Subthalamic deep brain stimulation after anesthetic inhalation in Parkinson disease: a preliminary study
ABSTRACT The authors of this preliminary study investigated the outcome and feasibility of intraoperative microelectrode recording (MER) in patients with Parkinson disease (PD) undergoing deep brain stimulation of the subthalamic nucleus (STN) after anesthetic inhalation.
The authors conducted a retrospective analysis of 10 patients with PD who received a desflurane anesthetic during bilateral STN electrode implantation. The MERs were obtained as an intraoperative guide for final electrode implantation and the data were analyzed offline. The functional target coordinates of the electrodes were compared preoperatively with estimated target coordinates.
Outcomes were evaluated using the Unified Parkinson's Disease Rating Scale 6 months after surgery. The mean improvement in total and motor Unified Parkinson's Disease Rating Scale scores was 54.27 +/- 17.96% and 48.85 +/- 16.97%, respectively. The mean STN neuronal firing rate was 29.7 +/- 14.6 Hz. Typical neuronal firing patterns of the STN and substantia pars nigra reticulata were observed in each patient during surgery. Comparing the functional target coordinates, the z axis coordinates were noted to be significantly different between the pre- and postoperative coordinates.
The authors found that MER can be adequately performed while the patient receives a desflurane anesthetic, and the results can serve as a guide for STN electrode implantation. This may be a good alternative surgical method in patients with PD who are unable to tolerate deep brain stimulation surgery with local anesthesia.
Full-textDOI: · Available from: Yu-Cheng Chou, Mar 21, 2014
- SourceAvailable from: Yuan-jen Chang[Show abstract] [Hide abstract]
ABSTRACT: Parkinson’s Disease (PD) is a common neurodegenerative disorder with progressive loss of dopaminergic and other sub-cortical neurons. Among various approaches, gait analysis is commonly used to help identify the biometric features of PD. There have been some studies to date on both the classification of PD and estimation of gait parameters. However, it is also important to construct a regression system that can evaluate the degree of abnormality in PD patients. In this paper, we intended to develop a PD gait regression model that is capable of predicting the severity of motor dysfunction from given gait image sequences. We used a model-free strategy and thus avoided the critical demands of segmentation and parameter estimation. Furthermore, we used linear discriminant analysis (LDA) to increase the feature efficiency by maximizing and minimizing the between- and within-group variations. Regression was also achieved by assessing the spatial and temporal information through classification and finally by using these two new indices for linear regression. According to the experiments, the outcomes significantly correlated with the sum of sub-scores from the Unified Parkinson’s Disease Rating Scale (UPDRS): motor examination section with r = 0.92 and 0.85 for training and testing, respectively, with p < 0.0001. Compared with conventional methods, our system provided a better evaluation of PD abnormality.Expert Systems with Applications 01/2012; 39(1):520-526. DOI:10.1016/j.eswa.2011.07.042
Conference Paper: QoS-aware resource request mechanisms for HIPERLAN/2[Show abstract] [Hide abstract]
ABSTRACT: Recent advances in wireless technology are enabling the design and deployment of multiservice wireless networks. In order to be able to meet the QoS requirements of the various applications, it is essential to deploy QoS provisioning mechanisms. In this paper, we present various QoS provisioning mechanisms. Our simulation results show the effectiveness of the mechanisms when supporting various types of services.Global Telecommunications Conference, 2004. GLOBECOM '04. IEEE; 01/2004
- [Show abstract] [Hide abstract]
ABSTRACT: Parkinson's disease is the second most prevalent neurodegenerative disease and presents a particular anaesthetic challenge. The clinical features are described in detail, and recent advances in medical management and neurosurgical treatment options are highlighted. Deep brain stimulation (DBS) has experienced a renaissance for selected patients. Potential drug interactions with anaesthetics are described and recommendations are made about suitable anaesthetic techniques, especially for DBS. In addition to the classic DBS in an awake state, stimulation under modified general anaesthesia seems possible in selected patients who are not suitable for awake craniotomy. DBS is an attractive option for severely disabled patients with Parkinson's disease who pose a particular anaesthetic challenge.Current opinion in anaesthesiology 05/2009; 22(3):419-424. DOI:10.1097/ACO.0b013e32832a4b31