus (STN) reduces motor symptoms in patients with Parkinson's disease (PD) and improves their quality of life; however, the effect of DBS on cognitive functions and its psychiatric side-effects are still controversial.
Here we report two patients with bilateral fetal nigral grafts in the caudate and putamen subjected to deep brain stimulation (DBS) of the globus pallidus internus (GPi) or Subthalamic nucleus (STN).
To investigate the mechanisms involved, we analyzed changes in local field potentials from the subthalamic area (STN-LFPs) recorded through the deep brain macroelectrode during monopolar DBS of the Subthalamic nucleus area (STN-DBS) in a group of eight patients (16 nuclei) with idiopathic Parkinson's disease.
Deep brain stimulation of the Subthalamic nucleus (STN-DBS) is commonly utilized as surgical treatment for advanced PD with motor complications.
At postnatal day (P) 7, many Lmx1b-expressing neurons were found in the posterior hypothalamic area, supramammillary nucleus, ventral premammillary nucleus, and Subthalamic nucleus.
Subthalamic nucleus (STN) deep brain stimulation (DBS) is also a promising treatment.
Deep brain stimulation (DBS) of the bilateral Subthalamic nucleus (STN) in Parkinson's disease is thought to produce adverse events such as emotional disorders, and in a recent study, we found fear recognition to be impaired as a result.
A recent study highlighted the importance of subcortical processes during stop signal inhibition in 13 individuals and suggested that the Subthalamic nucleus (STN) may play a role in blocking response execution (Aron and Poldrack, 2006. Cortical and subcortical contributions to Stop signal response inhibition: role of the Subthalamic nucleus.
OBJECTIVE: To study the neurochemical change during high-frequency stimulation of the Subthalamic nucleus in epileptic rats. Concentric bipolar electrodes were stereotaxically implanted in the unilateral Subthalamic nucleus (STN), stimulated by high frequencies of 130 and 260 Hz in each group.
OBJECTIVE: To investigate the correlation of the neuronal activity in the Subthalamic nucleus (STN), active contacts of deep brain stimulation (DBS), and clinical outcome of Parkinson's disease (PD).
OBJECTIVE: The goal of the present study was to evaluate the effects of bilateral deep brain stimulation (DBS) of the Subthalamic nucleus (STN) on olfaction in patients with Parkinson's disease (PD).
OBJECTIVE: To investigate the influence of high frequency stimulation of the Subthalamic nucleus on the levels of amino acids neurotransmitters in striatum of hemiparkinsonian monkeys. Collecting the dialyate before turning on the pulse generator, and collecting at 1 week, 1, 8 and 12 months after high frequency stimulation of the Subthalamic nucleus.
RECENT FINDINGS: Although some studies indicate improvement in voice and speech with dopamine therapy and deep brain stimulation of the Subthalamic nucleus, others show minimal or adverse effects.
BACKGROUND: The misplacement of electrodes is a possible explanation for suboptimal response to bilateral Subthalamic nucleus (STN) stimulation in patients with Parkinson disease.
As a treatment for advanced Parkinson's disease, deep brain stimulation (DBS) of the thalamus was introduced in 1987 to treat tremor, and was applied in 1993 to the Subthalamic nucleus. Now high-frequency stimulation of the Subthalamic nucleus has become a surgical therapy of choice.
In the Subthalamic nucleus (STN) of Parkinson's disease (PD) patients, a pronounced synchronization of oscillatory activity at beta frequencies (15-30 Hz) accompanies movement difficulties.
The mechanisms by which deep brain stimulation (DBS) of the Subthalamic nucleus (STN) leads to clinical benefit in Parkinson's disease (PD), especially with regard to dopaminergic transmission, remain unclear.
INTRODUCTION: The purpose of this study was to compare the visibility of the normal Subthalamic nucleus (STN) between fast spin-echo T2-weighted (FSE T2-W) images and fast short inversion time inversion-recovery (FSTIR) images, and to assess the age-related changes of the STN at 3.0 T.
We report our experience with dexmedetomidine during MER of Subthalamic nucleus (STN).
