• Improving the targeted treatment of move

    From ScienceDaily@1:317/3 to All on Friday, April 01, 2022 22:30:36
    Improving the targeted treatment of movement disorders
    Optimizing deep brain stimulation in patients with dystonia

    Date:
    April 1, 2022
    Source:
    Charite' - Universita"tsmedizin Berlin
    Summary:
    Recent discoveries may prove vital in improving the treatment of
    dystonia, a neurological movement disorder. Their findings show
    that very specific networks in the brain must be stimulated in
    order to relieve the symptoms seen in different types of dystonia.



    FULL STORY ========================================================================== Recent discoveries made by researchers from Charite' -
    Universita"tsmedizin Berlin may prove vital in improving the treatment
    of dystonia, a neurological movement disorder. Published in PNAS, their findings show that very specific networks in the brain must be stimulated
    in order to relieve the symptoms seen in different types of dystonia.


    ========================================================================== Dystonia is a rare neurological disorder, which is characterized by involuntary, twisting and distorting movements and postures. People with dystonia may be limited in their ability to perform activities of daily
    living, such as drinking, walking and speaking. In Germany, approximately 160,000 people have dystonia. The condition is subdivided into generalized dystonia, which affects the entire body, and focal dystonia, which is
    limited to specific parts of the body. The latter category includes
    cervical dystonia, which affects the neck. The condition's underlying
    causes are not fully understood, but experts assume that symptoms are
    the result of faulty interactions between specific areas of the brain
    which lead to abnormal signal transmission.

    Depending on the form of dystonia involved, genetic defects may also
    play a role.

    One treatment option available to patients with dystonia is a
    neurosurgical procedure involving the implantation of electrodes into
    specific areas of the brain. Once implanted, the electrodes emit weak electrical signals which help to restore normal brain function. Known
    as deep brain stimulation, the procedure involves the implantation
    of a pacemaker-like device and is often the only treatment capable of
    providing relief of symptoms.

    "The precision with which this stimulation has to be adapted to the
    symptoms seen in different types of dystonia was not clear until
    now," explains study lead Prof. Dr. Andrea Ku"hn, who is Head of
    the Department of Neurology and Experimental Neurology's Movement
    Disorders and Neuromodulation Section and Spokesperson of the `ReTune' Transregional Collaborative Research Center (SFB/ Transregio TRR 295),
    which helped to support the current study.

    Prof. Ku"hn's team examined a total of 80 patients who had received
    treatment for either generalized or cervical dystonia at one of
    five different hospitals in Germany and Austria. After analyzing the electrodes' precise positions, the researchers were able to generate
    computer models showing which brain networks were being activated in each
    of the patients investigated. By mapping data on symptom improvements
    to their network models, the researchers were then able to determine
    which of the identified networks were crucial to treatment success.

    One key finding was that the optimal target for stimulation depends on
    the type of dystonia being treated. This means that optimal treatment
    outcomes were associated with specific connections between the thalamus
    (the largest structure in the diencephalon, or `interbrain') and the
    pallidum (a pale- colored structure at the core of the basal ganglia). The basal ganglia are deep-seated brain structures which play a part in
    movement control. In patients with cervical dystonia, the determining
    factor was electrical stimulation of a specific neural network which
    also activated the head and neck region of the primary motor cortex. As
    the brain's motor command center, this area is responsible for planning
    and initiating movements as well as storing movement memory. In contrast,
    for patients with generalized dystonia, beneficial effects were elicited through the stimulation of a different network which projected to the
    entire primary motor cortex.

    "Our study shows clear differences in optimal stimulation sites, which correspond to the somatotopic structure of the inner pallidum. This
    means that neural areas in the brain map to the areas of the body they represent," says the study's first author, Dr. Andreas Horn of the
    Department of Neurology and Experimental Neurology. He adds: "Due to the paucity of alternative treatment options beyond deep brain stimulation,
    our findings make an important contribution to improving treatment for dystonia. In the future, we will be able to more deliberately treat
    specific types of the disorder."

    ========================================================================== Story Source: Materials provided by
    Charite'_-_Universita"tsmedizin_Berlin. Note: Content may be edited for
    style and length.


    ========================================================================== Journal Reference:
    1. Andreas Horn, Martin M. Reich, Siobhan Ewert, Ningfei Li, Bassam Al-
    Fatly, Florian Lange, Jonas Roothans, Simon Oxenford, Isabel
    Horn, Steffen Paschen, Joachim Runge, Fritz Wodarg, Karsten Witt,
    Robert C.

    Nickl, Matthias Wittstock, Gerd-Helge Schneider, Philipp Mahlknecht,
    Werner Poewe, Wilhelm Eisner, Ann-Kristin Helmers, Cordula Matthies,
    Joachim K. Krauss, Gu"nther Deuschl, Jens Volkmann, Andrea A. Ku"hn.

    Optimal deep brain stimulation sites and networks for cervical vs.

    generalized dystonia. Proceedings of the National Academy of
    Sciences, 2022; 119 (14) DOI: 10.1073/pnas.2114985119 ==========================================================================

    Link to news story: https://www.sciencedaily.com/releases/2022/04/220401094840.htm

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