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Expectations and Level of Satisfaction of the Patient with Parkinson’s Disease Undergoing deep brain stimulation Surgery at the National Institute of Neurology and Neurosurgery

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Advances in Parkinson's Disease 2024年第1期13卷 1-7页

作者： Paola Bazán-Rodríguez Eduardo Ichikawa-Escamilla Etienne Reséndiz-Henríquez Carlos E. Martínez-Cortés Amin Cervantes-Arriaga Mayela Rodríguez-Violante Lisette Bazán-Rodríguez Laboratorio de Enfermedades Neurodegenerativas en el Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez Ciudad de México México Laboratorio de Enfermedades Neurodegenerativas en el Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez Ciudad de México México. Unidad Periférica para el Estudio de la Neuroinflamación en Patologías Neurológicas del Instituto de Investigaciones Biomédicas en el Instituto Nacional de Neurología y Neurocirugía Manuel Velasco Suarez Ciudad de México México

Background: deep brain stimulation (DBS) is an established treatment for patients with advanced Parkinson’s disease (PD). Reports show continued patient satisfaction after surgery despite not maintaining clinical improvement as measured by evolution scales. Objectives: The present study sought to explore expectations and level of satisfaction in patients after DBS surgery with a semi-structured questionnaire and subsequent correlation with functional scales, Quality of Life (QoL), and motor and non-motor symptoms. Methods: We performed descriptive statistics to represent demographic data, Wilcoxon rank tests to determine significant differences, and Spearman correlation between the applied scales. Results: We evaluated 20 patients with a history of DBS surgery. 45% were female, with a mean age of 55.7 ± 14.15 years, a mean disease duration of 13.42 ± 8.3 years, and a mean time after surgery of 3.18 ± 1.86 years. Patients reported surgery meeting expectations in 85.5% and continued satisfaction in 92%. These two variables showed a significant correlation. Conclusions: This sample of patients remained satisfied after DBS surgery, although we found no differences in motor and non-motor clinimetric scales. Further studies are needed to confirm the importance of assessing quality of life in patients with DBS.

关键词： Parkinson’s Disease Quality of Life deep brain stimulation Patient Satisfaction

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deep brain stimulation of the subthalamic nucleus treats Parkinson's disease through enhancing metabolic activity of the corpus striatum Verification by single photon emission computed tomography and positron emission tomography

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Neural Regeneration Research 2010年第6期5卷 405-410页

作者： Yiqun Cao Xiaoping Zhou Zhifeng Zhang Xiaowu Hu Xiufeng Jiang Department of Neurosurgery Changhai Hospital Second Military Medical University of Chinese PLA Shanghai 200433 China Department of Nuclear Medicine Changhai HospitalSecond Military Medical University of Chinese PLA Shanghai 200433 China

BACKGROUND： Subthalamic nucleus deep brain stimulation （STN DBS） for Parkinson＇s disease （PD） has achieved good effects, but to date the mechanism of STN DBS remains poorly understood STN DBS may increase dopamine levels or metabolic activity of the corpus striatum. OBJECTIVE： To validate the effects of STN DBS on dopamine metabolism and glucose metabolism in the corpus striatum of hemiparkinsonian monkeys using single photon emission computed tomography （SPECT） and position emission tomography （PET）. DESIGN, TIME AND SET＇rING： A controlled animal study was performed at the Neurosurgery Laboratory, Changhai Hospital of the Second Military Medical University of Chinese PLA between January 2004 and December 2007. METHODS： Hemiparkinsonism was induced in adult Rhesus Macaque monkeys, which exhibit similar characteristics of PD in humans, through unilateral internal carotid artery infusion of 1-methy-4-phenyl-1, 2, 3, 6-tetrahydropyrindine. Following model establishment, stimulation electrodes were implanted in the right STN, and chronic high-frequency stimulation （60 μs pulse width, 130 Hz frequency, and 1.5-2.0 V pressure） was performed. MAIN OUTCOME MEASURES： The changes in dopamine transporter （DAT）, D2 receptor （D2R）, and glucose metabolism in the corpus striatum following STN DBS were observed using SPECT and PET. RESULTS： SPECT examination showed that DAT specific binding in the right corpus striatum was increased at 3 months after DBS compared with prior to stimulation, and D2R specific binding in the right corpus striatum gradually decreased near levels on the left （non-electrode-implanted） side within 3 months after DBS. PET examination showed that the glucose metabolism in the right corpus striatum was markedly increased at 3 months after effective DBS. Hemiparkinsonism monkeys showed improved left limb rigidity, increased activities, and stable gait under chronic high-frequency stimulation. CONCLUSION： STN DBS increased striatal DAT, decreased D2R, and enhan

