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Wu MY, Sun YT. Hyperintensity in Bilateral Posterior Limbs of Internal Capsule Due to Hypernatremia. Acta Neurol Taiwan 2024; 33(3):127-133. [PMID: 37968847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/17/2023]
Abstract
PURPOSE Osmotic demyelination syndrome is usually caused by rapid correction of hyponatremia but sometimes develops from acute severe hypernatremia. Studies suggested that serum sodium increasing at the rate of less than 6~8 mmol/L in 24 hours has a low risk of osmotic demyelination syndrome, but sometimes exceptions present. Aside from the classical sites of involvement, such as pons and basal ganglia, internal capsules are rarely affected. We report a case with acute paraparesis caused by acute hypernatremia-induced extrapontine myelinolysis involving the posterior limbs of bilateral internal capsules. CASE A 54-year-old man was admitted for aseptic encephalitis and moved to the intensive care unit due to poor consciousness and respiratory failure. Although cerebrospinal fluid pleocytosis was improved later, acute hypernatremia due to partial diabetes insipidus developed. He presented acute paraplegia two days later with a negative result on the whole spine MRI. Although the increasing rate of serum sodium did not exceed the recommended safety range, the extrapontine myelinolysis involving posterior limbs of the bilateral internal capsule, as long as the corpus callosum, still developed. The patient regained partial walking ability after one year. CONCLUSION This case report extends the spectrum of classical osmotic demyelination in clinical manifestations, image findings, and the causal range of electrolyte derangements.
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Affiliation(s)
- Min-Yang Wu
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan701, Taiwan
| | - Yuan-Ting Sun
- Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan701, Taiwan. Department of Medical Genomics, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
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Tatekawa H, Ueda D, Takita H, Matsumoto T, Walston SL, Mitsuyama Y, Horiuchi D, Matsushita S, Oura T, Tomita Y, Tsukamoto T, Shimono T, Miki Y. Deep learning-based diffusion tensor image generation model: a proof-of-concept study. Sci Rep 2024; 14:2911. [PMID: 38316892 PMCID: PMC10844503 DOI: 10.1038/s41598-024-53278-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2023] [Accepted: 01/29/2024] [Indexed: 02/07/2024] Open
Abstract
This study created an image-to-image translation model that synthesizes diffusion tensor images (DTI) from conventional diffusion weighted images, and validated the similarities between the original and synthetic DTI. Thirty-two healthy volunteers were prospectively recruited. DTI and DWI were obtained with six and three directions of the motion probing gradient (MPG), respectively. The identical imaging plane was paired for the image-to-image translation model that synthesized one direction of the MPG from DWI. This process was repeated six times in the respective MPG directions. Regions of interest (ROIs) in the lentiform nucleus, thalamus, posterior limb of the internal capsule, posterior thalamic radiation, and splenium of the corpus callosum were created and applied to maps derived from the original and synthetic DTI. The mean values and signal-to-noise ratio (SNR) of the original and synthetic maps for each ROI were compared. The Bland-Altman plot between the original and synthetic data was evaluated. Although the test dataset showed a larger standard deviation of all values and lower SNR in the synthetic data than in the original data, the Bland-Altman plots showed each plot localizing in a similar distribution. Synthetic DTI could be generated from conventional DWI with an image-to-image translation model.
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Affiliation(s)
- Hiroyuki Tatekawa
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan.
| | - Daiju Ueda
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Hirotaka Takita
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Toshimasa Matsumoto
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Shannon L Walston
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Yasuhito Mitsuyama
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Daisuke Horiuchi
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Shu Matsushita
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Tatsushi Oura
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Yuichiro Tomita
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Taro Tsukamoto
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Taro Shimono
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
| | - Yukio Miki
- Department of Diagnostic and Interventional Radiology, Graduate School of Medicine, Osaka Metropolitan University, 1-4-3, Asahi-Machi, Abeno-Ku, Osaka, 545-8585, Japan
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Xiong B, Li B, Wen R, Gao Y, Gong F, Li D, Xu Y, Deng H, Xiao L, Yin S, Zhang W, Lozano AM, Wang W. Use of differential stimulation of the nucleus accumbens and anterior limb of the internal capsule to improve outcomes of obsessive-compulsive disorder. J Neurosurg 2023; 139:1376-1385. [PMID: 37243560 DOI: 10.3171/2023.4.jns221824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2022] [Accepted: 04/11/2023] [Indexed: 05/29/2023]
Abstract
OBJECTIVE Personalized stimulation is key to optimizing the outcomes of deep brain stimulation (DBS) for refractory obsessive-compulsive disorder (OCD). However, the contacts in a single conventional electrode cannot be programmed independently, which may affect the therapeutic efficacy of DBS for OCD. Therefore, a novel designed electrode and implantable pulse generator (IPG) that could achieve differential stimulation parameters for different contacts was implanted into the nucleus accumbens (NAc) and anterior limb of the internal capsule (ALIC) of a cohort of patients with OCD. METHODS Thirteen consecutive patients underwent bilateral DBS of the NAc-ALIC between January 2016 and May 2021. Differential stimulation of the NAc-ALIC was applied at initial activation. Primary effectiveness was assessed on the basis of change in scores on the Yale-Brown Obsessive Compulsive Scale (Y-BOCS) from baseline to 6-month follow-up. Full-response was defined as a 35% decrease in Y-BOCS score. Secondary effectiveness measures were the Hamilton Anxiety Rating Scale (HAMA) and Hamilton Depression Rating Scale (HAMD). The local field potential of bilateral NAc-ALIC was recorded in 4 patients who were reimplanted with a sensing IPG after battery depletion of the previous IPG. RESULTS The Y-BOCS, HAMA, and HAMD scores decreased remarkably during the first 6 months of DBS. Ten of 13 patients were categorized as responders (76.9%). Differential stimulation of the NAc-ALIC was favorable to optimization of the stimulation parameters by increasing the parameter configurations. Power spectral density analysis revealed pronounced delta-alpha frequency activity in the NAc-ALIC. Phase-amplitude coupling of the NAc-ALIC showed that strong coupling is present between the phase of delta-theta and broadband gamma amplitude. CONCLUSIONS These preliminary findings indicate that differential stimulation of the NAc-ALIC can improve the efficacy of DBS for OCD. Clinical trial registration no.: NCT02398318 (ClinicalTrials.gov).
