• Title/Summary/Keyword: Essential Tremor

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Magnetic Resonance-Guided Focused Ultrasound : Current Status and Future Perspectives in Thermal Ablation and Blood-Brain Barrier Opening

  • Lee, Eun Jung;Fomenko, Anton;Lozano, Andres M.
    • Journal of Korean Neurosurgical Society
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    • v.62 no.1
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    • pp.10-26
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    • 2019
  • Magnetic resonance-guided focused ultrasound (MRgFUS) is an emerging new technology with considerable potential to treat various neurological diseases. With refinement of ultrasound transducer technology and integration with magnetic resonance imaging guidance, transcranial sonication of precise cerebral targets has become a therapeutic option. Intensity is a key determinant of ultrasound effects. High-intensity focused ultrasound can produce targeted lesions via thermal ablation of tissue. MRgFUS-mediated stereotactic ablation is non-invasive, incision-free, and confers immediate therapeutic effects. Since the US Food and Drug Administration approval of MRgFUS in 2016 for unilateral thalamotomy in medication-refractory essential tremor, studies on novel indications such as Parkinson's disease, psychiatric disease, and brain tumors are underway. MRgFUS is also used in the context of blood-brain barrier (BBB) opening at low intensities, in combination with intravenously-administered microbubbles. Preclinical studies show that MRgFUS-mediated BBB opening safely enhances the delivery of targeted chemotherapeutic agents to the brain and improves tumor control as well as survival. In addition, BBB opening has been shown to activate the innate immune system in animal models of Alzheimer's disease. Amyloid plaque clearance and promotion of neurogenesis in these studies suggest that MRgFUS-mediated BBB opening may be a new paradigm for neurodegenerative disease treatment in the future. Here, we review the current status of preclinical and clinical trials of MRgFUS-mediated thermal ablation and BBB opening, described their mechanisms of action, and discuss future prospects.

Characteristics of somatosensory thalamic neurons : Study on motor disease patients

  • Lee, Bae-Hwan;Lee, Kyung-Hee;Park, Yong-Gou;Chung, Sang-Sup;Chang, Jin-Woo
    • Proceedings of the Korean Society for Emotion and Sensibility Conference
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    • 2002.11a
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    • pp.140-147
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    • 2002
  • 시상은 체감각 정보를 처리하는데 있어서 매우 중요한 역할을 하는 부위이다. 본 연구는 운동장애 환자의 시상에서 뉴론의 활동 특성을 알아보기 위해 수행되었다. 그 결과 체감각으로서의 운동자극에 반응하는 뉴론이 essential tremor (ET) 환자의 nucleus ventralis intermedius (VIM)에서 발견되었다. ET 환자 뉴론의 평균 활동율(firing rate)은 Parkinson's disease (PD) 환자 보다 높았다. 또한 ET 환자의 VIM에서 운동자극에 반응하는 뉴론의 평균 활동율은 PD 환자 보다 높았다. 하지만 촉각자극(touch)에 반응하는 nucleus ventralis caudalis (VC) 뉴론의 활동율은 ET와 PD 집단간에 차가 없었다. Bursting activity를 나타내는 뉴론은 nucleus ventralis oralis anterior (VOP)에서 ET집단이 PD 집단보다 적었다. tremor cell은 VIM에서 PD 보다 ET집단이 더 적었다. 이러한 결과는 체감각 자극에 반응하는 시상 뉴론의 특성이 운동장애의 유형에 따라 서로 다르다는 것을 시사한다.

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Other Functional and Neurological Dysphonia (기타 기능성 발성장애 및 신경성 발성장애)

  • Lee, Seung Won
    • Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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    • v.25 no.2
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    • pp.82-85
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    • 2014
  • Functional dysphonia is a specific voice disorder refers to dysphonia without abnormal anatomical vocal fold findings at larynx. The proportions of this disorder are estimated up to 40% of dysphonia patients at ENT clinics. In this article, we will discuss about other functional dysphonia and neurological dysphonia except for muslce tension dysphonia and spasmodic dysphonia. For details, will describe about phonatory charateristics and treatment options about paradoxical vocal fold motion disorder, mutational dysphonia, essential vocal tremor, conversion dysphonia, and vocal tremor related with parkinson's disease.

