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Views</span></p><p class="data"><span class="js-profile-view-count"></span></p></div></span></div><div class="ri-section"><div class="ri-section-header"><span>Interests</span></div><div class="ri-tags-container"><a data-click-track="profile-user-info-expand-research-interests" data-has-card-for-ri-list="33000306" href="https://www.academia.edu/Documents/in/Software_Cost_Estimation"><div id="js-react-on-rails-context" style="display:none" data-rails-context="{"inMailer":false,"i18nLocale":"en","i18nDefaultLocale":"en","href":"https://independent.academia.edu/MOkun","location":"/MOkun","scheme":"https","host":"independent.academia.edu","port":null,"pathname":"/MOkun","search":null,"httpAcceptLanguage":null,"serverSide":false}"></div> <div class="js-react-on-rails-component" style="display:none" data-component-name="Pill" data-props="{"color":"gray","children":["Software Cost Estimation"]}" data-trace="false" data-dom-id="Pill-react-component-b056f5f5-cec6-44fa-9a24-413b8c8d14b1"></div> 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href="https://www.academia.edu/71482322/Non_motor_Characterization_of_the_Basal_Ganglia_Evidence_From_Human_and_Non_human_Primate_Electrophysiology"><img alt="Research paper thumbnail of Non-motor Characterization of the Basal Ganglia: Evidence From Human and Non-human Primate Electrophysiology" class="work-thumbnail" src="https://attachments.academia-assets.com/80805460/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482322/Non_motor_Characterization_of_the_Basal_Ganglia_Evidence_From_Human_and_Non_human_Primate_Electrophysiology">Non-motor Characterization of the Basal Ganglia: Evidence From Human and Non-human Primate Electrophysiology</a></div><div class="wp-workCard_item"><span>Frontiers in neuroscience</span><span>, 2018</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Although the basal ganglia have been implicated in a growing list of human behaviors, they includ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Although the basal ganglia have been implicated in a growing list of human behaviors, they include some of the least understood nuclei in the brain. For several decades studies have employed numerous methodologies to uncover evidence pointing to the basal ganglia as a hub of both motor and non-motor function. Recently, new electrophysiological characterization of the basal ganglia in humans has become possible through direct access to these deep structures as part of routine neurosurgery. Electrophysiological approaches for identifying non-motor function have the potential to unlock a deeper understanding of pathways that may inform clinical interventions and particularly neuromodulation. Various electrophysiological modalities can also be combined to reveal functional connections between the basal ganglia and traditional structures throughout the neocortex that have been linked to non-motor behavior. Several reviews have previously summarized evidence for non-motor function in the ...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="bd1659a67c8df7954310b4118d9f8b5b" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":80805460,"asset_id":71482322,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/80805460/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482322"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482322"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482322; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482322]").text(description); $(".js-view-count[data-work-id=71482322]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482322; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482322']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482322, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "bd1659a67c8df7954310b4118d9f8b5b" } } $('.js-work-strip[data-work-id=71482322]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482322,"title":"Non-motor Characterization of the Basal Ganglia: Evidence From Human and Non-human Primate Electrophysiology","translated_title":"","metadata":{"abstract":"Although the basal ganglia have been implicated in a growing list of human behaviors, they include some of the least understood nuclei in the brain. 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482317"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482317/Postoperative_lead_migration_in_deep_brain_stimulation_surgery_Incidence_risk_factors_and_clinical_impact"><img alt="Research paper thumbnail of Postoperative lead migration in deep brain stimulation surgery: Incidence, risk factors, and clinical impact" class="work-thumbnail" src="https://attachments.academia-assets.com/80805462/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482317/Postoperative_lead_migration_in_deep_brain_stimulation_surgery_Incidence_risk_factors_and_clinical_impact">Postoperative lead migration in deep brain stimulation surgery: Incidence, risk factors, and clinical impact</a></div><div class="wp-workCard_item"><span>PLOS ONE</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="413739b3034602d1bee007d5f0bb2bc6" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":80805462,"asset_id":71482317,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/80805462/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482317"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482317"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482317; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482317]").text(description); $(".js-view-count[data-work-id=71482317]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482317; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482317']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482317, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "413739b3034602d1bee007d5f0bb2bc6" } } $('.js-work-strip[data-work-id=71482317]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482317,"title":"Postoperative lead migration in deep brain stimulation surgery: Incidence, risk factors, and clinical impact","translated_title":"","metadata":{"publisher":"Public Library of Science (PLoS)","grobid_abstract":"pdf). The funders had no role in study design, data indices were collected and analyzed. Clinical outcomes were characterized with validated rating scales for all cases, and a comparison was made between outcomes of cases with lead migration versus those where migration of the lead did not occur. Results Data from 138 leads in 132 patients with initial and delayed lead localization CT scans were analyzed. The mean distance between initial and delayed DBS lead tip position was 2.2 mm and the mean change in intracranial lead length was 0.45 mm. Significant delayed migration (\u003e3 mm) was observed in 17 leads in 16 patients (12.3% of leads, 12.1% of patients). Factors associated with lead migration were: technical error, repetitive dystonic head movement, and twiddler's syndrome. Outcomes were worse in dystonia patients with lead migration (p = 0.035). In the PD group, worse clinical outcomes trended in cases with lead migration. Conclusions Over 10% of DBS leads in this large single center cohort were displaced by greater than 3 mm on delayed measurement, adversely affecting outcomes. Multiple risk factors emerged, including technical error during implantation of the DBS pulse generator and failure of lead fixation at the burr hole site. We hypothesize that a change in surgical technique and a more effective lead fixation device might mitigate this problem.","publication_name":"PLOS ONE","grobid_abstract_attachment_id":80805462},"translated_abstract":null,"internal_url":"https://www.academia.edu/71482317/Postoperative_lead_migration_in_deep_brain_stimulation_surgery_Incidence_risk_factors_and_clinical_impact","translated_internal_url":"","created_at":"2022-02-14T04:19:35.280-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33000306,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[{"id":80805462,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/80805462/thumbnails/1.jpg","file_name":"76c426c30f31ab458ed22206903c22d35bf8.pdf","download_url":"https://www.academia.edu/attachments/80805462/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"Postoperative_lead_migration_in_deep_bra.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/80805462/76c426c30f31ab458ed22206903c22d35bf8-libre.pdf?1644841530=\u0026response-content-disposition=attachment%3B+filename%3DPostoperative_lead_migration_in_deep_bra.pdf\u0026Expires=1733271341\u0026Signature=cLmabWRyWOcmnkQyNfHxi73Y15q00-cT6CBT3Tpd4bwMcbA2syKsQN~5xODHyyR2Vkjh~Gq05mWnXkD0y1OAreIy3A4NuNbnOtEUM91Df-~9tLMPvJUJbbTKSBw8anv3JEN~aMwgR74hWajYhz7vDKCBV~s6-cpdEcnVvGYQ6R3cLeKu3gs88O8VacaoJv9IbUBG5dHcWwLfZ7QcI4fzj2r4N6JYOrJdURlEIlvgJU2qwmWTa3jNI9TYX3uMTPZeWt6cCMshS9YUoI9IYwyFZ~eXwIrxiWc1mbhFxqjLQins-G3ZWGsgJ2y00v-SBAjv8MXlaLgos8OUGPWhyqg4ww__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Postoperative_lead_migration_in_deep_brain_stimulation_surgery_Incidence_risk_factors_and_clinical_impact","translated_slug":"","page_count":22,"language":"en","content_type":"Work","owner":{"id":33000306,"first_name":"Michael","middle_initials":null,"last_name":"Okun","page_name":"MOkun","domain_name":"independent","created_at":"2015-07-12T04:47:31.779-07:00","display_name":"Michael Okun","url":"https://independent.academia.edu/MOkun"},"attachments":[{"id":80805462,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/80805462/thumbnails/1.jpg","file_name":"76c426c30f31ab458ed22206903c22d35bf8.pdf","download_url":"https://www.academia.edu/attachments/80805462/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"Postoperative_lead_migration_in_deep_bra.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/80805462/76c426c30f31ab458ed22206903c22d35bf8-libre.pdf?1644841530=\u0026response-content-disposition=attachment%3B+filename%3DPostoperative_lead_migration_in_deep_bra.pdf\u0026Expires=1733271341\u0026Signature=cLmabWRyWOcmnkQyNfHxi73Y15q00-cT6CBT3Tpd4bwMcbA2syKsQN~5xODHyyR2Vkjh~Gq05mWnXkD0y1OAreIy3A4NuNbnOtEUM91Df-~9tLMPvJUJbbTKSBw8anv3JEN~aMwgR74hWajYhz7vDKCBV~s6-cpdEcnVvGYQ6R3cLeKu3gs88O8VacaoJv9IbUBG5dHcWwLfZ7QcI4fzj2r4N6JYOrJdURlEIlvgJU2qwmWTa3jNI9TYX3uMTPZeWt6cCMshS9YUoI9IYwyFZ~eXwIrxiWc1mbhFxqjLQins-G3ZWGsgJ2y00v-SBAjv8MXlaLgos8OUGPWhyqg4ww__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":2583,"name":"Deep Brain Stimulation","url":"https://www.academia.edu/Documents/in/Deep_Brain_Stimulation"},{"id":6200,"name":"Magnetic Resonance Imaging","url":"https://www.academia.edu/Documents/in/Magnetic_Resonance_Imaging"},{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome"},{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine"},{"id":28235,"name":"Multidisciplinary","url":"https://www.academia.edu/Documents/in/Multidisciplinary"},{"id":61474,"name":"Brain","url":"https://www.academia.edu/Documents/in/Brain"},{"id":174502,"name":"Incidence","url":"https://www.academia.edu/Documents/in/Incidence"},{"id":192721,"name":"Risk factors","url":"https://www.academia.edu/Documents/in/Risk_factors"},{"id":220780,"name":"PLoS one","url":"https://www.academia.edu/Documents/in/PLoS_one"},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged"},{"id":469105,"name":"Retrospective Studies","url":"https://www.academia.edu/Documents/in/Retrospective_Studies"},{"id":620049,"name":"Risk Factors","url":"https://www.academia.edu/Documents/in/Risk_Factors-1"},{"id":745088,"name":"FOREIGN BODY MIGRATION","url":"https://www.academia.edu/Documents/in/FOREIGN_BODY_MIGRATION"},{"id":1541077,"name":"Parkinson Disease","url":"https://www.academia.edu/Documents/in/Parkinson_Disease"},{"id":2463621,"name":"Postoperative Complications","url":"https://www.academia.edu/Documents/in/Postoperative_Complications"}],"urls":[{"id":17665201,"url":"http://dx.plos.org/10.1371/journal.pone.0183711"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482314"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482314/The_human_subthalamic_nucleus_and_globus_pallidus_internus_differentially_encode_reward_during_action_control"><img alt="Research paper thumbnail of The human subthalamic nucleus and globus pallidus internus differentially encode reward during action control" class="work-thumbnail" src="https://attachments.academia-assets.com/80805459/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482314/The_human_subthalamic_nucleus_and_globus_pallidus_internus_differentially_encode_reward_during_action_control">The human subthalamic nucleus and globus pallidus internus differentially encode reward during action control</a></div><div class="wp-workCard_item"><span>Human brain mapping</span><span>, Apr 28, 2017</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">The subthalamic nucleus (STN) and globus pallidus internus (GPi) have recently been shown to enco...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">The subthalamic nucleus (STN) and globus pallidus internus (GPi) have recently been shown to encode reward, but few studies have been performed in humans. We investigated STN and GPi encoding of reward and loss (i.e., valence) in humans with Parkinson&#39;s disease. To test the hypothesis that STN and GPi neurons would change their firing rate in response to reward- and loss-related stimuli, we recorded the activity of individual neurons while participants performed a behavioral task. In the task, action choices were associated with potential rewarding, punitive, or neutral outcomes. We found that STN and GPi neurons encode valence-related information during action control, but the proportion of valence-responsive neurons was greater in the STN compared to the GPi. In the STN, reward-related stimuli mobilized a greater proportion of neurons than loss-related stimuli. We also found surprising limbic overlap with the sensorimotor regions in both the STN and GPi, and this overlap was g...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="1ef6233c34f47797936d4254dae7ca4a" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":80805459,"asset_id":71482314,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/80805459/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482314"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482314"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482314; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482314]").text(description); $(".js-view-count[data-work-id=71482314]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482314; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482314']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482314, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "1ef6233c34f47797936d4254dae7ca4a" } } $('.js-work-strip[data-work-id=71482314]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482314,"title":"The human subthalamic nucleus and globus pallidus internus differentially encode reward during action control","translated_title":"","metadata":{"abstract":"The subthalamic nucleus (STN) and globus pallidus internus (GPi) have recently been shown to encode reward, but few studies have been performed in humans. We investigated STN and GPi encoding of reward and loss (i.e., valence) in humans with Parkinson\u0026#39;s disease. To test the hypothesis that STN and GPi neurons would change their firing rate in response to reward- and loss-related stimuli, we recorded the activity of individual neurons while participants performed a behavioral task. In the task, action choices were associated with potential rewarding, punitive, or neutral outcomes. We found that STN and GPi neurons encode valence-related information during action control, but the proportion of valence-responsive neurons was greater in the STN compared to the GPi. In the STN, reward-related stimuli mobilized a greater proportion of neurons than loss-related stimuli. We also found surprising limbic overlap with the sensorimotor regions in both the STN and GPi, and this overlap was g...","publication_date":{"day":28,"month":4,"year":2017,"errors":{}},"publication_name":"Human brain mapping"},"translated_abstract":"The subthalamic nucleus (STN) and globus pallidus internus (GPi) have recently been shown to encode reward, but few studies have been performed in humans. We investigated STN and GPi encoding of reward and loss (i.e., valence) in humans with Parkinson\u0026#39;s disease. To test the hypothesis that STN and GPi neurons would change their firing rate in response to reward- and loss-related stimuli, we recorded the activity of individual neurons while participants performed a behavioral task. In the task, action choices were associated with potential rewarding, punitive, or neutral outcomes. We found that STN and GPi neurons encode valence-related information during action control, but the proportion of valence-responsive neurons was greater in the STN compared to the GPi. In the STN, reward-related stimuli mobilized a greater proportion of neurons than loss-related stimuli. We also found surprising limbic overlap with the sensorimotor regions in both the STN and GPi, and this overlap was g...","internal_url":"https://www.academia.edu/71482314/The_human_subthalamic_nucleus_and_globus_pallidus_internus_differentially_encode_reward_during_action_control","translated_internal_url":"","created_at":"2022-02-14T04:19:33.398-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33000306,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[{"id":80805459,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/80805459/thumbnails/1.jpg","file_name":"hbm.pdf","download_url":"https://www.academia.edu/attachments/80805459/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"The_human_subthalamic_nucleus_and_globus.