المؤلفون: Bjarki D. Djurhuus, Pedro F. Viana, Esben Ahrens, Sofie S. Nielsen, Harishchandra L. Srinivasan, Mark P. Richardson, Preben Homøe, Harutomo Hasegawa, Ali A. Zarei, Pia L. K. Gauger, Jonas Duun-Henriksen

المصدر: Frontiers in Surgery, Vol 10 (2023)

مصطلحات موضوعية: subcutaneous EEG, minimally-invasive surgery, ultra long-term monitoring, epilepsy, sub-scalp, Surgery, RD1-811

الوصف: BackgroundA new class of subcutaneous electroencephalography has enabled ultra long-term monitoring of people with epilepsy. The objective of this paper is to describe surgeons' experiences in an early series of implantations as well as discomfort or complications experienced by the participants.MethodsWe included 38 implantation procedures from two trials on people with epilepsy and healthy adults. Questionnaires to assess surgeons' and participants’ experience were analyzed as well as all recorded adverse events occurring up to 21 days post-surgery.ResultsWith training, the implantation could be performed in approximately 15 min. Overall, the implantation procedure was considered easy to perform with only 2 episodes where the implant got fixated in the introducing needle and a new implant had to be used. The explantation procedure was considered effortless. In 2 cases the silicone sheath covering the lead was damaged during the explantation, but it was possible to remove the entire implant without leaving any foreign body under the skin. Especially in the trial on healthy participants, a proportion experienced adverse events in the form of headache or implant-pain up to 21 days post-operatively. In 6 cases, adverse events contributed to the decision to explant and discontinue the study: Four of these cases involved implant pain or headache; One case involved a post-operative local infection; and in one case superficial lead placement resulted in skin perforation a few weeks after implantation.ConclusionThe implantation and explantation procedures are considered swift and easy to perform by both neurosurgeons and ENT surgeons. The implant is well tolerated by most participants. However, headache or pain around the implant can occur for up to 21 days post-operatively as anticipated with any such surgery. The expected benefits from the implant should always outweigh the potential disadvantages.

وصف الملف: electronic resource

العلاقة: https://www.frontiersin.org/articles/10.3389/fsurg.2023.1304343/fullTest; https://doaj.org/toc/2296-875XTest

الوصول الحر: https://doaj.org/article/e1954eb9548649e4aea0512d1f708205Test

المؤلفون: Christoph Wiest, Shenghong He, Benoit Duchet, Alek Pogosyan, Moaad Benjaber, Timothy Denison, Harutomo Hasegawa, Keyoumars Ashkan, Fahd Baig, Ilaria Bertaina, Francesca Morgante, Erlick A. Pereira, Flavie Torrecillos, Huiling Tan

المصدر: Neurobiology of Disease, Vol 178, Iss , Pp 106019- (2023)

مصطلحات موضوعية: Parkinson's disease, Deep brain stimulation, Evoked resonant neural activity, Adaptive DBS, Local field potentials, Subthalamic nucleus, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571

الوصف: Evoked resonant neural activity (ERNA) is induced by subthalamic deep brain stimulation (DBS) and was recently suggested as a marker of lead placement and contact selection in Parkinson's disease. Yet, its underlying mechanisms and how it is modulated by stimulation parameters are unclear. Here, we recorded local field potentials from 27 Parkinson's disease patients, while leads were externalised to scrutinise the ERNA. First, we show that ERNA in the time series waveform and spectrogram likely represent the same activity, which was contested before. Second, our results show that the ERNA has fast and slow dynamics during stimulation, consistent with the synaptic failure hypothesis. Third, we show that ERNA parameters are modulated by different DBS frequencies, intensities, medication states and stimulation modes (continuous DBS vs. adaptive DBS). These results suggest the ERNA might prove useful as a predictor of the best DBS frequency and lowest effective intensity in addition to contact selection. Changes with levodopa and DBS mode suggest that the ERNA may indicate the state of the cortico-basal ganglia circuit making it a putative biomarker to track clinical state in adaptive DBS.

