• 제목/요약/키워드: essential tremor

검색결과 55건 처리시간 0.029초

Magnetic Resonance-Guided Focused Ultrasound : Current Status and Future Perspectives in Thermal Ablation and Blood-Brain Barrier Opening

  • Lee, Eun Jung;Fomenko, Anton;Lozano, Andres M.
    • Journal of Korean Neurosurgical Society
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    • 제62권1호
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    • pp.10-26
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    • 2019
  • Magnetic resonance-guided focused ultrasound (MRgFUS) is an emerging new technology with considerable potential to treat various neurological diseases. With refinement of ultrasound transducer technology and integration with magnetic resonance imaging guidance, transcranial sonication of precise cerebral targets has become a therapeutic option. Intensity is a key determinant of ultrasound effects. High-intensity focused ultrasound can produce targeted lesions via thermal ablation of tissue. MRgFUS-mediated stereotactic ablation is non-invasive, incision-free, and confers immediate therapeutic effects. Since the US Food and Drug Administration approval of MRgFUS in 2016 for unilateral thalamotomy in medication-refractory essential tremor, studies on novel indications such as Parkinson's disease, psychiatric disease, and brain tumors are underway. MRgFUS is also used in the context of blood-brain barrier (BBB) opening at low intensities, in combination with intravenously-administered microbubbles. Preclinical studies show that MRgFUS-mediated BBB opening safely enhances the delivery of targeted chemotherapeutic agents to the brain and improves tumor control as well as survival. In addition, BBB opening has been shown to activate the innate immune system in animal models of Alzheimer's disease. Amyloid plaque clearance and promotion of neurogenesis in these studies suggest that MRgFUS-mediated BBB opening may be a new paradigm for neurodegenerative disease treatment in the future. Here, we review the current status of preclinical and clinical trials of MRgFUS-mediated thermal ablation and BBB opening, described their mechanisms of action, and discuss future prospects.

Characteristics of somatosensory thalamic neurons : Study on motor disease patients

  • Lee, Bae-Hwan;Lee, Kyung-Hee;Park, Yong-Gou;Chung, Sang-Sup;Chang, Jin-Woo
    • 한국감성과학회:학술대회논문집
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    • 한국감성과학회 2002년도 추계학술대회 논문집
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    • pp.140-147
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    • 2002
  • 시상은 체감각 정보를 처리하는데 있어서 매우 중요한 역할을 하는 부위이다. 본 연구는 운동장애 환자의 시상에서 뉴론의 활동 특성을 알아보기 위해 수행되었다. 그 결과 체감각으로서의 운동자극에 반응하는 뉴론이 essential tremor (ET) 환자의 nucleus ventralis intermedius (VIM)에서 발견되었다. ET 환자 뉴론의 평균 활동율(firing rate)은 Parkinson's disease (PD) 환자 보다 높았다. 또한 ET 환자의 VIM에서 운동자극에 반응하는 뉴론의 평균 활동율은 PD 환자 보다 높았다. 하지만 촉각자극(touch)에 반응하는 nucleus ventralis caudalis (VC) 뉴론의 활동율은 ET와 PD 집단간에 차가 없었다. Bursting activity를 나타내는 뉴론은 nucleus ventralis oralis anterior (VOP)에서 ET집단이 PD 집단보다 적었다. tremor cell은 VIM에서 PD 보다 ET집단이 더 적었다. 이러한 결과는 체감각 자극에 반응하는 시상 뉴론의 특성이 운동장애의 유형에 따라 서로 다르다는 것을 시사한다.

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기타 기능성 발성장애 및 신경성 발성장애 (Other Functional and Neurological Dysphonia)

  • 이승원
    • 대한후두음성언어의학회지
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    • 제25권2호
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    • pp.82-85
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    • 2014
  • Functional dysphonia is a specific voice disorder refers to dysphonia without abnormal anatomical vocal fold findings at larynx. The proportions of this disorder are estimated up to 40% of dysphonia patients at ENT clinics. In this article, we will discuss about other functional dysphonia and neurological dysphonia except for muslce tension dysphonia and spasmodic dysphonia. For details, will describe about phonatory charateristics and treatment options about paradoxical vocal fold motion disorder, mutational dysphonia, essential vocal tremor, conversion dysphonia, and vocal tremor related with parkinson's disease.