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/80805459/hbm-libre.pdf?1644841524=\u0026response-content-disposition=attachment%3B+filename%3DThe_human_subthalamic_nucleus_and_globus.pdf\u0026Expires=1733271341\u0026Signature=JfCZJqf9OMbg6DWY5ksA1eHY7PaoN2Irp0g~KWgVqD838JNiwJWy0ExUp8lMsZYbn1xfIhpuobWn15jth1mKg5~P1ytTrP5hiG7iF1ZRJ4-2MB6jFotGxbUTOqujQN1s-kGEYUJFJS0gEU0PcUUpS5~gUyyebipHjgSU~~uYTAOx2OPKc0AuJBRzlExm0o3oBicJmQxE5-~Wbg97uXwpEQoeSMIWvsvMY1fVAjBRx-9Nm7r1k-lIiO~tOhtTnwF0INgT26gGmGAgYPhKccb70-7IoeHoOlZw7jZXLV8Jarf~DBwW7BReaPysIr-ovB~Rff1zVzDC4NPikMbyfJdN5g__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"The_human_subthalamic_nucleus_and_globus_pallidus_internus_differentially_encode_reward_during_action_control","translated_slug":"","page_count":13,"language":"en","content_type":"Work","owner":{"id":33000306,"first_name":"Michael","middle_initials":null,"last_name":"Okun","page_name":"MOkun","domain_name":"independent","created_at":"2015-07-12T04:47:31.779-07:00","display_name":"Michael Okun","url":"https://independent.academia.edu/MOkun"},"attachments":[{"id":80805459,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/80805459/thumbnails/1.jpg","file_name":"hbm.pdf","download_url":"https://www.academia.edu/attachments/80805459/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"The_human_subthalamic_nucleus_and_globus.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/80805459/hbm-libre.pdf?1644841524=\u0026response-content-disposition=attachment%3B+filename%3DThe_human_subthalamic_nucleus_and_globus.pdf\u0026Expires=1733271341\u0026Signature=JfCZJqf9OMbg6DWY5ksA1eHY7PaoN2Irp0g~KWgVqD838JNiwJWy0ExUp8lMsZYbn1xfIhpuobWn15jth1mKg5~P1ytTrP5hiG7iF1ZRJ4-2MB6jFotGxbUTOqujQN1s-kGEYUJFJS0gEU0PcUUpS5~gUyyebipHjgSU~~uYTAOx2OPKc0AuJBRzlExm0o3oBicJmQxE5-~Wbg97uXwpEQoeSMIWvsvMY1fVAjBRx-9Nm7r1k-lIiO~tOhtTnwF0INgT26gGmGAgYPhKccb70-7IoeHoOlZw7jZXLV8Jarf~DBwW7BReaPysIr-ovB~Rff1zVzDC4NPikMbyfJdN5g__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":237,"name":"Cognitive Science","url":"https://www.academia.edu/Documents/in/Cognitive_Science"},{"id":7710,"name":"Biology","url":"https://www.academia.edu/Documents/in/Biology"},{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine"},{"id":42408,"name":"Subthalamic Nucleus","url":"https://www.academia.edu/Documents/in/Subthalamic_Nucleus"},{"id":49021,"name":"Reward","url":"https://www.academia.edu/Documents/in/Reward"},{"id":193974,"name":"Neurons","url":"https://www.academia.edu/Documents/in/Neurons"},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged"},{"id":383087,"name":"Globus Pallidus","url":"https://www.academia.edu/Documents/in/Globus_Pallidus"},{"id":685368,"name":"Human Brain Mapping","url":"https://www.academia.edu/Documents/in/Human_Brain_Mapping"},{"id":955727,"name":"Action Potentials","url":"https://www.academia.edu/Documents/in/Action_Potentials"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences"},{"id":1541077,"name":"Parkinson Disease","url":"https://www.academia.edu/Documents/in/Parkinson_Disease"},{"id":2451403,"name":"Avoidance Learning","url":"https://www.academia.edu/Documents/in/Avoidance_Learning"}],"urls":[]}, dispatcherData: dispatcherData }); 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Case Report: A 38-year-old male with Parkinson's disease developed intractable hemiballism in his left extremities due to a small lesion that was located adjacent to the right deep brain stimulation (DBS) lead, 10 months after bilateral subthalamic nucleus (STN)-DBS placement. He underwent a right globus pallidus internus (GPi)-DBS lead implantation. GPi-DBS satisfactorily addressed his hemiballism. Discussion: This case offered a unique look at basal ganglia physiology in human hemiballism. 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482307"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/71482307/Brittle_dyskinesia_following_STN_but_not_GPi_deep_brain_stimulation"><img alt="Research paper thumbnail of Brittle dyskinesia following STN but not GPi deep brain stimulation" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/71482307/Brittle_dyskinesia_following_STN_but_not_GPi_deep_brain_stimulation">Brittle dyskinesia following STN but not GPi deep brain stimulation</a></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482307"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482307"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482307; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482303"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482303/Deep_brain_stimulation_for_tremor_associated_with_underlying_ataxia_syndromes_a_case_series_and_discussion_of_issues"><img alt="Research paper thumbnail of Deep brain stimulation for tremor associated with underlying ataxia syndromes: a case series and discussion of issues" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482303/Deep_brain_stimulation_for_tremor_associated_with_underlying_ataxia_syndromes_a_case_series_and_discussion_of_issues">Deep brain stimulation for tremor associated with underlying ataxia syndromes: a case series and discussion of issues</a></div><div class="wp-workCard_item"><span>Tremor and other hyperkinetic movements (New York, N.Y.)</span><span>, 2014</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Deep brain stimulation (DBS) has been utilized to treat various symptoms in patients suffering fr...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Deep brain stimulation (DBS) has been utilized to treat various symptoms in patients suffering from movement disorders such as Parkinson&#39;s disease, dystonia, and essential tremor. Though ataxia syndromes have not been formally or frequently addressed with DBS, there are patients with ataxia and associated medication refractory tremor or dystonia who may potentially benefit from therapy. A retrospective database review was performed, searching for cases of ataxia where tremor and/or dystonia were addressed by utilizing DBS at the University of Florida Center for Movement Disorders and Neurorestoration between 2008 and 2011. Five patients were found who had DBS implantation to address either medication refractory tremor or dystonia. The patient&#39;s underlying diagnoses included spinocerebellar ataxia type 2 (SCA2), fragile X associated tremor ataxia syndrome (FXTAS), a case of idiopathic ataxia (ataxia not otherwise specified [NOS]), spinocerebellar ataxia type 17 (SCA17), and a...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482303"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482303"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482303; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482303]").text(description); $(".js-view-count[data-work-id=71482303]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482303; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482303']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482303, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=71482303]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482303,"title":"Deep brain stimulation for tremor associated with underlying ataxia syndromes: a case series and discussion of issues","translated_title":"","metadata":{"abstract":"Deep brain stimulation (DBS) has been utilized to treat various symptoms in patients suffering from movement disorders such as Parkinson\u0026#39;s disease, dystonia, and essential tremor. Though ataxia syndromes have not been formally or frequently addressed with DBS, there are patients with ataxia and associated medication refractory tremor or dystonia who may potentially benefit from therapy. A retrospective database review was performed, searching for cases of ataxia where tremor and/or dystonia were addressed by utilizing DBS at the University of Florida Center for Movement Disorders and Neurorestoration between 2008 and 2011. Five patients were found who had DBS implantation to address either medication refractory tremor or dystonia. The patient\u0026#39;s underlying diagnoses included spinocerebellar ataxia type 2 (SCA2), fragile X associated tremor ataxia syndrome (FXTAS), a case of idiopathic ataxia (ataxia not otherwise specified [NOS]), spinocerebellar ataxia type 17 (SCA17), and a...","publication_date":{"day":null,"month":null,"year":2014,"errors":{}},"publication_name":"Tremor and other hyperkinetic movements (New York, N.Y.)"},"translated_abstract":"Deep brain stimulation (DBS) has been utilized to treat various symptoms in patients suffering from movement disorders such as Parkinson\u0026#39;s disease, dystonia, and essential tremor. Though ataxia syndromes have not been formally or frequently addressed with DBS, there are patients with ataxia and associated medication refractory tremor or dystonia who may potentially benefit from therapy. A retrospective database review was performed, searching for cases of ataxia where tremor and/or dystonia were addressed by utilizing DBS at the University of Florida Center for Movement Disorders and Neurorestoration between 2008 and 2011. Five patients were found who had DBS implantation to address either medication refractory tremor or dystonia. The patient\u0026#39;s underlying diagnoses included spinocerebellar ataxia type 2 (SCA2), fragile X associated tremor ataxia syndrome (FXTAS), a case of idiopathic ataxia (ataxia not otherwise specified [NOS]), spinocerebellar ataxia type 17 (SCA17), and a...","internal_url":"https://www.academia.edu/71482303/Deep_brain_stimulation_for_tremor_associated_with_underlying_ataxia_syndromes_a_case_series_and_discussion_of_issues","translated_internal_url":"","created_at":"2022-02-14T04:19:28.822-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33000306,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Deep_brain_stimulation_for_tremor_associated_with_underlying_ataxia_syndromes_a_case_series_and_discussion_of_issues","translated_slug":"","page_count":null,"language":"en","content_type":"Work","owner":{"id":33000306,"first_name":"Michael","middle_initials":null,"last_name":"Okun","page_name":"MOkun","domain_name":"independent","created_at":"2015-07-12T04:47:31.779-07:00","display_name":"Michael Okun","url":"https://independent.academia.edu/MOkun"},"attachments":[],"research_interests":[{"id":380006,"name":"Rest","url":"https://www.academia.edu/Documents/in/Rest"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences"},{"id":1357280,"name":"Oscillation","url":"https://www.academia.edu/Documents/in/Oscillation"}],"urls":[]}, dispatcherData: dispatcherData }); 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There are numerous reports of mood changes following DBS, however, most have focused on bilateral simultaneous STN implants with rapid and aggressive post-operative medication reduction. A standardized evaluation was applied to a subset of patients undergoing STN and GPi DBS and who were also enrolled in the NIH COMPARE study. The Unified Parkinson Disease Rating Scale (UPDRS III), the Hamilton depression (HAM-D) and anxiety rating scales (HAM-A), the Yale-Brown obsessive-compulsive rating scale (YBOCS), the Apathy Scale (AS), and the Young mania rating scale (YMRS) were used. The scales were repeated at acute and chronic intervals. A post-operative strategy of non-aggressive medication reduction was employed. Thirty patients were randomized and underwent unilateral DBS (16 STN, 14 GPi). Th...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="a0bacba8d9a0faf0c928c6e7dc7b7119" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":80805487,"asset_id":71482296,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/80805487/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482296"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482296"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482296; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482296]").text(description); $(".js-view-count[data-work-id=71482296]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482296; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482296']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482296, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "a0bacba8d9a0faf0c928c6e7dc7b7119" } } $('.js-work-strip[data-work-id=71482296]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482296,"title":"Acute and Chronic Mood and Apathy Outcomes from a Randomized Study of Unilateral STN and GPi DBS","translated_title":"","metadata":{"abstract":"To study mood and behavioral effects of unilateral and staged bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) for Parkinson\u0026#39;s disease (PD). 