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Deep Brain Stimulation for Parkinson’s Disease and Other Movement Disorders: The Long Road toward Personalized Medicine

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Clinical Neurology".

Deadline for manuscript submissions: closed (25 November 2024) | Viewed by 1040

Special Issue Editors


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Guest Editor
Department of Neuroscience Rita Levi Montalcini, University of Turin, 10124 Turin, Italy
Interests: Parkinson’s disease; dystonia; tremor; movement disorders; deep brain stimulation; neuromodulation

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Guest Editor
Department of Human Neurosciences, Sapienza University of Rome, 00185 Rome, Italy
Interests: non-invasive brain stimulation; neurophysiology; movement disorders; dementia; transcranial magnetic stimulation; transcranial electrical stimulation; electroencephalography
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Special Issue Information

Dear Colleagues,

Deep Brain Stimulation (DBS) is a valid therapy for Parkinson's disease (PD), dystonia, and invalidating tremor, and is also an emerging treatment for other movement disorders. However, several challenges still remain in order to maximize the benefit from DBS, including but not limited to the optimal selection of candidates, the most appropriate anatomical target, the knowledge of network modulation, the use of novel devices, and the potentiality of advanced or novel parameter settings, as well as the role of phenotype, genetics, and other clinical aspects, including motor and nonmotor symptoms, in determining DBS outcome.

This Special Issue aims to collect different types of articles exploring the efficacy and safety of DBS in uncommon movement disorders, offering deeper knowledge on the underlying mechanisms of DBS, including the modulation of neural networks and neuroplasticity, and addressing the challenges associated with achieving personalized medicine in DBS for movement disorders by investigating various factors that contribute to inter-individual variability in treatment outcomes, such as patient-specific anatomy, electrode placement, stimulation parameters, and disease progression. This Special Issue also welcomes studies on the role of advanced technologies, such as neuroimaging and electrophysiology, in optimizing DBS therapy, as well as high-quality reviews of the existing literature on DBS for PD and other movement disorders aimed at clarifying the efficacy and safety of DBS, its impact on motor and nonmotor symptoms, and its potential for improving the quality of life of patients. The ultimate goal of this Special Issue is to advance our understanding of DBS as a personalized treatment approach for Parkinson's disease, dystonia, tremor, and other movement disorders. By identifying key factors that influence treatment outcomes, we aspire to pave the way for tailored therapies that can maximize the benefits of DBS while minimizing its adverse effects.

Dr. Carlo Alberto Artusi
Dr. Andrea Guerra
Guest Editors

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Keywords

  • Deep Brain Stimulation
  • movement disorders
  • personalized medicine
  • Parkinson’s disease
  • dystonia
  • tremor

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Published Papers (1 paper)

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Research

12 pages, 1674 KiB  
Article
Managing Lead Fractures in Deep Brain Stimulation for Movement Disorders: A Decade-Long Case Series from a National Neurosurgical Centre
by Chingiz Nurimanov, Iroda Mammadinova, Karashash Menlibayeva, Seitzhan Aidarov, Nurtay Nurakay, Assylbek Kaliyev, Yerbol Makhambetov and Serik K. Akshulakov
J. Clin. Med. 2024, 13(24), 7509; https://doi.org/10.3390/jcm13247509 - 10 Dec 2024
Viewed by 585
Abstract
Background: Deep brain stimulation (DBS) is an effective treatment for movement disorders, but its long-term efficacy may be undermined by hardware complications such as lead fractures. These complications increase healthcare costs and necessitate surgical revisions. The frequency, timing, and clinical factors associated [...] Read more.
Background: Deep brain stimulation (DBS) is an effective treatment for movement disorders, but its long-term efficacy may be undermined by hardware complications such as lead fractures. These complications increase healthcare costs and necessitate surgical revisions. The frequency, timing, and clinical factors associated with lead fractures remain poorly understood. Objective: This study aimed to determine the incidence, timing, and clinical factors associated with lead fractures in a large cohort of DBS patients over a 10-year period. Methods: This retrospective study analyzed data from 325 patients who underwent bilateral DBS implantation at the National Centre for Neurosurgery from 2013 to 2023. The analysis specifically focused on 17 patients who experienced lead fractures during the long-term follow-up period. Results: Among the 325 patients, lead fractures were identified in 17 patients (5.23%), affecting 18 electrodes. The majority of cases involved patients with Parkinson’s disease (76.5%) or dystonia (23.5%), with an average age of 59.17 ± 8.77 years. Nearly all patients with lead fractures had a history of trauma. Additionally, two cases were associated with active engagement in sports, particularly activities involving movements like pulling up on a horizontal bar, while Twiddler’s Syndrome was identified in two other cases. All electrode fractures required surgical revision. Conclusions: Lead fractures, while rare, remain a significant complication in DBS systems. Precise surgical techniques, early detection, and advancements in DBS hardware design may help to mitigate this risk. Future innovations, such as durable leads or wireless systems, may improve long-term outcomes in DBS therapy for movement disorders. Full article
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