64 results on '"Yang, Andrew I."'
Search Results
52. Endoscopic versus microscopic microvascular decompression for trigeminal neuralgia: equivalent pain outcomes with possibly decreased postoperative headache after endoscopic surgery
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Lee, John Y. K., primary, Pierce, John T., additional, Sandhu, Sukhmeet K., additional, Petrov, Dmitriy, additional, and Yang, Andrew I., additional
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- 2017
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53. Multifocal dysembryoplastic neuroepithelial tumours associated with refractory epilepsy
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Yang, Andrew I., additional, Khawaja, Ayaz M., additional, Ballester-Fuentes, Leo, additional, Pack, Svetlana D., additional, Abdullaev, Ziedulla, additional, Patronas, Nicholas J., additional, Inati, Sara K., additional, Theodore, William H., additional, Quezado, Martha M., additional, and Zaghloul, Kareem A., additional
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- 2014
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54. Retropharyngeal Ganglioneuroma: A Case Report
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Yang, Andrew I., primary, Ozsvath, Jessica, additional, Shukla, Pratibha, additional, and Fatterpekar, Girish M., additional
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- 2012
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55. Beta-Coupled High-Frequency Activity and Beta-Locked Neuronal Spiking in the Subthalamic Nucleus of Parkinson’s Disease.
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Yang, Andrew I., Vanegas, Nora, Lungu, Codrin, and Zaghloul, Kareem A.
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- 2014
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56. Ruptured Anterior Inferior Cerebellar Artery Aneurysm From a Persistent Trigeminal Artery: A Case Report.
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Ahmad H, Albayar A, Muhammad N, Romeo D, Salem M, Yang AI, and Burkhardt JK
- Abstract
Persistent trigeminal artery (PTA) is the most common remnant of the primitive carotid-vertebrobasilar anastomoses, which typically form and obliterate during the early stages of human embryonic development. While PTA can be non-pathologic and is usually an incidental finding, it is also associated with various other vascular abnormalities, such as arteriovenous malformations and fistulae, but most commonly cerebral aneurysms. In these cases, aneurysms are usually reported in the anterior cerebral circulation or in the PTA trunk itself; to date, only one report exists of an associated aneurysm in the posterior circulation (basilar artery). These associated vascular pathologies are not only a source of morbidity and mortality but can also complicate subsequent endovascular treatment due to different flow patterns and increased vessel tortuosity. In this case report, we present the first reported case of PTA-associated aneurysm in the anterior inferior cerebellar artery and its resulting impact on the endovascular treatment of this aneurysm., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2024, Ahmad et al.)
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- 2024
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57. Odor representations from the two nostrils are temporally segregated in human piriform cortex.
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Dikecligil GN, Yang AI, Sanghani N, Lucas T, Chen HI, Davis KA, and Gottfried JA
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The human olfactory system has two discrete channels of sensory input, arising from olfactory epithelia housed in the left and right nostrils. Here, we asked whether primary olfactory cortex (piriform cortex, PC) encodes odor information arising from the two nostrils as integrated or distinct stimuli. We recorded intracranial EEG signals directly from PC while human subjects participated in an odor identification task where odors were delivered to the left, right, or both nostrils. We analyzed the time-course of odor-identity coding using machine learning approaches, and found that uni-nostril odor inputs to the ipsilateral nostril are encoded ~480 ms faster than odor inputs to the contralateral nostril on average. During naturalistic bi-nostril odor sampling, odor information emerged in two temporally segregated epochs with the first epoch corresponding to the ipsilateral and the second epoch corresponding to the contralateral odor representations. These findings reveal that PC maintains distinct representations of odor input from each nostril through temporal segregation, highlighting an olfactory coding scheme at the cortical level that can parse odor information across nostrils within the course of a single inhalation.
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- 2023
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58. Multitarget deep brain stimulation for epilepsy.