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482281"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482281/Unilateral_deep_brain_stimulation_surgery_in_Parkinson_s_disease_improves_ipsilateral_symptoms_regardless_of_laterality"><img alt="Research paper thumbnail of Unilateral deep brain stimulation surgery in Parkinson’s disease improves ipsilateral symptoms regardless of laterality" class="work-thumbnail" src="https://attachments.academia-assets.com/80805439/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482281/Unilateral_deep_brain_stimulation_surgery_in_Parkinson_s_disease_improves_ipsilateral_symptoms_regardless_of_laterality">Unilateral deep brain stimulation surgery in Parkinson’s disease improves ipsilateral symptoms regardless of laterality</a></div><div class="wp-workCard_item"><span>Parkinsonism & Related Disorders</span><span>, 2011</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="907e6d7c199933f470f4625422ae76c9" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":80805439,"asset_id":71482281,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/80805439/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482281"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482281"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482281; 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dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "907e6d7c199933f470f4625422ae76c9" } } $('.js-work-strip[data-work-id=71482281]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482281,"title":"Unilateral deep brain stimulation surgery in Parkinson’s disease improves ipsilateral symptoms regardless of laterality","translated_title":"","metadata":{"publisher":"Elsevier BV","grobid_abstract":"Purpose-Researchers have consistently observed in right-handed individuals across normal and disease states that the 'dominant' left hemisphere has greater ipsilateral control of the left side than the right hemisphere has over the right. We sought to determine whether this ipsilateral influence of the dominant hemisphere reported in Parkinson's disease extends to treatments such as deep brain stimulation (DBS) and whether it affects outcome. We hypothesised that among Parkinson right-handers, unilateral left DBS would provide greater ipsilateral motor improvement compared with the ipsilateral motor improvement experienced on the right side. Scope-A total of 73 Parkinson patients who underwent unilateral DBS of the subthalamic nucleus (STN) or globus palidus internus (GPi) participated. Left and right 'composite scores', were computed by separately adding all items on the left and right side from the motor section of the Unified Parkinson Disease Rating Scale. The change in the pre-and 4-month postimplantation score was the primary outcome measure. The mean motor scores improved by 4.96 ± 11.79 points (p \u003c 0.001) post-surgery on the ipsilateral side of the DBS implantation. Regression analyses revealed that the side (left vs. right) and target (STN vs. GPi) did not significantly contribute in the effect of ipsilateral motor improvement (p = 0.3557). Conclusion-While DBS on the 'dominant' left side failed to exert a greater ipsilateral influence compared with DBS on the non-dominant right side, significant ipsilateral motor","publication_date":{"day":null,"month":null,"year":2011,"errors":{}},"publication_name":"Parkinsonism \u0026 Related Disorders","grobid_abstract_attachment_id":80805439},"translated_abstract":null,"internal_url":"https://www.academia.edu/71482281/Unilateral_deep_brain_stimulation_surgery_in_Parkinson_s_disease_improves_ipsilateral_symptoms_regardless_of_laterality","translated_internal_url":"","created_at":"2022-02-14T04:19:22.477-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33000306,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[{"id":80805439,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/80805439/thumbnails/1.jpg","file_name":"ptpmcrender.pdf","download_url":"https://www.academia.edu/attachments/80805439/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"Unilateral_deep_brain_stimulation_surger.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/80805439/ptpmcrender-libre.pdf?1644841525=\u0026response-content-disposition=attachment%3B+filename%3DUnilateral_deep_brain_stimulation_surger.pdf\u0026Expires=1733271341\u0026Signature=SvoOUmVHELn6XrU5CeloD39CtZq4ICW7pmsjGJz2P7~pIx7fwilboWuGkM3bWnU4WH7QP5iTirdLbRFopR5SaDv51q4vhis4Xyi4CX3WxJhz4IdqIL4JrC2ZiCsqTrU1X45AXL7SLZHr80OKmlZ1B2VQDVN~Ukz8BxcxdPMO43Jeyy-5QUrcO0JMHWlM2TmoLyxRLYodBDAF0gBDCN~JwHX-nJz20Q-OGKNZe5z~9vLq45UHq0zBjAVRfKZGGeosvYEIv9pdauS1jOi-3ZtNV4jZhzHoeC2nwbo58F5ogKhraSgdu8U5B-BdlFAhk0rbVbH~cZQa7GqpOukHUZghWQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Unilateral_deep_brain_stimulation_surgery_in_Parkinson_s_disease_improves_ipsilateral_symptoms_regardless_of_laterality","translated_slug":"","page_count":10,"language":"en","content_type":"Work","owner":{"id":33000306,"first_name":"Michael","middle_initials":null,"last_name":"Okun","page_name":"MOkun","domain_name":"independent","created_at":"2015-07-12T04:47:31.779-07:00","display_name":"Michael Okun","url":"https://independent.academia.edu/MOkun"},"attachments":[{"id":80805439,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/80805439/thumbnails/1.jpg","file_name":"ptpmcrender.pdf","download_url":"https://www.academia.edu/attachments/80805439/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"Unilateral_deep_brain_stimulation_surger.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/80805439/ptpmcrender-libre.pdf?1644841525=\u0026response-content-disposition=attachment%3B+filename%3DUnilateral_deep_brain_stimulation_surger.pdf\u0026Expires=1733271341\u0026Signature=SvoOUmVHELn6XrU5CeloD39CtZq4ICW7pmsjGJz2P7~pIx7fwilboWuGkM3bWnU4WH7QP5iTirdLbRFopR5SaDv51q4vhis4Xyi4CX3WxJhz4IdqIL4JrC2ZiCsqTrU1X45AXL7SLZHr80OKmlZ1B2VQDVN~Ukz8BxcxdPMO43Jeyy-5QUrcO0JMHWlM2TmoLyxRLYodBDAF0gBDCN~JwHX-nJz20Q-OGKNZe5z~9vLq45UHq0zBjAVRfKZGGeosvYEIv9pdauS1jOi-3ZtNV4jZhzHoeC2nwbo58F5ogKhraSgdu8U5B-BdlFAhk0rbVbH~cZQa7GqpOukHUZghWQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":237,"name":"Cognitive Science","url":"https://www.academia.edu/Documents/in/Cognitive_Science"},{"id":2583,"name":"Deep Brain Stimulation","url":"https://www.academia.edu/Documents/in/Deep_Brain_Stimulation"},{"id":54755,"name":"Right Hemisphere Functions","url":"https://www.academia.edu/Documents/in/Right_Hemisphere_Functions"},{"id":244814,"name":"Clinical Sciences","url":"https://www.academia.edu/Documents/in/Clinical_Sciences"},{"id":810789,"name":"Left Hemisphere","url":"https://www.academia.edu/Documents/in/Left_Hemisphere"},{"id":1274453,"name":"Right Handed","url":"https://www.academia.edu/Documents/in/Right_Handed"},{"id":1541077,"name":"Parkinson Disease","url":"https://www.academia.edu/Documents/in/Parkinson_Disease"},{"id":2234200,"name":"Functional Laterality","url":"https://www.academia.edu/Documents/in/Functional_Laterality"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482275"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/71482275/Mood_changes_with_deep_brain_stimulation_of_STN_and_GPi_results_of_a_pilot_study"><img alt="Research paper thumbnail of Mood changes with deep brain stimulation of STN and GPi: results of a pilot study" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/71482275/Mood_changes_with_deep_brain_stimulation_of_STN_and_GPi_results_of_a_pilot_study">Mood changes with deep brain stimulation of STN and GPi: results of a pilot study</a></div><div class="wp-workCard_item"><span>Journal of Neurology, Neurosurgery & Psychiatry</span><span>, 2003</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482275"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482275"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482275; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482273"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482273/Erratum_to_The_number_and_nature_of_emergency_department_encounters_in_patients_with_deep_brain_stimulators"><img alt="Research paper thumbnail of Erratum to: The number and nature of emergency department encounters in patients with deep brain stimulators" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482273/Erratum_to_The_number_and_nature_of_emergency_department_encounters_in_patients_with_deep_brain_stimulators">Erratum to: The number and nature of emergency department encounters in patients with deep brain stimulators</a></div><div class="wp-workCard_item"><span>Journal of Neurology</span><span>, 2010</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482273"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482273"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482273; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482270"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/71482270/Efficacy_and_Safety_of_Deep_Brain_Stimulation_in_Patients_With_Medication_Induced_Tardive_Dyskinesia_and_or_Dystonia"><img alt="Research paper thumbnail of Efficacy and Safety of Deep Brain Stimulation in Patients With Medication-Induced Tardive Dyskinesia and/or Dystonia" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/71482270/Efficacy_and_Safety_of_Deep_Brain_Stimulation_in_Patients_With_Medication_Induced_Tardive_Dyskinesia_and_or_Dystonia">Efficacy and Safety of Deep Brain Stimulation in Patients With Medication-Induced Tardive Dyskinesia and/or Dystonia</a></div><div class="wp-workCard_item"><span>The Journal of Clinical Psychiatry</span><span>, 2012</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482270"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482270"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482270; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482268"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482268/An_evaluation_of_rating_scales_utilized_for_deep_brain_stimulation_for_dystonia"><img alt="Research paper thumbnail of An evaluation of rating scales utilized for deep brain stimulation for dystonia" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482268/An_evaluation_of_rating_scales_utilized_for_deep_brain_stimulation_for_dystonia">An evaluation of rating scales utilized for deep brain stimulation for dystonia</a></div><div class="wp-workCard_item"><span>Journal of …</span><span>, 2010</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">The objective of this study was to examine globus pallidus internus deep brain stimulation (GPi-D...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">The objective of this study was to examine globus pallidus internus deep brain stimulation (GPi-DBS) outcomes in primary and secondary dystonia, derived from blinded ratings using two scales and two raters. Twenty-five patients with variable presentations of dystonia were evaluated with videotaped standardized dystonia rating scales at preoperative baseline and at 6 and 12 months following GPi-DBS implantation. These 75 examination videos were retrospectively evaluated, independently and in random order, by two movement disorder neurologists who were blinded to the treatment status. Both neurologists scored each videotaped evaluation using the Burke-Fahn-Marsden Dystonia Rating Scale-motor part (BFMDRS-M) and the Unified Dystonia Rating Scale (UDRS). A final score for each video was assigned by averaging the raters&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; scores. An intra-class correlation coefficient was used to calculate inter-rater reliability. A linear mixed model was fitted to investigate the time effect and its interaction with type of dystonia (primary versus secondary) for each rating scale. Inter-rater reliability was excellent. Intraclass correlation coefficients ranged from 0.994 to 0.997 for both scales at baseline, 6 and 12 months. The average motor improvement scores after GPi DBS for the entire heterogeneous group of dystonia patients after 6 and 12 months of stimulation was 21.32% (p = 0.0010) and 28.95% (p = 0.0017), respectively, when the UDRS score was used. Similar levels of improvement 20.46% (p = 0.0055) at 6 months and 27.39% (p = 0.00197) at 12 months were found using the BFMDRS-M score. Analysis using unblinded scores from our database revealed a 32.99 and 37.27% UDRS improvement at 6 and 12 months, and an improvement in UDRS score of 38.5 and 43.7% when the analysis was limited to only primary dystonia. If the data were further segregated to include only cases of DYT-1 primary generalized dystonia, the UDRS benefit increased to 48.24%. Our primary dystonia group was diluted by the presence of both old- and young-onset patients, as well as focal, segmental and generalized dystonia. In conclusion, (1) evaluating motor outcomes of DBS therapy for dystonia using independent, randomized retrospective rating by blinded raters&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; results in lower improvement scores than when outcomes are rated by unblinded treating neurologists. Blinded methodology may be superior and might produce a more realistic assessment of motor outcomes after DBS in patients with dystonia; (2) outcomes were similar whether the BFMDRS-M or UDRS was utilized; (3) GPi-DBS was effective in treating sustained involuntary motor co-contractions in medication refractory dystonia patients, more so in primary dystonia.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482268"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482268"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482268; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482268]").text(description); $(".js-view-count[data-work-id=71482268]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482268; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482268']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482268, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=71482268]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482268,"title":"An evaluation of rating scales utilized for deep brain stimulation for dystonia","translated_title":"","metadata":{"abstract":"The objective of this study was to examine globus pallidus internus deep brain stimulation (GPi-DBS) outcomes in primary and secondary dystonia, derived from blinded ratings using two scales and two raters. Twenty-five patients with variable presentations of dystonia were evaluated with videotaped standardized dystonia rating scales at preoperative baseline and at 6 and 12 months following GPi-DBS implantation. These 75 examination videos were retrospectively evaluated, independently and in random order, by two movement disorder neurologists who were blinded to the treatment status. Both neurologists scored each videotaped evaluation using the Burke-Fahn-Marsden Dystonia Rating Scale-motor part (BFMDRS-M) and the Unified Dystonia Rating Scale (UDRS). A final score for each video was assigned by averaging the raters\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; scores. An intra-class correlation coefficient was used to calculate inter-rater reliability. A linear mixed model was fitted to investigate the time effect and its interaction with type of dystonia (primary versus secondary) for each rating scale. Inter-rater reliability was excellent. Intraclass correlation coefficients ranged from 0.994 to 0.997 for both scales at baseline, 6 and 12 months. The average motor improvement scores after GPi DBS for the entire heterogeneous group of dystonia patients after 6 and 12 months of stimulation was 21.32% (p = 0.0010) and 28.95% (p = 0.0017), respectively, when the UDRS score was used. Similar levels of improvement 20.46% (p = 0.0055) at 6 months and 27.39% (p = 0.00197) at 12 months were found using the BFMDRS-M score. Analysis using unblinded scores from our database revealed a 32.99 and 37.27% UDRS improvement at 6 and 12 months, and an improvement in UDRS score of 38.5 and 43.7% when the analysis was limited to only primary dystonia. If the data were further segregated to include only cases of DYT-1 primary generalized dystonia, the UDRS benefit increased to 48.24%. Our primary dystonia group was diluted by the presence of both old- and young-onset patients, as well as focal, segmental and generalized dystonia. In conclusion, (1) evaluating motor outcomes of DBS therapy for dystonia using independent, randomized retrospective rating by blinded raters\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; results in lower improvement scores than when outcomes are rated by unblinded treating neurologists. Blinded methodology may be superior and might produce a more realistic assessment of motor outcomes after DBS in patients with dystonia; (2) outcomes were similar whether the BFMDRS-M or UDRS was utilized; (3) GPi-DBS was effective in treating sustained involuntary motor co-contractions in medication refractory dystonia patients, more so in primary dystonia.","publisher":"Springer","publication_date":{"day":null,"month":null,"year":2010,"errors":{}},"publication_name":"Journal of …"},"translated_abstract":"The objective of this study was to examine globus pallidus internus deep brain stimulation (GPi-DBS) outcomes in primary and secondary dystonia, derived from blinded ratings using two scales and two raters. Twenty-five patients with variable presentations of dystonia were evaluated with videotaped standardized dystonia rating scales at preoperative baseline and at 6 and 12 months following GPi-DBS implantation. These 75 examination videos were retrospectively evaluated, independently and in random order, by two movement disorder neurologists who were blinded to the treatment status. Both neurologists scored each videotaped evaluation using the Burke-Fahn-Marsden Dystonia Rating Scale-motor part (BFMDRS-M) and the Unified Dystonia Rating Scale (UDRS). A final score for each video was assigned by averaging the raters\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; scores. An intra-class