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1. Proceedings of the Fourth Annual Deep Brain Stimulation Think Tank - A Review of Emerging Issues and Technologies

Author

Wissam Deeb, James J Giordano, Peter Justin Rossi, Alon Mogilner, Aysegul Gunduz, Jack William Judy, Bryan T. Klassen, Christopher R. Butson, Craig van Horne, Damiaan Denys, Darin D Dougherty, David Rowell, Greg A Gerhardt, Gwenn S. Smith, Harrison C. Walker, Helen M Bronte-Stewart, Helen S. Mayberg, Howard J. Chizeck, Jean-Philippe Langevin, Jens Volkmann, Jill Ostrem, Jonathan B Shute, Joohi Jimenez-Shahed, Kelly Douglas Foote, Marvin A Rossi, Michael Oh, Michael Pourfar, Paul B. Rosenburg, Peter Allen Silburn, Coralie De Hemptinne, Philip A. Starr, Timothy Denison, Umer Akbar, Warren M Grill, and Michael S. Okun

Subjects
Alzheimer Disease, Depression, Parkinson Disease, Tourette Syndrome, Neuromodulation, deep brain stimulation (DBS), Neurosciences. Biological psychiatry. Neuropsychiatry, RC321-571, Neurology. Diseases of the nervous system, RC346-429
Abstract

This paper provides an overview of current progress in the technological advances and the use of deep brain stimulation (DBS) to treat neurological and neuropsychiatric disorders, as presented by participants of the Fourth Annual Deep Brain Stimulation Think Tank, which was convened in March 2016 in conjunction with the Center for Movement Disorders and Neurorestoration at the University of Florida, Gainesveille FL, USA. The Think Tank discussions first focused on policy and advocacy in DBS research and clinical practice, formation of registries, and issues involving the use of DBS in the treatment of Tourette Syndrome. Next, advances in the use of neuroimaging and electrochemical markers to enhance DBS specificity were addressed. Updates on ongoing use and developments of DBS for the treatment of Parkinson’s disease, essential tremor, Alzheimer’s disease, depression, post-traumatic stress disorder, obesity, addiction were presented, and progress toward innovation(s) in closed-loop applications were discussed. Each section of these proceedings provides updates and highlights of new information as presented at this year’s international Think Tank, with a view toward current and near future advancement of the field.

Published
2016
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2. Deep Brain Stimulation for the Treatment of Tremor and Ataxia Associated with Abetalipoproteinemia

Author

Antonios Mammis, Michael Pourfar, Andrew Feigin, and Alon Y. Mogilner

Subjects
Diseases of the musculoskeletal system, RC925-935, Neurology. Diseases of the nervous system, RC346-429
Abstract

Background: Abetalipoproteinemia is a rare disorder of fat absorption, characterized by vitamin deficiency, acanthocytosis, and neurologic symptoms including ataxia and tremor.Case Report: A 41-year-old male with abetalipoproteinemia is presented. He underwent staged bilateral thalamic deep brain stimulation (DBS) for the treatment of his tremors. After DBS, the patient achieved significant improvements in his tremors, ataxia, and quality of life.Discussion: Thalamic DBS proved to be both safe and efficacious in the management of ataxia and tremors in a patient with abetalipoproteinemia. This is the first report of DBS in abetalipoproteinemia in the literature.

Published
2012
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4. Three-Year Follow-Up of a Prospective, Double Blinded Multi-Center RCT Evaluating DBS with a Multiple Source, Constant-Current Rechargeable System for Treatment of Parkinson's Disease (INTREPID)

Author

Philip A Starr, Alexander Tröster, Lauren Schrock, Paul A House, Monique Giroux, Adam O Hebb, Sierra Farris, Donald M Whiting, Timothy Lechliter, Jill L Ostrem, Marta S.L Palenzuela, Nicholas Galifianakis, Leo V Metman, Sepehr Sani, Jessica Karl, Mustafa Siddiqui, Stephen B Tatter, Ihtsham ul Haq, Andre Machado, Michal Gostkowski, Michele Tagliati, Adam N Mamelak, Michael S Okun, Kelly D Foote, Guillermo Moguel-Cobos, Francisco A Ponce, Rajesh Pahwa, Jules M Nazzaro, Cathrin Buetefisch, Robert E Gross, Corneliu Luca, Jonathan R Jagid, Gonzalo Revuelta, Istvan Takacs, Michael Pourfar, Alon Y Mogilner, Andy Duker, George T Mandybur, Joshua M Rosenow, Scott Cooper, Michael Park, Suketu Khandhar, Mark Sedrak, Julie G Pilitsis, Fenna Phibbs, Ryan J Uitti, Lilly Chen, Jain Roshini, and Jerrold L Vitek

