Resolving dyskinesias at sustained anti-OCD efficacy by steering of DBS away from the anteromedial STN to the mesencephalic ventral tegmentum - case report.

Anteromedial STN Case report DBS Directional Focal Mesencephalic ventral tegmentum Obsessive–compulsive disorder slMFB

Journal

Acta neurochirurgica
ISSN: 0942-0940
Titre abrégé: Acta Neurochir (Wien)
Pays: Austria
ID NLM: 0151000

Informations de publication

Date de publication:
09 2022
Historique:
received: 24 02 2022
accepted: 03 04 2022
pubmed: 3 5 2022
medline: 3 9 2022
entrez: 2 5 2022
Statut: ppublish

Résumé

Here we describe therapeutic results in a female patient who underwent bilateral slMFB DBS for OCD. During a 35-month long course of stimulation, she suffered from stimulation-induced dyskinesia of her right leg which we interpreted as co-stimulation of the adjacent anteromedial subthalamic nucleus (amSTN). After reprogramming to steer the stimulation away from the amSTN medial into the direction of the mesencephalic ventral tegmentum (MVT which contains the ventral tegmental area, VTA), the dyskinesias disappeared. Remarkably, anti-OCD efficacy in the presented patient was preserved and achieved with a bilateral stimulation which by our imaging study fully avoided the amSTN.

Identifiants

pubmed: 35499574
doi: 10.1007/s00701-022-05206-w
pii: 10.1007/s00701-022-05206-w
pmc: PMC9427876
doi:

Types de publication

Case Reports Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

2303-2307

Informations de copyright

© 2022. The Author(s).

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Auteurs

Volker A Coenen (VA)

Department of Stereotactic and Functional Neurosurgery, Medical Center of Freiburg University, Freiburg, Germany. volker.coenen@unikllinik-freiburg.de.
Medical Faculty of Freiburg University, Freiburg, Germany. volker.coenen@unikllinik-freiburg.de.
Center for Deep Brain Stimulation, Medical Center of Freiburg University, Freiburg, Germany. volker.coenen@unikllinik-freiburg.de.

Thomas E Schlaepfer (TE)

Medical Faculty of Freiburg University, Freiburg, Germany.
Center for Deep Brain Stimulation, Medical Center of Freiburg University, Freiburg, Germany.
Department of Interventional Biological Psychiatry, University Hospital Freiburg, Freiburg, Germany.

Dora Meyer (D)

Medical Faculty of Freiburg University, Freiburg, Germany.
Department of Interventional Biological Psychiatry, University Hospital Freiburg, Freiburg, Germany.

Hannah Kilian (H)

Medical Faculty of Freiburg University, Freiburg, Germany.
Department of Interventional Biological Psychiatry, University Hospital Freiburg, Freiburg, Germany.

Susanne Spanier (S)

Medical Faculty of Freiburg University, Freiburg, Germany.
Department of Interventional Biological Psychiatry, University Hospital Freiburg, Freiburg, Germany.

Bastian E A Sajonz (BEA)

Department of Stereotactic and Functional Neurosurgery, Medical Center of Freiburg University, Freiburg, Germany.
Medical Faculty of Freiburg University, Freiburg, Germany.

Peter C Reinacher (PC)

Department of Stereotactic and Functional Neurosurgery, Medical Center of Freiburg University, Freiburg, Germany.
Medical Faculty of Freiburg University, Freiburg, Germany.
Fraunhofer Institute for Laser Technology (ILT), Aachen, Germany.

Marco Reisert (M)

Department of Stereotactic and Functional Neurosurgery, Medical Center of Freiburg University, Freiburg, Germany.
Medical Faculty of Freiburg University, Freiburg, Germany.
Department of Diagnostic and Interventional Radiology, Medical Physics, Medical Center - University of Freiburg, Freiburg, Germany.

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