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Affiliation(s)
- Botao Xiong
- 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
- 2Psychiatric Laboratory and Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Bin Li
- 2Psychiatric Laboratory and Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Rong Wen
- 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
- 4Department of Neurosurgery, The Second Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Yuan Gao
- 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Feilong Gong
- 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Denghui Li
- 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Yangyang Xu
- 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Hao Deng
- 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Linglong Xiao
- 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Senlin Yin
- 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
| | - Wei Zhang
- 2Psychiatric Laboratory and Mental Health Center, West China Hospital, Sichuan University, Chengdu, China
| | - Andres M Lozano
- 3Department of Surgery, Division of Neurosurgery, University of Toronto, Ontario, Canada; and
| | - Wei Wang
- 1Department of Neurosurgery, West China Hospital, Sichuan University, Chengdu, China
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van den Boom BJG, Elhazaz-Fernandez A, Rasmussen PA, van Beest EH, Parthasarathy A, Denys D, Willuhn I. Unraveling the mechanisms of deep-brain stimulation of the internal capsule in a mouse model. Nat Commun 2023; 14:5385. [PMID: 37666830 PMCID: PMC10477328 DOI: 10.1038/s41467-023-41026-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 08/17/2023] [Indexed: 09/06/2023] Open
Abstract
Deep-brain stimulation (DBS) is an effective treatment for patients suffering from otherwise therapy-resistant psychiatric disorders, including obsessive-compulsive disorder. Modulation of cortico-striatal circuits has been suggested as a mechanism of action. To gain mechanistic insight, we monitored neuronal activity in cortico-striatal regions in a mouse model for compulsive behavior, while systematically varying clinically-relevant parameters of internal-capsule DBS. DBS showed dose-dependent effects on both brain and behavior: An increasing, yet balanced, number of excited and inhibited neurons was recruited, scattered throughout cortico-striatal regions, while excessive grooming decreased. Such neuronal recruitment did not alter basic brain function such as resting-state activity, and only occurred in awake animals, indicating a dependency on network activity. In addition to these widespread effects, we observed specific involvement of the medial orbitofrontal cortex in therapeutic outcomes, which was corroborated by optogenetic stimulation. Together, our findings provide mechanistic insight into how DBS exerts its therapeutic effects on compulsive behaviors.
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Affiliation(s)
- Bastijn J G van den Boom
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
| | - Alfredo Elhazaz-Fernandez
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Peter A Rasmussen
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Enny H van Beest
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
| | - Aishwarya Parthasarathy
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Damiaan Denys
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Ingo Willuhn
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, The Netherlands.
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.
