Neuromodulation for Dystonia
28
Citation
125
Reference
10
Related Paper
Citation Trend
Keywords:
Subthalamic Nucleus
Neuromodulation
Cervical dystonia
Subthalamic Nucleus
Antidromic
Medium spiny neuron
Cite
Citations (110)
Abstract The organization of the major efferents of the rat subthalamic nucleus (STN) was investigated using a fluorescent retrograde double‐labeling technique. Red fluorcrescent Evans Blue was injected into the globus pallidus and blue fluorescent DAPI‐Primuline was injected into the substantia nigra. After retrograde axonal transport many double‐labeled neurons were seen throughout the STN. Occasional double‐labeled cells were seen in the lateral hypothalamus just medial to the STN and in a thin lateral strip of neurons extending laterally from the STN. Evidence for a mediolateral topography in both the STN‐pallidal and STN‐nigral pathways was obtained. The STN contains few, if any, local interneurons. Cell counts revealed that at least 94% of, and possibly all, STN neurons send axon collaterals to both the globus pallidus and substantia nigra.
Subthalamic Nucleus
Medium spiny neuron
5-HT4 receptor
Red nucleus
Zona incerta
Retrograde tracing
Axoplasmic transport
Pars reticulata
Cite
Citations (182)
Subthalamic Nucleus
Ventral pallidum
Cite
Citations (11)
Subthalamic Nucleus
Cite
Citations (3)
Abstract The link between dystonia and tremor has been known for decades, but the question of whether they are two separate illnesses or just different manifestations of one disease with the same pathophysiological background remains unanswered. We distinguish two types of tremor in dystonia: dystonic tremor (DT), which appears on the body part affected by dystonia, and tremor associated with dystonia (TAWD), which appears in locations where the dystonia does not occur. In this study, the frequency of occurrence of different forms of tremor was determined by clinical examination in a group of adult-onset isolated cervical dystonia (CD) patients treated with regular local injections of botulinum toxin A in our department. In total, 120 patients were included in the study, of which 70 (58.3%) had DT of the head. TAWD was, in all 14 cases (11.7%), observed on the upper limbs, in the form of static or intentional tremor. The aim of this study was to point out the presence of TAWD as one of the clinical signs of CD. DT occurred in more than half of the patients and appears to be a relatively common part of the clinical picture in patients with CD.
Cervical dystonia
Focal dystonia
Cite
Citations (29)
The subthalamic nucleus, substantia nigra, and globus pallidus, three nuclei of the human basal ganglia, play an important role in motor, associative, and limbic processing. The network of the basal ganglia is generally characterized by a direct, indirect, and hyperdirect pathway. This study aims to investigate the mesoscopic nature of these connections between the subthalamic nucleus, substantia nigra, and globus pallidus and their surrounding structures.A human post mortem brain specimen including the substantia nigra, subthalamic nucleus, and globus pallidus was scanned on a 7 T MRI scanner. High resolution diffusion weighted images were used to reconstruct the fibers intersecting the substantia nigra, subthalamic nucleus, and globus pallidus. The course and density of these tracks was analyzed.Most of the commonly established projections of the subthalamic nucleus, substantia nigra, and globus pallidus were successfully reconstructed. However, some of the reconstructed fiber tracks such as the connections of the substantia nigra pars compacta to the other included nuclei and the connections with the anterior commissure have not been shown previously. In addition, the quantitative tractography approach showed a typical degree of connectivity previously not documented. An example is the relatively larger projections of the subthalamic nucleus to the substantia nigra pars reticulata when compared to the projections to the globus pallidus internus.This study shows that ultra-high field post mortem tractography allows for detailed 3D reconstruction of the projections of deep brain structures in humans. Although the results should be interpreted carefully, the newly identified connections contribute to our understanding of the basal ganglia.
Subthalamic Nucleus
5-HT4 receptor
Pars compacta
Pars reticulata
Putamen
Red nucleus
Cite
Citations (45)
Subthalamic Nucleus
Zona incerta
Cite
Citations (86)
Background: Family studies of dystonia may be limited in part by small family size and incomplete ascertainment of dystonia in geographically dispersed families. Further, prevalence estimates of dystonia are believed to be underestimates, as most studies are clinic-based and many individuals do not present to a physician or are misdiagnosed. As a low-cost highly sensitive screening tool is needed to improve case detection for genetic and epidemiologic studies, the authors developed the Beth Israel Dystonia Screen (BIDS), a computer-assisted telephone interview. Objective: To evaluate the validity and utility of a computer-assisted telephone interview in screening for cervical dystonia. Methods: The BIDS was administered and videotaped neurologic examinations performed on 193 individuals from 16 families with cervical and cranial dystonia. With use of a final rating of definite dystonia, as determined by video review of a systematic neurologic evaluation, as the gold standard, the predictive value of a subset of questions from the BIDS was assessed. Results: A positive response to at least two of five screening questions had a sensitivity for cervical dystonia of 100% and a specificity of 92%. With use of a positive response to three or more questions, definite dystonia was determined with 81% sensitivity and 97% specificity. Conclusions: The Beth Israel Dystonia Screen (BIDS) identifies cervical dystonia with excellent sensitivity and specificity in a family-based sample. The authors recommend the BIDS for family studies, but cross-validation in a population sample is advisable before applying this method to epidemiologic studies.
Cervical dystonia
Gold standard (test)
Telephone interview
Cite
Citations (19)
Cervical dystonia
Sanger sequencing
Cite
Citations (15)
Abstract In Iceland, the crude prevalence for all types of primary dystonia was 37.1/10 5 (confidence interval, 30.4–44.9). Focal dystonia had the highest prevalence (31.2/10 5 ), followed by segmental (3.1/10 5 ), multifocal (2.4/10 5 ) and generalized dystonia (0.3/10 5 ). Cervical dystonia was the most common focal dystonia (11.5/10 5 ), followed by limb dystonia (8.0/10 5 ), laryngeal dystonia (5.9/10 5 ), blepharospasm (3.1/10 5 ), and oromandibular dystonia (2.8/10 5 ). The male:female ratio for all patients was 1:1.9 ( P = 0.0007), and females outnumbered males in all subtypes except oromandibular dystonia. Mean age of onset for all patients was 42.7 years (range, 3–82 years). This prevalence of primary dystonia is higher than in most reported studies, possibly because of more complete ascertainment but the relative frequencies of dystonia subtypes is similar. © 2005 Movement Disorder Society
Cite
Citations (90)