correlation coefficient was used to calculate inter-rater reliability. A linear mixed model was fitted to investigate the time effect and its interaction with type of dystonia (primary versus secondary) for each rating scale. Inter-rater reliability was excellent. Intraclass correlation coefficients ranged from 0.994 to 0.997 for both scales at baseline, 6 and 12 months. The average motor improvement scores after GPi DBS for the entire heterogeneous group of dystonia patients after 6 and 12 months of stimulation was 21.32% (p = 0.0010) and 28.95% (p = 0.0017), respectively, when the UDRS score was used. Similar levels of improvement 20.46% (p = 0.0055) at 6 months and 27.39% (p = 0.00197) at 12 months were found using the BFMDRS-M score. Analysis using unblinded scores from our database revealed a 32.99 and 37.27% UDRS improvement at 6 and 12 months, and an improvement in UDRS score of 38.5 and 43.7% when the analysis was limited to only primary dystonia. If the data were further segregated to include only cases of DYT-1 primary generalized dystonia, the UDRS benefit increased to 48.24%. Our primary dystonia group was diluted by the presence of both old- and young-onset patients, as well as focal, segmental and generalized dystonia. In conclusion, (1) evaluating motor outcomes of DBS therapy for dystonia using independent, randomized retrospective rating by blinded raters\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; results in lower improvement scores than when outcomes are rated by unblinded treating neurologists. Blinded methodology may be superior and might produce a more realistic assessment of motor outcomes after DBS in patients with dystonia; (2) outcomes were similar whether the BFMDRS-M or UDRS was utilized; (3) GPi-DBS was effective in treating sustained involuntary motor co-contractions in medication refractory dystonia patients, more so in primary 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Brain Stimulation on Impulse Control Disorders and Dopamine Dysregulation Syndrome" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/71482265/Effects_of_STN_and_GPi_Deep_Brain_Stimulation_on_Impulse_Control_Disorders_and_Dopamine_Dysregulation_Syndrome">Effects of STN and GPi Deep Brain Stimulation on Impulse Control Disorders and Dopamine Dysregulation Syndrome</a></div><div class="wp-workCard_item"><span>PLoS ONE</span><span>, 2012</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper 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href="https://www.academia.edu/71482262/Deep_brain_stimulation_for_intractable_obsessive_compulsive_disorder_pilot_study_using_a_blinded_staggered_onset_design"><img alt="Research paper thumbnail of Deep brain stimulation for intractable obsessive compulsive disorder: pilot study using a blinded, staggered-onset design" class="work-thumbnail" src="https://attachments.academia-assets.com/80805475/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482262/Deep_brain_stimulation_for_intractable_obsessive_compulsive_disorder_pilot_study_using_a_blinded_staggered_onset_design">Deep brain stimulation for intractable obsessive compulsive disorder: pilot study using a blinded, staggered-onset design</a></div><div class="wp-workCard_item"><span>Biological …</span><span>, 2010</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">In this pilot study, six adult patients (2 male; 4 female) meeting stringent criteria for severe ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">In this pilot study, six adult patients (2 male; 4 female) meeting stringent criteria for severe (minimum Yale-Brown Obsessive Compulsive Scale [Y-BOCS] of 28) and treatment-refractory OCD had DBS electrode arrays placed bilaterally in an area spanning the ventral anterior limb of ...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="c4be02add6e3d001c52a0739f96212e5" class="wp-workCard--action" rel="nofollow" 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$a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482257"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482257/Pre_and_Post_GPi_DBS_Neuropsychological_Profiles_in_a_Case_of_X_Linked_Dystonia_Parkinsonism"><img alt="Research paper thumbnail of Pre-and Post-GPi DBS Neuropsychological Profiles in a Case of X-Linked Dystonia-Parkinsonism" class="work-thumbnail" src="https://attachments.academia-assets.com/80805347/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482257/Pre_and_Post_GPi_DBS_Neuropsychological_Profiles_in_a_Case_of_X_Linked_Dystonia_Parkinsonism">Pre-and Post-GPi DBS Neuropsychological Profiles in a Case of X-Linked Dystonia-Parkinsonism</a></div><div class="wp-workCard_item"><span>The Clinical …</span><span>, 2011</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">We present the pre to post bilateral globus pallidus interna (GPi) deep brain stimulation neurops...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">We present the pre to post bilateral globus pallidus interna (GPi) deep brain stimulation neuropsychological profiles of a 69-year-old patient with a 12-year history of X-linked dystonia-Parkinsonism (XDP). Pre-operative cognitive function was impaired in almost all domains and this impaired performance was not dependent on his medications. Following DBS, changes in neuropsychological functioning were examined using Reliable Change Indices and standardized z-score comparisons. Results showed reductions in processing speed in the context of stable performance in language and visuospatial domains. Postoperative improvements occurred on a cognitive screening measure, verbal memory, and a test of problem-solving skills. This is the first report on an individual with XDP who was cognitively impaired, but had good outcome following GPi bilateral stimulation to treat debilitating motor symptoms. The possible mechanisms for his stable cognitive performance include the target of his DBS, reduced medication dosage, and improvement in dystonia that may in turn have reduced patient’s pain.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="cf5b61e5563cd9b170b12edff6eb7a1b" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":80805347,"asset_id":71482257,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/80805347/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482257"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482257"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482257; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482257]").text(description); $(".js-view-count[data-work-id=71482257]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482257; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482257']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482257, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "cf5b61e5563cd9b170b12edff6eb7a1b" } } $('.js-work-strip[data-work-id=71482257]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482257,"title":"Pre-and Post-GPi DBS Neuropsychological Profiles in a Case of X-Linked Dystonia-Parkinsonism","translated_title":"","metadata":{"abstract":"We present the pre to post bilateral globus pallidus interna (GPi) deep brain stimulation neuropsychological profiles of a 69-year-old patient with a 12-year history of X-linked dystonia-Parkinsonism (XDP). 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The possible mechanisms for his stable cognitive performance include the target of his DBS, reduced medication dosage, and improvement in dystonia that may in turn have reduced patient’s pain.","publisher":"Psychology Press","publication_date":{"day":null,"month":null,"year":2011,"errors":{}},"publication_name":"The Clinical …"},"translated_abstract":"We present the pre to post bilateral globus pallidus interna (GPi) deep brain stimulation neuropsychological profiles of a 69-year-old patient with a 12-year history of X-linked dystonia-Parkinsonism (XDP). Pre-operative cognitive function was impaired in almost all domains and this impaired performance was not dependent on his medications. Following DBS, changes in neuropsychological functioning were examined using Reliable Change Indices and standardized z-score comparisons. Results showed reductions in processing speed in the context of stable performance in language and visuospatial domains. Postoperative improvements occurred on a cognitive screening measure, verbal memory, and a test of problem-solving skills. This is the first report on an individual with XDP who was cognitively impaired, but had good outcome following GPi bilateral stimulation to treat debilitating motor symptoms. The possible mechanisms for his stable cognitive performance include the target of his DBS, reduced medication dosage, and improvement in dystonia that may in turn have reduced patient’s pain.","internal_url":"https://www.academia.edu/71482257/Pre_and_Post_GPi_DBS_Neuropsychological_Profiles_in_a_Case_of_X_Linked_Dystonia_Parkinsonism","translated_internal_url":"","created_at":"2022-02-14T04:19:17.033-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33000306,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[{"id":80805347,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/80805347/thumbnails/1.jpg","file_name":"pdf.pdf","download_url":"https://www.academia.edu/attachments/80805347/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"Pre_and_Post_GPi_DBS_Neuropsychological.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/80805347/pdf-libre.pdf?1644841533=\u0026response-content-disposition=attachment%3B+filename%3DPre_and_Post_GPi_DBS_Neuropsychological.pdf\u0026Expires=1733271341\u0026Signature=Z2nD-k-mwdrFpiKtYySe585V1jUaz4qyuVtKxggwL04nhfwRisXxBCdiwvatFqahGjR~L23fehSrDBXanfXyP3pOiWbADTRlEjIYeWrYlMVOshf3ZVBXq-sV26dBtYeqElzwRNkPzuw8KdCuatoywdoGcgGCUKGGO0ajVbE2PcgD8H4ObyDhBx9Zq6e76ra-neNKoGjNdkEPLGrHUt8K-H1wqMuEcORMbobJ4C77FmUN32vl1grda9E7D~fcnLFU40okfIL-FPX-I5iMYQlmwxxCC4Q9xblNe0439dQh07cepcjKPxhRLNv1PFcyRmu-53acXvCfcJCct5Ud0n7QVQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Pre_and_Post_GPi_DBS_Neuropsychological_Profiles_in_a_Case_of_X_Linked_Dystonia_Parkinsonism","translated_slug":"","page_count":16,"language":"en","content_type":"Work","owner":{"id":33000306,"first_name":"Michael","middle_initials":null,"last_name":"Okun","page_name":"MOkun","domain_name":"independent","created_at":"2015-07-12T04:47:31.779-07:00","display_name":"Michael Okun","url":"https://independent.academia.edu/MOkun"},"attachments":[{"id":80805347,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/80805347/thumbnails/1.jpg","file_name":"pdf.pdf","download_url":"https://www.academia.edu/attachments/80805347/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"Pre_and_Post_GPi_DBS_Neuropsychological.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/80805347/pdf-libre.pdf?1644841533=\u0026response-content-disposition=attachment%3B+filename%3DPre_and_Post_GPi_DBS_Neuropsychological.pdf\u0026Expires=1733271341\u0026Signature=Z2nD-k-mwdrFpiKtYySe585V1jUaz4qyuVtKxggwL04nhfwRisXxBCdiwvatFqahGjR~L23fehSrDBXanfXyP3pOiWbADTRlEjIYeWrYlMVOshf3ZVBXq-sV26dBtYeqElzwRNkPzuw8KdCuatoywdoGcgGCUKGGO0ajVbE2PcgD8H4ObyDhBx9Zq6e76ra-neNKoGjNdkEPLGrHUt8K-H1wqMuEcORMbobJ4C77FmUN32vl1grda9E7D~fcnLFU40okfIL-FPX-I5iMYQlmwxxCC4Q9xblNe0439dQh07cepcjKPxhRLNv1PFcyRmu-53acXvCfcJCct5Ud0n7QVQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":221,"name":"Psychology","url":"https://www.academia.edu/Documents/in/Psychology"},{"id":237,"name":"Cognitive Science","url":"https://www.academia.edu/Documents/in/Cognitive_Science"},{"id":2583,"name":"Deep Brain Stimulation","url":"https://www.academia.edu/Documents/in/Deep_Brain_Stimulation"},{"id":2599,"name":"Psychometrics","url":"https://www.academia.edu/Documents/in/Psychometrics"},{"id":49419,"name":"Problem Solving","url":"https://www.academia.edu/Documents/in/Problem_Solving"},{"id":52437,"name":"Processing Speed","url":"https://www.academia.edu/Documents/in/Processing_Speed"},{"id":97764,"name":"Neuropsychological Assessment","url":"https://www.academia.edu/Documents/in/Neuropsychological_Assessment"},{"id":209780,"name":"Dystonia","url":"https://www.academia.edu/Documents/in/Dystonia"},{"id":233770,"name":"Cognitive Performance","url":"https://www.academia.edu/Documents/in/Cognitive_Performance"},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged"},{"id":341121,"name":"Cognitive impairment","url":"https://www.academia.edu/Documents/in/Cognitive_impairment"},{"id":441653,"name":"Cognitive Function","url":"https://www.academia.edu/Documents/in/Cognitive_Function"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences"},{"id":1541077,"name":"Parkinson Disease","url":"https://www.academia.edu/Documents/in/Parkinson_Disease"},{"id":1627527,"name":"Cognition disorders","url":"https://www.academia.edu/Documents/in/Cognition_disorders"},{"id":2467548,"name":"Neuropsychological Tests","url":"https://www.academia.edu/Documents/in/Neuropsychological_Tests"},{"id":2676416,"name":"parkinsonian disorders","url":"https://www.academia.edu/Documents/in/parkinsonian_disorders"},{"id":4002193,"name":"Macho","url":"https://www.academia.edu/Documents/in/Macho"}],"urls":[{"id":17665189,"url":"http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3070298/"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482254"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482254/TH_C_M100J_10_Development_of_Image_Guidance_Methods_for_Deep_Brain_Stimulation"><img alt="Research paper thumbnail of TH‐C‐M100J‐10: Development of Image Guidance Methods for Deep Brain Stimulation" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482254/TH_C_M100J_10_Development_of_Image_Guidance_Methods_for_Deep_Brain_Stimulation">TH‐C‐M100J‐10: Development of Image Guidance Methods for Deep Brain Stimulation</a></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Purpose: To develop and employ novel image guidance methods for targeting in the stereotactic fun...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Purpose: To develop and employ novel image guidance methods for targeting in the stereotactic functional procedure of deep brain stimulation (DBS) in regions that are poorly defined with anatomic imaging using a deformable atlas and functional imaging.Method and Materials: An image guidance system was developed to enhance targeting for stereotactic DBS surgeries. An atlas of the structures in the basal ganglia was created from the Schaltenbrand‐Bailey series of histologically stained sagittal and axial sections. By defining a surface that connects each plane, a voxelized binary atlas was created and smoothed to reduce inconsistencies. A set of programs were created using Matlab to allow for user driven linear atlas deformation to match the atlas with patient specific anatomy and landmarks. An additional set of programs were created to record intraoperative microelectrode recording (MER) maps and to visualize these maps through sagittal and coronal cuts in the patient deformed atlas. To add additional functional information, a high resolution functional MRI (fMRI) protocol was developed that allows for localization of motor, sensory, language, and emotional regions in the basal ganglia. Software to visualize the deformed atlas, MRI and fMRI all together was created to allow for target definition and planning based off multiple sources of information simultaneously. Results: The developed atlas‐based image guidance system has been used as a clinical tool for several months and now allows physicians the ability to deform an anatomic atlas to patient specific anatomy and also obtain and view electrode tracks through the atlas in oblique angles. fMRI data on initial subjects has shown good qualitative agreement with expected physiological locations and MER maps in patients. Conclusion: This work allows for improved targeting in DBS based off the simultaneous usage of a 3D deformed atlas, microelectrode recording maps, and fMRI data.