关键词： subthalamic nucleus deep brain stimulation Parkinson's disease monkey single photon emission computed tomography positron emission tomography neural regeneration

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deep brain stimulation in the treatment of secondary dystonia

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Chinese Medical Journal 2006年第24期119卷 2069-2074页

作者： ZHANG Jian-guo,ZHANG Kai,WANG Zhong-cheng,GE Ming and MA Yu Department of Neurosurgery,Beijing Tiantan Hospital,Capital University of Medical Sciences Functional Neurosurgical Department,Beijing Neurosurgical Institute,Beijing 100050,China Department of Neurosurgery Beijing Tiantan Hospital Capital University of Medical Sciences

Background Dystonia is one of the most challenging movement disorders to treat. Medications and surgeries are the two methods to control dystonic symptoms. For patients with dystonia in whom symptoms are inadequately controlled with pharmacologic measures, the use of deep brain stimulation （DBS） can improve symptoms and enhance functional capacity. The best candidate for DBS is believed to be primary generalized dystonia, especially the DYT-1 type. Here, we report 9 cases of secondary dystonia to explore the feasibility, indications and complications of DBS in the treatment of secondary dystonia. Methods From July 2003 to June 2006, nine patients with secondary dystonia underwent surgery at Beijing Tiantan Hospital. Among them, 2 were diagnosed as having tardive dystonia, 1 had posttraumatic dystonia, 3 had a history of perinatal anoxia, 1 had neonatal pathologic jaundice, and 2 had no exact contributory history; MRI showed bilateral lentiform nuclei degeneration in one patient. Six patients underwent bilateral subthalamic nucleus （STN）-DBS, two underwent unilateral STN-DBS, the other underwent left STN and fight globus pallidus internus（GPi）-DBS. Results With intraoperative microelectrode recording, the targeted nucleus was accurately localized. Tentative stimulation could decrease muscle tension to the same extent, but twisting was not obviously improved. Follow-up for 3 months to 3 years showed satisfactory results in 3 patients with tardive dystonia and posttraumatic dystonia and that Burke-Fahn-Marsden Dystonia Scale （BFMS） decreased by more than 90%. The improvement of symptoms was progressive along with time. The other 6 patients had slight to moderate improvement. None of them had severe surgery-related complications. One had lead fracture 16 months after surgery and the lead was then evacuated. Conclusions DBS could be an ideal treatment for patients with tardive and posttraumatic dystonia. For patients with perinatal anoxia and diffuse impairment in the ba

关键词： subthalamic nucleus deep brain stimulation secondary dystonia

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deep brain stimulation of the Globus Pallidus Internus in Patients with Intractable Tourette Syndrome： A 1-year Follow-up Study

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Chinese Medical Journal 2016年第9期129卷 1022-1027页

作者： Xiao-Hua Zhang Jian-Yu Li Yu-Qing Zhang Yong-Jie Li Department of Functional Neurosurgery Beijing Institute of Functional Neurosurgery Xuanwu Hospital Capital Medical University Beijing 100053 China