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Shofty B, Gadot R, Viswanathan A, Provenza NR, Storch EA, McKay SA, Meyers MS, Hertz AG, Avendano-Ortega M, Goodman WK, Sheth SA. Intraoperative valence testing to adjudicate between ventral capsule/ventral striatum and bed nucleus of the stria terminalis target selection in deep brain stimulation for obsessive-compulsive disorder. J Neurosurg 2023; 139:442-450. [PMID: 36681982 DOI: 10.3171/2022.10.jns221683] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Accepted: 10/12/2022] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Deep brain stimulation (DBS) is an accepted therapy for severe, treatment-refractory obsessive-compulsive disorder (trOCD). The optimal DBS target location within the anterior limb of the internal capsule, particularly along the anterior-posterior axis, remains elusive. Empirical evidence from several studies in the past decade has suggested that the ideal target lies in the vicinity of the anterior commissure (AC), either just anterior to the AC, above the ventral striatum (VS), or just posterior to the AC, above the bed nucleus of the stria terminalis (BNST). Various methods have been utilized to optimize target selection for trOCD DBS. The authors describe their practice of planning trajectories to both the VS and BNST and adjudicating between them with awake intraoperative valence testing to individualize permanent target selection. METHODS Eight patients with trOCD underwent awake DBS with trajectories planned for both VS and BNST targets bilaterally. The authors intraoperatively assessed the acute effects of stimulation on mood, energy, and anxiety and implanted the trajectory with the most reliable positive valence responses and least stimulation-induced side effects. The method of intraoperative target adjudication is described, and the OCD outcome at last follow-up is reported. RESULTS The mean patient age at surgery was 41.25 ± 15.1 years, and the mean disease duration was 22.75 ± 10.2 years. The median preoperative Yale-Brown Obsessive Compulsive Scale (Y-BOCS) score was 39 (range 34-40). Two patients had previously undergone capsulotomy, with insufficient response. Seven (44%) of 16 leads were moved to the second target based on intraoperative stimulation findings, 4 of them to avoid strong negative valence effects. Three patients had an asymmetric implant (1 lead in each target). All 8 patients (100%) met full response criteria, and the mean Y-BOCS score reduction across the full cohort was 51.2% ± 12.8%. CONCLUSIONS Planning and intraoperatively testing trajectories flanking the AC-superjacent to the VS anteriorly and to the BNST posteriorly-allowed identification of positive valence responses and acute adverse effects. Awake testing helped to select between possible trajectories and identify individually optimized targets in DBS for trOCD.
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Affiliation(s)
- Ben Shofty
- 1Department of Neurosurgery, University of Utah, Salt Lake City, Utah; and
| | | | | | | | - Eric A Storch
- 3Psychiatry, Baylor College of Medicine, Houston, Texas
| | - Sarah A McKay
- 3Psychiatry, Baylor College of Medicine, Houston, Texas
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Najera RA, Provenza N, Dang H, Katlowitz KA, Hertz A, Reddy S, Shofty B, Bellows ST, Storch EA, Goodman WK, Sheth SA. Dual-Target Deep Brain Stimulation for Obsessive-Compulsive Disorder and Tourette Syndrome. Biol Psychiatry 2023; 93:e53-e55. [PMID: 36863881 DOI: 10.1016/j.biopsych.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 01/18/2023] [Indexed: 03/04/2023]
Affiliation(s)
- Ricardo A Najera
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - Nicole Provenza
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - Huy Dang
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | | | - Alyssa Hertz
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Sandesh Reddy
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas
| | - Ben Shofty
- Department of Neurosurgery, University of Utah, Salt Lake City, Utah
| | - Steven T Bellows
- Department of Neurology, Baylor College of Medicine, Houston, Texas
| | - Eric A Storch
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Wayne K Goodman
- Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston, Texas
| | - Sameer A Sheth
- Department of Neurosurgery, Baylor College of Medicine, Houston, Texas.
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Zolyan A, Crawford JR. Unusual radiographic presentation of methotrexate-induced leukoencephalopathy involving the internal capsule. BMJ Case Rep 2022; 15:e253342. [PMID: 36428027 PMCID: PMC9703313 DOI: 10.1136/bcr-2022-253342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Anna Zolyan
- Neurology, University of California, Irvine, California, USA
| | - John Ross Crawford
- Pediatrics, University of California, Irvine, California, USA
- Pediatrics, Children's Hospital Orange County, Orange, California, USA
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Soe TT, Chattha N, Mahmood A. Rare case of pseudobulbar palsy: subopercular syndrome. BMJ Case Rep 2021; 14:e245613. [PMID: 34711624 PMCID: PMC8557275 DOI: 10.1136/bcr-2021-245613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/07/2021] [Indexed: 11/04/2022] Open
Abstract
We present a case of a 73-year-old man who developed sudden onset dysarthria, dysphagia and bilateral facial weakness with automato-voluntary dissociation, which deteriorated rapidly to anarthria and aphonia within a few days. MRI scan of the head showed acute infarct in right internal capsule and an old infarct in the left corona radiata while the rest of the investigations were normal. Based on these findings, diagnosis was thought to be subopercular syndrome. He recovered significantly in a few weeks' time.