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482254"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482254"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482254; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482254]").text(description); $(".js-view-count[data-work-id=71482254]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482254; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482254']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482254, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=71482254]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482254,"title":"TH‐C‐M100J‐10: Development of Image Guidance Methods for Deep Brain Stimulation","translated_title":"","metadata":{"abstract":"Purpose: To develop and employ novel image guidance methods for targeting in the stereotactic functional procedure of deep brain stimulation (DBS) in regions that are poorly defined with anatomic imaging using a deformable atlas and functional imaging.Method and Materials: An image guidance system was developed to enhance targeting for stereotactic DBS surgeries. An atlas of the structures in the basal ganglia was created from the Schaltenbrand‐Bailey series of histologically stained sagittal and axial sections. By defining a surface that connects each plane, a voxelized binary atlas was created and smoothed to reduce inconsistencies. A set of programs were created using Matlab to allow for user driven linear atlas deformation to match the atlas with patient specific anatomy and landmarks. An additional set of programs were created to record intraoperative microelectrode recording (MER) maps and to visualize these maps through sagittal and coronal cuts in the patient deformed atlas. To add additional functional information, a high resolution functional MRI (fMRI) protocol was developed that allows for localization of motor, sensory, language, and emotional regions in the basal ganglia. Software to visualize the deformed atlas, MRI and fMRI all together was created to allow for target definition and planning based off multiple sources of information simultaneously. Results: The developed atlas‐based image guidance system has been used as a clinical tool for several months and now allows physicians the ability to deform an anatomic atlas to patient specific anatomy and also obtain and view electrode tracks through the atlas in oblique angles. fMRI data on initial subjects has shown good qualitative agreement with expected physiological locations and MER maps in patients. Conclusion: This work allows for improved targeting in DBS based off the simultaneous usage of a 3D deformed atlas, microelectrode recording maps, and fMRI data.","publication_date":{"day":null,"month":null,"year":2007,"errors":{}}},"translated_abstract":"Purpose: To develop and employ novel image guidance methods for targeting in the stereotactic functional procedure of deep brain stimulation (DBS) in regions that are poorly defined with anatomic imaging using a deformable atlas and functional imaging.Method and Materials: An image guidance system was developed to enhance targeting for stereotactic DBS surgeries. An atlas of the structures in the basal ganglia was created from the Schaltenbrand‐Bailey series of histologically stained sagittal and axial sections. By defining a surface that connects each plane, a voxelized binary atlas was created and smoothed to reduce inconsistencies. A set of programs were created using Matlab to allow for user driven linear atlas deformation to match the atlas with patient specific anatomy and landmarks. An additional set of programs were created to record intraoperative microelectrode recording (MER) maps and to visualize these maps through sagittal and coronal cuts in the patient deformed atlas. To add additional functional information, a high resolution functional MRI (fMRI) protocol was developed that allows for localization of motor, sensory, language, and emotional regions in the basal ganglia. Software to visualize the deformed atlas, MRI and fMRI all together was created to allow for target definition and planning based off multiple sources of information simultaneously. 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> </div><div class="profile--tab_content_container js-tab-pane tab-pane" data-section-id="3202763" id="papers"><div class="js-work-strip profile--work_container" data-work-id="71482322"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482322/Non_motor_Characterization_of_the_Basal_Ganglia_Evidence_From_Human_and_Non_human_Primate_Electrophysiology"><img alt="Research paper thumbnail of Non-motor Characterization of the Basal Ganglia: Evidence From Human and Non-human Primate Electrophysiology" class="work-thumbnail" src="https://attachments.academia-assets.com/80805460/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482322/Non_motor_Characterization_of_the_Basal_Ganglia_Evidence_From_Human_and_Non_human_Primate_Electrophysiology">Non-motor Characterization of the Basal Ganglia: Evidence From Human and Non-human Primate Electrophysiology</a></div><div class="wp-workCard_item"><span>Frontiers in neuroscience</span><span>, 2018</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Although the basal ganglia have been implicated in a growing list of human behaviors, they includ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Although the basal ganglia have been implicated in a growing list of human behaviors, they include some of the least understood nuclei in the brain. For several decades studies have employed numerous methodologies to uncover evidence pointing to the basal ganglia as a hub of both motor and non-motor function. Recently, new electrophysiological characterization of the basal ganglia in humans has become possible through direct access to these deep structures as part of routine neurosurgery. Electrophysiological approaches for identifying non-motor function have the potential to unlock a deeper understanding of pathways that may inform clinical interventions and particularly neuromodulation. Various electrophysiological modalities can also be combined to reveal functional connections between the basal ganglia and traditional structures throughout the neocortex that have been linked to non-motor behavior. Several reviews have previously summarized evidence for non-motor function in the ...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="bd1659a67c8df7954310b4118d9f8b5b" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":80805460,"asset_id":71482322,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/80805460/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482322"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482322"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482322; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482322]").text(description); $(".js-view-count[data-work-id=71482322]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482322; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482322']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482322, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "bd1659a67c8df7954310b4118d9f8b5b" } } $('.js-work-strip[data-work-id=71482322]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482322,"title":"Non-motor Characterization of the Basal Ganglia: Evidence From Human and Non-human Primate Electrophysiology","translated_title":"","metadata":{"abstract":"Although the basal ganglia have been implicated in a growing list of human behaviors, they include some of the least understood nuclei in the brain. 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Various electrophysiological modalities can also be combined to reveal functional connections between the basal ganglia and traditional structures throughout the neocortex that have been linked to non-motor behavior. 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482317"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482317/Postoperative_lead_migration_in_deep_brain_stimulation_surgery_Incidence_risk_factors_and_clinical_impact"><img alt="Research paper thumbnail of Postoperative lead migration in deep brain stimulation surgery: Incidence, risk factors, and clinical impact" class="work-thumbnail" src="https://attachments.academia-assets.com/80805462/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482317/Postoperative_lead_migration_in_deep_brain_stimulation_surgery_Incidence_risk_factors_and_clinical_impact">Postoperative lead migration in deep brain stimulation surgery: Incidence, risk factors, and clinical impact</a></div><div class="wp-workCard_item"><span>PLOS ONE</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="413739b3034602d1bee007d5f0bb2bc6" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":80805462,"asset_id":71482317,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/80805462/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482317"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482317"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482317; 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The funders had no role in study design, data indices were collected and analyzed. Clinical outcomes were characterized with validated rating scales for all cases, and a comparison was made between outcomes of cases with lead migration versus those where migration of the lead did not occur. Results Data from 138 leads in 132 patients with initial and delayed lead localization CT scans were analyzed. The mean distance between initial and delayed DBS lead tip position was 2.2 mm and the mean change in intracranial lead length was 0.45 mm. Significant delayed migration (\u003e3 mm) was observed in 17 leads in 16 patients (12.3% of leads, 12.1% of patients). Factors associated with lead migration were: technical error, repetitive dystonic head movement, and twiddler's syndrome. Outcomes were worse in dystonia patients with lead migration (p = 0.035). In the PD group, worse clinical outcomes trended in cases with lead migration. Conclusions Over 10% of DBS leads in this large single center cohort were displaced by greater than 3 mm on delayed measurement, adversely affecting outcomes. Multiple risk factors emerged, including technical error during implantation of the DBS pulse generator and failure of lead fixation at the burr hole site. We hypothesize that a change in surgical technique and a more effective lead fixation device might mitigate this problem.","publication_name":"PLOS ONE","grobid_abstract_attachment_id":80805462},"translated_abstract":null,"internal_url":"https://www.academia.edu/71482317/Postoperative_lead_migration_in_deep_brain_stimulation_surgery_Incidence_risk_factors_and_clinical_impact","translated_internal_url":"","created_at":"2022-02-14T04:19:35.280-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33000306,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[{"id":80805462,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/80805462/thumbnails/1.jpg","file_name":"76c426c30f31ab458ed22206903c22d35bf8.pdf","download_url":"https://www.academia.edu/attachments/80805462/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"Postoperative_lead_migration_in_deep_bra.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/80805462/76c426c30f31ab458ed22206903c22d35bf8-libre.pdf?1644841530=\u0026response-content-disposition=attachment%3B+filename%3DPostoperative_lead_migration_in_deep_bra.pdf\u0026Expires=1733271341\u0026Signature=cLmabWRyWOcmnkQyNfHxi73Y15q00-cT6CBT3Tpd4bwMcbA2syKsQN~5xODHyyR2Vkjh~Gq05mWnXkD0y1OAreIy3A4NuNbnOtEUM91Df-~9tLMPvJUJbbTKSBw8anv3JEN~aMwgR74hWajYhz7vDKCBV~s6-cpdEcnVvGYQ6R3cLeKu3gs88O8VacaoJv9IbUBG5dHcWwLfZ7QcI4fzj2r4N6JYOrJdURlEIlvgJU2qwmWTa3jNI9TYX3uMTPZeWt6cCMshS9YUoI9IYwyFZ~eXwIrxiWc1mbhFxqjLQins-G3ZWGsgJ2y00v-SBAjv8MXlaLgos8OUGPWhyqg4ww__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Postoperative_lead_migration_in_deep_brain_stimulation_surgery_Incidence_risk_factors_and_clinical_impact","translated_slug":"","page_count":22,"language":"en","content_type":"Work","owner":{"id":33000306,"first_name":"Michael","middle_initials":null,"last_name":"Okun","page_name":"MOkun","domain_name":"independent","created_at":"2015-07-12T04:47:31.779-07:00","display_name":"Michael Okun","url":"https://independent.academia.edu/MOkun"},"attachments":[{"id":80805462,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/80805462/thumbnails/1.jpg","file_name":"76c426c30f31ab458ed22206903c22d35bf8.pdf","download_url":"https://www.academia.edu/attachments/80805462/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"Postoperative_lead_migration_in_deep_bra.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/80805462/76c426c30f31ab458ed22206903c22d35bf8-libre.pdf?1644841530=\u0026response-content-disposition=attachment%3B+filename%3DPostoperative_lead_migration_in_deep_bra.pdf\u0026Expires=1733271341\u0026Signature=cLmabWRyWOcmnkQyNfHxi73Y15q00-cT6CBT3Tpd4bwMcbA2syKsQN~5xODHyyR2Vkjh~Gq05mWnXkD0y1OAreIy3A4NuNbnOtEUM91Df-~9tLMPvJUJbbTKSBw8anv3JEN~aMwgR74hWajYhz7vDKCBV~s6-cpdEcnVvGYQ6R3cLeKu3gs88O8VacaoJv9IbUBG5dHcWwLfZ7QcI4fzj2r4N6JYOrJdURlEIlvgJU2qwmWTa3jNI9TYX3uMTPZeWt6cCMshS9YUoI9IYwyFZ~eXwIrxiWc1mbhFxqjLQins-G3ZWGsgJ2y00v-SBAjv8MXlaLgos8OUGPWhyqg4ww__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":2583,"name":"Deep Brain Stimulation","url":"https://www.academia.edu/Documents/in/Deep_Brain_Stimulation"},{"id":6200,"name":"Magnetic Resonance Imaging","url":"https://www.academia.edu/Documents/in/Magnetic_Resonance_Imaging"},{"id":12426,"name":"Treatment Outcome","url":"https://www.academia.edu/Documents/in/Treatment_Outcome"},{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine"},{"id":28235,"name":"Multidisciplinary","url":"https://www.academia.edu/Documents/in/Multidisciplinary"},{"id":61474,"name":"Brain","url":"https://www.academia.edu/Documents/in/Brain"},{"id":174502,"name":"Incidence","url":"https://www.academia.edu/Documents/in/Incidence"},{"id":192721,"name":"Risk factors","url":"https://www.academia.edu/Documents/in/Risk_factors"},{"id":220780,"name":"PLoS one","url":"https://www.academia.edu/Documents/in/PLoS_one"},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged"},{"id":469105,"name":"Retrospective Studies","url":"https://www.academia.edu/Documents/in/Retrospective_Studies"},{"id":620049,"name":"Risk Factors","url":"https://www.academia.edu/Documents/in/Risk_Factors-1"},{"id":745088,"name":"FOREIGN BODY MIGRATION","url":"https://www.academia.edu/Documents/in/FOREIGN_BODY_MIGRATION"},{"id":1541077,"name":"Parkinson Disease","url":"https://www.academia.edu/Documents/in/Parkinson_Disease"},{"id":2463621,"name":"Postoperative Complications","url":"https://www.academia.edu/Documents/in/Postoperative_Complications"}],"urls":[{"id":17665201,"url":"http://dx.plos.org/10.1371/journal.pone.0183711"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482314"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482314/The_human_subthalamic_nucleus_and_globus_pallidus_internus_differentially_encode_reward_during_action_control"><img alt="Research paper thumbnail of The human subthalamic nucleus and globus pallidus internus differentially encode reward during action control" class="work-thumbnail" src="https://attachments.academia-assets.com/80805459/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482314/The_human_subthalamic_nucleus_and_globus_pallidus_internus_differentially_encode_reward_during_action_control">The human subthalamic nucleus and globus pallidus internus differentially encode reward during action control</a></div><div class="wp-workCard_item"><span>Human brain mapping</span><span>, Apr 28, 2017</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">The subthalamic nucleus (STN) and globus pallidus internus (GPi) have recently been shown to enco...