Background： deep brain stimulation （DBS） has been a promising treatment for patients with refractory Tourette syndrome （TS） for more than a decade. Despite successful DBS treatment of TS in more than 100 patients worldwide, studies with a large patient sample and long-term follow-up assessments are still scarce. Accordingly, we investigated the clinical efficacy and safety of globus pallidus internus （GPi） DBS in the treatment of intractable TS in 24 patients with a 1-year follow-up assessment. Methods： Bilateral/unilateral GPi-DBS was performed in 24 patients with TS. We evaluated symptoms of tics and obsessive-compulsive disorder （OCD） through the Yale Global Tic Severity Scale （YGTSS） and Yale-Brown Obsessive-compulsive Scale （Y-BOCS）. We used the Wechsler Adult Intelligence Scale-Revised in China （WAIS-RC） to evaluate the safety of the treatment. We conducted follow-up assessments of all patients for at least 12 months （12-99 months）. Results： Symptoms of tics and OCD were significantly relieved at a 12-month follow-up assessment. The mean YGTSS score was 74.04 ± 11.52, 49.83 ± 10.91, 32.58 ± 7.97, and 31.21 ± 8.87 at baseline, 3, 6, and 12 months, respectively. The mean YGTSS scores obtained at the follow-up assessments were significantly different from the baseline （P 〈 0.05）. The improvement in motor tics was superior to that in phonic tics. The mean Y-BOCS scores were 21.61 ± 4.97, 18 ± 4.58, 14.39 ± 3.99, and 13.78 ± 4.56 at baseline, 3, 6, and 12 months, respectively （P 〈 0.05）. We observed a remarkable improvement in psychiatric comorbidities, such as OCD and attention-deficit hyperactivity disorder, after the procedure. WAIS-RC scores were comparable before and after the operation. There were no severe postoperative complications. Conclusion： GPi-DBS appears to comprehensively alleviate tic symptoms and psychiatric comorbidities in patients with TS, thus significantly improving patients＇ quality of life.

关键词： deep brain stimulation Tourette Syndrome Treatment

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deep brain stimulation of the subthalamic nucleus for essential tremor

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Chinese Medical Journal 2013年第2期126卷 395-396页

作者： MENG Fan-gang KAO C. Chris CHEN Ning GE Yan HU Wen-han ZHANG Kai MAYu LIU Chong ZHANG Xin ZHANG Jian-guo Beijing Neurosurgical Institute Capital Medical UniversityBeijing 100050 China Department of Neurological Surgery Vanderbilt UniversityMedical Center Nashville TN 37232 USA Department of Neurosurgery Beijing Tiantan Hospital CapitalMedical University Beijing 100050 China

Essential tremor （ET）, characterized by a postural and/or kinetic tremor and primarily manifested in theupper extremities, head, and other parts of the body, is one of the most common neurological disorders.1 The traditional target for the neurosurgical treatment of ET, the ventral intermedius nucleus （Vim） of the thalamus, has confirmed that chronic deep brain stimulation （DBS1 is an effective, standard, and primary procedure for ET. However, the loss of tremor suppression due to tolerance of chronic Vim stimulation, accompanied by other adverse effects, such as paresthesias, dysarthria, dysequilibrium, hyperhidrosis, and localized pain, has necessitated changes in the stimulation target in some patients.

关键词： deep brain stimulation ventral intermedius nucleus of the thalamus subthalamic nucleus essential tremor

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deep brain stimulation in the treatment of tardive dystonia

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Chinese Medical Journal 2006年第9期119卷 789-792页

作者： ZHANG Jian-guo ZHANG Kai WANG Zhong-cheng Department of Neurosurgery Beijing Tiantan Hospital ＆ Functional Neurosurgical Department Beijing Neurosurgical Institute Beijing 100050 China

Dystonia refers to a clinical syndrome in which sustained involuntary muscle contractions result in twisting and repetitive movements, or abnormal postures. Secondary dystonia is associated with acquired or exogenous causes, hereditary neurologic syndromes or neurodegenerative disorders. Tardive dystonia is a special type of secondary dystonia due to exposure to certain medicines such as neuroleptics, with a chronic and persistent extrapyramidal symptoms.