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Affiliation(s)
- Thet Thet Soe
- Stroke, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - Navraj Chattha
- Stroke, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
| | - Afzal Mahmood
- Stroke, Maidstone and Tunbridge Wells NHS Trust, Maidstone, UK
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Sullivan CRP, Olsen S, Widge AS. Deep brain stimulation for psychiatric disorders: From focal brain targets to cognitive networks. Neuroimage 2021; 225:117515. [PMID: 33137473 PMCID: PMC7802517 DOI: 10.1016/j.neuroimage.2020.117515] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2020] [Revised: 08/19/2020] [Accepted: 10/24/2020] [Indexed: 01/16/2023] Open
Abstract
Deep brain stimulation (DBS) is a promising intervention for treatment-resistant psychiatric disorders, particularly major depressive disorder (MDD) and obsessive-compulsive disorder (OCD). Up to 90% of patients who have not recovered with therapy or medication have reported benefit from DBS in open-label studies. Response rates in randomized controlled trials (RCTs), however, have been much lower. This has been argued to arise from surgical variability between sites, and recent psychiatric DBS research has focused on refining targeting through personalized imaging. Much less attention has been given to the fact that psychiatric disorders arise from dysfunction in distributed brain networks, and that DBS likely acts by altering communication within those networks. This is in part because psychiatric DBS research relies on subjective rating scales that make it difficult to identify network biomarkers. Here, we overview recent DBS RCT results in OCD and MDD, as well as the follow-on imaging studies. We present evidence for a new approach to studying DBS' mechanisms of action, focused on measuring objective cognitive/emotional deficits that underpin these and many other mental disorders. Further, we suggest that a focus on cognition could lead to reliable network biomarkers at an electrophysiologic level, especially those related to inter-regional synchrony of the local field potential (LFP). Developing the network neuroscience of DBS has the potential to finally unlock the potential of this highly specific therapy.
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Affiliation(s)
- Christi R P Sullivan
- University of Minnesota Medical School Department of Psychiatry and Behavioral Sciences, 2001 6th Street SE, Minneapolis, MN 55454, USA.
| | - Sarah Olsen
- University of Minnesota Medical School Department of Psychiatry and Behavioral Sciences, 2001 6th Street SE, Minneapolis, MN 55454, USA.
| | - Alik S Widge
- University of Minnesota Medical School Department of Psychiatry and Behavioral Sciences, 2001 6th Street SE, Minneapolis, MN 55454, USA.
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10
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Affiliation(s)
- Wayne K Goodman
- From the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Goodman, Storch); the Department of Psychology, University of Pittsburgh (Cohn); and the Department of Neurosurgery, Baylor College of Medicine, Houston (Sheth)
| | - Eric A Storch
- From the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Goodman, Storch); the Department of Psychology, University of Pittsburgh (Cohn); and the Department of Neurosurgery, Baylor College of Medicine, Houston (Sheth)
| | - Jeffrey F Cohn
- From the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Goodman, Storch); the Department of Psychology, University of Pittsburgh (Cohn); and the Department of Neurosurgery, Baylor College of Medicine, Houston (Sheth)
| | - Sameer A Sheth
- From the Menninger Department of Psychiatry and Behavioral Sciences, Baylor College of Medicine, Houston (Goodman, Storch); the Department of Psychology, University of Pittsburgh (Cohn); and the Department of Neurosurgery, Baylor College of Medicine, Houston (Sheth)
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11
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Park HR, Kim IH, Kang H, McCairn KW, Lee DS, Kim BN, Kim DG, Paek SH. Electrophysiological and imaging evidence of sustained inhibition in limbic and frontal networks following deep brain stimulation for treatment refractory obsessive compulsive disorder. PLoS One 2019; 14:e0219578. [PMID: 31323037 PMCID: PMC6641158 DOI: 10.1371/journal.pone.0219578] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2019] [Accepted: 06/26/2019] [Indexed: 01/05/2023] Open
Abstract
Obsessive-compulsive disorder (OCD) is a neuropsychiatric disorder that arises from a complex interaction of environmental and genetic factors. Despite numerous pharmacological and behavioral interventions, approximately 10% of patients remain refractory. High-frequency deep brain stimulation (HF-DBS) has shown promising results for treatment-refractory OCD. We report the follow-up result of up to 6 years of 4 treatment-refractory OCD patients treated by HF-DBS. Targets of stimulation were the anterior limb of the internal capsule (ALIC) in two cases, and the nucleus accumbens (NAc) in the remaining cohort. The clinical profiles were quantified by the Yale-Brown obsessive-compulsive scale (Y-BOCS). Highly significant reductions in Y-BOCS scores were obtained from all patients during the follow-up period. A greater that 90% reduction in Y-BOCS, observed in the most successful case, was achieved with NAc HF-DBS. Y-BOCS scores in the other patients consistently achieved over 50% reductions in OCD symptoms. FDG-PET imaging indicated post-surgical reductions in metabolism, in not only targeted limbic networks, but also other frontal cortical and subcortical regions, suggesting that large-scale network modulation and inhibitions are associated with functional recovery in OCD. This study demonstrates that HF-DBS targeted to the ALIC and NAc is a safe and effective method for ameliorating intractable, treatment-refractory OCD symptoms. The NAc appeared to be the superior target for symptom reduction, and local inhibition of NAc activity and reduced frontal metabolism are key therapeutic indications.