Although a brain CT did not detect any abnormal density areas, we suspected that the patient had cerebral infarction of the basal ganglia or the parietal lobe on the left side, or of the Subthalamic nucleus on the right side because choreic involuntary movements were more prominent on the right side.
Treatment is difficult; deep brain stimulation of the Subthalamic nucleus may therefore prove useful in some cases..
In the present study, psychophysical tests assessing several aspects of auditory temporal processing were administered to a group of PD patients treated with bilateral Subthalamic nucleus (STN) stimulation and to a normal control group.
Objectives of the present trial were to investigate the effects of bilateral deep brain stimulation (DBS) of the Subthalamic nucleus (STN) on the performance of complex and simple movement series, on the execution of simple reaction time (SRT) paradigms following an acoustic or a visual stimulus, on scored motor symptoms and the interrelation of the various study parameters in PD patients.
Leads were placed into the Subthalamic nucleus, ventral intermediate nucleus, globus pallidus interna, and anterior thalamic nucleus.
Even several years after initiation, high-frequency Subthalamic nucleus deep brain stimulation (STN-DBS) is still very effective for controlling segmental symptoms. CONCLUSIONS: Our results prompt consideration of a new strategy for two-stage Subthalamic nucleus deep brain stimulation (STN-DBS) frequency optimization, with stimulation at 130 Hz and the usual voltage during the initial years of STN-DBS and then at 60 Hz at a high voltage in Parkinson disease patients who develop severe gait disorders..
We investigated levels of mRNA for three neurexins (Nrxn) and three neuroligins (Nlgn) in the globus pallidus, Subthalamic nucleus, and substantia nigra, in control conditions and after short-term exposure to cocaine. The expression of Nrxn2beta and Nlgn3 in the substantia nigra and Nlgn1 in the Subthalamic nucleus depended on genetic background.
These changes in network activity were compared with those occurring during Subthalamic nucleus (STN) deep brain stimulation (DBS), and those observed in a test-retest PD control group.
In this study, we assessed whether modulation of basal ganglia activity by high-frequency stimulation of the Subthalamic nucleus (STN-HFS) in PD had an impact on the brainstem-controlled startle system. CONCLUSION: High-frequency stimulation of the Subthalamic nucleus alters the excitability of the brainstem startle system in Parkinson disease, most likely by releasing the reticular motor system from abnormal descending input of the basal ganglia via pallidotegmental pathways..
OBJECTIVE: We studied the effects of Subthalamic nucleus (STN) stimulation vs levodopa on freezing of gait (FOG) and gait impairments in a large consecutive series of patients with Parkinson disease with bilateral STN stimulation. CONCLUSIONS: Overall, Subthalamic nucleus stimulation improved levodopa-responsive freezing of gait in most patients, although it was not always as effective as levodopa to improve gait impairments.
The present study tested whether lesions of the Subthalamic nucleus (STN), a major node of the indirect pathway, would affect compulsive behavior, using the signal attenuation rat model of OCD.
A microsubthalamotomy (mSTN) effect is commonly described after implantation that improves Parkinson's motor disability and is considered to be an obvious sign of good placement of the definitive electrode within the Subthalamic nucleus (STN).
The primary goal of this study was to integrate neuroimaging, neurophysiology, and neurostimulation data sets from 10 PD patients, unilaterally implanted with Subthalamic nucleus (STN) DBS electrodes, to identify the theoretical volume of tissue activated (VTA) by clinically defined therapeutic stimulation parameters.
A higher than expected frequency of suicide has been reported among patients undergoing Subthalamic nucleus deep brain stimulation (STN DBS) for advanced Parkinson's disease (PD).
This technique requires the localization of an objective structure: the Subthalamic nucleus. In this work the creation of a deformable brain atlas that enables the identification of the Subthalamic nucleus in T1-weighted magnetic resonance imaging (MRI) in an automatic, precise and fast way is presented.
Overactivity of Subthalamic nucleus (STN) neurons is a consistent feature of Parkinson's disease (PD) and is a target of therapy for this disorder.
