• Clinical Psychopharmacology and Neuroscience
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• 제16권4호
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• pp.494-496
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• 2018

No previous reports have described a case in which deep brain stimulation elicited an acute mood swing from a depressive to manic state simply by switching one side of the bilateral deep brain stimulation electrode on and off. The patient was a 68-year-old woman with a 10-year history of Parkinson's disease. She underwent bilateral subthalamic deep brain stimulation surgery. After undergoing surgery, the patient exhibited hyperthymia. She was scheduled for admission. On the first day of admission, it was clear that resting tremors in the right limbs had relapsed and her hyperthymia had reverted to depression. It was discovered that the left-side electrode of the deep brain stimulation device was found to be accidentally turned off. As soon as the electrode was turned on, motor impairment improved and her mood switched from depression to mania. The authors speculate that the lateral balance of stimulation plays an important role in mood regulation. The current report provides an intriguing insight into possible mechanisms of mood swing in mood disorders.

• Journal of Korean Neurosurgical Society
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• 제65권5호
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• pp.640-651
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• 2022

Clinical studies on neuromodulation intervention for trigeminal neuralgia have not yet shown promising results. This might be due to the fact that the pathophysiology of chronic trigeminal neuropathy is not yet fully understood. Chronic trigeminal neuropathy includes trigeminal autonomic neuropathy, painful trigeminal neuropathy, and persistent idiopathic facial pain. This disorder is caused by complex abnormalities in the pain processing system, which is comprised of the affective, emotional, and sensory components, rather than mere abnormal sensation. Therefore, integrative understanding of the pain system is necessary for appropriate neuromodulation of chronic trigeminal neuropathy. The possible neuromodulation targets that participate in complex pain processing are as follows : the ventral posterior medial nucleus, periaqueductal gray, motor cortex, nucleus accumbens, subthalamic nucleus, globus pallidus internus, anterior cingulate cortex, hypothalamus, sphenopalatine ganglion, and occipital nerve. In conclusion, neuromodulation interventions for trigeminal neuralgia is yet to be elucidated; future advancements in this area are required.

• Annals of Clinical Neurophysiology
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• 제14권2호
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• pp.59-63
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• 2012

Epilepsy has continued to provide challenges to epileptologists, as a significant proportion of patients continue to suffer from seizures despite medical and surgical treatments. Deep brain stimulation (DBS) has emerged as a new therapeutic modality that has the potential to improve quality of life and occasionally be curative for patients with medically refractory epilepsy who are not surgical candidates. Several groups have used DBS in drug-resistant epilepsy cases for which resective surgery cannot be applied. The promising subcortical brain structures are anterior and centromedian nucleus of the thalamus, subthalamic nucleus, and other nuclei to treat epilepsy in light of previous clinical and experimental data. Recently two randomized trials of neurostimulation for controlling refractory epilepsy employed the strategies to stimulate electrodes placed on both anterior thalamic nuclei or near seizure foci in response to electroencephalographically detected epileptiform activity. However, the more large-scale, long-term clinical trials which elucidates optimal stimulation parameters, ideal selection criteria for epilepsy DBS should be performed before long. In order to continue to advance the frontier of this field, it is imperative to have a good grasp of the current body of knowledge.

• Journal of Yeungnam Medical Science
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• 제19권2호
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• pp.136-143
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• 2002

저자들은 고령의 여성 당뇨 환자에서 비케톤성 고혈당과 동반되어 나타난 전신성 무도병과 그 특징적인 방사선학적 소견을 보이는 1예를 경험하였기에 문헌고찰과 함께 보고하는 바이다.

• Animal cells and systems
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• 제2권1호
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• pp.71-80
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• 1998

Glutamate dehydrogenase (GDH) is one of the main enzymes involved in the formation and metabolism of the neurotransmitter glutamate. In the present study, we investigated the distribution of the GDH-immunoreactive cells in the rat brain using monoclonal antibodies against bovine brain GDH isoprotein. GDH-immunoreactive cell were distributed in the basal ganglia, thalamus and the nuclei belong to substantia innominata, and its connecting area, subthalamic nucleus, zona incerta, and substantia niqra. We could see GDH-immunoreactive cells in the hippocampus, septal nuclei associated with the limbic system, the anterior thalamic nuclei connecting between the hypothalamus and limbic system, and its associated structures, amygdaloid nuclear complex, the dorsal raphe and median raphe nuclei and the reticular formation of the midbrain. The GDH-immunoreactive cells were shown in the pyramidal neurons of the cerebral cortex, the Purkinie cells of the cerebella cortex, their associated structures, ventral thalamic nuclei and the reticular thalamic nuclei that seem to function as neural conduction in the thalamus.