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Affiliation(s)
- Hye Ran Park
- Department of Neurosurgery, Soonchunhyang University Seoul Hospital, Seoul, Korea
| | - In Hyang Kim
- Department of Psychiatry, Hanyang University Medical Center, Seoul, Korea
| | - Hyejin Kang
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Kevin W. McCairn
- Systems Neuroscience Section, Primate Research Institute, Kyoto University, Inuyama, Aichi, Japan
| | - Dong Soo Lee
- Department of Nuclear Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Bung-Nyun Kim
- Department of Psychiatry, Hanyang University Medical Center, Seoul, Korea
| | - Dong Gyu Kim
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
| | - Sun Ha Paek
- Department of Neurosurgery, Seoul National University College of Medicine, Seoul, Korea
- * E-mail:
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Voon V. Toward Precision Medicine: Prediction of Deep Brain Stimulation Targets of the Ventral Internal Capsule for Obsessive-Compulsive Disorder. Biol Psychiatry 2019; 85:708-710. [PMID: 30999985 DOI: 10.1016/j.biopsych.2019.03.969] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 03/08/2019] [Indexed: 10/27/2022]
Affiliation(s)
- Valerie Voon
- Department of Psychiatry, University of Cambridge, Cambridge, United Kingdom.
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13
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Affiliation(s)
- Sooraj Patil
- Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh UT, India
| | - Chandana Bhagwat
- Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh UT, India
| | - Arushi Gahlot Saini
- Pediatrics, Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh UT, India
| | - Sameer Vyas
- Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh UT, India
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Widge AS, Zorowitz S, Link K, Miller EK, Deckersbach T, Eskandar EN, Dougherty DD. Ventral Capsule/Ventral Striatum Deep Brain Stimulation Does Not Consistently Diminish Occipital Cross-Frequency Coupling. Biol Psychiatry 2016; 80:e59-60. [PMID: 26852071 PMCID: PMC5770190 DOI: 10.1016/j.biopsych.2015.10.029] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2015] [Accepted: 10/22/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Alik S Widge
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Maryland; Picower Institute for Learning & Memory, Massachusetts Institute of Technology, Cambridge, Massachusetts.
| | - Samuel Zorowitz
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Maryland
| | | | - Earl K Miller
- Picower Institute for Learning & Memory, Massachusetts Institute of Technology, Cambridge, Massachusetts
| | - Thilo Deckersbach
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Maryland
| | - Emad N Eskandar
- Department of Neurological Surgery, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Darin D Dougherty
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Charlestown, Maryland
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Affiliation(s)
- Damien Biotti
- Hôpital Neurologique Pierre Wertheimer, Lyon, France.
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Saotome K, Ishimori Y, Isobe T, Satou E, Shinoda K, Ookubo J, Hirano Y, Oosuka S, Matsushita A, Miyamoto K, Sankai Y. [Comparison of diffusion tensor imaging-derived fractional anisotropy in multiple centers for identical human subjects]. Nihon Hoshasen Gijutsu Gakkai Zasshi 2012; 68:1242-1249. [PMID: 23001272 DOI: 10.6009/jjrt.2012_jsrt_68.9.1242] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
The fractional anisotropy (FA) is calculated by using diffusion tensor imaging (DTI) with multiple motion probing gradients (MPG). While FA has become a widely used tool to detect moderate changes in water diffusion in brain tissue, the measured value is sensitive to scan parameters (e.g. MPG-direction, signal to noise ratio, etc.). Therefore, it is paramount to address the reproducibility of DTI measurements among multiple centers. The purpose of this study was to assess the inter-center variability of FA. We studied five healthy volunteers who underwent DTI brain scanning three times at three different centers (I-III), each with a 1.5 T scanner having a different MPG-schema. Then, we compared the FA and eigenvalue from the three centers measured in seven brain regions: splenium of corpus callosum (CCs), genu of corpus callosum (CCg), putamen, posterior limb of internal capsule, cerebral peduncle, optic radiation, and middle cerebellar peduncle. At the CCs and CCg, there was a statistical difference (p<0.05) between center Iand center IIfor the same MPG-directions. Furthermore, at CCs and CCg, there was a statistical difference (p<0.05) between center II and center III for different MPG-directions. Conversely, no statistical differences were found between center I and center III for the different MPG-directions for all regions. These results indicate that the FA value was affected by the MPG-schema as well as by the MPG-directions.
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Affiliation(s)
- Hu Liang Low
- Surgical Centre for Movement Disorders, University of British Columbia, Laurel Street, Vancouver, BC, Canada
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Nabika S, Kiya K, Satoh H, Mizoue T, Oshita J, Kondo H. Ischemia of the internal capsule due to mild head injury in a child. Pediatr Neurosurg 2007; 43:312-5. [PMID: 17627149 DOI: 10.1159/000103313] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2005] [Accepted: 05/23/2006] [Indexed: 11/19/2022]
Abstract
We encountered an instructive case of repetitive reversible severe neurological deficit due to ischemia of the internal capsule after mild head injury. A 1-year-old boy fell and hit his head on the floor without losing consciousness. Intermittent episodes of left hemiparesis lasting from 30 s to 30 min developed 4 h later. Magnetic resonance (MR) imaging revealed acute infarction in the left internal capsule and corona radiata on diffusion-weighted imaging, and no microbleeding on susceptibility-weighted imaging. MR angiography of the intracranial and cervical vessels showed no obstruction of the large cerebral arteries. Motor impairment began to improve the next day with conservative therapy. Neurological deficit gradually resolved over the course of 1 month. This tiny lesion of the internal capsule and corona radiata may have represented a small infarction caused by mechanical vasospasm of the perforating vessels branching from the middle cerebral artery after minor injury. Even mild head injuries may cause infarction of the internal capsule, although minor head injuries are common accidents in childhood and usually do not result in severe complications.
