Multimodal Imaging in a Patient with Hemidystonia Responsive to GPi Deep Brain Stimulation
Background. Dystonia is a syndrome with varied phenomenology but our understanding of its mechanisms is deficient. With neuroimaging techniques, such as fiber tractography (FT) and magnetoencephalography (MEG), pathway connectivity can be studied to that end. We present a hemidystonia patient treate...
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| Format: | Article |
| Language: | English |
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Wiley
2017-01-01
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| Series: | Case Reports in Neurological Medicine |
| Online Access: | http://dx.doi.org/10.1155/2017/9653520 |
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| author | Christos Sidiropoulos Susan M. Bowyer Andrew Zillgitt Peter A. LeWitt Hassan Bagher-Ebadian Esmaeil Davoodi-Bojd Jason M. Schwalb Richard Rammo Ellen Air Hamid Soltanian-Zadeh |
| author_facet | Christos Sidiropoulos Susan M. Bowyer Andrew Zillgitt Peter A. LeWitt Hassan Bagher-Ebadian Esmaeil Davoodi-Bojd Jason M. Schwalb Richard Rammo Ellen Air Hamid Soltanian-Zadeh |
| author_sort | Christos Sidiropoulos |
| collection | DOAJ |
| description | Background. Dystonia is a syndrome with varied phenomenology but our understanding of its mechanisms is deficient. With neuroimaging techniques, such as fiber tractography (FT) and magnetoencephalography (MEG), pathway connectivity can be studied to that end. We present a hemidystonia patient treated with deep brain stimulation (DBS). Methods. After 10 years of left axial hemidystonia, a 45-year-old male underwent unilateral right globus pallidus internus (GPi) DBS. Whole brain MEG before and after anticholinergic medication was performed prior to surgery. 26-direction diffusion tensor imaging (DTI) was obtained in a 3 T MRI machine along with FT. The patient was assessed before and one year after surgery by using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). Results. In the eyes-closed MEG study there was an increase in brain coherence in the gamma band after medication in the middle and inferior frontal region. FT demonstrated over 50% more intense ipsilateral connectivity in the right hemisphere compared to the left. After DBS, BFMDRS motor and disability scores both dropped by 71%. Conclusion. Multimodal neuroimaging techniques can offer insights into the pathophysiology of dystonia and can direct choices for developing therapeutics. Unilateral pallidal DBS can provide significant symptom control in axial hemidystonia poorly responsive to medication. |
| format | Article |
| id | doaj-art-2f58e2371ba644de8d54a19caf4aab1b |
| institution | Kabale University |
| issn | 2090-6668 2090-6676 |
| language | English |
| publishDate | 2017-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Case Reports in Neurological Medicine |
| spelling | doaj-art-2f58e2371ba644de8d54a19caf4aab1b2025-02-03T05:52:42ZengWileyCase Reports in Neurological Medicine2090-66682090-66762017-01-01201710.1155/2017/96535209653520Multimodal Imaging in a Patient with Hemidystonia Responsive to GPi Deep Brain StimulationChristos Sidiropoulos0Susan M. Bowyer1Andrew Zillgitt2Peter A. LeWitt3Hassan Bagher-Ebadian4Esmaeil Davoodi-Bojd5Jason M. Schwalb6Richard Rammo7Ellen Air8Hamid Soltanian-Zadeh9Parkinson’s Disease and Movement Disorders Program, Henry Ford Hospital, 6777 West Maple Road, West Bloomfield, MI, USADepartment of Neurology, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, MI 48202, USADepartment of Neurology, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, MI 48202, USAParkinson’s Disease and Movement Disorders Program, Henry Ford Hospital, 6777 West Maple Road, West Bloomfield, MI, USAImage Analysis Laboratory, Departments of Neurology and Research Administration, Henry Ford Health System, Detroit, MI 48202, USAImage Analysis Laboratory, Departments of Neurology and Research Administration, Henry Ford Health System, Detroit, MI 48202, USADepartment of Neurosurgery, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, MI 48202, USADepartment of Neurosurgery, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, MI 48202, USADepartment of Neurosurgery, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, MI 48202, USAImage Analysis Laboratory, Departments of Radiology and Research Administration, Henry Ford Health System, Detroit, MI 48202, USABackground. Dystonia is a syndrome with varied phenomenology but our understanding of its mechanisms is deficient. With neuroimaging techniques, such as fiber tractography (FT) and magnetoencephalography (MEG), pathway connectivity can be studied to that end. We present a hemidystonia patient treated with deep brain stimulation (DBS). Methods. After 10 years of left axial hemidystonia, a 45-year-old male underwent unilateral right globus pallidus internus (GPi) DBS. Whole brain MEG before and after anticholinergic medication was performed prior to surgery. 26-direction diffusion tensor imaging (DTI) was obtained in a 3 T MRI machine along with FT. The patient was assessed before and one year after surgery by using the Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS). Results. In the eyes-closed MEG study there was an increase in brain coherence in the gamma band after medication in the middle and inferior frontal region. FT demonstrated over 50% more intense ipsilateral connectivity in the right hemisphere compared to the left. After DBS, BFMDRS motor and disability scores both dropped by 71%. Conclusion. Multimodal neuroimaging techniques can offer insights into the pathophysiology of dystonia and can direct choices for developing therapeutics. Unilateral pallidal DBS can provide significant symptom control in axial hemidystonia poorly responsive to medication.http://dx.doi.org/10.1155/2017/9653520 |
| spellingShingle | Christos Sidiropoulos Susan M. Bowyer Andrew Zillgitt Peter A. LeWitt Hassan Bagher-Ebadian Esmaeil Davoodi-Bojd Jason M. Schwalb Richard Rammo Ellen Air Hamid Soltanian-Zadeh Multimodal Imaging in a Patient with Hemidystonia Responsive to GPi Deep Brain Stimulation Case Reports in Neurological Medicine |
| title | Multimodal Imaging in a Patient with Hemidystonia Responsive to GPi Deep Brain Stimulation |
| title_full | Multimodal Imaging in a Patient with Hemidystonia Responsive to GPi Deep Brain Stimulation |
| title_fullStr | Multimodal Imaging in a Patient with Hemidystonia Responsive to GPi Deep Brain Stimulation |
| title_full_unstemmed | Multimodal Imaging in a Patient with Hemidystonia Responsive to GPi Deep Brain Stimulation |
| title_short | Multimodal Imaging in a Patient with Hemidystonia Responsive to GPi Deep Brain Stimulation |
| title_sort | multimodal imaging in a patient with hemidystonia responsive to gpi deep brain stimulation |
| url | http://dx.doi.org/10.1155/2017/9653520 |
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