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S0969996123000335Test; https://doaj.org/toc/1095-953XTest

الوصول الحر: https://doaj.org/article/db0c6fc1a66b4d1897ee67d1ff60d886Test

المؤلفون: Christoph Wiest, Flavie Torrecillos, Alek Pogosyan, Manuel Bange, Muthuraman Muthuraman, Sergiu Groppa, Natasha Hulse, Harutomo Hasegawa, Keyoumars Ashkan, Fahd Baig, Francesca Morgante, Erlick A Pereira, Nicolas Mallet, Peter J Magill, Peter Brown, Andrew Sharott, Huiling Tan

المصدر: eLife, Vol 12 (2023)

مصطلحات موضوعية: aperiodic exponent, excitation/inhibition balance, Parkinson's disease, adaptive deep brain stimulation, subthalamic nucleus, local field potential, Medicine, Science, Biology (General), QH301-705.5

الوصف: Periodic features of neural time-series data, such as local field potentials (LFPs), are often quantified using power spectra. While the aperiodic exponent of spectra is typically disregarded, it is nevertheless modulated in a physiologically relevant manner and was recently hypothesised to reflect excitation/inhibition (E/I) balance in neuronal populations. Here, we used a cross-species in vivo electrophysiological approach to test the E/I hypothesis in the context of experimental and idiopathic Parkinsonism. We demonstrate in dopamine-depleted rats that aperiodic exponents and power at 30–100 Hz in subthalamic nucleus (STN) LFPs reflect defined changes in basal ganglia network activity; higher aperiodic exponents tally with lower levels of STN neuron firing and a balance tipped towards inhibition. Using STN-LFPs recorded from awake Parkinson’s patients, we show that higher exponents accompany dopaminergic medication and deep brain stimulation (DBS) of STN, consistent with untreated Parkinson’s manifesting as reduced inhibition and hyperactivity of STN. These results suggest that the aperiodic exponent of STN-LFPs in Parkinsonism reflects E/I balance and might be a candidate biomarker for adaptive DBS.

وصف الملف: electronic resource

العلاقة: https://elifesciences.org/articles/82467Test; https://doaj.org/toc/2050-084XTest

الوصول الحر: https://doaj.org/article/7387dc14ba204a988e5ed94e7914e603Test

المؤلفون: Luciano Furlanetti, Harutomo Hasegawa, Natasha Hulse, Rachael Morris-Jones, Keyoumars Ashkan

المصدر: Journal of Translational Medicine, Vol 19, Iss 1, Pp 1-9 (2021)

مصطلحات موضوعية: Neuropathic pain, Deep brain stimulation, Thalamus, Central itch, Medicine

الوصف: Abstract Background Central itch syndrome has been previously described in conditions such as stroke. The neurophysiology of central itch syndrome has been investigated in non-human primates but remains incompletely understood. Methods We report an observational study of a rare case of severe central itch following thalamic deep brain stimulation and postulate the location of the central itch centre in humans. Results The patient was a 47-year-old female, with congenital spinal malformations, multiple previous corrective spinal surgeries and a 30-year history of refractory neuropathic pain in her back and inferior limbs. Following multidisciplinary pain assessment and recommendation, she was referred for spinal cord stimulation, but the procedure failed technically due to scarring related to her multiple previous spinal surgeries. She was therefore referred to our centre and underwent bilateral deep brain stimulation (DBS) of the ventral posterolateral nucleus of the thalamus for management of her chronic pain. Four weeks after switching on the stimulation, the patient reported significant improvement in her pain but developed a full body progressive itch which was then complicated with a rash. Common causes of skin eczema were ruled out by multiple formal dermatological evaluation. A trial of unilateral “off stimulation” was performed showing improvement of the itchy rash. Standard and normalized brain atlases were used to localize the active stimulating contact within the thalamus at a location we postulate as the central itch centre. Conclusions Precise stereotactic imaging points to the lateral portion of the ventral posterolateral and posteroinferior nuclei of the thalamus as critical in the neurophysiology of itch in humans.

