Abstract
This index case report describes a novel programming approach that utilizes the 8-contact directional Deep Brain Stimulation (DBS) lead to effectively control the akinesia, rigidity and tremor of Parkinson's Disease (PD), as well as a severe kinetic tremor of Essential Tremor (ET), in a patient with overlapping symptoms of both PD and ET. Through utilizing a bipolar directional montage on a single segmented contact, symptom control was attained via likely co-activation of the Subthalamic Nucleus (STN) and the adjacent Zona Incerta (ZI). The patient is a 67-year-old professional guitarist with a long-standing diagnosis of ET manifesting with bilateral kinetic tremor, who then developed right lateralizing symptoms indicative of PD. After optimal medical management did not confer sufficient control, he underwent left-sided unilateral DBS targeting the STN. Both intraoperatively and post-operatively, omnidirectional, and directional electrode review resulted in significant akinesia, rigidity, and as well as resting tremor control but failed to sufficiently improve the kinetic tremor. As electrode 2B was shown to be the most efficacious with the largest therapeutic window, a bipolar directional montage on a single segmented contact ...Continue Reading
References
Sep 29, 2001·The New England Journal of Medicine·UNKNOWN Deep-Brain Stimulation for Parkinson's Disease Study GroupA E Lang
Nov 14, 2003·The New England Journal of Medicine·Paul KrackPierre Pollak
May 25, 2006·Brain : a Journal of Neurology·Puneet PlahaSteven S Gill
Oct 9, 2007·British Journal of Neurosurgery·P BlomstedtL-O D Koskinen
Jul 12, 2008·Movement Disorders : Official Journal of the Movement Disorder Society·Mia T Minen, Elan D Louis
Mar 9, 2011·Neurologia i neurochirurgia polska·Tomasz MandatPaweł Nauman
Sep 10, 2011·Acta neurochirurgica·Patric BlomstedtMarwan I Hariz
Dec 30, 2011·Journal of Neurology, Neurosurgery, and Psychiatry·Anders FytagoridisPatric Blomstedt
Nov 12, 2013·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Timothy Ross LukinsBenjamin Jonker
May 23, 2014·Brain : a Journal of Neurology·Claudio PolloMichael Schüpbach
Sep 4, 2016·Parkinsonism & Related Disorders·Paul RekerLars Timmermann
Oct 12, 2016·Stereotactic and Functional Neurosurgery·Adolfo Ramirez-ZamoraJulie G Pilitsis
Aug 27, 2017·Movement Disorders : Official Journal of the Movement Disorder Society·Till A DembekLars Timmermann
Jan 27, 2018·Brain Stimulation·P RebeloB Cheeran
Citations
Jun 18, 2019·Advanced Materials·Nikita ObidinCanan Dagdeviren
Feb 13, 2020·Neurology·Takashi TsuboiAparna Wagle Shukla
Mar 7, 2020·Frontiers in Neurology·Drew FalconerMahesh Shenai
May 16, 2020·Frontiers in Human Neuroscience·Ilknur TelkesJulie G Pilitsis
Aug 11, 2020·Tremor and Other Hyperkinetic Movements·Anant WadhwaAmar Patel
Sep 27, 2019·Frontiers in Neurology·Chengyuan Wu, Caio Matias
Dec 18, 2020·NeuroImage. Clinical·Karlo A MalagaParag G Patil
Feb 15, 2021·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Islam FayedChristopher G Kalhorn
Jul 31, 2021·Expert Review of Medical Devices·Bhavana PatelAdolfo Ramirez-Zamora