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Yang AI, Isbaine F, Alwaki A, and Gross RE
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- Adult, Humans, Retrospective Studies, Seizures etiology, Electrodes, Implanted adverse effects, Deep Brain Stimulation, Epilepsy therapy, Epilepsy etiology, Drug Resistant Epilepsy therapy
- Abstract
Objective: Deep brain stimulation (DBS) is a rapidly growing surgical option for patients with drug-resistant epilepsy who are not candidates for resective/ablative surgery. Recent randomized controlled trials have demonstrated efficacy of DBS of the anterior nucleus of the thalamus (ANT), particularly in frontal or temporal epilepsy, whereas DBS of the centromedian (CM) nucleus appears to be most suitable in well-defined generalized epilepsy syndromes. At the authors' institution, DBS candidates who did not fit the populations represented in these trials were managed with DBS of multiple distinct targets, which included ANT, CM, and less-studied nuclei-i.e., mediodorsal nucleus, pulvinar, and subthalamic nucleus. The goal of this study was to present the authors' experience with these types of cases, and to motivate future investigations that can determine the long-term efficacy of multitarget DBS., Methods: This single-center retrospective study of adult patients with drug-resistant epilepsy who underwent multitarget DBS was performed to demonstrate the feasibility and safety of this approach, and to present seizure outcomes. Patients in this cohort had epilepsy with features that were difficult to treat with DBS of the ANT or CM nucleus alone, including multifocal/multilobar, diffuse-onset, and/or posterior-onset seizures; or both generalized and focal seizures., Results: Eight patients underwent DBS of 2-3 distinct thalamic/subthalamic nuclei. DBS was performed with 2 electrodes in each hemisphere. All leads in each patient were implanted with either frontal or parietal trajectories. There were no surgical complications. Among those with > 6 months of follow-up (n = 5; range 7-21 months), all patients were responders in terms of overall seizure frequency and/or convulsive seizure frequency (i.e., ≥ 50% reduction). Two patients had adverse stimulation effects, which resolved with further programming., Conclusions: Multitarget DBS is a procedurally feasible and safe treatment strategy to maximize outcomes in patients with complex epilepsy. The authors highlight their approach to inform future studies that are sufficiently powered to assess its efficacy.
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- 2023
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59. Pain Outcomes Following Endoscopic Microvascular Decompression for Trigeminal Neuralgia Based on Vascular Compression Type.
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Blue R, Yang AI, Ajmera S, Spadola M, Howard S, Saylany A, Kvint S, Harber A, Daly M, Shekhtman E, Nair A, Deshpande R, and Lee JYK
- Abstract
Background Arterial compression of the trigeminal nerve at the root entry zone has been the long-attributed cause of compressive trigeminal neuralgia despite numerous studies reporting distal and/or venous compression. The impact of compression type on patient outcomes has not been fully elucidated. Objective We categorized vascular compression (VC) based on vessel and location of compression to correlate pain outcomes based on compression type. Methods A retrospective video review of 217 patients undergoing endoscopic microvascular decompression for trigeminal neuralgia categorizing VC into five distinct types, proximal arterial compression (VC1), proximal venous compression (VC2), distal arterial compression (VC3), distal venous compression (VC4), and no VC (VC5). VC type was correlated with postoperative pain outcomes at 1 month ( n = 179) and last follow-up (mean = 42.9 mo, n = 134). Results At 1 month and longest follow-up, respectively, pain was rated as "much improved" or "very much improved" in 89 69% of patients with VC1, 86.6 and 62.5% of patients with VC2, 100 and 87.5% of patients with VC3, 83 and 62.5% of patients with VC4, and 100 and 100% of patients with VC5. Multivariate analysis demonstrated VC4 as a significant negative of predictor pain outcomes at 1 month, but not longest follow-up, and advanced age as a significant positive predictor. Conclusion The degree of clinical improvement in all types of VC was excellent, but at longest follow-up VC type was not a significant predictor out outcome. However distal venous compression was significantly associated with worse outcomes at 1 month., Competing Interests: Conflict of Interest None declared., (Thieme. All rights reserved.)
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- 2023
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60. Towards personalized and value-based spine care: objective patient monitoring with smartphone activity data.
