| Title |
Deep brain stimulation
|
|---|---|
| Published in |
Cell and Tissue Research, August 2004
|
| DOI | 10.1007/s00441-004-0936-0 |
| Pubmed ID | |
| Authors |
Sorin Breit, Jörg B. Schulz, Alim-Louis Benabid |
| Abstract |
During the last decade deep brain stimulation (DBS) has become a routine method for the treatment of advanced Parkinson's disease (PD), leading to striking improvements in motor function and quality of life of PD patients. It is associated with minimal morbidity. The rationale of targeting specific structures within basal ganglia such as the subthalamic nucleus (STN) or the internal segment of the globus pallidus (GPi) is strongly supported by the current knowledge of the basal ganglia pathophysiology, which is derived from extensive experimental work and which provides the theoretical basis for surgical therapy in PD. In particular, the STN has advanced to the worldwide most used target for DBS in the treatment of PD, due to the marked improvement of all cardinal symptoms of the disease. Moreover on-period dyskinesias are reduced in parallel with a marked reduction of the equivalent daily levodopa dose following STN-DBS. The success of the therapy largely depends on the selection of the appropriate candidate patients and on the precise implantation of the stimulation electrode, which necessitates careful imaging-based pre-targeting and extensive electrophysiological exploration of the target area. Despite the clinical success of the therapy, the fundamental mechanisms of high-frequency stimulation are still not fully elucidated. There is a large amount of evidence from experimental and clinical data that stimulation frequency represents a key factor with respect to clinical effect of DBS. Interestingly, high-frequency stimulation mimics the functional effects of ablation in various brain structures. The main hypotheses for the mechanism of high-frequency stimulation are: (1) depolarization blocking of neuronal transmission through inactivation of voltage dependent ion-channels, (2) jamming of information by imposing an efferent stimulation-driven high-frequency pattern, (3) synaptic inhibition by stimulation of inhibitory afferents to the target nucleus, (4) synaptic failure by stimulation-induced neurotransmitter depletion. As the hyperactivity of the STN is considered a functional hallmark of PD and as there is experimental evidence for STN-mediated glutamatergic excitotoxicity on neurons of the substantia nigra pars compacta (SNc), STN-DBS might reduce glutamatergic drive, leading to neuroprotection. Further studies will be needed to elucidate if STN-DBS indeed provides a slow-down of disease progression. |
Mendeley readers
The data shown below were compiled from readership statistics for 284 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United States | 7 | 2% |
| Germany | 3 | 1% |
| Colombia | 1 | <1% |
| Australia | 1 | <1% |
| Sweden | 1 | <1% |
| United Kingdom | 1 | <1% |
| Ireland | 1 | <1% |
| China | 1 | <1% |
| Iran, Islamic Republic of | 1 | <1% |
| Other | 2 | <1% |
| Unknown | 265 | 93% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Student > Master | 52 | 18% |
| Student > Ph. D. Student | 51 | 18% |
| Student > Bachelor | 43 | 15% |
| Researcher | 37 | 13% |
| Student > Doctoral Student | 18 | 6% |
| Other | 41 | 14% |
| Unknown | 42 | 15% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 49 | 17% |
| Engineering | 47 | 17% |
| Agricultural and Biological Sciences | 43 | 15% |
| Neuroscience | 30 | 11% |
| Psychology | 29 | 10% |
| Other | 37 | 13% |
| Unknown | 49 | 17% |
Attention Score in Context
This research output has an Altmetric Attention Score of 15. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 26 October 2021.
All research outputs
#2,190,974
of 23,839,820 outputs
Outputs from Cell and Tissue Research
#36
of 2,279 outputs
Outputs of similar age
#3,119
of 59,389 outputs
Outputs of similar age from Cell and Tissue Research
#2
of 14 outputs
Altmetric has tracked 23,839,820 research outputs across all sources so far. Compared to these this one has done particularly well and is in the 90th percentile: it's in the top 10% of all research outputs ever tracked by Altmetric.
So far Altmetric has tracked 2,279 research outputs from this source. They receive a mean Attention Score of 3.3. This one has done particularly well, scoring higher than 98% of its peers.
Older research outputs will score higher simply because they've had more time to accumulate mentions. To account for age we can compare this Altmetric Attention Score to the 59,389 tracked outputs that were published within six weeks on either side of this one in any source. This one has done particularly well, scoring higher than 94% of its contemporaries.
We're also able to compare this research output to 14 others from the same source and published within six weeks on either side of this one. This one has done well, scoring higher than 85% of its contemporaries.