• Title/Summary/Keyword: STN

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Deep Brain Stimulation of the Subthalamic and Pedunculopontine Nucleus in a Patient with Parkinson's Disease

  • Liu, Huan-Guang;Zhang, Kai;Yang, An-Chao;Zhang, Jian-Guo
    • Journal of Korean Neurosurgical Society
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    • v.57 no.4
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    • pp.303-306
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    • 2015
  • Deep brain stimulation (DBS) of the pedunculopontine nucleus (PPN) is a novel therapy developed to treat Parkinson's disease. We report a patient who underwent bilateral DBS of the PPN and subthalamic nucleus (STN). He suffered from freezing of gait (FOG), bradykinesia, rigidity and mild tremors. The patient underwent bilateral DBS of the PPN and STN. We compared the benefits of PPN-DBS and STN-DBS using motor and gait subscores. The PPN-DBS provided modest improvements in the gait disorder and freezing episodes, while the STN-DBS failed to improve the dominant problems. This special case suggests that PPN-DBS may have a unique role in ameliorating the locomotor symptoms and has the potential to provide improvement in FOG.

Neuronal Responses in the Globus Pallidus during Subthalamic Nucleus Electrical Stimulation in Normal and Parkinson's Disease Model Rats

  • Ryu, Sang Baek;Bae, Eun Kyung;Kim, Jinhyung;Hwang, Yong Sup;Im, Changkyun;Chang, Jin Woo;Shin, Hyung-Cheul;Kim, Kyung Hwan
    • The Korean Journal of Physiology and Pharmacology
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    • v.17 no.4
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    • pp.299-306
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    • 2013
  • Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been widely used as a treatment for the movement disturbances caused by Parkinson's disease (PD). Despite successful application of DBS, its mechanism of therapeutic effect is not clearly understood. Because PD results from the degeneration of dopamine neurons that affect the basal ganglia (BG) network, investigation of neuronal responses of BG neurons during STN DBS can provide informative insights for the understanding of the mechanism of therapeutic effect. However, it is difficult to observe neuronal activity during DBS because of large stimulation artifacts. Here, we report the observation of neuronal activities of the globus pallidus (GP) in normal and PD model rats during electrical stimulation of the STN. A custom artifact removal technique was devised to enable monitoring of neural activity during stimulation. We investigated how GP neurons responded to STN stimulation at various stimulation frequencies (10, 50, 90 and 130 Hz). It was observed that activities of GP neurons were modulated by stimulation frequency of the STN and significantly inhibited by high frequency stimulation above 50 Hz. These findings suggest that GP neuronal activity is effectively modulated by STN stimulation and strongly dependent on the frequency of stimulation.

The Origin and Characteristics of Sedimentary Organic Matter on Sindu-ri Tidal Flat, Korea (신두리 갯벌 퇴적 유기물의 기원과 특성)

  • Shin, Woo Seok
    • Journal of Wetlands Research
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    • v.22 no.2
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    • pp.59-65
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    • 2020
  • The purpose of this study is to determine the origin of organic matter on sediment at Sindu-ri tidal flat. Grain size, organic matter, C/N ratio and the 13C and δ15N ratio were measured at three stations (Stn. A, B, C) of the tidal flat. As a result, the spatial variation in sediment properties showed that organic matter was related positively to the sediment mud content. Organic matters originating from marine particulate organic matter (marine POM) and fish farm particulate organic matter (fish farm POM) showed sedimentation of organic matters at Stn. A, sandy tidal flat, though terrestial plant (TP) and benthic microalgae (BMA) did at Stn.C, muddy tidal flat. Meanwhile, Stn. B, the intermediate property of Stn. A and C, was affected by marine POM and BMA. Furthermore, it was revealed that the amount and origin of organic matters in the sediments depended on spatial variation, and the factors were different from the stations. Particularly, at the Stn. C, the sediment showed high concentration of TOC in terrestrial organic matter and smaller size particles (< 63 ㎛). These facts suggest the many small size particles and organic matter will affect the sediment environmental condition in the Stn. C.

Speech Evaluation Tasks Related to Subthalamic Nucleus Deep Brain Stimulation in Idiopathic Parkinson's Disease: A Review (특발성 파킨슨병의 시상밑부핵 심부뇌자극술 관련 말 평가 과제에 대한 문헌연구)

  • Kim, Sun Woo;Kim, Hyang Hee
    • 재활복지
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    • v.18 no.4
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    • pp.237-255
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    • 2014
  • Idiopathic Parkinson disease(IPD) is an neurodegenerative disease caused by the loss of dopamine cells in the substantia nigra, a region of midbrain. Its major symptoms are muscular rigidity, bradykinesia, resting tremor, and postural instability. An estimated 70~90% of patients with IPD also have hypokinetic dysarthria. Subthalamic nucleus deep brain stimulation (STN-DBS) has been reported to be successful in relieving the core motor symptoms of IPD in the advanced stages of the disease. However, data on the effects of STN-DBS on speech performance are inconsistent. A medline literature search was done to retrieve articles published from 1987 to 2012. The results were narrowed down to focus on speech performance under STN-DBS based perceptual, acoustic, and/or aerodynamic analyses. Among the 32 publications which dealt with speech performance after STN-DBS indicated improvement(42%), deterioration(29%), mixed results(26%), or no change(3%). The most favorite method was found to be based upon acoustic analysis by using a vowel prolongation and Unified Parkinson's Disease Rating Scale(UPDRS). For the purpose of verifying the effect of the STN-DBS, speech evaluation should be undertaken on all speech components such as articulation, resonance, phonation, respiration, and prosody by using a contextual speech task.