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Affiliation(s)
- S Nabika
- Department of Neurosurgery, Hiroshima Prefectural Hospital, Hiroshima, Japan.
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Kwon YH, Lee CH, Ahn SH, Lee MY, Yang DS, Byun WM, Park JW, Jang SH. Motor recovery via the peri-infarct area in patients with corona radiata infarct. NeuroRehabilitation 2007; 22:105-8. [PMID: 17656835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
OBJECTIVES Diffusion tensor image tracography (DTT) could be useful for exploration of the state of the corticospinal tract at the subcortical white matter level. We investigated the neural pathway associated with motor recovery in the patients with corona radiata infarct (CR) using DTT. DESIGN Three hemiparetic patients who showed severe weakness of the affected upper extremity at stroke onset, were recruited. DTT was performed twice (subacute and chronic stage) using 1.5-T system. Three-dimensional reconstructions of the fiber tracts were obtained with FA <0.2, angle >45 degrees as termination criteria. RESULTS In all patients, the motor function of the affected upper extremity has recovered to be functional state at second DTT scanning. The motor tracts of the affected hemisphere were observed to pass along the posterior portion of the CR infarct on both the first and second DTT. CONCLUSIONS It seems that the motor function of the affected upper extremity of the patients recovered via the posterior portion of infarct. This finding may reflect functional reorganization of the motor pathway following damage to the corticospinal tract.
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Affiliation(s)
- Yong-Hyun Kwon
- Department of Physical Medicine and Rehabilitation, School of Medicine, Yeungnam University, Taegu, Republic of Korea
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Abstract
INTRODUCTION Capsular warning syndrome (CWS) carries a significant risk of permanent stroke. There are no proven therapies for preventing completed stroke in this unstable situation. METHODS Clinical observation in two patients with aspirin-resistant CWS treated with a loading dose of oral clopidogrel. RESULTS Both patients had excellent neurological outcome, although one sustained an asymptomatic brain infarction. CONCLUSION High-dose oral clopidogrel plus aspirin merits formal evaluation in high-risk transient brain ischemia such as CWS, preferably in a randomized trial compared to aspirin alone.
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Affiliation(s)
- Christopher D Fahey
- Ken and Ruth Davee Department of Neurology and Clinical Neurological Sciences, Feinberg School of Medicine of Northwestern University, Chicago, IL 60611, USA
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Arboix A, Martínez-Rebollar M, Oliveres M, García-Eroles L, Massons J, Targa C. Acute isolated capsular stroke. A clinical study of 148 cases. Clin Neurol Neurosurg 2005; 107:88-94. [PMID: 15708221 DOI: 10.1016/j.clineuro.2003.11.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/29/2003] [Accepted: 11/24/2003] [Indexed: 11/16/2022]
Abstract
The objectives of the study were to assess differential features between capsular stroke of ischemic and hemorrhagic origin, and to compare capsular strokes with all other (non-capsular) strokes. Data of 148 patients with isolated capsular stroke were collected from a prospective hospital-based stroke registry in which 2000 consecutive acute stroke patients were included. Isolated capsular stroke accounted for 8.4% of strokes included in the registry (8.4% of ischemic strokes and 10.5% of intracerebral hemorrhages). Capsular stroke of hemorrhagic origin (n = 24) was more severe than ischemic capsular stroke (n = 124) as determined by a significantly higher in-hospital mortality, length of stay, and lower number of patients free of functional deficit at discharge. After multivariate analysis, limb weakness, sudden onset, and sensory symptoms were independently associated with capsular hemorrhage, whereas pure motor hemiparesis appeared to be associated with capsular infarction. In summary, one of each 12 patients with acute ischemic stroke and one of each 10 patients with acute intracerebral hemorrhage had an isolated capsular stroke. Lacunar syndrome was the most frequent clinical presentation being more common (particularly pure motor hemiparesis) in ischemic than in hemorrhagic capsular stroke. Capsular hemorrhage and capsular infarction showed identical risk factor profiles suggesting the same underlying vascular pathology for both conditions.
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Affiliation(s)
- Adrià Arboix
- Acute Stroke Unit, Department of Neurology, Hospital del Sagrat Cor, Viladomat 288, E-08029 Barcelona, Spain.