وصف الملف: electronic resource

العلاقة: https://doaj.org/toc/1479-5876Test

الوصول الحر: https://doaj.org/article/de53b224e3c148b99896705b70a48004Test

المؤلفون: Ioannis Stavropoulos, Richard Selway, Harutomo Hasegawa, Elaine Hughes, Chris Rittey, Diego Jiménez-Jiménez, Antonio Valentin

المصدر: Brain Stimulation, Vol 14, Iss 2, Pp 226-229 (2021)

مصطلحات موضوعية: Epilepsy, Super refractory status epilepticus (srSE), Deep brain stimulation (DBS), Neuromodulation, Centromedian thalamic nuclei, Low frequency stimulation, Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571

وصف الملف: electronic resource

العلاقة: http://www.sciencedirect.com/science/article/pii/S1935861X20303168Test; https://doaj.org/toc/1935-861XTest

الوصول الحر: https://doaj.org/article/0f28445014da474b87aca24d6e4db167Test

المؤلفون: Shenghong He, Abteen Mostofi, Emilie Syed, Flavie Torrecillos, Gerd Tinkhauser, Petra Fischer, Alek Pogosyan, Harutomo Hasegawa, Yuanqing Li, Keyoumars Ashkan, Erlick Pereira, Peter Brown, Huiling Tan

المصدر: eLife, Vol 9 (2020)

مصطلحات موضوعية: beta oscillations, neurofeedback, beta burst, parkinson's disease, parkinsonian tremor, Medicine, Science, Biology (General), QH301-705.5

الوصف: Previous studies have explored neurofeedback training for Parkinsonian patients to suppress beta oscillations in the subthalamic nucleus (STN). However, its impacts on movements and Parkinsonian tremor are unclear. We developed a neurofeedback paradigm targeting STN beta bursts and investigated whether neurofeedback training could improve motor initiation in Parkinson’s disease compared to passive observation. Our task additionally allowed us to test which endogenous changes in oscillatory STN activities are associated with trial-to-trial motor performance. Neurofeedback training reduced beta synchrony and increased gamma activity within the STN, and reduced beta band coupling between the STN and motor cortex. These changes were accompanied by reduced reaction times in subsequently cued movements. However, in Parkinsonian patients with pre-existing symptoms of tremor, successful volitional beta suppression was associated with an amplification of tremor which correlated with theta band activity in STN local field potentials, suggesting an additional cross-frequency interaction between STN beta and theta activities.

وصف الملف: electronic resource

العلاقة: https://elifesciences.org/articles/60979Test; https://doaj.org/toc/2050-084XTest

الوصول الحر: https://doaj.org/article/03fe1beb28b24276bf5406c6b8022004Test

المؤلفون: Lalgudi Srinvasan, Harischandra, Raslan, Ahmed, Tambirajoo, Kantharuby, Selway, Richard, Ashkan, Keyoumars, Harutomo Hasegawa

المصدر: British Journal of Neurosurgery; Dec2023, Vol. 37 Issue 6, p1689-1692, 4p

مصطلحات موضوعية: CEREBROSPINAL fluid shunts, CATHETERS, ARNOLD-Chiari deformity, EPILEPSY surgery, CATHETERIZATION, CLINICAL deterioration, EPILEPSY

مستخلص: Background and importance: Insertion of ventricular catheters into small ventricles may require image guidance. Several options exist, including ultrasound guidance, frameless, and frame-based stereotactic approaches. There is no literature on management options when conventional image guidance fails to cannulate the ventricle. The accuracy of the robotic arm is well established in functional and epilepsy surgery. We report the first case using the Neuromate® robot for the placement of a shunt ventricular catheter into the lateral ventricle after a failed attempt with a more commonly used frameless electromagnetic navigation system. Clinical presentation: A 30-year-old man had twice previously undergone foramen magnum decompression for a Chiari 1 malformation. He subsequently developed a significant cervical syrinx with clinical deterioration and a decision was made to place a ventriculoperitoneal shunt. As the ventricles were small, frameless electromagnetic navigation was used but the ventricle could not be cannulated. The Neuromate® robot was subsequently used to place the ventricular catheter successfully. Conclusion: Neuromate®R robot-assisted ventricular catheter placement may be considered when difficulty is experienced with more commonly used image guidance techniques. [ABSTRACT FROM AUTHOR]