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지진하중을 받는 고층건물의 동적응답 해석에 관한 연구 (A Study on Dynamic Response Analysis of High Structure under Earthquake Load)

  • 배동명;신창혁
    • 수산해양기술연구
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    • 제36권4호
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    • pp.337-346
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    • 2000
  • Earthquake is a natural disaster accompanied by damage of human and properties caused by the ground motion, crustal movements, faults as well as tidal wave. The earthquake is known to occur mostly in earthquake-prone areas and the Korean Peninsula is known to be relatively safe in terms of geological characteristics. In order to withstand on severe environmental dynamic random load such as an earthquake, the large structure need to be designed to withstand the anticipated seismic tremor. The seismetic design is essential for building structures, bridges, and large structures which is handles explosive gases. Thus, the necessity of earthquake resistant analysis for large structure is growing and the capability of dynamic analysis should be obtained. In this thesis, dynamic responses of a high building(height 60m, width 18) which subjected to random earthquake load are presented which responses are derived using dynamic analysis methods such as response spectrum analysis, mode superposition and direct integration. Each results are also compared to review the merit of each methods.

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도파민운반체 영상의 임상적 유용성 (Clinical Usefulness of Dopamine Transporter Imaging)

  • 김종민;김유경;김상은;전범석
    • Nuclear Medicine and Molecular Imaging
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    • 제41권2호
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    • pp.152-157
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    • 2007
  • Imaging of the dopamine transporter (DAT) provides a marker for the integrity of presynaptic nigrostriatal dopaminergic system. DAT density is reduced in Parkinson disease, multiple system atrophy, and progressive supranuclear palsy. In patients with suspicious parkinsonism, normal DAT imaging suggests an alternative diagnosis such as essential tremor, vascular parkinsonism, or drug-induced parkinsonism. DAT imaging is a useful tool to aid clinician's differential diagnosis in parkinsonism.

파킨슨병과 본태성 진전의 감별진단에서 I-123 IPT(I-123-N-(3-iodopropen-2-yl)-$2{\beta}$-carbomethoxy-$3{\beta}$-(4-cholorophenyl) tropane) 뇌 단일광전자방출 전산화단층촬영의 역할 (Differentiation of Parkinson's Disease and Essential Tremor on I-123 IPT(I-123-N-(3-iodopropen-2-yl)-$2{\beta}$-carbomethoxy- $3{\beta}$-(4-cholorophenyl) tropane) Brain SPECT)

  • 배문선;최태현;안성민;최재용;류원기;이재훈;유영훈
    • Nuclear Medicine and Molecular Imaging
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    • 제43권2호
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    • pp.100-106
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    • 2009
  • 목적: 파킨슨병은 비교적 흔한 운동장애질환으로 흑질(substantia nigra)의 도파민성 신경세포와 해당되는 기저핵의 도파민 함유 신경말단의 퇴행성 변화에 의하여 선조체에서의 도파민 운반체 농도도 감소하는 것으로 알려져 있다. 본 연구는 I-123 IPT SPECT에서 선조체의 도파민 특이결합과 후두염 뇌피질의 비특이 결합비를 이용하여 초기 및 진행된 파킨슨병 환자군과 본태성 진전 등의 다른 운동장애 질환군, 정상 대조군에서 도파민 운반체 영상을 비교하였다. 대상 및 방법: 정상 대조군 50명과 초기 파킨슨병 환자군 20명, 진행된 파킨슨병 환자군 30명, 본태성 진전환자군 20명을 대상으로 I-123 IPT를 정맥 주사후 20분과 2시간 후에 SPECT 영상을 획득하고 재구성하였다. 후두염에 배후방사능 관심영역을 그리고 선조체의 I-123 IPT의 특이/비특이 결합비를 구하여 각 군간의 차이를 정량적 및 정성적으로 비교하여 보았다. 결과: 선조체의 I-123 IPT의 특이/비특이 결합비는 진행된 파킨슨병 환자군과 정상 대조군에서는 평균값의 차이가 유의하였다. 그러나 초기 파킨슨병 환자군과 본태성 진전 환자군 사이에는 특이/비특이 결합비가 중첩됨이 관찰되었다. 정상 대조군과 본태성 진전환자군에서는 2시간 영상이 20분 영상에 비하여 특이/비특이 결합비도 높게 나타났고 표준 편차도 적었다. 진행된 파킨슨병 환자에서는 20분 영상과 2 시간 영상의 특이/비특이 결합비는 차이가 없었고 그 값도 낮았다. 편측 파킨슨병 환자에서 I-123 IPT의 특이/비특이 결합비는 증상이 나타난 반대측 선조체뿐만 아니라 같은쪽 선조체에서도 감소되어 있었다. 초기 파킨슨 환자20명 중 편측 증상을 보인 7명의 환자에서 I-123 IPT SPECT상의 좌우측 선조체간의 특이/비특이 결합비 간의 차이를 이용한 편측화 결과는 임상 증상의 편측화와 일치하였다. 결론: I-123 IPT SPECT는 진행된 파킨슨병의 진단과 치료에 따른 임상경과 진행의 객관적인 지표로서의 역할을 할 수 있을 것으로 생각되며 임상 증상이 발현되기 전단계의 초기 파킨슨병의 진단이나 파킨슨병과 유사한 운동증상을 보일 수 있는 다른 운동질환군과의 감별진단에 있어서는 각 군간의 중첩되는 비율이 있으므로 적용에 신중을 기해야 하겠다.

