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Related Concept Videos

Long-term Potentiation01:35

Long-term Potentiation

Long-term potentiation, or LTP, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTP is the process of synaptic strengthening that occurs over time between pre- and postsynaptic neuronal connections. The synaptic strengthening of LTP works in opposition to the synaptic weakening of long-term depression (LTD) and together are the main mechanisms that underlie learning and memory.
Long-term Potentiation01:25

Long-term Potentiation

Long-term potentiation, or LTP, is one of the ways by which synaptic plasticity—changes in the strength of chemical synapses—can occur in the brain. LTP is the process of synaptic strengthening that occurs over time between pre and postsynaptic neuronal connections. The synaptic strengthening of LTP works in opposition to the synaptic weakening of long-term depression (LTD) and together are the main mechanisms that underlie learning and memory.
Hebbian LTP
LTP can occur when presynaptic neurons...

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Intra-Operative Behavioral Tasks in Awake Humans Undergoing Deep Brain Stimulation Surgery
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Directional Deep Brain Stimulation Programming: Is the Segment Clearly Identifiable and Stable Over Time?

Jessica A Karl1, Jessica M Joyce2, Bichun Ouyang2

  • 1Movement Disorder Division, Department of Neurology, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.

Movement Disorders Clinical Practice
|June 10, 2024
PubMed
Summary

Optimal directional deep brain stimulation (d-DBS) programming settings for Parkinson's disease (PD) showed low agreement between programmers and over time. This suggests reassessing stimulation settings is important for effective PD management.

Keywords:
Parkinson's diseasedeep brain stimulationdirectional deep brain stimulationsubthalamic nucleus

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Area of Science:

  • Neurology
  • Biomedical Engineering

Background:

  • Directional deep brain stimulation (d-DBS) programming in Parkinson's disease (PD) may require adjustments over time.
  • Investigating the consistency of optimal electrode selection is crucial for reliable d-DBS therapy.

Purpose of the Study:

  • To assess the reliability and stability of optimal electrode selection in d-DBS programming for PD.
  • To evaluate inter-rater and intra-rater agreement on optimal electrode selection over time.

Main Methods:

  • Prospective, double-blind study involving 21 PD patients undergoing d-DBS.
  • Mono-polar surveys were conducted four times by two separate assessors at 1 and 6 months.
  • Primary aim: inter-rater agreement; Secondary aim: intra-rater agreement.

Main Results:

  • Fair inter-rater agreement at 1 month, improving to moderate at 6 months.
  • Minimal intra-rater agreement was observed between 1 and 6 months.
  • The study's hypothesis of high agreement was refuted.

Conclusions:

  • Low agreement suggests the subjective nature of identifying optimal electrodes or acute stimulation changes.
  • Programmers should consider exploring different electrode montages periodically.
  • Reviewing directional electrode montages may be best guided by clinical symptoms or disease progression.