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المؤلفون: Shenghong He, Fahd Baig, Anca Merla, Flavie Torrecillos, Andrea Perera, Christoph Wiest, Jean Debarros, Moaad Benjaber, Michael G Hart, Francesca Morgante, Harutomo Hasegawa, Michael Samuel, Mark Edwards, Timothy Denison, Alek Pogosyan, Keyoumars Ashkan, Erlick Pereira, Huiling Tan

الوصف: Subthalamic nucleus (STN) beta-triggered adaptive deep brain stimulation (ADBS) has been shown to provide clinical improvement comparable to conventional continuous DBS (CDBS) in people with Parkinson’s disease (PD) with less energy delivered to the brain and less stimulation induced side-effects. However, several questions remain unanswered. First, there is a normal physiological reduction of STN beta band power just prior to and during voluntary movement. ADBS systems will therefore reduce or cease stimulation during movement and could therefore compromise motor performance compared to CDBS. Second, beta power was smoothed and estimated over time periods of 400ms or longer in most previous ADBS studies. A shorter smoothing period could have the advantage of being more sensitive to changes in beta power which could enhance motor performance. In this study, we addressed these two questions by evaluating the effectiveness of STN beta-triggered ADBS using a standard 400ms and a shorter 200ms smoothing window during reaching movements. Results from 13 people with PD showed that STN beta-triggered ADBS is effective in improving motor performance during reaching movements as it better preserves gamma oscillation than CDBS in people with PD, and that shortening the smoothing window does not result in any additional behavioural benefit. ADBS significantly improved tremor compared with no DBS but was not as effective as CDBS. When developing ADBS systems for PD, it might not be necessary to track very fast beta dynamics; combining beta, gamma, and motor decoding might be more beneficial with additional biomarkers needed for optimal treatment of tremor.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::0a7fba3bce5b570b2c6b601886b3011fTest
https://doi.org/10.1101/2022.12.20.22283430Test

المؤلفون: Christoph Wiest, Flavie Torrecillos, Alek Pogosyan, Manuel Bange, Muthuraman Muthuraman, Sergiu Groppa, Natasha Hulse, Harutomo Hasegawa, Keyoumars Ashkan, Fahd Baig, Francesca Morgante, Erlick A Pereira, Nicolas Mallet, Peter J Magill, Peter Brown, Andrew Sharott, Huiling Tan

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::4ad7e296597b40e2226468c75054af22Test
https://doi.org/10.7554/elife.82467.sa2Test

المؤلفون: Christoph Wiest, Flavie Torrecillos, Alek Pogosyan, Manuel Bange, Muthuraman Muthuraman, Sergiu Groppa, Natasha Hulse, Harutomo Hasegawa, Keyoumars Ashkan, Fahd Baig, Francesca Morgante, Erlick A. Pereira, Nicolas Mallet, Peter J. Magill, Peter Brown, Andrew Sharott, Huiling Tan

الوصف: Periodic features of neural time series data, such as local field potentials (LFP), are often quantified using power spectra. While the aperiodic exponent of spectra is typically disregarded, it is nevertheless modulated in a physiologically-relevant manner and was recently hypothesised to reflect excitation/inhibition (E/I) balance in neuronal populations. Here, we used a cross-species in vivo electrophysiological approach to test the E/I hypothesis in the context of experimental and idiopathic Parkinsonism. We demonstrate in dopamine-depleted rats that aperiodic exponents and power at 30-100 Hz in subthalamic nucleus (STN) LFPs reflect defined changes in basal ganglia network activity; higher aperiodic exponents tally with lower levels of STN neuron firing and a balance tipped towards inhibition. Using STN-LFPs recorded from awake Parkinson’s patients, we show that higher exponents accompany dopaminergic medication and deep brain stimulation (DBS) of STN, consistent with untreated Parkinson’s manifesting as reduced inhibition and hyperactivity of STN. These results suggest that the aperiodic exponent of STN-LFPs in Parkinsonism reflects E/I balance, and might be a candidate biomarker for adaptive DBS.

الوصول الحر: https://explore.openaire.eu/search/publication?articleId=doi_________::a96bcf2147f7327e86b27af1b40b3fd4Test
https://doi.org/10.1101/2022.08.23.504923Test