Subjects
Surgery, Neurology (clinical)
Published
2020
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5. Assessing the microlesion effect of subthalamic deep brain stimulation surgery with FDG PET

Author

Michael, Pourfar, Chengke, Tang, Tanya, Lin, Vijay, Dhawan, Michael G, Kaplitt, and David, Eidelberg

Subjects
Male, Deep Brain Stimulation, Parkinson Disease, Middle Aged, Electrodes, Implanted, Fluorodeoxyglucose F18, Positron-Emission Tomography, Subthalamus, Humans, Female, Prospective Studies, Radiopharmaceuticals, Aged, Follow-Up Studies
Abstract

The authors investigated whether the insertion of deep brain stimulation electrodes into the subthalamic nucleus can alter regional brain metabolism in the absence of stimulation.Six patients with Parkinson disease (PD) underwent preoperative FDG PET scanning, and again after STN electrode implantation with stimulation turned off.Compared with baseline values, glucose utilization was reduced in the postoperative off-stimulation scans in the putamen/globus pallidus and in the ventral thalamus (p0.01), and there was increased metabolism in the sensorimotor cortex and cerebellum (p0.005). The expression of a specific PD-related spatial covariance pattern measured in the FDG PET data did not change after electrode implantation (p = 0.36), nor was there a significant change in clinical motor ratings (p = 0.44). Differences in PD-related spatial covariance pattern expression among the patients after electrode implantation did, however, correlate with the number of microelectrode recording trajectories placed during surgery (r = -0.82, p0.05).These findings suggest that electrode implantation can impart a microlesion effect on regional brain function. Nonetheless, these local changes did not cross the threshold of network modulation needed to achieve clinical benefit.

Published
2009

7. Contributors

Author

Neha P. Amin, Charles E. Argoff, Allen J. Askamit, Alon Y. Avidan, Laura J. Balcer, Tallie Z. Baram, Allan J. Belzberg, Sara E. Benjamin, Anish Bhardwaj, Kevin M. Biglan, Tom J. Blanchard, John B. Bodensteiner, Devin L. Brown, John C.M. Brust, Arthur L. Burnett, Anthony S. Burns, Peter Calabresi, Grant L. Campbell, Vinay Chaudhry, William P. Cheshire, Kenneth Cohen, Andrew J. Cole, Anne Comi, James J. Corbett, Andrea M. Corse, Nathan E. Crone, Ricardo Cruciani, Marinos C. Dalakas, Josep Dalmau, Stephanie K. Daniels, Larry E. Davis, David W. Dodick, Heinrich Elinzano, Robert D. Fealey, Anne L. Foundas, Jacqueline A. French, Linda P. Fried, Scott Fromherz, Bhuwan P. Garg, Donald L. Gilbert, Mark R. Gilbert, Donald H. Gilden, Frank G. Gilliam, Jonathan P. Gladstone, Jonathan D. Glass, David S. Goldstein, Joao A. Gomes, Benjamin M. Greenberg, Adam L. Hartman, Susan T. Herman, Argye E. Hillis, Michio Hirano, David Irani, Sallu Jabati, Alan C. Jackson, Jee-Hyang Jeong, H.A. Jinnah, S. Claiborne Johnston, Burk Jubelt, Douglas Kerr, Richard M. Kimball, Kleopas A. Kleopa, Carol Lee Koski, Eric H. Kossoff, Allan Krumholz, Roger W. Kula, Ralph W. Kuncl, John Laterra, Robert Laureno, Rafael H. Llinás, Elan D. Louis, Yukari Manabe, Nicholas J. Maragakis, Morri E. Markowitz, Christina M. Marra, Laura Marsh, James A. Mastrianni, Justin C. McArthur, Una D. McCann, Micheline McCarthy, Emmanuel Mignot, Bruce Miller, Steven P. Miller, Lewis B. Morgenstern, Richard T. Moxley, Beth Murinson, Neal J. Naff, Vinodh Narayanan, Avindra Nath, Elizabeth O'Hearn, Richard K. Olney, Andrew R. Pachner, Carlos A. Pardo-Villamizar, Roy A. Patchell, Michael Polydefkis, Beth S. Porter, Michael Pourfar, Tyler Reimschisel, George A. Ricaurte, Daniele Rigamonti, Stacie L. Ropka, Paul Rosenberg, Robert L. Ruff, David B. Rye, Steven S. Scherer, Jacob P. Schwarz, Erick Scott, James J. Sejvar, Michael E. Selzer, Jehuda Sepkuty, Barbara E. Shapiro, Rachelle Smith Doody, Yuen T. So, Tom Solomon, Elijah W. Stommel, Gene Sung, Tricia Ting, B. Todd Troost, Eileen P.G. Vining, Jerrold L. Vitek, Kathryn R. Wagner, Mark F. Walker, Laurence Walsh, Benjamin L. Walter, Michael R. Watters, Michael A. Williams, Max Wiznitzer, Wendy L. Wright, Kaleb Yohay, Phyllis C. Zee, Wendy C. Ziai, and Andrew W. Zimmerman