To evaluate the effects of the dopamine D2-D3 agonist ropinirole in patients who developed apathy after complete withdrawal from dopaminergic medication following successful Subthalamic nucleus (STN) stimulation for advanced Parkinson disease (PD).
The GP is reciprocally connected with the Subthalamic nucleus (STN) and projects to the SNr and motor thalamus analog, the ventral intermediate area (VIA).
We present a high functioning patient (an accountant) who underwent a palliative trial of RN region DBS in an approach targeted through the Subthalamic nucleus region.
Electrical stimulation of the Subthalamic nucleus is an effective treatment for the motor symptoms of Parkinson's disease. One explanation for the possible disturbance of cognitive functions is that electrical stimulation of the Subthalamic nucleus disrupts the normal flow of information within cortico-striatal loops involving prefrontal, associative, or limbic cortex. We wished to assess the effect of high frequency electrical stimulation of the Subthalamic nucleus in Parkinson's disease patients while they performed a comprehensive neuropsychological test battery. We conclude that electrical stimulation of the motor Subthalamic nucleus does not cause appreciable declines in cognitive function in well-selected patients..
Other targets were therefore investigated, and the procedure was applied to the Subthalamic nucleus (STN) and the internal globus pallidus (GPi).
Did this occur because pallidotomy was not effective or safe, or because DBS was found to be more effective and safer? This review focuses on the evidence-and its quality-supporting the effectiveness and safety of pallidotomy for PD and dystonia, and the comparative effectiveness and safety of DBS of the Subthalamic nucleus (STN) and globus pallidus pars interna (GPi).
Candidate genes tested in PD patients encode 1) glutamic acid decarboxylase, which is injected into the Subthalamic nucleus to catalyze biosynthesis of the inhibitory neurotransmitter gamma-aminobutyric acid and so essentially mimic deep brain stimulation of this nucleus; 2) aromatic l-amino acid decarboxylase, which converts l-dopa to dopamine; and 3) neurturin, a member of the glial cell line-derived neurotrophic factor family.
OBJECTIVE: High-frequency Subthalamic nucleus deep brain stimulation (STN-DBS) is an established treatment for patients with advanced Parkinson disease (PD). CONCLUSION: Using a noninvasive, simple, and sensitive electronic recording method of intraoperative motor symptom registration, we were able to supplement short-term clinical observation by objectively quantifying the characteristics of tremor and finger tapping in response to Subthalamic nucleus deep brain macrostimulation..
When PD conditions like reduced dopamine and altered dynamics of the Subthalamic nucleus and globus pallidus externa subsystems are simulated, the handwriting produced by the model manifested characteristic PD handwriting distortions like micrographia and velocity fluctuations.
Abnormal neuronal activity in the Subthalamic nucleus (STN) plays a crucial role in the pathophysiology of Parkinson's disease (PD).
Precise placement of the electrodes for stimulation of the Subthalamic nucleus (STN) in Parkinson's disease (PD) is crucial for the therapeutic benefit.
By use of Raprl stereotactic coordinates, electrodes were placed behind the Subthalamic nucleus..
METHODS: This review analyzes the effects of early surgical procedures to treat hyperkinesia and the current methods and targets used to combat LID in Parkinson's disease, which are mainly thalamotomy, pallidotomy, and deep brain stimulation of the globus pallidus internus and the Subthalamic nucleus. RESULTS: Available information indicates that surgery of the globus pallidus internus and thalamus (the pallidal receiving area) and of the Subthalamic nucleus has a pronounced antidyskinetic effect. Thus, LID is less frequent after subthalamotomy or deep brain stimulation of the Subthalamic nucleus through a functional effect mediated by the physiological normalization of the motor system and by an indirect effect associated with a reduction in the daily dose of L-dopa. Alternatively, the antidyskinetic effect of Subthalamic nucleus surgery may in part be attributable to a reduction in the L-dopa dose as well as to the stabilization of the basal ganglia circuits after the surgical procedure..