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A Study on Dynamic Response Analysis of High Structure under Earthquake Load (지진하중을 받는 고층건물의 동적응답 해석에 관한 연구)

  • 배동명;신창혁
    • Journal of the Korean Society of Fisheries and Ocean Technology
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    • v.36 no.4
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    • pp.337-346
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    • 2000
  • Earthquake is a natural disaster accompanied by damage of human and properties caused by the ground motion, crustal movements, faults as well as tidal wave. The earthquake is known to occur mostly in earthquake-prone areas and the Korean Peninsula is known to be relatively safe in terms of geological characteristics. In order to withstand on severe environmental dynamic random load such as an earthquake, the large structure need to be designed to withstand the anticipated seismic tremor. The seismetic design is essential for building structures, bridges, and large structures which is handles explosive gases. Thus, the necessity of earthquake resistant analysis for large structure is growing and the capability of dynamic analysis should be obtained. In this thesis, dynamic responses of a high building(height 60m, width 18) which subjected to random earthquake load are presented which responses are derived using dynamic analysis methods such as response spectrum analysis, mode superposition and direct integration. Each results are also compared to review the merit of each methods.

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Clinical Usefulness of Dopamine Transporter Imaging (도파민운반체 영상의 임상적 유용성)

  • Kim, Jong-Min;Kim, Yu-Kyeong;Kim, Sang-Eun;Jeon, Beom-S.
    • Nuclear Medicine and Molecular Imaging
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    • v.41 no.2
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    • pp.152-157
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    • 2007
  • Imaging of the dopamine transporter (DAT) provides a marker for the integrity of presynaptic nigrostriatal dopaminergic system. DAT density is reduced in Parkinson disease, multiple system atrophy, and progressive supranuclear palsy. In patients with suspicious parkinsonism, normal DAT imaging suggests an alternative diagnosis such as essential tremor, vascular parkinsonism, or drug-induced parkinsonism. DAT imaging is a useful tool to aid clinician's differential diagnosis in parkinsonism.

Differentiation of Parkinson's Disease and Essential Tremor on I-123 IPT(I-123-N-(3-iodopropen-2-yl)-$2{\beta}$-carbomethoxy- $3{\beta}$-(4-cholorophenyl) tropane) Brain SPECT (파킨슨병과 본태성 진전의 감별진단에서 I-123 IPT(I-123-N-(3-iodopropen-2-yl)-$2{\beta}$-carbomethoxy-$3{\beta}$-(4-cholorophenyl) tropane) 뇌 단일광전자방출 전산화단층촬영의 역할)

  • Pai, Moon-Sun;Choi, Tae-Hyun;Ahn, Sung-Min;Choi, Jai-Yong;Ryu, Won-Gee;Lee, Jae-Hoon;Ryu, Young-Hoon
    • Nuclear Medicine and Molecular Imaging
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    • v.43 no.2
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    • pp.100-106
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    • 2009
  • Purpose: The study was to assess I-123-N-(3-iodopropen-2-yl)-2[beta]-carbomethoxy-3[beta]-(4-cholorophenyl) tropane(IPT) SPECT in differential diagnosis among early stage of Parkinson's disease(PD) and essential tremor(ET) and normal control(NL) groups quantitatively. Materials and Methods: I-123 IPT brain SPECT of 50 NL, 20 early PD, 30 advanced PD, and 20 ET were performed at 20 minutes and 2 hours. Specific/nonspecific binding of striatum was calculated by using right and left striatal specific to occipital non-specific uptake ratio(striatum-OCC/OCC). Results: Mean value of specific/nonspecific binding ratio was significantly different between advanced PD group and NL group. However, significant overlap of striatal specific/nonspecific binding ratio was observed between PD group and ET group. Bilateral striatal specific/nonspecific binding ratios were decreased in advanced PD. Lateralized differences in the striatal uptake of I-123 IPT correlated with asymmetry in clinical findings in PD group. Conclusion: I-123 IPT SPECT may be a useful method for the diagnosis of PD and objective evaluation of progress of clinical stages. Care should be made in the differential diagnosis of early stage of PD and other motor disturbances mimicking PD such as ET in view of significant overlap in striatal I-123 specific/nonspecific binding ratio.

