Disorders of consciousness(DoC),including coma,vegetative state,and minimally conscious state,present a spectrum of conditions characterized by impaired awareness and responsiveness due to severe brain injury.Conventi...Disorders of consciousness(DoC),including coma,vegetative state,and minimally conscious state,present a spectrum of conditions characterized by impaired awareness and responsiveness due to severe brain injury.Conventional interventions for DoC primarily focus on promoting conditions conducive to spontaneous neurological recovery including pharmacological treatments such as dopaminergic agents(e.g.,amantadine)and rehabilitative strategies including sensory stimulation programs and physical therapy.展开更多
Purpose:Deep brain stimulation(DBS)of the subthalamic nucleus(STN)is an indispensable and effective surgery for patients with primary Parkinson’s disease(PD).Nonetheless,its postoperative effects can be decided by ma...Purpose:Deep brain stimulation(DBS)of the subthalamic nucleus(STN)is an indispensable and effective surgery for patients with primary Parkinson’s disease(PD).Nonetheless,its postoperative effects can be decided by many factors including the optimal programmed stimulation parameters.In this study,we analyzed the correlation between different postoperative programmed stimulation parameters and their efficacy after STN–DBS electrode implantation in patients with PD.Methods:A total of 87 patients underwent electrode implantation and completed at least one year follow-up.Then,various combinations of stimulation parameters,including stimulus intensity,frequency,and pulse width,were examined for their effects on the clinical improvement of the patients.Improvements in motor and nonmotor symptoms were analyzed using Mini-Mental State Examination,Parkinson’s Disease Quality of Life Questionnaire-39,and Unified Parkinson’s Disease Rating Scale(UPDRS)scores before and after surgery.Results:We found significantly improved UPDRS scores,quality of life,and neuropsychiatric symptoms postoperatively considering the findings of the aforementioned stimulation parameters compared with those observed preoperatively.Conclusion:This study provides a better understanding on how pro-grammed stimulation parameters help relieve PD symptoms and improve quality of life in patients with PD undergoing STN–DBS.展开更多
Background:Deep brain stimulation(DBS)has proved effective for Parkinson’s disease(PD),but the identification of stimulation parameters relies on doctors’subjective judgment on patient behavior.Methods:Five PD patie...Background:Deep brain stimulation(DBS)has proved effective for Parkinson’s disease(PD),but the identification of stimulation parameters relies on doctors’subjective judgment on patient behavior.Methods:Five PD patients performed 10-meter walking tasks under different brain stimulation frequencies.During walking tests,a wearable functional near-infrared spectroscopy(fNIRS)system was used to measure the concentration change of oxygenated hemoglobin(ΔHbO_(2))in prefrontal cortex,parietal lobe and occipital lobe.Brain functional connectivity and global efficiency were calculated to quantify the brain activities.Results:We discovered that both the global and regional brain efficiency of all patients varied with stimulation parameters,and the DBS pattern enabling the highest brain efficiency was optimal for each patient,in accordance with the clinical assessments and DBS treatment decision made by the doctors.Conclusions:Task fNIRS assessments and brain functional connectivity analysis promise a quantified and objective solution for patient-specific optimization of DBS treatment.Trial registration:Name:Accurate treatment under the multidisciplinary cooperative diagnosis and treatment model of Parkinson’s disease.Registration number is ChiCTR1900022715.Date of registration is April 23,2019.展开更多
文摘Disorders of consciousness(DoC),including coma,vegetative state,and minimally conscious state,present a spectrum of conditions characterized by impaired awareness and responsiveness due to severe brain injury.Conventional interventions for DoC primarily focus on promoting conditions conducive to spontaneous neurological recovery including pharmacological treatments such as dopaminergic agents(e.g.,amantadine)and rehabilitative strategies including sensory stimulation programs and physical therapy.
文摘Purpose:Deep brain stimulation(DBS)of the subthalamic nucleus(STN)is an indispensable and effective surgery for patients with primary Parkinson’s disease(PD).Nonetheless,its postoperative effects can be decided by many factors including the optimal programmed stimulation parameters.In this study,we analyzed the correlation between different postoperative programmed stimulation parameters and their efficacy after STN–DBS electrode implantation in patients with PD.Methods:A total of 87 patients underwent electrode implantation and completed at least one year follow-up.Then,various combinations of stimulation parameters,including stimulus intensity,frequency,and pulse width,were examined for their effects on the clinical improvement of the patients.Improvements in motor and nonmotor symptoms were analyzed using Mini-Mental State Examination,Parkinson’s Disease Quality of Life Questionnaire-39,and Unified Parkinson’s Disease Rating Scale(UPDRS)scores before and after surgery.Results:We found significantly improved UPDRS scores,quality of life,and neuropsychiatric symptoms postoperatively considering the findings of the aforementioned stimulation parameters compared with those observed preoperatively.Conclusion:This study provides a better understanding on how pro-grammed stimulation parameters help relieve PD symptoms and improve quality of life in patients with PD undergoing STN–DBS.
基金This work was supported by the National Natural Science Foundation of China(U1913208,61873135,61720106012)the fundamental research funds for the central universities.
文摘Background:Deep brain stimulation(DBS)has proved effective for Parkinson’s disease(PD),but the identification of stimulation parameters relies on doctors’subjective judgment on patient behavior.Methods:Five PD patients performed 10-meter walking tasks under different brain stimulation frequencies.During walking tests,a wearable functional near-infrared spectroscopy(fNIRS)system was used to measure the concentration change of oxygenated hemoglobin(ΔHbO_(2))in prefrontal cortex,parietal lobe and occipital lobe.Brain functional connectivity and global efficiency were calculated to quantify the brain activities.Results:We discovered that both the global and regional brain efficiency of all patients varied with stimulation parameters,and the DBS pattern enabling the highest brain efficiency was optimal for each patient,in accordance with the clinical assessments and DBS treatment decision made by the doctors.Conclusions:Task fNIRS assessments and brain functional connectivity analysis promise a quantified and objective solution for patient-specific optimization of DBS treatment.Trial registration:Name:Accurate treatment under the multidisciplinary cooperative diagnosis and treatment model of Parkinson’s disease.Registration number is ChiCTR1900022715.Date of registration is April 23,2019.
