المؤلفون: Jeff L. Waugh, Daniel J. Blezek, Shilpa Chitnis, Toral R. Patel, Rajiv Chopra, Richard B. Dewey, Joseph A. Maldjian, Timothy J. Kaufmann, Frank F. Yu, Bhavya R. Shah, Vance T. Lehman, Darren Imphean

المصدر: Brain : a journal of neurology. 143(9)

مصطلحات موضوعية: Extracorporeal Shockwave Therapy, Deep brain stimulation, medicine.medical_treatment, Deep Brain Stimulation, Essential Tremor, Grey matter, Globus Pallidus, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, 0302 clinical medicine, medicine, Humans, Mri techniques, medicine.diagnostic_test, Essential tremor, business.industry, Quantitative susceptibility mapping, Magnetic resonance imaging, Parkinson Disease, medicine.disease, Magnetic Resonance Imaging, High-intensity focused ultrasound, medicine.anatomical_structure, Susceptibility weighted imaging, Neurology (clinical), business, 030217 neurology & neurosurgery, Biomedical engineering

الوصف: Magnetic resonance guided high intensity focused ultrasound is a novel, non-invasive, image-guided procedure that is able to ablate intracranial tissue with submillimetre precision. It is currently FDA approved for essential tremor and tremor dominant Parkinson’s disease. The aim of this update is to review the limitations of current landmark-based targeting techniques of the ventral intermediate nucleus and demonstrate the role of emerging imaging techniques that are relevant for both magnetic resonance guided high intensity focused ultrasound and deep brain stimulation. A significant limitation of standard MRI sequences is that the ventral intermediate nucleus, dentatorubrothalamic tract, and other deep brain nuclei cannot be clearly identified. This paper provides original, annotated images demarcating the ventral intermediate nucleus, dentatorubrothalamic tract, and other deep brain nuclei on advanced MRI sequences such as fast grey matter acquisition T1 inversion recovery, quantitative susceptibility mapping, susceptibility weighted imaging, and diffusion tensor imaging tractography. Additionally, the paper reviews clinical efficacy of targeting with these novel MRI techniques when compared to current established landmark-based targeting techniques. The paper has widespread applicability to both deep brain stimulation and magnetic resonance guided high intensity focused ultrasound.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::ab73e395f5ef2d58f9f6c4309df26450Test
https://pubmed.ncbi.nlm.nih.gov/32537631Test

المؤلفون: Shilpa Chitnis, Umar Yazdani, Svjetlana Miocinovic, Richard B. Dewey, Neepa Patel, Shazia Mirza

المصدر: Parkinson's Disease, Vol 2017 (2017)
Parkinson's Disease

مصطلحات موضوعية: medicine.medical_specialty, Parkinson's disease, Deep brain stimulation, medicine.medical_treatment, Neuroscience (miscellaneous), Review Article, Disease, Multidisciplinary team, lcsh:RC346-429, 03 medical and health sciences, 0302 clinical medicine, Physical medicine and rehabilitation, Quality of life (healthcare), medicine, In patient, 030212 general & internal medicine, lcsh:Neurology. Diseases of the nervous system, business.industry, medicine.disease, nervous system diseases, Psychiatry and Mental health, Subthalamic nucleus, nervous system, Neurology (clinical), business, 030217 neurology & neurosurgery, Globus pallidus interna

الوصف: Deep Brain Stimulation (DBS) has revolutionized the lives of patients of Parkinson disease, offering therapeutic options to those not benefiting entirely from medications alone. With its proven track record of outperforming the best medical management, the goal is to unlock the full potential of this therapy. Currently, the Globus Pallidus Interna (GPi) and Subthalamic Nucleus (STN) are both viable targets for DBS, and the choice of site should focus on the constellation of symptoms, both motor and nonmotor, which are key determinants to quality of life. Our article sheds light on the specific advantages and drawbacks of the two sites, highlighting the need for matching the inherent properties of a target with specific desired effects in patients. UT Southwestern Medical Center has a robust and constantly evolving DBS program and the narrative from our center provides invaluable insight into the practical realities of DBS. The ultimate decision in selecting a DBS target is complex, ideally made by a multidisciplinary team, tailored towards each patient’s profile and their expectations, by drawing upon scientific evidence coupled with experience. Ongoing research is expanding our knowledge base, which should be dynamically incorporated into an institute’s DBS paradigm to ensure that patients receive the optimal therapy.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::01ff641fbe743dcf8a28b3b4816d9c94Test
https://doi.org/10.1155/2017/3410820Test