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Ahmad HS, Yang AI, Basil GW, Welch WC, Wang MY, and Yoon JW
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Competing Interests: Conflicts of Interest: All authors have completed the ICMJE uniform disclosure form (available at https://jss.amegroups.com/article/view/10.21037/jss-21-67/coif). The series “Objective Monitoring and Wearable Technologies including Sensor-Based Accelerometers and Mobile Health Applications for the Spine Patient” was commissioned by the editorial office without any funding or sponsorship. GWB reports standard stock ownership in Kinesiometrics LLC, outside the submitted work. MYW is a consultant for DePuy Synthes, K2M, Stryker, and Spineology; he is a patent holder with DePuy Synthes; he has direct stock ownership in ISD and Medical Device Partners; and has direct stock ownership in Kinesiometrics LLC; outside the submitted work. JWY reports standard stock ownership in Kinesiometrics LLC and MedCyclops LLC, outside the submitted work. The authors have no other conflicts of interest to declare.
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- 2022
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61. Feasibility of Magnetic Resonance-Guided Focused Ultrasound Thalamotomy for Essential Tremor in the Setting of Prior Craniotomy.
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Wathen C, Yang AI, Hitti FL, Henry L, Chaibainou H, and Baltuch GH
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- Craniotomy, Feasibility Studies, Humans, Magnetic Resonance Imaging methods, Magnetic Resonance Spectroscopy, Male, Essential Tremor diagnostic imaging, Essential Tremor surgery
- Abstract
Background: Magnetic resonance imaging-guided focused ultrasound (MRgFUS) thalamotomy is a rapidly evolving therapy for the treatment of essential tremor. Although the skull is a major determinant of the delivery of acoustic energy to the target, how the presence of a prior craniotomy must be accounted for during lesioning is unclear., Objective: To demonstrate novel application of this therapeutic option in a patient with a history of prior craniotomies for unrelated intracranial pathologies., Methods: A 55-yr-old man with a history of right frontal craniotomy for resection of a colloid cyst underwent a left ventrointermedius nucleus thalamotomy through MRgFUS. The prior craniotomy flap was not excluded in the treatment plan; however, all bony defects and hardware were marked as "no-pass" regions. Clinical outcomes were collected at the 6-mo follow-up., Results: Transducer elements whose acoustic paths would have been altered by the craniotomy defect were turned off. Sonications reaching lesional temperatures of up to 56°C were successfully delivered. The procedure was well-tolerated, without any persistent intra-ablation or postablation adverse effects. The presence of a lesion was confirmed on MRI, which was associated with a significant reduction in the patient's tremor that was sustained at the 6-mo follow-up., Conclusion: This case demonstrates the safety and efficacy of MRgFUS thalamotomy in a patient with prior craniotomies and highlights our strategy for acoustic lesioning in this setting., (Copyright © Congress of Neurological Surgeons 2021. All rights reserved.)
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- 2022
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62. Gamma Knife radiosurgery for trigeminal neuralgia provides greater pain relief at higher dose rates.
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Yang AI, Mensah-Brown KG, Shekhtman EF, Kvint S, Wathen CA, Hitti FL, Alonso-Basanta M, Avery SM, Dorsey JF, and Y K Lee J
- Abstract
In Gamma Knife (GK) radiosurgery, dose rate decreases during the life cycle of its radiation source, extending treatment times. Prolonged treatments influence the amount of sublethal radiation injury that is repaired during exposure, and is associated with decreased biologically-equivalent dose (BED). We assessed the impact of treatment times on clinical outcomes following GK of the trigeminal nerve - a rare clinical model to isolate the effects of treatment times. This is a retrospective analysis of 192 patients with facial pain treated across three source exchanges. All patients were treated to 80 Gy with a single isocenter. Treatment time was analyzed in terms of patient anatomy-specific dose rate, as well as BED calculated from individual patient beam-on times. An outcome tool measuring pain in three distinct domains (pain intensity, interference with general and oro-facial activities of daily living), was administered before and after intervention. Multivariate linear regression was performed with dose rate/BED, brainstem dose, sex, age, diagnosis, and prior intervention as predictors. BED was an independent predictor of the degree of improvement in all three dimensions of pain severity. A decrease in dose rate by 1.5 Gy/min corresponded to 31.8% less improvement in the overall severity of pain. Post-radiosurgery incidence of facial numbness was increased for BEDs in the highest quartile. Treatment time is an independent predictor of pain outcomes, suggesting that prescription dose should be customized to ensure iso-effective treatments, while accounting for the possible increase in adverse effects at the highest BEDs., Competing Interests: Authors’ disclosure of potential conflicts of interest The authors have nothing to disclose., (© 2022 Old City Publishing, Inc.)