A Study for Estimation of Scalp Condition by Impedance (임피던스 법을 이용한 두피 상태 추정에 관한 연구)

  • Sim, M.H.;Choi, H.Y.;Jeong, I.C.;Kim, K.W.;Yoon, H.R.
    • Proceedings of the KIEE Conference
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    • 2007.10a
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    • pp.471-472
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    • 2007
  • The scalp is skin tissue for skull-protection and roots for hair growth. Therefore continuous monitoring of scalp condition is essential for hair management. However, the equipments for existent are inconvenient to use because of focus tremor and external factors(Hair Gel, Wax, accessories and so on). Furthermore there is a problem to use an expensive optical devices like CCD (Charge Coupled Device) camera or lens of 200 - 1000 magnification. It causes a difficulty of using those equipment. We design the special electrode(length 5.65mm, diameter 0.8mm of needle shape) and the impedance system(1kHz, 78uA). Tn this paper, we can measure scalp impedance with our system. Moreover, we find the possibility of classifying scalp condition with measured impedance values. For the classification of scalp condition, we used ARAMO-TS as an imaging system. In conclusion, the problem of existent devices could be improved using these method. It also has a benefit of continuous monitoring of scalp condition.

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Human HS1BP3 induces cell apoptosis and activates AP-1

  • Shi, Taiping;Xie, Jieshi;Xiong, Ying;Deng, Weiwei;Guo, Jinhai;Wang, Feng;Ma, Dalong
    • BMB Reports
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    • v.44 no.6
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    • pp.381-386
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    • 2011
  • In the present study, we characterized the function of HS1-binding protein 3 (HS1BP3), which is mutated in essential tremor and may be involved in lymphocyte activation. We found that HS1BP3 localized to the mitochondria and endoplasmic reticulum partially. Overexpression of HS1BP3 induced apoptosis in HEK293T and HeLa cell lines. When these cell lines were transfected with HS1BP3, they exhibited nuclear DNA condensation, externalization of phosphatidylserine (PS), and cleavage of poly ADP ribose polymerase (PARP). Furthermore, suppression of HS1BP3 or HS1 expression attenuates HS1BP3 induced apoptosis. In addition, HS1BP3 enhanced activator protein 1 (AP-1)-mediated transcription in a dose-dependent manner. Therefore, we conclude that HS1BP3 regulates apoptosis via HS1 and stimulates AP-1-mediated transcription.

Magnetic Resonance-Guided Focused Ultrasound in Neurosurgery: Taking Lessons from the Past to Inform the Future

  • Jung, Na Young;Chang, Jin Woo
    • Journal of Korean Medical Science
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    • v.33 no.44
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    • pp.279.1-279.16
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    • 2018
  • Magnetic resonance-guided focused ultrasound (MRgFUS) is a new emerging neurosurgical procedure applied in a wide range of clinical fields. It can generate high-intensity energy at the focal zone in deep body areas without requiring incision of soft tissues. Although the effectiveness of the focused ultrasound technique had not been recognized because of the skull being a main barrier in the transmission of acoustic energy, the development of hemispheric distribution of ultrasound transducer phased arrays has solved this issue and enabled the performance of true transcranial procedures. Advanced imaging technologies such as magnetic resonance thermometry could enhance the safety of MRgFUS. The current clinical applications of MRgFUS in neurosurgery involve stereotactic ablative treatments for patients with essential tremor, Parkinson's disease, obsessive-compulsive disorder, major depressive disorder, or neuropathic pain. Other potential treatment candidates being examined in ongoing clinical trials include brain tumors, Alzheimer's disease, and epilepsy, based on MRgFUS abilities of thermal ablation and opening the blood-brain barrier. With the development of ultrasound technology to overcome the limitations, MRgFUS is gradually expanding the therapeutic field for intractable neurological disorders and serving as a trail for a promising future in noninvasive and safe neurosurgical care.