Andreas Nowacki

Andreas Nowacki
Inselspital, Universitätsspital Bern · Department of Neurosurgery

Doctor of Medicine

About

35
Publications
7,426
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488
Citations
Introduction
Andreas Nowacki currently works at the Department of Neurosurgery, Inselspital, Universitätsspital Bern and as a clinical fellow in functional neurosurgery at the Oxford university hospitals. Andreas does research in Neurosurgery and functional Neurosurgery. His research focus is on improvement of preoperative Image based targeting and prediction of stimulation-induced effects of neuromodulation.
Additional affiliations
February 2018 - present
Oxford University Hospitals NHS Trust
Position
  • Fellow
Description
  • Clinical Fellow Functional Neurosurgery
June 2013 - present
Inselspital, Universitätsspital Bern
Position
  • Medical Doctor
Education
April 2007 - April 2013
University of Tuebingen
Field of study
  • Medicine

Publications

Publications (35)
Article
OBJECTIVE Decompressive hemicraniectomy (DCE) is the standard of care for space-occupying malignant infarction of the medial cerebral artery in suitable patients. After DCE, the brain is susceptible to trauma and at risk for the syndrome of the trephined. This study aimed to assess the feasibility of using temporary space-expanding flaps, implanted...
Article
Objective We aimed to demonstrate the feasibility of using motor evoked responses to intraoperative double-train stimulation to guide lead placement and matching of intraoperative contacts with postoperative electrode programming in spinal cord stimulation for pain performed under general anesthesia. Materials and Methods The study included a seri...
Article
Full-text available
Objective: To obtain individual clinical and neuroimaging data of patients undergoing Deep Brain Stimulation for essential tremor from five different European centers to identify predictors of outcome and to identify an optimal stimulation site. Methods: We analysed retrospectively baseline covariates, pre- and postoperative clinical tremor scor...
Article
Full-text available
Background Deep brain stimulation (DBS) programming of multicontact DBS leads relies on a very time-consuming manual screening procedure, and strategies to speed up this process are needed. Beta activity in subthalamic nucleus (STN) local field potentials (LFP) has been suggested as a promising marker to index optimal stimulation contacts in patien...
Article
Objectives Subthalamic nucleus (STN) deep brain stimulation (DBS) programming in patients with Parkinson disease (PD) may be challenging, especially when using segmented leads. In this study, we integrated a previously validated probabilistic STN sweet spot into a commercially available software to evaluate its predictive value for clinically effec...
Conference Paper
Deep brain stimulation is an effective neurosurgical intervention for movement disorders such as Parkinson's disease. Despite its success, the underlying mechanisms are still debated. One tool to better understand them is the Volume of Tissue Activated (VTA), that estimates the region activated by electrical stimulation. Different estimation approa...
Article
Full-text available
Although deep brain stimulation (DBS) of the globus pallidus internus (GPi) and the subthalamic nucleus (STN) has become an established treatment for Parkinson's disease (PD), a recent meta-analysis of outcomes is lacking. To address this gap, we performed a meta-analysis of bilateral STN-and GPi-DBS studies published from 1990-08/2019. Studies wit...
Article
Full-text available
Background Open and stereotactic transfrontal or transcerebellar approaches have been used to biopsy brainstem lesions. Method In this report, a stereotactic posterior and midline approach to the distal medulla oblongata under microscopic view is described. The potential advantages and limitations are discussed, especially bilateral damage of the...
Article
Full-text available
Background Stereotactic biopsies for brainstem lesions are frequently performed to yield an accurate diagnosis and help guide subsequent management. In this study, we summarize our experience with different stereotactic approaches to brainstem lesions of different locations and discuss possible implications for safety and diagnostic yield. Methods...
Article
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Background Different deep brain stimulation (DBS) targets have been suggested as treatment for patients with pharmacologically refractory Holmes tremor (HT). We report the clinical and quality of life (QoL) long‐term (up to nine years) outcome in four patients with HT treated with DBS (in thalamic ventral intermediate nucleus‐VIM or in dentato‐rubr...
Article
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Background/Objective In order to monitor tissue oxygenation in patients with acute neurological disorders, probes for measurement of brain tissue oxygen tension (ptO 2 ) are often placed non-specifically in a right frontal lobe location. To improve the value of ptO 2 monitoring, placement of the probe into a specific area of interest is desirable....
Article
Full-text available
Deep Brain Stimulation of the posterior subthalamic area is an emergent target for the treatment of Essential Tremor. Due to the heterogeneous and complex anatomy of the posterior subthalamic area, it remains unclear which specific structures mediate tremor suppression and different side effects. The objective of the current work was to yield a bet...
Article
Objective Deep brain stimulation (DBS) is a treatment alternative for refractory chronic Cluster headache (CCH). Despite several recent prospective case series reporting on good outcome, the effectiveness and the optimal stimulation target of DBS for CCH remain unclear. We aimed to obtain precise estimates and predictors of long‐term pain relief in...
Article
Full-text available
Whilst exaggerated bursts of beta frequency band oscillatory synchronization in the subthalamic nucleus have been associated with motor impairment in Parkinson's disease, a plausible mechanism linking the two phenomena has been lacking. Here we test the hypothesis that increased synchronization denoted by beta bursting might compromise information...
