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Deep brain stimulation improved the therapy success for movement disorders
According to a recent study, certain patterns of brain activity are related to the severity of the movement disorder dystonia. Therapy using deep brain stimulation (THS) can lead to improved treatment success, the researchers at Charité - Universitätsmedizin Berlin report.
The brain activity patterns indicate the severity of the movement disorder and the therapeutic effect of deep brain stimulation, according to the Charité. For the first time, the scientists have succeeded in proving that a certain pattern of brain activity is related to the severity of the disease and the success of the brain stimulation treatment. The new findings could help “to adapt the therapy procedure even more to meet needs and thus decisively improve the quality of life of the patients,” the researchers hope. They published their study results in the specialist magazine "Annals of Neurology".
Dystonia is one of the most common movement disorders
According to the experts, more than 500,000 people across Europe suffer from dystonia. In the disease, the balance between excitatory and inhibitory nerve connections is disturbed, which ensures “orderly” movements, the researchers explain. The result is involuntary movements, twitches and spasms of certain muscles. Cervical dystonia mainly affects the neck and neck area. Overall, the disease is the third most common movement disorder worldwide after Parkinson's disease and essential tremor.
Electrodes in the brain
"In dystonia patients, the nerve cells vibrate in the so-called theta rhythm of four to twelve Hertz," the experts explain. In the current study, the Charité researchers were able to demonstrate for the first time a direct connection between a specific pattern of brain activity, the occurrence of symptoms and the subsequent effect of THS for isolated dystonia. In the study, electrodes were implanted in the globus pallidus internus (Gpi; area in the basal ganglia) on both sides in the study using stereotactic methods, the researchers report. Although it has long been known that the increased neuronal activity can be slowed down by stimulating the GPi and that the THS is an effective therapy, the exact mode of action has so far remained unclear, according to the experts.
Brain activity patterns evaluated from more than 400 patients
The team around Professor Dr. At the Charité, Andrea Kühn is intensively researching the causes of movement disorders and the use of THS as a form of therapy. Here, more than 400 THS patients have already taken measurements of brain activity. The data obtained were examined for certain patterns, which correlate with symptom severity and the therapeutic effect. Using the specially developed software "LEAD-DBS", the amplitude of the activity waves found was then mapped three-dimensionally in a virtual brain, reports the Charité. "There was a significant local increase in this pattern of activity precisely in the area of the brain where THS is most effective in dystonia," the scientists continued.
Further studies are already underway
According to Dr. Wolf-Julian Neumann from the Movement Disorders and Neuromodulation Section at the Charité provides the current study results "Indications for the causal meaning of theta activity for the symptoms of dystonia and offer an explanation for the mode of action and the optimal target point of deep brain stimulation in the affected patients "In order to investigate the long-term effects of THS on the activity of the nerve cells, this will be examined at the Charité in another study with 15 patients. These examinations are possible thanks to "an innovative THS system that records brain activity even after implantation", adds Prof. Dr. Andrea Kühn. (fp)