NDLI: The Physiological Effects of Pallidal Deep Brain Stimulation in Dystonia

Content Provider	IEEE Xplore Digital Library
Author	Tisch, S. Rothwell, J.C. Limousin, P. Hariz, M.I. Corcos, D.M.
Copyright Year	2001
Abstract	Dystonia is an involuntary movement disorder characterized by muscle contractions causing abnormal postures and spasms, affecting part or all of the body. Dystonia may be primary where an abnormal gene, most commonly DYT1, may be identified, or secondary to structural brain lesions or heredodegenerative disorders. The underlying defect is believed to be abnormal basal ganglia modulation of cortical motor pathways, and various motor and sensory physiological abnormalities have been demonstrated. The failure of medical treatment in many patients with the more severe and generalized forms of dystonia has led to renewed interest in neurosurgical treatment approaches. In recent years, deep brain stimulation (DBS) of globus pallidus internus (GPi) has emerged as an effective treatment for dystonia, particularly patients with primary generalized dystonia, where remarkable improvement may occur. In contrast to Parkinson's disease, the beneficial effects of DBS in dystonia are not immediate but progressive over weeks to months. Physiological and imaging studies in dystonia patients with GPi DBS have demonstrated both short and long-term effects of GPi DBS on motor cortex and subcortical circuits including progressive normalization of spinal and brainstem excitability after GPi DBS which correlate with clinical improvement. These effects, in light of existing physiological data in dystonia, suggest that GPi DBS acts primarily by major modification of basal ganglia output to brainstem, thalamus, and cortex resulting in neural reorganization, which may explain the characteristic progressive improvement in dystonia after GPi DBS.
Sponsorship	IEEE Engineering in Medicine and Biology Society
Page Count	7
File Size	401046
Starting Page	166
Ending Page	172
File Format	PDF
ISSN	15344320
Volume Number	15
Issue Number	2
Language	English
Publisher	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Publisher Date	2007-06-01
Publisher Place	U.S.A.
Access Restriction	Subscribed
Rights Holder	Institute of Electrical and Electronics Engineers, Inc. (IEEE)
Subject Keyword	Brain stimulation Satellite broadcasting Medical treatment Muscles Basal ganglia Neurosurgery Neuroscience Nervous system Spinal cord Lesions pallidal deep brain stimulation (DBS) Dystonia neurophysiology
Content Type	Text
Resource Type	Article
Subject	Neuroscience Rehabilitation Internal Medicine Biomedical Engineering Computer Science Applications

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