关键词： deep brain stimulation subthalamic nucleus tardive dystonia

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deep brain stimulation of the nucleus basalis of Meynert modulates hippocampal-frontoparietal networks in patients with advanced Alzheimer’s disease

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Translational Neurodegeneration 2022年第1期11卷 148-160页

作者： Yin Jiang Tian-Shuo Yuan Ying-Chuan Chen Peng Guo Teng-Hong Lian Yu-Ye Liu Wei Liu Yu-Tong Bai Quan Zhang Wei Zhang Jian-Guo Zhang Department of Functional Neurosurgery Beijing Neurosurgical InstituteCapital Medical UniversityBeijing 100070China Department of Functional Neurosurgery Beijing Tiantan HospitalCapital Medical UniversityBeijing 100070China Center for Cognitive Neurology Department of NeurologyBeijing Tiantan HospitalCapital Medical UniversityBeijing 100070China Beijing Key Laboratory of Neurostimulation Beijing 100070China.

Background:deep brain stimulation(DBS)of the nucleus basalis of Meynert(NBM)has shown potential for the treatment of mild-to-moderate Alzheimer’s disease(AD).However,there is little evidence of whether NBM-DBS can improve cognitive functioning in patients with advanced *** addition,the mechanisms underlying the modulation of brain networks remain *** study was aimed to assess the cognitive function and the resting-state connectivity following NBM-DBS in patients with advanced ***:Eight patients with advanced AD underwent bilateral NBM-DBS and were followed up for 12 *** outcomes were assessed by neuropsychological examinations using the Mini-Mental State Examination(MMSE)and Alzheimer’s Disease Assessment ***-state functional magnetic resonance imaging and positron emis-sion tomography data were also ***:The cognitive functioning of AD patients did not change from baseline to the 12-month ***,the MMSE score indicated clinical efficacy at 1 month of *** this time point,the connectivity between the hippocampal network and frontoparietal network tended to increase in the DBS-on state compared to the DBS-off ***,the increased functional connectivity between the parahippocampal gyrus(PHG)and the parietal cortex was associated with cognitive *** dynamic functional network analysis showed that NBM-DBS increased the proportion of the PHG-related connections,which was related to improved cognitive ***:The results indicated that NBM-DBS improves short-term cognitive performance in patients with advanced AD,which may be related to the modulation of multi-network connectivity patterns,and the hippocampus plays an important role within these networks.

关键词： Alzheimer’s disease deep brain stimulation Nucleus basalis of Meynert Hippocampal Frontoparietal Functional connectivity

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deep brain stimulation for obsessive-compulsive disorder:A systematic review of worldwide experience after 20 years

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World Journal of Psychiatry 2021年第9期11卷 659-680页

作者： Lorea Mar-Barrutia Eva Real Cinto Segalas Sara Bertolin Jose Manuel Menchon Pino Alonso OCD Clinical and Research Unit Department of PsychiatryHospital de BellvitgeBarcelona 08907Spain Bellvitge Biomedical Research Institute-IDIBELL Barcelona 08907Spain CIBERSAM(Centro de Investigaci on en Red de Salud Mental) Carlos Ⅲ Health InstituteMadrid 28029Spain Department of Clinical Sciences Faculty of MedicineUniversity of BarcelonaBarcelona 08907Spain

BACKGROUND Twenty years after its first use in a patient with obsessive-compulsive disorder(OCD),the results confirm that deep brain stimulation(DBS)is a promising therapy for patients with severe and resistant forms of the ***,many unknowns remain,including the optimal anatomical targets,the best stimulation parameters,the long-term(LT)effects of the therapy,and the clinical or biological factors associated with *** systematic review of the articles published to date on DBS for OCD assesses the short and LT efficacy of the therapy and seeks to identify predictors of *** To summarize the existing knowledge on the efficacy and tolerability of DBS in treatment-resistant *** A comprehensive search was conducted in the PubMed,Cochrane,Scopus,and *** databases from inception to December 31,2020,using the following strategy:“(Obsessive-compulsive disorder OR OCD)AND(deep brain stimulation OR DBS).”Clinical trials and observational studies published in English and evaluating the effectiveness of DBS for OCD in humans were included and screened for relevant information using a standardized collection *** inclusion criteria were as follows:a main diagnosis of OCD,DBS conducted for therapeutic purposes and variation in symptoms of OCD measured by the Yale-Brown Obsessive-Compulsive scale(Y-BOCS)as primary *** were analyzed with descriptive *** Forty articles identified by the search strategy met the eligibility *** a follow-up threshold of 36 mo,29 studies(with 230 patients)provided information on short-term(ST)response to DBS in,while 11(with 155 patients)reported results on LT *** follow-up period was 18.5±8.0 mo for the ST studies and 63.7±20.7 mo for the LT ***,the percentage of reduction in Y-BOCS scores was similar in ST(47.4%)and LT responses(47.2%)to DBS,but more patients in the LT reports met the criteria for response(defined as a reduction in