Article
Indirect targeting of the Ventralis Intermedius Nucleus (Vim) is widely used for functional neurosurgical procedures to treat essential tremor (ET). Here, we review if the laterality of the Vim depends on the diameter of the third ventricle and if a targeting approach that incorporates this correlation can facilitate targeting and yields accurate l...
Article
Full-text available
Objective Segmented deep brain stimulation leads in the subthalamic nucleus have shown to increase therapeutic window using directional stimulation. However, it is not fully understood how these segmented leads with reduced electrode size modify the volume of tissue activated (VTA) and how this in turn relates with clinically observed therapeutic a...
Article
Background: Directional deep brain stimulation (dDBS) of the subthalamic nucleus for Parkinson's disease (PD) increases the therapeutic window. However, empirical programming of the neurostimulator becomes more complex given the increasing number of stimulation parameters. A better understanding of dDBS is needed to improve therapy and help guide...
Article
Full-text available
In a single-center, randomized trial involving 361 patients, the use of routine computed tomography after the removal of a chronic hematoma had no advantage over CT performed only in patients with clinical deterioration.
Article
Objective: We present long-term follow-up results and analysis of stimulation sites of a prospective cohort study of six patients with chronic cluster headaches undergoing deep brain stimulation of the ipsilateral posterior hypothalamic region. Methods: The primary endpoint was the postoperative change in the composite headache severity score "h...
Article
Full-text available
Objective: Functional processes in the brain are segregated in both the spatial and spectral domain. Motivated by findings reported at the cortical level in healthy participants we test the hypothesis in the basal ganglia of Parkinson's disease patients that lower frequency beta band activity relates to motor circuits associated with the upper lim...
Article
OBJECTIVE Deep brain stimulation (DBS) of the posterior subthalamic area (PSA) is an alternative to thalamic DBS for the treatment of essential tremor (ET). The dentato-rubro-thalamic tract (DRTT) has recently been proposed as the anatomical substrate underlying effective stimulation. For clinical purposes, depiction of the DRTT mainly depends on d...
Article
INTRODUCTION Chronic subdural hematoma has a high recurrence rate after surgery and postoperative scans often show substantial residuals, eventually leading to a higher rate of reoperation. However, the benefit of postsurgical imaging for patient outcome remains unknown. METHODS We randomly assigned 368 patients with newly diagnosed chronic subdur...
Article
The pedunculopontine nucleus (PPN) is a reticular nucleus located in the mesencephalic and upper pontine tegmentum. Initially, characterized by its predominant cholinergic projection neurons, it was associated with the "mesencephalic locomotor region" and "reticular activating system". Furthermore, based on histopathological studies, the PPN was hy...
Article
Full-text available
Background: Accurate interindividual comparability of deep brain stimulation (DBS) lead locations in relation to the surrounding anatomical structures is of eminent importance to define and understand effective stimulation areas. The objective of the current work is to compare the accuracy of the DBS lead localisation relative to the STN in native...
Article
Background: External ventricular drainage (EVD) catheter placement is one of the most commonly performed neurosurgical procedures. The study's objective was to compare a computed tomography (CT) bolt scan-guided approach for the placement of EVDs with conventional landmark-based insertion. Methods: In this retrospective case-control study, we an...
Article
OBJECTIVE The dentatorubrothalamic tract (DRTT) has been suggested as the anatomical substrate for deep brain stimulation (DBS)–induced tremor alleviation. So far, little is known about how accurately and reliably tracking results correspond to the anatomical DRTT. The objective of this study was to systematically investigate and validate the resul...
Article
Full-text available
Background: Although recently introduced directional DBS leads provide control of the stimulation field, programing is time-consuming. Objectives: Here, we validate local field potentials recorded from directional contacts as a predictor of the most efficient contacts for stimulation in patients with PD. Methods: Intraoperative local field pot...
Article
Full-text available
Background: Subthalamic nucleus (STN) stimulation has been recognized to control resting tremor in Parkinson disease. Similarly, thalamic stimulation (ventral intermediate nucleus; VIM) has shown tremor control in Parkinson disease, essential, and intention tremors. Recently, stimulation of the posterior subthalamic area (PSA) has been associated...
Article
BACKGROUND: Targeting accuracy in deep brain stimulation (DBS) surgery can be defined as the level of accordance between selected and anatomic real target reflected by characteristic electrophysiological results of microelectrode recording (MER). OBJECTIVE: To determine the correspondence between the preoperative predicted target based on modern 3-...
Article
Full-text available
Objective: Recent advances in different MRI sequences have enabled direct visualization and targeting of the Globus pallidus internus (GPi) for DBS surgery. Modified Driven Equilibrium Fourier Transform (MDEFT) MRI sequences provide high spatial resolution and an excellent contrast of the basal ganglia with low distortion. In this study, we invest...
Article
Full-text available
Case presentation and systematic review of the literature to update our current knowledge of induction of fear by cortical stimulation. We present a case of refractory epilepsy associated with a lesion where fear could be induced by intraoperative electrical stimulation of the posterior inner part of the superior temporal gyrus. We performed a syst...

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