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- 2022
63. Theta Synchrony Is Increased near Neural Populations That Are Active When Initiating Instructed Movement.
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Ramayya AG, Yang AI, Buch VP, Burke JF, Richardson AG, Brandon C, Stein JM, Davis KA, Chen HI, Proekt A, Kelz MB, Litt B, Gold JI, and Lucas TH
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- Electroencephalography, Humans, Spatial Memory, Theta Rhythm, Brain, Movement
- Abstract
Theta oscillations (3-8 Hz) in the human brain have been linked to perception, cognitive control, and spatial memory, but their relation to the motor system is less clear. We tested the hypothesis that theta oscillations coordinate distributed behaviorally relevant neural representations during movement using intracranial electroencephalography (iEEG) recordings from nine patients ( n = 490 electrodes) as they performed a simple instructed movement task. Using high frequency activity (HFA; 70-200 Hz) as a marker of local spiking activity, we identified electrodes that were positioned near neural populations that showed increased activity during instruction and movement. We found that theta synchrony was widespread throughout the brain but was increased near regions that showed movement-related increases in neural activity. These results support the view that theta oscillations represent a general property of brain activity that may also play a specific role in coordinating widespread neural activity when initiating voluntary movement., (Copyright © 2021 Ramayya et al.)
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- 2021
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64. Long-term outcomes following deep brain stimulation for Parkinson's disease.
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Hitti FL, Ramayya AG, McShane BJ, Yang AI, Vaughan KA, and Baltuch GH
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Objective: Deep brain stimulation (DBS) is an effective treatment for several movement disorders, including Parkinson's disease (PD). While this treatment has been available for decades, studies on long-term patient outcomes have been limited. Here, the authors examined survival and long-term outcomes of PD patients treated with DBS., Methods: The authors conducted a retrospective analysis using medical records of their patients to identify the first 400 consecutive patients who underwent DBS implantation at their institution from 1999 to 2007. The medical record was used to obtain baseline demographics and neurological status. The authors performed survival analyses using Kaplan-Meier estimation and multivariate regression using Cox proportional hazards modeling. Telephone surveys were used to determine long-term outcomes., Results: Demographics for the cohort of patients with PD (n = 320) were as follows: mean age of 61 years, 70% male, 27% of patients had at least 1 medical comorbidity (coronary artery disease, congestive heart failure, diabetes mellitus, atrial fibrillation, or deep vein thrombosis). Kaplan-Meier survival analysis on a subset of patients with at least 10 years of follow-up (n = 200) revealed a survival probability of 51% (mean age at death 73 years). Using multivariate regression, the authors found that age at implantation (HR 1.02, p = 0.01) and male sex (HR 1.42, p = 0.02) were predictive of reduced survival. Number of medical comorbidities was not significantly associated with survival (p > 0.5). Telephone surveys were completed by 40 surviving patients (mean age 55.1 ± 6.4 years, 72.5% male, 95% subthalamic nucleus DBS, mean follow-up 13.0 ± 1.7 years). Tremor responded best to DBS (72.5% of patients improved), while other motor symptoms remained stable. Ability to conduct activities of daily living (ADLs) remained stable (dressing, 78% of patients; running errands, 52.5% of patients) or worsened (preparing meals, 50% of patients). Patient satisfaction, however, remained high (92.5% happy with DBS, 95% would recommend DBS, and 75% felt it provided symptom control)., Conclusions: DBS for PD is associated with a 10-year survival rate of 51%. Survey data suggest that while DBS does not halt disease progression in PD, it provides durable symptomatic relief and allows many individuals to maintain ADLs over long-term follow-up greater than 10 years. Furthermore, patient satisfaction with DBS remains high at long-term follow-up.
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- 2019
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