X-linked dystonia-parkinsonism (XDP) is a rare, adult-onset, progressive, hereditary neurological movement disorder primarily affecting Filipino men with maternal families from Panay province of the Philippines. Medical treatment modalities currently being used have offered temporary symptomatic relief. Surgical management in the form of bilateral globus pallidi internae (Gpi) deep brain stimulation (DBS) has shown promising results and is increasingly being performed in advanced centers, as reported in international literature. Presented herein is the local experience of seven (7) retrospectively reviewed cases from February 2018 to February 2019 in a tertiary center in the Philippines with a particular focus on anesthetic management. All patients were male, from Panay, and presented with progressive dystonia and parkinsonism. All patients underwent planned bilateral, simultaneous DBS electrode, and implantable pulse generator (IPG) placement performed by a multidisciplinary team. Anesthetic management consisted of Bispectral Index (BIS) guided conscious sedation with low dose propofol and remifentanil infusions with a complete scalp nerve block (SB) at the start of the procedure then shifted to awake monitored anesthesia care during electrode placement, microelectrode recording (MER) and macro stimulation testing. All were put under general anesthesia with a supraglottic airway device during the placement of the internal pulse generator (IPG) in the infraclavicular area. All seven patients had successful localization, and insertion of the DBS electrode and discharged improved. The anesthetic management of the DBS used in these cases warrants further investigation and may lead to standardization of future practice.
Deep Brain Stimulation

No abstract available.
Deep Brain Stimulation ; Dystonia ; Humans

Recently, deep brain stimulation(DBS) has been applied in many patients to treat movement disorder. Though this new methodology is in the stage of settlement, many aspects on DBS has not been well known yet. I reviewed related articles and my experience to summarize facts on DBS.
Brain ; Deep Brain Stimulation* ; Humans ; Movement Disorders*

The stereotactic surgical target for dystonic tremor is the subject of ongoing debate. Targeting the subthalamic area using deep brain stimulation has been regaining interest as a therapy for various types of involuntary movements. We describe the efficacy of stimulation of the subthalamic area in a patient with intractable dystonic tremor. Excellent control without neurological complications was achieved. This case report demonstrates that the subthalamic area is a valuable target for the control of dystonic tremor.
Deep Brain Stimulation ; Dyskinesias ; Humans ; Tremor

The field of functional neurosurgery has expanded in last decade to include newer indications, new devices, and new methods. This advancement has challenged anesthesia providers to adapt to these new requirements. This review aims to discuss the nuances and practical issues that are faced while administering anesthesia for deep brain stimulation surgery.
Anesthesia* ; Deep Brain Stimulation* ; Humans ; Neurosurgery

No abstract available.
Deep Brain Stimulation ; Gait ; Humans ; Parkinson Disease

Closed-loop transcranial ultrasound stimulation technology is based on real-time feedback signals, and has the potential for precise regulation of neural activity. In this paper, firstly the local field potential (LFP) and electromyogram (EMG) signals of mice under different intensities of ultrasound stimulation were recorded, then the mathematical model of ultrasound intensity and mouse LFP peak/EMG mean was established offline based on the data, and the closed-loop control system of LFP peak and EMG mean based on PID neural network control algorithm was simulated and built to realize closed-loop control of LFP peak and EMG mean of mice. In addition, using the generalized minimum variance control algorithm, the closed-loop control of theta oscillation power was realized. There was no significant difference between the LFP peak, EMG mean and theta power under closed-loop ultrasound control and the given value, indicating a significant control effect on the LFP peak, EMG mean and theta power of mice. Transcranial ultrasound stimulation based on closed-loop control algorithms provides a direct tool for precise modulation of electrophysiological signals in mice.
Mice ; Animals ; Deep Brain Stimulation ; Algorithms ; Electromyography

Brain ; physiology ; Deep Brain Stimulation ; methods ; Epilepsy ; therapy ; Humans

Transcranial electric stimulation (TES) is a non-invasive, economical, and well-tolerated neuromodulation technique. However, traditional TES is a whole-brain stimulation with a small current, which cannot satisfy the need for effectively focused stimulation of deep brain areas in clinical treatment. With the deepening of the clinical application of TES, researchers have constantly investigated new methods for deeper, more intense, and more focused stimulation, especially multi-electrode stimulation represented by high-precision TES and temporal interference stimulation. This paper reviews the stimulation optimization schemes of TES in recent years and further analyzes the characteristics and limitations of existing stimulation methods, aiming to provide a reference for related clinical applications and guide the following research on TES. In addition, this paper proposes the viewpoint of the development direction of TES, especially the direction of optimizing TES for deep brain stimulation, aiming to provide new ideas for subsequent research and application.
Transcranial Direct Current Stimulation/methods* ; Deep Brain Stimulation ; Brain/physiology* ; Head ; Electric Stimulation/methods*

OBJECTIVETo investigate the antiepileptic effects of various stimulation modes of low-frequency stimulation(LFS) on the kindling rats.

METHODSStimulating electrodes were implanted in the amygdala and current with constant intensity was applied to evoke kindling-induced seizures. The antiepileptic effect of LFS by open loop stimulation(before kindling), closed loop stimulation(immediately after kindling) and different forms of closed loop stimulation(whole stage after kindling and early stage after kindling) were investigated in amygdala kindled rats.

RESULTSThe closed loop LFS of whole stage after kindling can significantly inhibited seizure stages(P<0.01) and reduced afterdischarge duration(P<0.05). The closed loop LFS of early stage after kindling can significantly suppress the seizure stages, mainly in stages 0-3(P<0.05 or P<0.01). The open loop low-frequency stimulation did not inhibit the seizure stage during kindling acquisition(P>0.05).

CONCLUSIONThe antiepileptic effect of low frequency stimulation may have a mode-dependent effect. It may be helpful for the deep brain stimulation as a promising approach applied to clinical antiepileptic therapy in the future.