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Kim YH, Jang SH, Byun WM, Han BS, Lee KH, Ahn SH. Ipsilateral motor pathway confirmed by combined brain mapping of a patient with hemiparetic stroke: A case report11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit on the author(s) or on any organization with which the author(s) is/are associated. Arch Phys Med Rehabil 2004; 85:1351-3. [PMID: 15295764 DOI: 10.1016/j.apmr.2003.08.102] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
This study investigated the motor control pathway using both functional magnetic resonance imaging (fMRI) and transcranial magnetic stimulation (TMS) in a patient with left hemiparesis with an infarction on the posterior limb of the right internal capsule. fMRI was performed using the blood oxygen level-dependent technique at 1.5 T with a standard head coil. The motor activation task consisted of hand grasp-release movements in 1-Hz cycles. TMS was performed using a butterfly coil; the intersection of the wings (center of the coil) was applied tangentially to the scalp 1.0 cm apart. Stimulation was performed at 100% of maximal output. Motor evoked potentials (MEPs) from both abductor pollicis brevis (APB) muscles were obtained simultaneously. fMRI showed that the unaffected (left) primary sensorimotor cortex (SM1) was activated by movements of the unaffected (right) hand. Conversely, the bilateral SM1 were activated by movements of the affected (left) hand. Brain mapping using TMS showed that ipsilateral MEPs were obtained at the affected (left) APB muscle when the unaffected (left) motor cortex was stimulated. We concluded that the ipsilateral motor pathway from the unaffected motor cortex to the affected hand was present in this patient.
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Affiliation(s)
- Yun-Hee Kim
- Department of Physical Medicine & Rehabilitation, School of Medicine Sungkyunkwan University, Samsung Medical Center, Taegu, South Korea
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Abosch A, Gross RE. Surgical treatment of Parkinson's disease: deep brain stimulation versus radiofrequency ablation. Clin Neurosurg 2004; 51:296-303. [PMID: 15571158] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
Affiliation(s)
- Aviva Abosch
- Department of Neurosurgery, Center for Neurodegenerative Diseases, Emory University School of Medicine, Atlanta, Georgia, USA
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Abstract
AIM To evaluate the pattern and site of involvement in neuro-Behçet's disease (NBD). MATERIALS AND METHODS Twenty-one patients with NBD were evaluated. Using 1.5T magnetic resonance imaging (MRI), T1-weighted axial and sagittal images, gadolinium enhanced axial and coronal images and T2-weighted axial images were obtained. RESULTS The brainstem, basal ganglia, cerebral white matter, internal capsule, thalamus and spinal cord were involved in eighteen, nine, nine, seven, six and two patients, respectively. In nine patients with cerebral white matter involvement, four had subcortical involvement and three had periventricular involvement, in addition to two patients with focal deep white matter lesions. Among the brainstem lesions, pons involvement was seen in fourteen patients, all had ventrally located lesions, and nine had tegmental involvement. Midbrain involvement was seen in fourteen patients; the cerebral peduncle was involved in 11 of these. Five patients had brainstem atrophy: two cases were demonstrated at initial MRI, the other three cases were seen on follow-up MRI. Pyramidal signs, the most common neurological signs, were demonstrated in fourteen patients. Follow-up MRI was obtained 10 days to 20 months after the initial MRI in eight cases; all showed changes in size, shape and site of involvement. After gadolinium enhancement, thirteen patients demonstrated mottled non-confluent enhancement in the brainstem (eight patients), posterior limb of the internal capsule (three patients), pachymeninges (two patients) and spinal cord (two patients). CONCLUSION NBD manifests a reversible course, but chronic NBD may result in brainstem atrophy. Characteristic involvement along the corticospinal tract is well correlated with neurological signs.
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Affiliation(s)
- S H Lee
- Department of Diagnostic Radiology, Yonsei University College of Medicine, Research Institute of Radiological Science, Seoul, Korea
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ASANUMA H, BROOKS VB. RECURRENT CORTICAL EFFECTS FOLLOWING STIMULATION OF INTERNAL CAPSULE. Arch Ital Biol 1965; 103:220-46. [PMID: 14324719] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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BERTRAND G, BLUNDELL J, MUSELLA R. Electrical Exploration of the Internal Capsule and Neighbouring Structures During Stereotaxic Procedures. J Neurosurg 1965; 22:333-43. [PMID: 14318109 DOI: 10.3171/jns.1965.22.4.0333] [Citation(s) in RCA: 48] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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THUREL R, NEHLIL J. [THE PYRAMIDAL TRACT IN THE INTERNAL CAPSULE (ELECTRIC LOCALIZATION AND ELECTIVE ELECTROLYSIS IN THE TREATMENT OF INVOLUNTARY MOVEMENTS)]. Sem Hop 1964; 40:3119-22. [PMID: 14255838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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HORVATH FE, SOLTYSIK S, BUCHWALD NA. SPINDLES ELICITED BY STIMULATION OF THE CAUDATE NUCLEUS AND INTERNAL CAPSULE. Electroencephalogr Clin Neurophysiol 1964; 17:670-6. [PMID: 14240860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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NEHLIL J. [THE PYRAMIDAL TRACT IN THE INTERNAL CAPSULE. R OLE OF ITS LESION IN THE TREATMENT OF INVOLUNTARY MOVEMENTS. UTILITY OF ITS MARKING]. Neurochirurgie 1964; 10:443-6. [PMID: 