Subthalamic nucleus single-unit recordings were undertaken before and during pedunculopontine [ corrected] nucleus-stimulation at clinically relevant frequency (25 Hz) in six patients with Parkinson's disease. Pedunculopontine [ corrected] nucleus stimulation changed the firing activity of almost every Subthalamic nucleus cell (44/48) by decreasing the ongoing discharge in bursting Subthalamic nucleus neurons (-62.1%) and exciting irregular (+63.2%) and tonic/regular discharges (+20.1%). If the modulation of Subthalamic nucleus bursting units may corroborate the pedunculopontine [ corrected] nucleus therapeutic role, the simultaneous excitatory influence during nonbursty patterns might interfere with a favorable outcome on motor signs. As a result, the implantation of pedunculopontine [ corrected] nucleus alone may be hazardous while the association of Subthalamic nucleus plus pedunculopontine [ corrected] nucleus seems to be reasonable..
OBJECTIVES: To study the frequency of different gene mutations in patients with early-onset parkinsonism and bilateral Subthalamic nucleus deep brain stimulation (STN-DBS) and the short- and long-term surgical outcome in mutation-positive (MUT+) and -negative (MUT-) patients. CONCLUSIONS: Patients with Parkin or PINK1 mutations benefit from Subthalamic nucleus deep brain stimulation.
Intraoperative neuronal microrecordings can help in localizing the Subthalamic nucleus (STN) during stereotactic neurosurgery for deep-brain stimulation (DBS) in Parkinson's disease.
In patients with advanced Parkinson's disease, deep brain stimulation of the Subthalamic nucleus has a favorable impact on sleep quality and sleep architecture..
Theoretical and experimental analyses of deep brain stimulation (DBS) in the Subthalamic nucleus (STN) show both excitatory and inhibitory effects on the neural elements surrounding the electrode.
Here, we investigate the pattern of bidirectional coupling between mesial and lateral cortical areas and the Subthalamic nucleus (STN) at rest and during movement, with and without pharmacological dopaminergic input, in patients with Parkinson's disease.
Instrument-based studies for movement alteration detection after simultaneous ablation of the globus pallidus and the Subthalamic nucleus of these two patients showed greater sensitivity than clinical evaluation alone.
Recent clinicopathological studies showed much more severe and more widespread tau pathology in Richardson's syndrome (RS), clinically manifest by early onset, falls, supranuclear gaze palsy, dementia and shorter disease duration than in atypical PSP-parkinsonism (PSP-P) often mimicking Parkinson's disease, in which tau pathology is relatively restricted to substantia nigra, Subthalamic nucleus and internal globus pallidus.
Microscopically, there were occasional swollen axons within the cerebral cortex and deep nuclei, particularly the Subthalamic nucleus, with no neuronal loss, gliosis or microglial activation.
OBJECTIVE : To assess the differential effects of bilateral deep brain stimulation of the Subthalamic nucleus on proximal and distal muscle groups of the upper limb in Parkinson's disease. METHODS : Eight parkinsonian subjects with chronic bilateral stimulation of the Subthalamic nucleus performed index finger tapping (differentially drawing upon distal arm muscles), horizontal pointing (differentially drawing upon proximal arm muscles) and a complex reach-to-grasp task with cubes of different sizes, which involved both proximal and distal arm muscles. Subjects were investigated in two clinical conditions: on and off Subthalamic nucleus stimulation. RESULTS : Stimulation of the Subthalamic nucleus improved the UPDRS motor subscore (68 %). Bradykinesia of index finger tapping and horizontal pointing were equally improved by Subthalamic nucleus stimulation. CONCLUSION : The data suggest that bilateral stimulation of the Subthalamic nucleus improves bradykinesia of both distal and proximal muscles of the arm and hand in Parkinson's disease; however, dependent upon task complexity proximal and distal movement components may be affected differentially. Kinematic motion analysis is an efficient tool to objectively evaluate the beneficial effects of Subthalamic nucleus stimulation on dexterity in Parkinson's disease..
The persistent effects of unilateral deep brain stimulation (DBS) of the globus pallidus interna (GPi) or Subthalamic nucleus (STN) on specific movement parameters produced by Parkinson's disease (PD) patients are poorly understood.
