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Vztahy mezi oscilacemi a jejich využití u adaptivní hluboké mozkové stimulace
Lamoš, Martin ; Bočková, Martina ; Daniel, Pavel ; Baláž, Marek ; Chrastina, Jan ; Rektor, Ivan
Hluboká mozková stimulace (DBS) patří vedle dopaminergní léčby k nejvýznamnějším terapeutickým přístupům u Parkinsonovy nemoci (PN). Snaha potlačit některé limitace této terapie vede ke zvýšenému zájmu o přístupy jako je adaptivní DBS (aDBS). Stimulace s uzavřenou smyčkou řízená fluktuacemi výkonu v beta pásmu však nemusí být optimální pro všechny pacienty s PN. S cílem nalézt více senzitivní ukazatel než samotnou beta aktivitu byly analyzovány vztahy mezi jednotlivými oscilacemi v kontextu optimální stimulace subthalamického jádra (STN). Vztah fáze beta rytmu a amplitudy vysokofrekvenčních oscilací se jeví jako vhodný parametr pro cílení stimulace.
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Neuroanatomical aspects of nonGmotor effects of deep brain stimulation
Růžička, Filip ; Růžička, Evžen (advisor) ; Papežová, Hana (referee) ; Druga, Rastislav (referee)
Summery The underlying mechanisms of weight gain and other affective and cognitive changes after initiation of deep brain stimulation in Parkinson's disease are still unclear. Considering the functional organization within the subthalamic nucleus (STN); limbic, associative and sensorimotor regions residing in the medial, central and later STN respectively, we hypothesized that weight gain may be related to medial localization of stimulation, while motor improvement may be related to lateral localization of stimulation within the STN (study 1). We further hypothesized that stimulation close to the limbic and associative part of the STN may be associated with negative impact on limbic system leading to enhanced anxiety and changes in the hypothalamic- pituitary- adrenal axis (HPA)(study 2). Therefore, the primary aims our study were to assess changes in body weight (study 1) and the hypothalamic- pituitary- adrenal axis (HPA) (study 2) in relation to the position of the active stimulating contact within the nucleus. ...
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Weight changes in patients with Parkinson's disease treated with Deep Brain Stimulation.
Undus, Lucie ; Růžička, Evžen (advisor) ; Baláž, Marek (referee) ; Haninec, Pavel (referee)
1 Abstract Body weight changes have been described in the course of Parkinson's disease (PD) as well as following bilateral deep brain stimulation of the subthalamic nucleus (STN DBS) performed in advanced PD. According to the literature weight changes occur in 50-100% of patients who undergo STN DBS. In the last 15 years extensive efforts have been put in understanding the underlying mechanisms behind the weight changes following STN DBS in advanced PD patients however many sources still report conflicting evidence. Improved motor status, reduction in dyskinesias, decrease in energy expenditure, dopaminergic medication reduction, modification of food intake, hormonal factors, regional effects of stimulation were all speculated to cause this weight gain. We hypothesized that patients who underwent STN DBS procedure in our center would gain weight as reported in the literature (study 1, study 2). The etiology of post STN DBS weight gain has not been fully elucidated up to date, in our second study we further hypothesized that the weight changes are due to dysregulation of food related hormones and parameters (study 2). In the third study we hypothesized that weight gain is associated with position of active electrode contact (study 3). Aims of the study: The primary aims of our studies were to assess body...
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