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">The subthalamic nucleus (STN) and globus pallidus internus (GPi) have recently been shown to encode reward, but few studies have been performed in humans. We investigated STN and GPi encoding of reward and loss (i.e., valence) in humans with Parkinson&#39;s disease. To test the hypothesis that STN and GPi neurons would change their firing rate in response to reward- and loss-related stimuli, we recorded the activity of individual neurons while participants performed a behavioral task. In the task, action choices were associated with potential rewarding, punitive, or neutral outcomes. We found that STN and GPi neurons encode valence-related information during action control, but the proportion of valence-responsive neurons was greater in the STN compared to the GPi. In the STN, reward-related stimuli mobilized a greater proportion of neurons than loss-related stimuli. We also found surprising limbic overlap with the sensorimotor regions in both the STN and GPi, and this overlap was g...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="1ef6233c34f47797936d4254dae7ca4a" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":80805459,"asset_id":71482314,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/80805459/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482314"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482314"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482314; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482314]").text(description); $(".js-view-count[data-work-id=71482314]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482314; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482314']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482314, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "1ef6233c34f47797936d4254dae7ca4a" } } $('.js-work-strip[data-work-id=71482314]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482314,"title":"The human subthalamic nucleus and globus pallidus internus differentially encode reward during action control","translated_title":"","metadata":{"abstract":"The subthalamic nucleus (STN) and globus pallidus internus (GPi) have recently been shown to encode reward, but few studies have been performed in humans. We investigated STN and GPi encoding of reward and loss (i.e., valence) in humans with Parkinson\u0026#39;s disease. To test the hypothesis that STN and GPi neurons would change their firing rate in response to reward- and loss-related stimuli, we recorded the activity of individual neurons while participants performed a behavioral task. In the task, action choices were associated with potential rewarding, punitive, or neutral outcomes. We found that STN and GPi neurons encode valence-related information during action control, but the proportion of valence-responsive neurons was greater in the STN compared to the GPi. In the STN, reward-related stimuli mobilized a greater proportion of neurons than loss-related stimuli. We also found surprising limbic overlap with the sensorimotor regions in both the STN and GPi, and this overlap was g...","publication_date":{"day":28,"month":4,"year":2017,"errors":{}},"publication_name":"Human brain mapping"},"translated_abstract":"The subthalamic nucleus (STN) and globus pallidus internus (GPi) have recently been shown to encode reward, but few studies have been performed in humans. We investigated STN and GPi encoding of reward and loss (i.e., valence) in humans with Parkinson\u0026#39;s disease. To test the hypothesis that STN and GPi neurons would change their firing rate in response to reward- and loss-related stimuli, we recorded the activity of individual neurons while participants performed a behavioral task. In the task, action choices were associated with potential rewarding, punitive, or neutral outcomes. We found that STN and GPi neurons encode valence-related information during action control, but the proportion of valence-responsive neurons was greater in the STN compared to the GPi. In the STN, reward-related stimuli mobilized a greater proportion of neurons than loss-related stimuli. We also found surprising limbic overlap with the sensorimotor regions in both the STN and GPi, and this overlap was g...","internal_url":"https://www.academia.edu/71482314/The_human_subthalamic_nucleus_and_globus_pallidus_internus_differentially_encode_reward_during_action_control","translated_internal_url":"","created_at":"2022-02-14T04:19:33.398-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33000306,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[{"id":80805459,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/80805459/thumbnails/1.jpg","file_name":"hbm.pdf","download_url":"https://www.academia.edu/attachments/80805459/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"The_human_subthalamic_nucleus_and_globus.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/80805459/hbm-libre.pdf?1644841524=\u0026response-content-disposition=attachment%3B+filename%3DThe_human_subthalamic_nucleus_and_globus.pdf\u0026Expires=1733271341\u0026Signature=JfCZJqf9OMbg6DWY5ksA1eHY7PaoN2Irp0g~KWgVqD838JNiwJWy0ExUp8lMsZYbn1xfIhpuobWn15jth1mKg5~P1ytTrP5hiG7iF1ZRJ4-2MB6jFotGxbUTOqujQN1s-kGEYUJFJS0gEU0PcUUpS5~gUyyebipHjgSU~~uYTAOx2OPKc0AuJBRzlExm0o3oBicJmQxE5-~Wbg97uXwpEQoeSMIWvsvMY1fVAjBRx-9Nm7r1k-lIiO~tOhtTnwF0INgT26gGmGAgYPhKccb70-7IoeHoOlZw7jZXLV8Jarf~DBwW7BReaPysIr-ovB~Rff1zVzDC4NPikMbyfJdN5g__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"The_human_subthalamic_nucleus_and_globus_pallidus_internus_differentially_encode_reward_during_action_control","translated_slug":"","page_count":13,"language":"en","content_type":"Work","owner":{"id":33000306,"first_name":"Michael","middle_initials":null,"last_name":"Okun","page_name":"MOkun","domain_name":"independent","created_at":"2015-07-12T04:47:31.779-07:00","display_name":"Michael Okun","url":"https://independent.academia.edu/MOkun"},"attachments":[{"id":80805459,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/80805459/thumbnails/1.jpg","file_name":"hbm.pdf","download_url":"https://www.academia.edu/attachments/80805459/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"The_human_subthalamic_nucleus_and_globus.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/80805459/hbm-libre.pdf?1644841524=\u0026response-content-disposition=attachment%3B+filename%3DThe_human_subthalamic_nucleus_and_globus.pdf\u0026Expires=1733271341\u0026Signature=JfCZJqf9OMbg6DWY5ksA1eHY7PaoN2Irp0g~KWgVqD838JNiwJWy0ExUp8lMsZYbn1xfIhpuobWn15jth1mKg5~P1ytTrP5hiG7iF1ZRJ4-2MB6jFotGxbUTOqujQN1s-kGEYUJFJS0gEU0PcUUpS5~gUyyebipHjgSU~~uYTAOx2OPKc0AuJBRzlExm0o3oBicJmQxE5-~Wbg97uXwpEQoeSMIWvsvMY1fVAjBRx-9Nm7r1k-lIiO~tOhtTnwF0INgT26gGmGAgYPhKccb70-7IoeHoOlZw7jZXLV8Jarf~DBwW7BReaPysIr-ovB~Rff1zVzDC4NPikMbyfJdN5g__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":237,"name":"Cognitive Science","url":"https://www.academia.edu/Documents/in/Cognitive_Science"},{"id":7710,"name":"Biology","url":"https://www.academia.edu/Documents/in/Biology"},{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine"},{"id":42408,"name":"Subthalamic Nucleus","url":"https://www.academia.edu/Documents/in/Subthalamic_Nucleus"},{"id":49021,"name":"Reward","url":"https://www.academia.edu/Documents/in/Reward"},{"id":193974,"name":"Neurons","url":"https://www.academia.edu/Documents/in/Neurons"},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged"},{"id":383087,"name":"Globus Pallidus","url":"https://www.academia.edu/Documents/in/Globus_Pallidus"},{"id":685368,"name":"Human Brain Mapping","url":"https://www.academia.edu/Documents/in/Human_Brain_Mapping"},{"id":955727,"name":"Action Potentials","url":"https://www.academia.edu/Documents/in/Action_Potentials"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences"},{"id":1541077,"name":"Parkinson Disease","url":"https://www.academia.edu/Documents/in/Parkinson_Disease"},{"id":2451403,"name":"Avoidance Learning","url":"https://www.academia.edu/Documents/in/Avoidance_Learning"}],"urls":[]}, dispatcherData: dispatcherData }); 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Case Report: A 38-year-old male with Parkinson's disease developed intractable hemiballism in his left extremities due to a small lesion that was located adjacent to the right deep brain stimulation (DBS) lead, 10 months after bilateral subthalamic nucleus (STN)-DBS placement. He underwent a right globus pallidus internus (GPi)-DBS lead implantation. GPi-DBS satisfactorily addressed his hemiballism. Discussion: This case offered a unique look at basal ganglia physiology in human hemiballism. GPi-DBS is a reasonable therapeutic option for the treatment of medication refractory hemiballism in the setting of Parkinson's disease.","grobid_abstract_attachment_id":80805457},"translated_abstract":null,"internal_url":"https://www.academia.edu/71482310/Rescue_GPi_DBS_for_a_stroke_associated_hemiballism_in_a_patient_with_STN_DBS","translated_internal_url":"","created_at":"2022-02-14T04:19:31.758-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33000306,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[{"id":80805457,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/80805457/thumbnails/1.jpg","file_name":"214-5009-1-PB.pdf","download_url":"https://www.academia.edu/attachments/80805457/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"Rescue_GPi_DBS_for_a_stroke_associated_h.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/80805457/214-5009-1-PB-libre.pdf?1644841524=\u0026response-content-disposition=attachment%3B+filename%3DRescue_GPi_DBS_for_a_stroke_associated_h.pdf\u0026Expires=1733271341\u0026Signature=YzAuTlb7vMdYyjtvK9ybtdvvOa3P1nOOQK61E5w45fDwGIJ4AAAbrisomwmzemaRtGZ9YGto3r0jboC3OveGDyRhhYPvSXzOgw00nsMazxxFwt1hmoGttxtdSk-0Da6tWV4p9Vl1UvW8JBvgqL4tmLvsRbRU7M0hkfmNcPxFjNj~7kDqegL6gCh-9gD5b4Z2KwLtP3z7m15fFPm9qm-VsvEsjpVgd2BEgU6qCZyVWU56kVpLX4~qMd2vyhF9s2aWhEkjWG4-~2Xrtic5qQpt-ZJn-wKp6T~0STOUe~Th98zyJR~-k6diai5i51q1fFMiUXTjdix2ed5cjogZludP2Q__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Rescue_GPi_DBS_for_a_stroke_associated_hemiballism_in_a_patient_with_STN_DBS","translated_slug":"","page_count":5,"language":"en","content_type":"Work","owner":{"id":33000306,"first_name":"Michael","middle_initials":null,"last_name":"Okun","page_name":"MOkun","domain_name":"independent","created_at":"2015-07-12T04:47:31.779-07:00","display_name":"Michael Okun","url":"https://independent.academia.edu/MOkun"},"attachments":[{"id":80805457,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/80805457/thumbnails/1.jpg","file_name":"214-5009-1-PB.pdf","download_url":"https://www.academia.edu/attachments/80805457/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&","bulk_download_file_name":"Rescue_GPi_DBS_for_a_stroke_associated_h.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/80805457/214-5009-1-PB-libre.pdf?1644841524=\u0026response-content-disposition=attachment%3B+filename%3DRescue_GPi_DBS_for_a_stroke_associated_h.pdf\u0026Expires=1733271341\u0026Signature=YzAuTlb7vMdYyjtvK9ybtdvvOa3P1nOOQK61E5w45fDwGIJ4AAAbrisomwmzemaRtGZ9YGto3r0jboC3OveGDyRhhYPvSXzOgw00nsMazxxFwt1hmoGttxtdSk-0Da6tWV4p9Vl1UvW8JBvgqL4tmLvsRbRU7M0hkfmNcPxFjNj~7kDqegL6gCh-9gD5b4Z2KwLtP3z7m15fFPm9qm-VsvEsjpVgd2BEgU6qCZyVWU56kVpLX4~qMd2vyhF9s2aWhEkjWG4-~2Xrtic5qQpt-ZJn-wKp6T~0STOUe~Th98zyJR~-k6diai5i51q1fFMiUXTjdix2ed5cjogZludP2Q__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":26327,"name":"Medicine","url":"https://www.academia.edu/Documents/in/Medicine"},{"id":380006,"name":"Rest","url":"https://www.academia.edu/Documents/in/Rest"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences"},{"id":1357280,"name":"Oscillation","url":"https://www.academia.edu/Documents/in/Oscillation"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482307"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/71482307/Brittle_dyskinesia_following_STN_but_not_GPi_deep_brain_stimulation"><img alt="Research paper thumbnail of Brittle dyskinesia following STN but not GPi deep brain stimulation" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/71482307/Brittle_dyskinesia_following_STN_but_not_GPi_deep_brain_stimulation">Brittle dyskinesia following STN but not GPi deep brain stimulation</a></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482307"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482307"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482307; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482303"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482303/Deep_brain_stimulation_for_tremor_associated_with_underlying_ataxia_syndromes_a_case_series_and_discussion_of_issues"><img alt="Research paper thumbnail of Deep brain stimulation for tremor associated with underlying ataxia syndromes: a case series and discussion of issues" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482303/Deep_brain_stimulation_for_tremor_associated_with_underlying_ataxia_syndromes_a_case_series_and_discussion_of_issues">Deep brain stimulation for tremor associated with underlying ataxia syndromes: a case series and discussion of issues</a></div><div class="wp-workCard_item"><span>Tremor and other hyperkinetic movements (New York, N.Y.)</span><span>, 2014</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Deep brain stimulation (DBS) has been utilized to treat various symptoms in patients suffering fr...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Deep brain stimulation (DBS) has been utilized to treat various symptoms in patients suffering from movement disorders such as Parkinson&#39;s disease, dystonia, and essential tremor. Though ataxia syndromes have not been formally or frequently addressed with DBS, there are patients with ataxia and associated medication refractory tremor or dystonia who may potentially benefit from therapy. A retrospective database review was performed, searching for cases of ataxia where tremor and/or dystonia were addressed by utilizing DBS at the University of Florida Center for Movement Disorders and Neurorestoration between 2008 and 2011. Five patients were found who had DBS implantation to address either medication refractory tremor or dystonia. The patient&#39;s underlying diagnoses included spinocerebellar ataxia type 2 (SCA2), fragile X associated tremor ataxia syndrome (FXTAS), a case of idiopathic ataxia (ataxia not otherwise specified [NOS]), spinocerebellar ataxia type 17 (SCA17), and a...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482303"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482303"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482303; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482303]").text(description); $(".js-view-count[data-work-id=71482303]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482303; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482303']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482303, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=71482303]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482303,"title":"Deep brain stimulation for tremor associated with underlying ataxia syndromes: a case series and discussion of issues","translated_title":"","metadata":{"abstract":"Deep brain stimulation (DBS) has been utilized to treat various symptoms in patients suffering from movement disorders such as Parkinson\u0026#39;s disease, dystonia, and essential tremor. Though ataxia syndromes have not been formally or frequently addressed with DBS, there are patients with ataxia and associated medication refractory tremor or dystonia who may potentially benefit from therapy. A retrospective database review was performed, searching for cases of ataxia where tremor and/or dystonia were addressed by utilizing DBS at the University of Florida Center for Movement Disorders and Neurorestoration between 2008 and 2011. Five patients were found who had DBS implantation to address either medication refractory tremor or dystonia. 