임피던스 법을 이용한 두피 상태 추정에 관한 연구 (A Study for Estimation of Scalp Condition by Impedance)

  • 심명헌;최한윤;정인철;김기원;윤형로
    • 대한전기학회:학술대회논문집
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    • 대한전기학회 2007년도 심포지엄 논문집 정보 및 제어부문
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    • pp.471-472
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    • 2007
  • The scalp is skin tissue for skull-protection and roots for hair growth. Therefore continuous monitoring of scalp condition is essential for hair management. However, the equipments for existent are inconvenient to use because of focus tremor and external factors(Hair Gel, Wax, accessories and so on). Furthermore there is a problem to use an expensive optical devices like CCD (Charge Coupled Device) camera or lens of 200 - 1000 magnification. It causes a difficulty of using those equipment. We design the special electrode(length 5.65mm, diameter 0.8mm of needle shape) and the impedance system(1kHz, 78uA). Tn this paper, we can measure scalp impedance with our system. Moreover, we find the possibility of classifying scalp condition with measured impedance values. For the classification of scalp condition, we used ARAMO-TS as an imaging system. In conclusion, the problem of existent devices could be improved using these method. It also has a benefit of continuous monitoring of scalp condition.

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Human HS1BP3 induces cell apoptosis and activates AP-1

  • Shi, Taiping;Xie, Jieshi;Xiong, Ying;Deng, Weiwei;Guo, Jinhai;Wang, Feng;Ma, Dalong
    • BMB Reports
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    • 제44권6호
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    • pp.381-386
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    • 2011
  • In the present study, we characterized the function of HS1-binding protein 3 (HS1BP3), which is mutated in essential tremor and may be involved in lymphocyte activation. We found that HS1BP3 localized to the mitochondria and endoplasmic reticulum partially. Overexpression of HS1BP3 induced apoptosis in HEK293T and HeLa cell lines. When these cell lines were transfected with HS1BP3, they exhibited nuclear DNA condensation, externalization of phosphatidylserine (PS), and cleavage of poly ADP ribose polymerase (PARP). Furthermore, suppression of HS1BP3 or HS1 expression attenuates HS1BP3 induced apoptosis. In addition, HS1BP3 enhanced activator protein 1 (AP-1)-mediated transcription in a dose-dependent manner. Therefore, we conclude that HS1BP3 regulates apoptosis via HS1 and stimulates AP-1-mediated transcription.

Magnetic Resonance-Guided Focused Ultrasound in Neurosurgery: Taking Lessons from the Past to Inform the Future

  • Jung, Na Young;Chang, Jin Woo
    • Journal of Korean Medical Science
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    • 제33권44호
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    • pp.279.1-279.16
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    • 2018
  • Magnetic resonance-guided focused ultrasound (MRgFUS) is a new emerging neurosurgical procedure applied in a wide range of clinical fields. It can generate high-intensity energy at the focal zone in deep body areas without requiring incision of soft tissues. Although the effectiveness of the focused ultrasound technique had not been recognized because of the skull being a main barrier in the transmission of acoustic energy, the development of hemispheric distribution of ultrasound transducer phased arrays has solved this issue and enabled the performance of true transcranial procedures. Advanced imaging technologies such as magnetic resonance thermometry could enhance the safety of MRgFUS. The current clinical applications of MRgFUS in neurosurgery involve stereotactic ablative treatments for patients with essential tremor, Parkinson's disease, obsessive-compulsive disorder, major depressive disorder, or neuropathic pain. Other potential treatment candidates being examined in ongoing clinical trials include brain tumors, Alzheimer's disease, and epilepsy, based on MRgFUS abilities of thermal ablation and opening the blood-brain barrier. With the development of ultrasound technology to overcome the limitations, MRgFUS is gradually expanding the therapeutic field for intractable neurological disorders and serving as a trail for a promising future in noninvasive and safe neurosurgical care.