14293927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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KAMEYAMA M. [VASCULAR LESIONS OF THE INTERNAL CAPSULE; A CLINICO-PATHOLOGIC STUDY]. Yokufuen Chosa Kenkyu Kiyo 1964; 39:11-8. [PMID: 14201049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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D ANNA L, KRAUTHAMER G. [DISTRIBUTION IN THE INTERNAL CAPSULE AND CAUDATE NUCLEUS OF ZONES WHICH INHIBIT NONSPECIFIC CORTICAL ACTIVITIES]. J Physiol (Paris) 1964; 56:330-1. [PMID: 14219765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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THUREL R, NEHLIL J. [THE PYRAMIDAL BUNDLE IN THE INTERNAL CAPSULE. ELECTRIC MARKING AND ELECTIVE ELECTROLYSIS IN THE TREATMENT OF INVOLUNTARY MOVEMENTS]. Maroc Med 1963; 42:905-7. [PMID: 14095384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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KAMEYAMA M. [BILATERAL INJURIES OF THE INTERNAL CAPSULE, WITH SPECIAL REFERENCE TO PSEUDOBULBAR PARALYSIS]. Yokufuen Chosa Kenkyu Kiyo 1963; 37:1-7. [PMID: 14071330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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BAKLAVADZHIAN OG. [APROPOS OF THE LOCALIZATION OF CONDUCTIVE PATHWAYS OF THE VISCERAL AFFERENT SYSTEM IN THE REGION OF THE INTERNAL CAPSULE]. Biull Eksp Biol Med 1963; 55:8-13. [PMID: 14070888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
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HIRAYAMA K, TSUBAKI T, TOYOKURA Y, OKINAKA S. The representation of the pyramidal tract in the internal capsule and basis pedunculi: A study based on three cases of amyotrophic lateral sclerosis. Neurology 1962; 12:337-42. [PMID: 13907643 DOI: 10.1212/wnl.12.5.337] [Citation(s) in RCA: 29] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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MECHELSE K. The localization of the thalamo-cortical and cortico-thalamic fibres in the internal capsule and thalamus of the cat. J Hirnforsch 1962; 5:408-53. [PMID: 13934332] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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BLINKOV SM, BRAZOVSKIA FA. [On the topography of the internal capsule in humans under normal conditions and in the presence of brain tumors]. Probl Sovrem Neirokhirurgii 1962; 4:315-321. [PMID: 24546830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
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KAMEYAMA M. [Studies on motor disturbances due to cerebrovascular disorders. Clinico-pathological studies on lesions in the posterior limb of the internal capsule]. Yokufuen Chosa Kenkyu Kiyo 1961; 34:47-52. [PMID: 14453432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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THUREL R, NEHLIL J, O'KEEFE P. [Treatment of involuntary movements by electrolysis in the internal capsule of the corresponding contingent of the extrapyramidal tract]. Sem Hop Ther Paris 1961; 37:755-6. [PMID: 13921106] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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GUIOT G, BRION S, AKERMAN M. [Stereotaxic anatomy of the internal pallidum, of the thalamus and of the internal capsule. Studies of the individual variations. II]. Ann Chir 1961; 15:703-41. [PMID: 13709676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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GUIOT G, BRION S, AKERMAN M. [Stereotaxic anatomy of the internal pallidum, of the internal capsule. Study of the individual variations]. Ann Chir 1961; 15:557-86. [PMID: 13709675] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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HEWITT W. The development of the human internal capsule and lentiform nucleus. J Anat 1961; 95:191-9. [PMID: 13714037 PMCID: PMC1244463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023] Open
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THUREL R, NEHLIL J, O'KEEFE P. [Stereotaxic treatment of involuntary movements. Role of the lesion of the pyramidal tract in the internal capsule; possibility of an osseous reference mark associated with electric stimulation]. Rev Prat 1961; 104:327-9. [PMID: 13776774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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MANGHI E. [Projection fibers of the frontal cortex. Course and disposition in the internal capsule, in the thalamus and in the mesencephalon. (Experimental study in the cat)]. Arch Ital Anat Embriol 1961; 66:63-106. [PMID: 13766141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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MAZARS G, PANSINI A, CHIARELLI J. [Homolateral responses caused by stimulation of the radiating crown and of the internal capsule]. Rev Neurol (Paris) 1960; 103:134-6. [PMID: 13768639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/24/2023]
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GUIOT G, SACHS M, HERTZOG E, BRION S, ROUGERIE J, DALLOZ JC, NAPOLEONE F. [Electrostimulation & surgical lesions of the internal capsule; anatomical & physiology data]. Neurochirurgie 1959; 5:17-42. [PMID: 13657286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/23/2023]
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BRONNER A. [Injurious effects of cortisone therapy in some diseases of the anterior limb of internal capsule]. Bull Soc Ophtalmol Fr 1954; 6:514-7. [PMID: 14351935] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/26/2023]
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50
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BATES JA. A comparison between movements produced by stimulation of the motor cortex and the internal capsule in the same individual. J Physiol 1954; 123:49-50P. [PMID: 13143543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/05/2023] Open
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