Published
2006
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8. A Randomized, Placebo-Controlled Trial of Latrepirdine in Huntington Disease

Author

Karl, Kieburtz, Michael P, McDermott, Tiffini S, Voss, Jody, Corey-Bloom, Lisa M, Deuel, E Ray, Dorsey, Stewart, Factor, Michael D, Geschwind, Karen, Hodgeman, Elise, Kayson, Sarah, Noonberg, Michael, Pourfar, Karen, Rabinowitz, Bernard, Ravina, Juan, Sanchez-Ramos, Lynn, Seely, Francis, Walker, Andrew, Feigin, and Jason, Roy

Subjects
Adult, Male, Indoles, Time Factors, Tetrabenazine, Placebo-controlled study, Motor Activity, Neuropsychological Tests, Pharmacology, Placebo, Article, Electrocardiography, Cognition, Double-Blind Method, Arts and Humanities (miscellaneous), Huntington's disease, medicine, Humans, Aged, Retrospective Studies, Latrepirdine, Chorea, Middle Aged, medicine.disease, Huntington Disease, Treatment Outcome, Tolerability, Female, Neurology (clinical), Alzheimer's disease, medicine.symptom, Mental Status Schedule, Psychology, Neuroscience, Antipsychotic Agents, medicine.drug
Abstract

Huntington disease (HD) is a hereditary neurodegenerative disorder that affects movement, behavior, and cognition and leads to death within 20 years of disease onset. Cognitive impairment occurs early in the disease and deteriorates as HD progresses, contributing to loss of ability to work and perform activities of daily living. No effective treatments are currently available to alter the course of the disease or to improve cognition because tetrabenazine, the only approved therapy for HD, treats only chorea and other motor symptoms. Abnormal mitochondrial depolarization, which can lead to collapse of the mitochondrial membrane and ultimately neuronal apoptosis, has been implicated in the pathophysiologic progression of HD and other neurodegenerative diseases.1,2 Latrepirdine is a synthetic molecule that stabilizes mitochondrial membranes3,4 and increases neurite outgrowth to an extent comparable to the maximally effective dose of brain-derived neurotrophic factor in cultured neurons.4 Improvement in mitochondrial function may prevent apoptosis and also improve the efficiency of dynamic cellular activities, such as firing of action potentials and the maintenance or formation of synapses. Latrepirdine, 20 mg 3 times daily, has been studied in a randomized, double-blind, placebo-controlled trial in patients with mild to moderate Alzheimer disease (AD) and demonstrated significant improvement compared with placebo in cognitive, behavioral, and functional scores at 6 and 12 months.5 An earlier open-label, dose-escalation study in patients with HD suggested dosages up to 20 mg 3 times daily would be tolerated in this population.6 We studied the safety and tolerability of latrepirdine, 20 mg 3 times daily, and explored its effects on symptoms in patients with mild to moderate HD.

Published
2010
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