• Journal of Korean Neurosurgical Society
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• 제54권6호
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• pp.453-460
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• 2013

Objective : There is a rich literature confirming the default mode network found compatible with task-induced deactivation regions in normal subjects, but few investigations of alterations of the motor deactivation in patients with intracranial lesions. Therefore, we hypothesized that an intracranial lesion results in abnormal changes in a task-induced deactivation region compared with default mode network, and these changes are associated with specific attributes of allocated regions. Methods : Blood oxygenation level dependent (BOLD) functional magnetic resonance imaging (fMRI) during a motor task were obtained from 27 intracranial lesion patients (mean age, 57.3 years; range 15-78 years) who had various kinds of brain tumors. The BOLD fMRI data for each patient were evaluated to obtain activation or deactivation regions. The distinctive deactivation regions from intracranial lesion patients were evaluated by comparing to the literature reports. Results : There were additive deactivated regions according to intracranial lesions : fusiform gyrus in cavernous hemangioma; lateral occipital gyrus in meningioma; crus cerebri in hemangiopericytoma; globus pallidus, lateral occipital gyrus, caudate nucleus, fusiform gyrus, lingual gyrus, claustrum, substantia nigra, subthalamic nucleus in GBM; fusiform gyrus in metastatic brain tumors. Conclusion : There is increasing interest in human brain function using fMRI. The authors report the brain function migrations and changes that occur in patients with intracranial lesions.

• 한국정밀공학회지
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• 제29권9호
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• pp.1035-1040
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• 2012

Deep brain stimulation (DBS) of the subthalamic nucleus (STN) has been found to be effective treatment of Parkinson's disease (PD). This study aims to evaluate the effect of DBS for rigidity during DBS surgery. Six Parkinsonian patients who received STN-DBS surgery participated in this study. The examiner imposed flexion and extension of a patient's wrist randomly. Resistance to passive movement was quantified by viscoelastic properties (two damping constants for each of flexion and extension phase and one spring constant throughout both phases). All Viscoelastic constants decreased by DBS (p<0.01). Specifically, reduction in damping constant during flexion ($B_f$) was greater than those of damping constant during extension ($B_e$) and of spring constant (p<0.05). $B_f$ would be appropriate for evaluation of effect of DBS for rigidity during DBS surgery.

• 대한임상검사과학회지
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• 제51권4호
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• pp.468-474
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• 2019

뇌심부자극술은 뇌심부핵에 고주파 전기자극을 전달하여 약물 불응성 이상운동질환을 치료하는 효과적인 방법이다. 그리고 미세전극기록은 뇌심부자극 수술 중에 MRI와 함께 뇌심부핵의 위치를 정확히 파악하여 수술 결과를 향상시키고 부작용을 최소화 할 수 있는 보조적인 검사이다. 본 논문의 목적은 이상운동질환에 대한 뇌심부자극 수술 중에 실시한 미세전극기록을 분석하여 신경생리학적 파형과 유용성을 알아보고자 하였다. 2018년 1월부터 12월까지 이상운동질환에 대한 뇌심부자극 수술 중에 미세전극기록를 실시한 환자 대상으로 후향적 조사를 하였다. 총 28명의 환자 중에 시상하핵은 38 개의 MER, 내측 담창구는 10개의 MER, 복내측 시상핵은 4개의 MER을 실시했다. 모두 목표지점을 찾았고 미세자극을 이용해서 부작용의 여부를 확인하고 목표지점을 재조정하였다. 수술 후 총 28명의 환자에서 모두 임상 증상은 호전되었다. 결론적으로. 미세전극기록은 신경생리학적 파형을 이용해서 MRI와 함께 정확한 뇌심부핵 부위를 파악해서 이상운동질환에 대한 뇌심부자극 수술 결과를 향상시키고 부작용을 최소화할 수 있는 유용한 검사이다.

• Journal of Korean Neurosurgical Society
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• 제44권1호
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• pp.26-35
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• 2008

Objective : In the evaluation of patients with Parkinson's disease (PD), most neurologists only see their patients during a limited period of their fluctuating 24-hour-a-day lives. This study aimed to assess the short-term outcome of STN stimulation for patients with advanced PD evaluated in a 24-hour monitoring unit for movement disorder (MUMD) using a prospective protocol. Methods : Forty-two patients with advanced PD consecutively treated with bilateral STN stimulation using multi-channel microelectrode recording were included in this study. All patients were evaluated using a 24-hour MUMD with a video recording/editing system and were evaluated with a prospective protocol of the Unified Parkinson's Disease Rating Scale, Hoehn and Yahr Staging, Schwab and England Activities of Daily Living, levodopa equivalent daily dose (LEDD), Short Form-36 Health Survey, and neuropsychological tests. Magnetic resonance (MR) images of the brain were performed prior to and six months after surgery. Results : All patients were evaluated at three and six months after surgery. There was a rapid and significant improvement of the motor symptoms, especially in tremor and rigidity, after STN stimulation with low morbidity. Dyskinesia was markedly decreased with much lowered LEDD values by 50% after STN stimulation. 1.5T MR images were safely taken according to the manufacturer's guidelines at six months after surgery without any adverse effects in 41 patients treated with STN stimulations. Conclusion : Evaluations in a 24-hour monitoring unit could reduce the dose of medication efficiently to an optimal level with patients' comfort and improve the clinical symptoms in harmony with STN stimulation.