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The patient\u0026#39;s underlying diagnoses included spinocerebellar ataxia type 2 (SCA2), fragile X associated tremor ataxia syndrome (FXTAS), a case of idiopathic ataxia (ataxia not otherwise specified [NOS]), spinocerebellar ataxia type 17 (SCA17), and a...","internal_url":"https://www.academia.edu/71482303/Deep_brain_stimulation_for_tremor_associated_with_underlying_ataxia_syndromes_a_case_series_and_discussion_of_issues","translated_internal_url":"","created_at":"2022-02-14T04:19:28.822-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33000306,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"Deep_brain_stimulation_for_tremor_associated_with_underlying_ataxia_syndromes_a_case_series_and_discussion_of_issues","translated_slug":"","page_count":null,"language":"en","content_type":"Work","owner":{"id":33000306,"first_name":"Michael","middle_initials":null,"last_name":"Okun","page_name":"MOkun","domain_name":"independent","created_at":"2015-07-12T04:47:31.779-07:00","display_name":"Michael Okun","url":"https://independent.academia.edu/MOkun"},"attachments":[],"research_interests":[{"id":380006,"name":"Rest","url":"https://www.academia.edu/Documents/in/Rest"},{"id":1239755,"name":"Neurosciences","url":"https://www.academia.edu/Documents/in/Neurosciences"},{"id":1357280,"name":"Oscillation","url":"https://www.academia.edu/Documents/in/Oscillation"}],"urls":[]}, dispatcherData: dispatcherData }); 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482296"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482296/Acute_and_Chronic_Mood_and_Apathy_Outcomes_from_a_Randomized_Study_of_Unilateral_STN_and_GPi_DBS"><img alt="Research paper thumbnail of Acute and Chronic Mood and Apathy Outcomes from a Randomized Study of Unilateral STN and GPi DBS" class="work-thumbnail" src="https://attachments.academia-assets.com/80805487/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482296/Acute_and_Chronic_Mood_and_Apathy_Outcomes_from_a_Randomized_Study_of_Unilateral_STN_and_GPi_DBS">Acute and Chronic Mood and Apathy Outcomes from a Randomized Study of Unilateral STN and GPi DBS</a></div><div class="wp-workCard_item"><span>PLoS ONE</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">To study mood and behavioral effects of unilateral and staged bilateral subthalamic nucleus (STN)...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">To study mood and behavioral effects of unilateral and staged bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) for Parkinson&#39;s disease (PD). There are numerous reports of mood changes following DBS, however, most have focused on bilateral simultaneous STN implants with rapid and aggressive post-operative medication reduction. A standardized evaluation was applied to a subset of patients undergoing STN and GPi DBS and who were also enrolled in the NIH COMPARE study. The Unified Parkinson Disease Rating Scale (UPDRS III), the Hamilton depression (HAM-D) and anxiety rating scales (HAM-A), the Yale-Brown obsessive-compulsive rating scale (YBOCS), the Apathy Scale (AS), and the Young mania rating scale (YMRS) were used. The scales were repeated at acute and chronic intervals. A post-operative strategy of non-aggressive medication reduction was employed. Thirty patients were randomized and underwent unilateral DBS (16 STN, 14 GPi). Th...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="a0bacba8d9a0faf0c928c6e7dc7b7119" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":80805487,"asset_id":71482296,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/80805487/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482296"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482296"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482296; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482296]").text(description); $(".js-view-count[data-work-id=71482296]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482296; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482296']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482296, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "a0bacba8d9a0faf0c928c6e7dc7b7119" } } $('.js-work-strip[data-work-id=71482296]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482296,"title":"Acute and Chronic Mood and Apathy Outcomes from a Randomized Study of Unilateral STN and GPi DBS","translated_title":"","metadata":{"abstract":"To study mood and behavioral effects of unilateral and staged bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) for Parkinson\u0026#39;s disease (PD). 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Th...","publication_name":"PLoS ONE"},"translated_abstract":"To study mood and behavioral effects of unilateral and staged bilateral subthalamic nucleus (STN) and globus pallidus internus (GPi) deep brain stimulation (DBS) for Parkinson\u0026#39;s disease (PD). There are numerous reports of mood changes following DBS, however, most have focused on bilateral simultaneous STN implants with rapid and aggressive post-operative medication reduction. A standardized evaluation was applied to a subset of patients undergoing STN and GPi DBS and who were also enrolled in the NIH COMPARE study. The Unified Parkinson Disease Rating Scale (UPDRS III), the Hamilton depression (HAM-D) and anxiety rating scales (HAM-A), the Yale-Brown obsessive-compulsive rating scale (YBOCS), the Apathy Scale (AS), and the Young mania rating scale (YMRS) were used. The scales were repeated at acute and chronic intervals. A post-operative strategy of non-aggressive medication reduction was employed. Thirty patients were randomized and underwent unilateral DBS (16 STN, 14 GPi). 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482285"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/71482285/Coordinate_Based_Lead_Location_Does_Not_Predict_Parkinsons_Disease_Deep_Brain_Stimulation_Outcome"><img alt="Research paper thumbnail of Coordinate-Based Lead Location Does Not Predict Parkinson's Disease Deep Brain Stimulation Outcome" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/71482285/Coordinate_Based_Lead_Location_Does_Not_Predict_Parkinsons_Disease_Deep_Brain_Stimulation_Outcome">Coordinate-Based Lead Location Does Not Predict Parkinson's Disease Deep Brain Stimulation Outcome</a></div><div class="wp-workCard_item"><span>PLoS ONE</span><span>, 2014</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482285"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482285"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482285; 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482281"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482281/Unilateral_deep_brain_stimulation_surgery_in_Parkinson_s_disease_improves_ipsilateral_symptoms_regardless_of_laterality"><img alt="Research paper thumbnail of Unilateral deep brain stimulation surgery in Parkinson’s disease improves ipsilateral symptoms regardless of laterality" class="work-thumbnail" src="https://attachments.academia-assets.com/80805439/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482281/Unilateral_deep_brain_stimulation_surgery_in_Parkinson_s_disease_improves_ipsilateral_symptoms_regardless_of_laterality">Unilateral deep brain stimulation surgery in Parkinson’s disease improves ipsilateral symptoms regardless of laterality</a></div><div class="wp-workCard_item"><span>Parkinsonism & Related Disorders</span><span>, 2011</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="907e6d7c199933f470f4625422ae76c9" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":80805439,"asset_id":71482281,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/80805439/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482281"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482281"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482281; 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dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "907e6d7c199933f470f4625422ae76c9" } } $('.js-work-strip[data-work-id=71482281]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482281,"title":"Unilateral deep brain stimulation surgery in Parkinson’s disease improves ipsilateral symptoms regardless of laterality","translated_title":"","metadata":{"publisher":"Elsevier BV","grobid_abstract":"Purpose-Researchers have consistently observed in right-handed individuals across normal and disease states that the 'dominant' left hemisphere has greater ipsilateral control of the left side than the right hemisphere has over the right. We sought to determine whether this ipsilateral influence of the dominant hemisphere reported in Parkinson's disease extends to treatments such as deep brain stimulation (DBS) and whether it affects outcome. We hypothesised that among Parkinson right-handers, unilateral left DBS would provide greater ipsilateral motor improvement compared with the ipsilateral motor improvement experienced on the right side. Scope-A total of 73 Parkinson patients who underwent unilateral DBS of the subthalamic nucleus (STN) or globus palidus internus (GPi) participated. Left and right 'composite scores', were computed by separately adding all items on the left and right side from the motor section of the Unified Parkinson Disease Rating Scale. The change in the pre-and 4-month postimplantation score was the primary outcome measure. The mean motor scores improved by 4.96 ± 11.79 points (p \u003c 0.001) post-surgery on the ipsilateral side of the DBS implantation. Regression analyses revealed that the side (left vs. right) and target (STN vs. GPi) did not significantly contribute in the effect of ipsilateral motor improvement (p = 0.3557). 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$(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482268"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482268/An_evaluation_of_rating_scales_utilized_for_deep_brain_stimulation_for_dystonia"><img alt="Research paper thumbnail of An evaluation of rating scales utilized for deep brain stimulation for dystonia" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482268/An_evaluation_of_rating_scales_utilized_for_deep_brain_stimulation_for_dystonia">An evaluation of rating scales utilized for deep brain stimulation for dystonia</a></div><div class="wp-workCard_item"><span>Journal of …</span><span>, 2010</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">The objective of this study was to examine globus pallidus internus deep brain stimulation (GPi-D...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">The objective of this study was to examine globus pallidus internus deep brain stimulation (GPi-DBS) outcomes in primary and secondary dystonia, derived from blinded ratings using two scales and two raters. Twenty-five patients with variable presentations of dystonia were evaluated with videotaped standardized dystonia rating scales at preoperative baseline and at 6 and 12 months following GPi-DBS implantation. These 75 examination videos were retrospectively evaluated, independently and in random order, by two movement disorder neurologists who were blinded to the treatment status. Both neurologists scored each videotaped evaluation using the Burke-Fahn-Marsden Dystonia Rating Scale-motor part (BFMDRS-M) and the Unified Dystonia Rating Scale (UDRS). A final score for each video was assigned by averaging the raters&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; scores. An intra-class correlation coefficient was used to calculate inter-rater reliability. A linear mixed model was fitted to investigate the time effect and its interaction with type of dystonia (primary versus secondary) for each rating scale. Inter-rater reliability was excellent. Intraclass correlation coefficients ranged from 0.994 to 0.997 for both scales at baseline, 6 and 12 months. The average motor improvement scores after GPi DBS for the entire heterogeneous group of dystonia patients after 6 and 12 months of stimulation was 21.32% (p = 0.0010) and 28.95% (p = 0.0017), respectively, when the UDRS score was used. Similar levels of improvement 20.46% (p = 0.0055) at 6 months and 27.39% (p = 0.00197) at 12 months were found using the BFMDRS-M score. Analysis using unblinded scores from our database revealed a 32.99 and 37.27% UDRS improvement at 6 and 12 months, and an improvement in UDRS score of 38.5 and 43.7% when the analysis was limited to only primary dystonia. If the data were further segregated to include only cases of DYT-1 primary generalized dystonia, the UDRS benefit increased to 48.24%. Our primary dystonia group was diluted by the presence of both old- and young-onset patients, as well as focal, segmental and generalized dystonia. In conclusion, (1) evaluating motor outcomes of DBS therapy for dystonia using independent, randomized retrospective rating by blinded raters&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; results in lower improvement scores than when outcomes are rated by unblinded treating neurologists. Blinded methodology may be superior and might produce a more realistic assessment of motor outcomes after DBS in patients with dystonia; (2) outcomes were similar whether the BFMDRS-M or UDRS was utilized; (3) GPi-DBS was effective in treating sustained involuntary motor co-contractions in medication refractory dystonia patients, more so in primary dystonia.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482268"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482268"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482268; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482268]").text(description); $(".js-view-count[data-work-id=71482268]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482268; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482268']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482268, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=71482268]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482268,"title":"An evaluation of rating scales utilized for deep brain stimulation for dystonia","translated_title":"","metadata":{"abstract":"The objective of this study was to examine globus pallidus internus deep brain stimulation (GPi-DBS) outcomes in primary and secondary dystonia, derived from blinded ratings using two scales and two raters. 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A final score for each video was assigned by averaging the raters\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; scores. An intra-class correlation coefficient was used to calculate inter-rater reliability. A linear mixed model was fitted to investigate the time effect and its interaction with type of dystonia (primary versus secondary) for each rating scale. Inter-rater reliability was excellent. 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In conclusion, (1) evaluating motor outcomes of DBS therapy for dystonia using independent, randomized retrospective rating by blinded raters\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; results in lower improvement scores than when outcomes are rated by unblinded treating neurologists. Blinded methodology may be superior and might produce a more realistic assessment of motor outcomes after DBS in patients with dystonia; (2) outcomes were similar whether the BFMDRS-M or UDRS was utilized; (3) GPi-DBS was effective in treating sustained involuntary motor co-contractions in medication refractory dystonia patients, more so in primary dystonia.","publisher":"Springer","publication_date":{"day":null,"month":null,"year":2010,"errors":{}},"publication_name":"Journal of …"},"translated_abstract":"The objective of this study was to examine globus pallidus internus deep brain stimulation (GPi-DBS) outcomes in primary and secondary dystonia, derived from blinded ratings using two scales and two raters. Twenty-five patients with variable presentations of dystonia were evaluated with videotaped standardized dystonia rating scales at preoperative baseline and at 6 and 12 months following GPi-DBS implantation. 