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Electrical Brain Stimulation to Treat Neurological Disorders
Published in Bahman Zohuri, Patrick J. McDaniel, Electrical Brain Stimulation for the Treatment of Neurological Disorders, 2019
Bahman Zohuri, Patrick J. McDaniel
Deep brain stimulation is currently used to treat severe neurological conditions such as Essential Tremor, Parkinson’s Disease, Tourette’s Syndrome, and Dystonia. As with both TMS and ECT, DBS is considered a last resort treatment method, reserved only for those patients whom have undergone standard treatment options without seeing any benefits. Additionally, because DBS is still a relatively new technique, many candidates for deep brain stimulation are participants in clinical research trials (see Figure 6.12).
Objections to the Russo–Williamson Thesis
Published in Donald Gillies, Causality, Probability, and Medicine, 2019
I will now consider, as promised earlier, Howick’s list of counter-examples to the Russo–Williamson thesis (RWT). Howick begins his critical discussion of the RWT in 2011a, p. 130. On p. 131, he mentions the Semmelweis case, and then goes on (2011a, pp. 131–2) to give his full list of statistical counter-examples to the RWT as follows: there are many … examples where treatments were widely accepted before any semblance of a mechanism was established. To name a few, Percival Pott’s hypothesis that soot caused scrotum cancer (1775) was accepted years before benzpyrene was identified (1933). Edward Jenner introduced smallpox vaccines (1798) decades before anyone really understood how they worked. John Snow helped eliminate cholera with cleaner water (1849) years before the Vibrio cholerae was identified (1893), and Carlos Finlay reduced the rates of yellow fever by killing mosquitoes (1881) decades before flavivirus was identified (1927). In the last century, general anaesthesia, aspirin, and the steroids were widely used for decades before their mechanisms were understood. In this century, deep brain stimulation has been used to suppress tremors in patients with advanced Parkinson’s disease, and also to cure other motor function disorders such as dystonia or Tourette’s syndrome, yet researchers have not been able to identify its mechanism of action with any certainty.
Brain stimulation: new directions
Published in Alan Weiss, The Electroconvulsive Therapy Workbook, 2018
Deep brain stimulation is a surgical technique in which stimulation electrodes are surgically implanted into precise anatomical areas, altering electrical activity that changes brain function (Greenberg, 2004). DBS relies on modern stereotypic techniques to implant bilateral electrodes with millimetre accuracy into specific brain targets. Bilateral leads 1.27 millimetres in diameter are attached on one end to four platinum/iridium micro-electrodes and on the other end a pulse generator is usually placed in the chest wall. The device is sometimes referred to as a "brain pacemaker" (Greenberg, 2004). X-rays are used to show the location of the implanted electrodes.
Gait variability is sensitive to detect Parkinson’s disease patients at high fall risk
Published in International Journal of Neuroscience, 2022
Lin Ma, Tao-Mian Mi, Qian Jia, Chao Han, Jagadish K. Chhetri, Piu Chan
A total of 51 patients including both outpatients and inpatients from the Xuanwu Hospital of Capital Medical University participated in this study from February 2017 to August 2017. The study was approved by the local medical ethics committee. Inclusion criteria for this study were as follows: 1) Diagnosed as clinically established or clinically probable PD by neurologists (according to Movement Disorder Society (MDS) Clinical Diagnostic Criteria for PD) [10]; 2) Have a mini-mental state examination (MMSE) scores of over 24 points; 3) Be able to walk at least 14 meters without help; and 4) Provide informed written consent (either by the patient or their next to keen). Exclusion criteria were as follows: 1) Patients with a history of deep brain stimulation surgery; 2) Presence of other neurological disorders other than PD; and 3) Conditions affecting the mobility ability of the patients. All enrolled patients were adults between the ages of 40 and 80 years.
Estimating minimal clinically important differences for two scales in patients with chronic traumatic brain injury
Published in Current Medical Research and Opinion, 2020
Soeren Mattke, Steven C. Cramer, Mo Wang, Janet Prvu Bettger, Kevin M. Cockroft, Wuwei Feng, Michael Jaffee, Tolu O. Oyesanya, Ava M. Puccio, Nancy Temkin, Carolee Winstein, Steven L. Wolf, Michael R. Yochelson
Traumatic brain injury (TBI) constitutes a significant public health problem1. The estimated global prevalence of chronic impairments secondary to TBI was 55.5 million cases in 20162. In the U.S. alone, over 2.7 million TBIs occur each year, leading to approximately 288,000 TBI-related hospitalizations3 and resulting in long-term disability among both civilian4 and military5 populations. Residual motor deficits in the chronic phase of TBI are common and can be especially disabling. In the U.S., approximately 43% of surviving hospitalized patients with TBI experience long-term motor deficits, with 5.3 million people estimated to be living with long-term motor deficits secondary to TBI6,7. In an observational study, over 30% of patients with severe TBI had at least one neuromotor impairment two years after inpatient rehabilitation8. Advanced technologies, like deep brain stimulation, are now being investigated to support functional recovery of those patients. In addition, stem cell therapy, which has shown promise in the chronic phase after stroke9, is being investigated to address chronic motor deficits secondary to TBI10.
Post-diagnostic lived experiences of individuals with essential tremor
Published in Disability and Rehabilitation, 2020
Jessica Moore, Fiona J. R. Eccles, Jane Simpson
The diagnosis of essential tremor is complicated by a lack of understanding regarding the relationship (if any) of the condition with other neurological conditions which also involve tremor, particularly Parkinson’s disease [6]; this results in some individuals being given an incorrect diagnosis. It has been suggested that while essential tremor and Parkinson’s disease are distinct entities, evidence of a clinical overlap in the features of the two conditions does exist [7]. This overlap may explain why approximately 30-50% of individuals with essential tremor are commonly misdiagnosed with Parkinson’s disease [8]. Medication is commonly used as a treatment for essential tremor, although not everyone experiences benefit [9]. For individuals who are intolerant of, or resistant to, medication, neurosurgery may be considered [9] including deep brain stimulation.