STN DBS of Advanced Parkinson's Disease Experienced in a Specialized Monitoring Unit with a Prospective Protocol

  • Lee, Ji-Yeoun;Han, Jung-Ho;Kim, Han-Joon;Jeon, Beom-Seok;Kim, Dong-Gyu;Paek, Sun-Ha
    • Journal of Korean Neurosurgical Society
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    • v.44 no.1
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    • pp.26-35
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    • 2008
  • Objective : In the evaluation of patients with Parkinson's disease (PD), most neurologists only see their patients during a limited period of their fluctuating 24-hour-a-day lives. This study aimed to assess the short-term outcome of STN stimulation for patients with advanced PD evaluated in a 24-hour monitoring unit for movement disorder (MUMD) using a prospective protocol. Methods : Forty-two patients with advanced PD consecutively treated with bilateral STN stimulation using multi-channel microelectrode recording were included in this study. All patients were evaluated using a 24-hour MUMD with a video recording/editing system and were evaluated with a prospective protocol of the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr Staging, Schwab and England Activities of Daily Living, levodopa equivalent daily dose (LEDD), Short Form-36 Health Survey, and neuropsychological tests. Magnetic resonance (MR) images of the brain were performed prior to and six months after surgery. Results : All patients were evaluated at three and six months after surgery. There was a rapid and significant improvement of the motor symptoms, especially in tremor and rigidity, after STN stimulation with low morbidity. Dyskinesia was markedly decreased with much lowered LEDD values by 50% after STN stimulation. 1.5T MR images were safely taken according to the manufacturer's guidelines at six months after surgery without any adverse effects in 41 patients treated with STN stimulations. Conclusion : Evaluations in a 24-hour monitoring unit could reduce the dose of medication efficiently to an optimal level with patients' comfort and improve the clinical symptoms in harmony with STN stimulation.

Striatal Glutamate and GABA after High Frequency Subthalamic Stimulation in Parkinsonian Rat

  • Lee, Kyung Jin;Shim, Insop;Sung, Jae Hoon;Hong, Jae Taek;Kim, Il sup;Cho, Chul Bum
    • Journal of Korean Neurosurgical Society
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    • v.60 no.2
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    • pp.138-145
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    • 2017
  • Objective : High frequency stimulation (HFS) of the subthalamic nucleus (STN) is recognized as an effective treatment of advanced Parkinson's disease. However, the neurochemical basis of its effects remains unknown. The aim of this study is to investigate the effects of STN HFS in intact and 6-hydroxydopamine (6-OHDA)-lesioned hemiparkinsonian rat model on changes of principal neurotransmitters, glutamate, and gamma-aminobutyric acid (GABA) in the striatum. Methods : The authors examined extracellular glutamate and GABA change in the striatum on sham group, 6-OHDA group, and 6-OHDA plus deep brain stimulation (DBS) group using microdialysis methods. Results : High-pressure liquid chromatography was used to quantify glutamate and GABA. The results show that HFS-STN induces a significant increase of extracellular glutamate and GABA in the striatum of 6-OHDA plus DBS group compared with sham and 6-OHDA group. Conclusion : Therefore, the clinical results of STN-HFS are not restricted to the direct STN targets but involve widespread adaptive changes within the basal ganglia.

Factors Related to Outcomes of Subthalamic Deep Brain Stimulation in Parkinson's Disease

  • Kim, Hae Yu;Chang, Won Seok;Kang, Dong Wan;Sohn, Young Ho;Lee, Myung Sik;Chang, Jin Woo
    • Journal of Korean Neurosurgical Society
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    • v.54 no.2
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    • pp.118-124
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    • 2013
  • Objective : Subthalamic nucleus (STN) deep brain stimulation (DBS) is an effective treatment of choice for patients with advanced idiopathic Parkinson's disease (PD) who have motor complication with medication. The objectives of this study are to analyze long-term follow-up data of STN DBS cases and to identify the factors related to outcomes. Methods : Fifty-two PD patients who underwent STN DBS were followed-up for more than 3 years. The Unified Parkinson's Disease Rating Scale (UPDRS) and other clinical profiles were assessed preoperatively and during follow-up. A linear regression model was used to analyze whether factors predict the results of STN DBS. We divided the study individuals into subgroups according to several factors and compared subgroups. Results : Preoperative activity of daily living (ADL) and the magnitude of preoperative levodopa response were shown to predict the improvement in UPDRS part II without medication, and preoperative ADL and levodopa equivalent dose (LED) were shown to predict the improvement in UPDRS part II with medication. In UPDRS part III with medication, the magnitude of preoperative levodopa response was a predicting factor. Conclusion : The intensity of preoperative levodopa response was a strong factor for motor outcome. And preoperative ADL and LED were strong factors for ADL improvement. More vigorous studies should be conducted to elucidate how levodopa-induced motor complications are ameliorated after STN DBS.

Design of a reflective multi-color STN-LCD on the poincare sphere (뽀앙까레 구면을 이용한 반사형 칼라 STN 액정 표시소자의 설계)

  • 강기형;문정민;윤태훈;김재창;이기동;이응상
    • Journal of the Korean Institute of Telematics and Electronics D
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    • v.34D no.7
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    • pp.62-70
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    • 1997
  • In this paper, the optical conditins of a reflective multi-color STN-LCD based on electrical control of birefringence is designed on the poincare sphere. First of all, the angles of polarizer and analyzer for the best color purity are decided in the configuration without a retardation film. A retardation film is introduced for a bright white in the range of the applied voltage. The sretardation and the angle of the retardation film are also decided on the poincare shpere. The test cell is farbricated and its measured spectral transmittance and the CIE chromaticity diagram agree well with simulations.

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