المؤلفون: Shilpa Chitnis, Vibhash D. Sharma, Amy W. Amara, Samarpita Sengupta

المصدر: Frontiers in Neurology, Vol 9 (2018)
Frontiers in Neurology

مصطلحات موضوعية: 0301 basic medicine, sleep-wake pathophysiology, Deep brain stimulation, medicine.medical_treatment, Thalamus, Stimulation, Review, lcsh:RC346-429, 03 medical and health sciences, 0302 clinical medicine, medicine, lcsh:Neurology. Diseases of the nervous system, Pedunculopontine nucleus, subthalamic nucleus, business.industry, Neurodegeneration, Dopaminergic, medicine.disease, Sleep in non-human animals, deep brain stimulation, Parkinson disease, sleep-wake disturbances, Subthalamic nucleus, 030104 developmental biology, Neurology, Neurology (clinical), business, Neuroscience, 030217 neurology & neurosurgery

الوصف: Sleep-wake disturbances are common non-motor manifestations in Parkinson Disease (PD). Complex pathophysiological changes secondary to neurodegeneration in combination with motor symptoms and dopaminergic medications contribute to development of sleep-wake disturbances. The management of sleep complaints in PD is important as this symptom can affect daily activities and impair quality of life. Deep brain stimulation (DBS) is an effective adjunctive therapy for management of motor symptoms in PD. However, its effect on non-motor symptoms including sleep-wake disturbances is not widely understood. In this article, we reviewed studies assessing the effect of DBS at various therapeutic targets on sleep-wake disturbances. Of the studies examining the role of DBS in sleep-wake disturbances, the effect of subthalamic nucleus stimulation is most widely studied and has shown improvement in sleep quality, sleep efficiency, and sleep duration. Although, studies investigating changes in sleep with stimulation of thalamus, globus pallidus interna, and pedunculopontine nucleus are limited, they support the potential for modulation of sleep-wake centers with DBS at these sites. The mechanism by which DBS at different anatomical targets affects sleep-wake disturbances in PD is unclear and may involves multiple factors, including improved motor symptoms, medication adjustment, and direct modulation of sleep-wake centers.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::683cec6da4bb9707412593e9b5854931Test
https://doi.org/10.3389/fneur.2018.00697Test

المؤلفون: Elizabeth J. Chambers, Pravin Khemani, Meagen R. Salinas, Shilpa Chitnis, Sonja E. Stutzman, DaiWai M. Olson, Travis Ho

المصدر: Clinical Parkinsonism & Related Disorders, Vol 3, Iss, Pp 100038-(2020)
Clinical Parkinsonism & Related Disorders

مصطلحات موضوعية: medicine.medical_specialty, Rehabilitation, Parkinson's disease, business.industry, medicine.medical_treatment, Health literacy, Patient education, General Medicine, Disease, medicine.disease, lcsh:RC346-429, Health education, Cohort, Physical therapy, Medicine, Original Article, Disease management (health), Questionnaire design, business, lcsh:Neurology. Diseases of the nervous system

الوصف: Background: As the 2nd most common neurodegenerative disorder, Parkinson's disease (PD) affects over 1 million Americans. Treatment is complex and may include pharmacotherapy, rehabilitative measures, and surgical intervention. A comprehensive understanding of the patient's perceptions about PD is a vital step towards improving health literacy and clinical outcomes. Methods: KnowPD is a web-based survey with Likert responses for a cross-sectional, nonrandomized study to assess patients' knowledge of PD symptoms, medications, deep brain stimulation (DBS), rehabilitation, and other factors relevant to disease management. Results: Of the 98 subjects surveyed, 90% agreed they had sufficient knowledge of PD. However, in this cohort, 82% incorrectly believed levodopa stops working as the disease progresses, 77% erroneously thought DBS improves balance and reduces falls, and

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::f433453e9fe0d1c038d63b4c215987f7Test
https://doi.org/10.1016/j.prdoa.2020.100038Test

المؤلفون: Richard B. Dewey, Padraig E. O’Suilleabhain, Manjit Sanghera, Neepa Patel, Pravin Khemani, Laura H. Lacritz, Shilpa Chitnis, Louis A. Whitworth

