{"id":73,"date":"2020-08-14T16:17:33","date_gmt":"2020-08-14T16:17:33","guid":{"rendered":"http:\/\/newsletters.aans.org\/assfn\/?page_id=73"},"modified":"2020-08-14T16:17:33","modified_gmt":"2020-08-14T16:17:33","slug":"assfn-news-views","status":"publish","type":"page","link":"https:\/\/newsletters.aans.org\/assfn\/summer-2020\/assfn-news-views\/","title":{"rendered":"ASSFN News &#038; Views"},"content":{"rendered":"<p><em>Chronic Pain and Spasticity<\/em><\/p>\n<ul>\n<li><strong>Medtronic rolled out DTM\u2122 (differential target multiplexed) stimulation<\/strong><span> for their Intellis system. DTM is a high-density stimulation program that depends on using multiple simultaneous stimulation frequencies to target neuroglial interactions. Despite claims of superior efficacy, and preclinical rodent data, published human data on DTM is not yet available. <\/span><\/li>\n<li><strong>Nevro released their Omnia generator<\/strong>, which has paresthesia-based settings, in addition to their signature HF10\u2122 high-density waveform.<\/li>\n<li><strong>Medtronic\u2019s Synchromed II pump was recalled<\/strong> in December, due to a manufacturing issue, which led to several motor stalls. <\/li>\n<\/ul>\n<p><em>Movement Disorders<\/em><\/p>\n<ul>\n<li><strong>Nine patients who underwent DBS for Parkinson\u2019s disease lost the ability to swim<\/strong><span> (Waldvogel, 2020). This report led to a Medtronic communique issued to all providers, to warn patients about possible loss of swimming ability. <\/span><\/li>\n<li>Despite extensive data implicating the cerebellum in essential tremor, mechanistic information has been elusive. A group at Baylor used optogenetics to show that <strong>tremor could be turned on and off at the level of the Purkinje cells<\/strong>, which in turn modulate activity in deep nuclei (Brown, 2020). <\/li>\n<li>The first long-term follow-up of voice tremor suggests that <strong>voice benefit in caudal zona incerta stimulation is sustained <\/strong>(Sandstr\u00f6m, 2019). Many of the implants were unilateral, suggesting that a single electrode may be enough to treat this problem.<\/li>\n<\/ul>\n<p><em>Epilepsy<\/em><\/p>\n<ul>\n<li><strong>A new epilepsy syndrome<\/strong><span> was described in <\/span><em><span>Annals of Neurology<\/span><\/em><span>. Four patients presented with limbic encephalitis and seizures, and careful work identified autoantibodies to drebin, an intracellular protein found in neuronal processes.<\/span><\/li>\n<li><strong>Epilepsy is a progressive, neurodegenerative disease<\/strong>. A case-control study of 190 patients with epilepsy showed that cortex progressively thins in patients with epilepsy, significantly faster than it does in normal aging (Galovic, 2019).<\/li>\n<\/ul>\n<p><em>New Directions<\/em><\/p>\n<ul>\n<li><strong>The first case report of habenula stimulation for treatment of obsessive-compulsive disorder<\/strong><span> was published in Frontiers in Psychiatry (Zhang, 2020). The patient had a significant Yale-Brown Obsessive Compulsive Scale decrease (from 31 to 20), despite having previously failed cingulotomy and capsulotomy. <\/span><\/li>\n<li><strong>Eight patients with treatment-refractory schizophrenia underwent DBS<\/strong> with four meeting symptomatic improvement criteria, measured by PANSS (Positive and Negative Symptom Scale). One patient had an infection requiring explant, and of the remaining seven, three had nucleus accumbens electrodes and four were implanted in subgenual cingulate. <\/li>\n<li><strong>MR-guided focused ultrasound was used to open the blood-brain barrier<\/strong> in the primary motor cortex in four ALS patients (Abrahao, 2019) as well as in Alzheimer\u2019s patients (Rezai, 2020). The treatment was well-tolerated, and opens the door for therapeutics that act directly on involved areas of the brain.<\/li>\n<\/ul>\n<p><strong>References<\/strong><\/p>\n<ol>\n<li>Abrahao, Agessandro, et al. &#8220;First-in-human trial of blood\u2013brain barrier opening in amyotrophic lateral sclerosis using MR-guided focused ultrasound.&#8221; <em>Nature communications<\/em><span> 10.1 (2019): 1-9.<\/span><\/li>\n<li>Brown, Amanda M., et al. &#8220;Purkinje cell misfiring generates high-amplitude action tremors that are corrected by cerebellar deep brain stimulation.&#8221; <em>Elife<\/em> 9 (2020): e51928.<\/li>\n<li>Galovic, Marian, et al. &#8220;Progressive Cortical Thinning in Patients With Focal Epilepsy.&#8221; <em>JAMA Neurology<\/em> 76.10 (2019): 1230-1239.<\/li>\n<li>Pitsch, Julika, et al. &#8220;Drebrin autoantibodies in patients with seizures and suspected encephalitis.&#8221; <em>Annals of Neurology<\/em> (2020).<\/li>\n<li>Rezai, Ali R., et al. &#8220;Noninvasive hippocampal blood\u2212 brain barrier opening in Alzheimer\u2019s disease with focused ultrasound.&#8221; <em>Proceedings of the National Academy of Sciences<\/em> (2020).<\/li>\n<li>Sandstr\u00f6m, Linda, Patric Blomstedt, and Fredrik Karlsson. &#8220;Long-term effects of unilateral deep brain stimulation on voice tremor in patients with essential tremor.&#8221; <em>Parkinsonism &amp; Related Disorders <\/em>60(2019): 70-75.<\/li>\n<li>Waldvogel, Daniel, et al. &#8220;Beware of deep water after subthalamic deep brain stimulation.&#8221; <em>Neurology<\/em> 94.1 (2020): 39-41.<\/li>\n<li>Zhang, Chencheng, et al. &#8220;Habenular Stimulation for Neurosurgery Resistant Obsessive-Compulsive Disorder: A Case Report.&#8221; <em>Frontiers in Psychiatry<\/em> 11 (2020): 29.<\/li>\n<\/ol>\n","protected":false},"excerpt":{"rendered":"<p>Chronic Pain and Spasticity Medtronic rolled out DTM\u2122 (differential target multiplexed) stimulation for their Intellis system. DTM is a high-density stimulation program that depends on using multiple simultaneous stimulation frequencies to target neuroglial interactions. Despite claims of superior efficacy, and preclinical rodent data, published human data on DTM is not yet available. Nevro released their [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"parent":70,"menu_order":1,"comment_status":"closed","ping_status":"closed","template":"NewsletterTOC.php","meta":{"_acf_changed":false,"footnotes":""},"class_list":["post-73","page","type-page","status-publish","hentry"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.3 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>ASSFN News &amp; Views - American Society for Stereotactic and Functional Neurosurgery<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/newsletters.aans.org\/assfn\/summer-2020\/assfn-news-views\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"ASSFN News &amp; Views - American Society for Stereotactic and Functional Neurosurgery\" \/>\n<meta property=\"og:description\" content=\"Chronic Pain and Spasticity Medtronic rolled out DTM\u2122 (differential target multiplexed) stimulation for their Intellis system. 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