One patient required Subthalamic nucleus deep-brain stimulation with a good motor outcome.
Microelectrode recording during deep brain stimulation surgery is a useful adjunct for Subthalamic nucleus (STN) localization. Subthalamic nucleus boundaries determined by inspection, based on sustained deviations from baseline for each feature profile, were compared against those determined intraoperatively by the clinical neurophysiologist.
In particular, we compared the action of CM/PF and Subthalamic nucleus (STN) DBS on resting hand tremor using EMG surface of ulnar and radial right-hand muscles.
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 electrophysiological definitive targeting.
AIMS: To assess the variability of the Subthalamic nucleus (STN) size, orientation and target coordinates from direct visualization on high-resolution magnetic resonance (MR) images in patients undergoing surgical intervention for Parkinson's disease.
BACKGROUND: Bilateral deep brain stimulation (DBS) of the Subthalamic nucleus (STN) improves motor function in Parkinson disease (PD).
OBJECTIVE: This study reports a retrospective analysis of 67 consecutive parkinsonian patients to assess changes in antiparkinsonian medications after Deep Brain Stimulation (DBS) of the Subthalamic nucleus (STN).
Apraxia of eyelid opening (ALO) is an infrequent side effect of deep brain stimulation (DBS) of the Subthalamic nucleus (STN) for Parkinson's disease (PD).
A remarkable c-fos expression was found in the lesioned side of GP, Subthalamic nucleus (STN), and substantia nigra pars reticulata (SNr) of rats that received the ACPD or DHPG injection, compared to rats treated with L-AP-4 or phosphate buffer-injection.
Depth recordings in patients with Parkinson's disease (PD) have demonstrated exaggerated local field potential (LFP) activity at frequencies between 10 and 30 Hz in the Subthalamic nucleus (STN).
Currently, no study of Subthalamic nucleus (STN) stimulation has compared continuous stimulation with a period of short-term stimulation, which is frequently employed in the clinic and in research studies.
Target nuclei have mainly three structures: the nucleus ventrointermedius externus of the thalamus (Vim), the globus pallidus internum (GPi) and the Subthalamic nucleus (STN).
Reciprocally connected glutamatergic Subthalamic nucleus (STN) and GABAergic external globus pallidus (GP) neurons normally exhibit weakly correlated, irregular activity but following the depletion of dopamine in Parkinson's disease they express more highly correlated, rhythmic bursting activity.
The pattern of signal change for the internal globus pallidus (GPi) and Subthalamic nucleus (STN) was nonlinear and parameters of the exponential function were altered by feedback type.
Stimulation at this site is typically delivered at low frequencies in contrast to the high frequency stimulation required for therapeutic benefit in the Subthalamic nucleus.
We examined the effect of bilateral Subthalamic nucleus stimulation on levodopa-resistant balance impairment in 14 patients with Parkinson's disease and 18 matched controls.
This study tested the hypothesis that left versus right deep brain stimulation (DBS) of the Subthalamic nucleus (STN) would have differential effects on speech.
The study also investigates the effect of this variability on the localization of targets like the Subthalamic nucleus, ventralis intermedius nucleus and globus pallidus internus. These data also show that, even for experienced neurosurgeons, variations in selecting the AC and the PC point result in substantial variations at the target points: 1.15 +/- 0.89 mm, 1.45 +/- 1.25 mm, 1.21 +/- 0.83 for the Subthalamic nucleus, ventralis intermedius nucleus, and globus pallidus internus, respectively, for the first MRI volumeand 1.08 +/- 1.37 mm, 1.35 +/- 1.71 mm, 1.12 +/- 1.17 mm for the same structures for the second volume.
The Subthalamic nucleus (STN) plays a pivotal role in normal and abnormal motor function.
INTRODUCTION: Ballism is a rare movement disorder that presents with violent and wide amplitude flinging movements of the limbs, mainly caused by injury in the contralateral Subthalamic nucleus or its afferent or efferent connections.
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