المصدر: PLoS ONE, Vol 11, Iss 10, p e0164154 (2016)
PLoS ONE

مصطلحات موضوعية: 0301 basic medicine, Quality management, Movement disorders, Deep Brain Stimulation, medicine.medical_treatment, Social Sciences, lcsh:Medicine, Biochemistry, Diagnostic Radiology, Cognition, 0302 clinical medicine, Outcome Assessment, Health Care, Medicine and Health Sciences, Psychology, Medicine, Postoperative Period, lcsh:Science, Cognitive Impairment, Dystonia, Movement Disorders, Multidisciplinary, Essential tremor, Cognitive Neurology, Neuromodulation, Radiology and Imaging, Parkinson Disease, Neurodegenerative Diseases, Neurochemistry, Quality Improvement, Magnetic Resonance Imaging, Neuromodulation (medicine), Neurology, medicine.symptom, Research Article, medicine.medical_specialty, Deep brain stimulation, Imaging Techniques, Essential Tremor, Cognitive Neuroscience, MEDLINE, Surgical and Invasive Medical Procedures, Research and Analysis Methods, 03 medical and health sciences, Physical medicine and rehabilitation, Neuropsychology, Diagnostic Medicine, Humans, Neuropsychological Testing, business.industry, lcsh:R, Biology and Life Sciences, medicine.disease, Otolaryngological Procedures, 030104 developmental biology, Physical therapy, Cognitive Science, lcsh:Q, business, Quality assurance, 030217 neurology & neurosurgery, Neuroscience

الوصف: Objective To develop a process to improve patient outcomes from deep brain stimulation (DBS) surgery for Parkinson disease (PD), essential tremor (ET), and dystonia. Methods We employed standard quality improvement methodology using the Plan-Do-Study-Act process to improve patient selection, surgical DBS lead implantation, postoperative programming, and ongoing assessment of patient outcomes. Results The result of this quality improvement process was the development of a neuromodulation network. The key aspect of this program is rigorous patient assessment of both motor and non-motor outcomes tracked longitudinally using a REDCap database. We describe how this information is used to identify problems and to initiate Plan-Do-Study-Act cycles to address them. Preliminary outcomes data is presented for the cohort of PD and ET patients who have received surgery since the creation of the neuromodulation network. Conclusions Careful outcomes tracking is essential to ensure quality in a complex therapeutic endeavor like DBS surgery for movement disorders. The REDCap database system is well suited to store outcomes data for the purpose of ongoing quality assurance monitoring.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::d60cdb9bbd15ddb71b01d85c31f0f483Test
http://europepmc.org/articles/PMC5053513?pdf=renderTest

المؤلفون: Cherian Abraham Karunapuzha, Shilpa Chitnis

المصدر: Clinical Medicine Insights: Therapeutics, Vol 1 (2009)

مصطلحات موضوعية: congenital, hereditary, and neonatal diseases and abnormalities, Pediatrics, medicine.medical_specialty, Movement disorders, business.industry, Tetrabenazine, lcsh:RM1-950, Chorea, General Medicine, Neurological disorder, Disease, medicine.disease, Botulinum toxin, nervous system diseases, lcsh:Therapeutics. Pharmacology, Huntington's disease, Dopamine, mental disorders, medicine, medicine.symptom, business, Neuroscience, medicine.drug

الوصف: Huntington's disease (HD) is a heredodegenerative neurological disorder with chorea and other hyperkinetic movement disorders being part of the disease spectrum. These along with cognitive and neurobehavioral manifestations contribute significantly to patient's disability. Several classes of drugs have been used to treat the various symptoms of HD. These include typical and atypical neuroleptics along with dopamine depletors for treatment of chorea and antidepressants, GABA agonists, antiepileptic medications, cholinesterase inhibitors, antiglutamatergic drugs and botulinum toxin for treatment of other manifestations. Tetrabenazine (TBZ), a dopamine depleting medication was recently approved by the US FDA for treatment of chorea in HD. The purpose of this article is to briefly review information regarding HD and current treatments for chorea and specifically focus on TBZ and review the literature related to its use in HD chorea.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_dedup___::de3bd086950ea4c80f05d34b12c120fbTest
https://doi.org/10.4137/cmt.s2134Test