关键词： deep brain stimulation Obsessive-compulsive disorder Predictors of response Side effects Short-term Long-term

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deep brain stimulation in Parkinson’s disease

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Translational Neurodegeneration 2013年第1期2卷 154-163页

作者： Raja Mehanna Eugene C Lai UT Move University of Texas Health Care Science CenterHoustonTXUSA Department of Neurology Houston Methodist Neurological Institute6560 FanninSuite 802Houston 77030TXUSA

For the last 50 years,levodopa has been the cornerstone of Parkinson’s disease ***,a majority of patients develop motor complications a few years after therapy *** brain stimulation has been approved by the FDA as an adjunctive treatment in Parkinson disease,especially aimed at controlling these ***,the exact mechanism of action of deep brain stimulation,the best nucleus to target as well as the best timing for surgery are still *** here provide an in-depth and critical review of the current literature on this topic.

关键词： deep brain stimulation Parkinson’s disease Subthalamic nucleus Globus pallidus

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deep brain stimulation for psychiatric disorders: roleof imaging in identifying/confirming DBS targets,predicting, and optimizing outcome and unravellingmechanisms of action

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Psychoradiology 2021年第3期1卷 118-151页

作者： Dejan Georgiev Harith Akram Marjan Jahanshahi Department of Clinical and Movement Neurosciences UCL Queen Square Institute of NeurologyQueen SquareLondonWC1N 3BGUK Department of Neurology University Medical Centre LjubljanaZaloska cesta 21000 LjubljanaSlovenia Artificial Intelligence Laboratory Faculty of Computer and Information ScienceUniversity of LjubljanaVecna pot 1131000 LjubljanaSlovenia The Clinical Hospital of Chengdu brain Science Institute MOE Key Laboratory for NeuroinformationUniversity of Electronic Science and Technology of ChinaChengdu611731China

Following the established application of deep brain stimulation(DBS)in the treatment of movement disorders,new non-neurological indications have emerged,such as for obsessive–compulsive disorders,major depressive disorder,dementia,Gilles de la Tourette Syndrome,anorexia nervosa,and *** DBS is a network mod-ulation surgical treatment,the development of DBS for both neurological and psychiatric disorders has been partly driven by advances in neuroimaging,which has helped explain the brain networks *** in magnetic resonance imaging connectivity and electrophysiology have led to the development of the con-cept of modulating widely distributed,complex brain ***,the increasing number of targets for treating psychiatric disorders have indicated that there may be a convergence of the effect of stimulating dif-ferent targets for the same disorder,and the effect of stimulating the same target for different *** aim of this paper is to review the imaging studies of DBS for psychiatric ***,and particularly connectivity analysis,offers exceptional opportunities to better understand and even predict the clinical out-comes of DBS,especially where there is a lack of objective biomarkers that are essential to properly guide DBS pre-and *** future,imaging might also prove useful to individualize DBS ***,one of the most important aspects of imaging in DBS is that it allows us to better understand the brain through observing the changes of the functional connectome under neuromodulation,which may in turn help explain the mechanisms of action of DBS that remain elusive.

关键词： deep brain stimulation psychiatric disorders major depressive disorder obsessive–compulsive disorder dementia

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