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Intraclass correlation coefficients ranged from 0.994 to 0.997 for both scales at baseline, 6 and 12 months. The average motor improvement scores after GPi DBS for the entire heterogeneous group of dystonia patients after 6 and 12 months of stimulation was 21.32% (p = 0.0010) and 28.95% (p = 0.0017), respectively, when the UDRS score was used. Similar levels of improvement 20.46% (p = 0.0055) at 6 months and 27.39% (p = 0.00197) at 12 months were found using the BFMDRS-M score. Analysis using unblinded scores from our database revealed a 32.99 and 37.27% UDRS improvement at 6 and 12 months, and an improvement in UDRS score of 38.5 and 43.7% when the analysis was limited to only primary dystonia. If the data were further segregated to include only cases of DYT-1 primary generalized dystonia, the UDRS benefit increased to 48.24%. Our primary dystonia group was diluted by the presence of both old- and young-onset patients, as well as focal, segmental and generalized dystonia. In conclusion, (1) evaluating motor outcomes of DBS therapy for dystonia using independent, randomized retrospective rating by blinded raters\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; results in lower improvement scores than when outcomes are rated by unblinded treating neurologists. Blinded methodology may be superior and might produce a more realistic assessment of motor outcomes after DBS in patients with dystonia; (2) outcomes were similar whether the BFMDRS-M or UDRS was utilized; (3) GPi-DBS was effective in treating sustained involuntary motor co-contractions in medication refractory dystonia patients, more so in primary 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Brain Stimulation on Impulse Control Disorders and Dopamine Dysregulation Syndrome" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" rel="nofollow" href="https://www.academia.edu/71482265/Effects_of_STN_and_GPi_Deep_Brain_Stimulation_on_Impulse_Control_Disorders_and_Dopamine_Dysregulation_Syndrome">Effects of STN and GPi Deep Brain Stimulation on Impulse Control Disorders and Dopamine Dysregulation Syndrome</a></div><div class="wp-workCard_item"><span>PLoS ONE</span><span>, 2012</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper 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href="https://www.academia.edu/71482262/Deep_brain_stimulation_for_intractable_obsessive_compulsive_disorder_pilot_study_using_a_blinded_staggered_onset_design"><img alt="Research paper thumbnail of Deep brain stimulation for intractable obsessive compulsive disorder: pilot study using a blinded, staggered-onset design" class="work-thumbnail" src="https://attachments.academia-assets.com/80805475/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482262/Deep_brain_stimulation_for_intractable_obsessive_compulsive_disorder_pilot_study_using_a_blinded_staggered_onset_design">Deep brain stimulation for intractable obsessive compulsive disorder: pilot study using a blinded, staggered-onset design</a></div><div class="wp-workCard_item"><span>Biological …</span><span>, 2010</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">In this pilot study, six adult patients (2 male; 4 female) meeting stringent criteria for severe ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">In this pilot study, six adult patients (2 male; 4 female) meeting stringent criteria for severe (minimum Yale-Brown Obsessive Compulsive Scale [Y-BOCS] of 28) and treatment-refractory OCD had DBS electrode arrays placed bilaterally in an area spanning the ventral anterior limb of ...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="c4be02add6e3d001c52a0739f96212e5" class="wp-workCard--action" rel="nofollow" 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$a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482257"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482257/Pre_and_Post_GPi_DBS_Neuropsychological_Profiles_in_a_Case_of_X_Linked_Dystonia_Parkinsonism"><img alt="Research paper thumbnail of Pre-and Post-GPi DBS Neuropsychological Profiles in a Case of X-Linked Dystonia-Parkinsonism" class="work-thumbnail" src="https://attachments.academia-assets.com/80805347/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482257/Pre_and_Post_GPi_DBS_Neuropsychological_Profiles_in_a_Case_of_X_Linked_Dystonia_Parkinsonism">Pre-and Post-GPi DBS Neuropsychological Profiles in a Case of X-Linked Dystonia-Parkinsonism</a></div><div class="wp-workCard_item"><span>The Clinical …</span><span>, 2011</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">We present the pre to post bilateral globus pallidus interna (GPi) deep brain stimulation neurops...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">We present the pre to post bilateral globus pallidus interna (GPi) deep brain stimulation neuropsychological profiles of a 69-year-old patient with a 12-year history of X-linked dystonia-Parkinsonism (XDP). Pre-operative cognitive function was impaired in almost all domains and this impaired performance was not dependent on his medications. Following DBS, changes in neuropsychological functioning were examined using Reliable Change Indices and standardized z-score comparisons. Results showed reductions in processing speed in the context of stable performance in language and visuospatial domains. Postoperative improvements occurred on a cognitive screening measure, verbal memory, and a test of problem-solving skills. This is the first report on an individual with XDP who was cognitively impaired, but had good outcome following GPi bilateral stimulation to treat debilitating motor symptoms. The possible mechanisms for his stable cognitive performance include the target of his DBS, reduced medication dosage, and improvement in dystonia that may in turn have reduced patient’s pain.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="cf5b61e5563cd9b170b12edff6eb7a1b" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":80805347,"asset_id":71482257,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/80805347/download_file?st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&st=MTczMzI2Nzc0MSw4LjIyMi4yMDguMTQ2&s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482257"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482257"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482257; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482257]").text(description); $(".js-view-count[data-work-id=71482257]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482257; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482257']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482257, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "cf5b61e5563cd9b170b12edff6eb7a1b" } } $('.js-work-strip[data-work-id=71482257]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482257,"title":"Pre-and Post-GPi DBS Neuropsychological Profiles in a Case of X-Linked Dystonia-Parkinsonism","translated_title":"","metadata":{"abstract":"We present the pre to post bilateral globus pallidus interna (GPi) deep brain stimulation neuropsychological profiles of a 69-year-old patient with a 12-year history of X-linked dystonia-Parkinsonism (XDP). 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The possible mechanisms for his stable cognitive performance include the target of his DBS, reduced medication dosage, and improvement in dystonia that may in turn have reduced patient’s 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$a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") }); </script> <div class="js-work-strip profile--work_container" data-work-id="71482254"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/71482254/TH_C_M100J_10_Development_of_Image_Guidance_Methods_for_Deep_Brain_Stimulation"><img alt="Research paper thumbnail of TH‐C‐M100J‐10: Development of Image Guidance Methods for Deep Brain Stimulation" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/71482254/TH_C_M100J_10_Development_of_Image_Guidance_Methods_for_Deep_Brain_Stimulation">TH‐C‐M100J‐10: Development of Image Guidance Methods for Deep Brain Stimulation</a></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Purpose: To develop and employ novel image guidance methods for targeting in the stereotactic fun...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Purpose: To develop and employ novel image guidance methods for targeting in the stereotactic functional procedure of deep brain stimulation (DBS) in regions that are poorly defined with anatomic imaging using a deformable atlas and functional imaging.Method and Materials: An image guidance system was developed to enhance targeting for stereotactic DBS surgeries. An atlas of the structures in the basal ganglia was created from the Schaltenbrand‐Bailey series of histologically stained sagittal and axial sections. By defining a surface that connects each plane, a voxelized binary atlas was created and smoothed to reduce inconsistencies. A set of programs were created using Matlab to allow for user driven linear atlas deformation to match the atlas with patient specific anatomy and landmarks. An additional set of programs were created to record intraoperative microelectrode recording (MER) maps and to visualize these maps through sagittal and coronal cuts in the patient deformed atlas. To add additional functional information, a high resolution functional MRI (fMRI) protocol was developed that allows for localization of motor, sensory, language, and emotional regions in the basal ganglia. Software to visualize the deformed atlas, MRI and fMRI all together was created to allow for target definition and planning based off multiple sources of information simultaneously. Results: The developed atlas‐based image guidance system has been used as a clinical tool for several months and now allows physicians the ability to deform an anatomic atlas to patient specific anatomy and also obtain and view electrode tracks through the atlas in oblique angles. fMRI data on initial subjects has shown good qualitative agreement with expected physiological locations and MER maps in patients. Conclusion: This work allows for improved targeting in DBS based off the simultaneous usage of a 3D deformed atlas, microelectrode recording maps, and fMRI data.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="71482254"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span><span id="work-strip-rankings-button-container"></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="71482254"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 71482254; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=71482254]").text(description); $(".js-view-count[data-work-id=71482254]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 71482254; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='71482254']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span><span><script>$(function() { new Works.PaperRankView({ workId: 71482254, container: "", }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-f77ea15d77ce96025a6048a514272ad8becbad23c641fc2b3bd6e24ca6ff1932.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=71482254]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":71482254,"title":"TH‐C‐M100J‐10: Development of Image Guidance Methods for Deep Brain Stimulation","translated_title":"","metadata":{"abstract":"Purpose: To develop and employ novel image guidance methods for targeting in the stereotactic functional procedure of deep brain stimulation (DBS) in regions that are poorly defined with anatomic imaging using a deformable atlas and functional imaging.Method and Materials: An image guidance system was developed to enhance targeting for stereotactic DBS surgeries. An atlas of the structures in the basal ganglia was created from the Schaltenbrand‐Bailey series of histologically stained sagittal and axial sections. By defining a surface that connects each plane, a voxelized binary atlas was created and smoothed to reduce inconsistencies. A set of programs were created using Matlab to allow for user driven linear atlas deformation to match the atlas with patient specific anatomy and landmarks. An additional set of programs were created to record intraoperative microelectrode recording (MER) maps and to visualize these maps through sagittal and coronal cuts in the patient deformed atlas. To add additional functional information, a high resolution functional MRI (fMRI) protocol was developed that allows for localization of motor, sensory, language, and emotional regions in the basal ganglia. Software to visualize the deformed atlas, MRI and fMRI all together was created to allow for target definition and planning based off multiple sources of information simultaneously. Results: The developed atlas‐based image guidance system has been used as a clinical tool for several months and now allows physicians the ability to deform an anatomic atlas to patient specific anatomy and also obtain and view electrode tracks through the atlas in oblique angles. fMRI data on initial subjects has shown good qualitative agreement with expected physiological locations and MER maps in patients. Conclusion: This work allows for improved targeting in DBS based off the simultaneous usage of a 3D deformed atlas, microelectrode recording maps, and fMRI data.","publication_date":{"day":null,"month":null,"year":2007,"errors":{}}},"translated_abstract":"Purpose: To develop and employ novel image guidance methods for targeting in the stereotactic functional procedure of deep brain stimulation (DBS) in regions that are poorly defined with anatomic imaging using a deformable atlas and functional imaging.Method and Materials: An image guidance system was developed to enhance targeting for stereotactic DBS surgeries. An atlas of the structures in the basal ganglia was created from the Schaltenbrand‐Bailey series of histologically stained sagittal and axial sections. By defining a surface that connects each plane, a voxelized binary atlas was created and smoothed to reduce inconsistencies. A set of programs were created using Matlab to allow for user driven linear atlas deformation to match the atlas with patient specific anatomy and landmarks. An additional set of programs were created to record intraoperative microelectrode recording (MER) maps and to visualize these maps through sagittal and coronal cuts in the patient deformed atlas. To add additional functional information, a high resolution functional MRI (fMRI) protocol was developed that allows for localization of motor, sensory, language, and emotional regions in the basal ganglia. Software to visualize the deformed atlas, MRI and fMRI all together was created to allow for target definition and planning based off multiple sources of information simultaneously. Results: The developed atlas‐based image guidance system has been used as a clinical tool for several months and now allows physicians the ability to deform an anatomic atlas to patient specific anatomy and also obtain and view electrode tracks through the atlas in oblique angles. fMRI data on initial subjects has shown good qualitative agreement with expected physiological locations and MER maps in patients. Conclusion: This work allows for improved targeting in DBS based off the simultaneous usage of a 3D deformed atlas, microelectrode recording maps, and fMRI data.","internal_url":"https://www.academia.edu/71482254/TH_C_M100J_10_Development_of_Image_Guidance_Methods_for_Deep_Brain_Stimulation","translated_internal_url":"","created_at":"2022-02-14T04:19:16.365-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":33000306,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[],"downloadable_attachments":[],"slug":"TH_C_M100J_10_Development_of_Image_Guidance_Methods_for_Deep_Brain_Stimulation","translated_slug":"","page_count":null,"language":"en","content_type":"Work","owner":{"id":33000306,"first_name":"Michael","middle_initials":null,"last_name":"Okun","page_name":"MOkun","domain_name":"independent","created_at":"2015-07-12T04:47:31.779-07:00","display_name":"Michael Okun","url":"https://independent.academia.edu/MOkun"},"attachments":[],"research_interests":[{"id":1131,"name":"Biomedical Engineering","url":"https://www.academia.edu/Documents/in/Biomedical_Engineering"},{"id":2583,"name":"Deep Brain Stimulation","url":"https://www.academia.edu/Documents/in/Deep_Brain_Stimulation"},{"id":13422,"name":"Medical Physics","url":"https://www.academia.edu/Documents/in/Medical_Physics"},{"id":806593,"name":"Image Guidance","url":"https://www.academia.edu/Documents/in/Image_Guidance"}],"urls":[]}, dispatcherData: dispatcherData }); 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