Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Dead on against Tremors - Imaging technique improves tremor surgery

12.09.2014

Freiburg researchers publish in Neurosurgery

The idea of having a doctor operate on your open brain while you are wide awake does not sound pleasant. Unfortunately, however, deep brain stimulation in a fully conscious state is currently the only operative method available for many patients suffering from tremor diseases who can no longer tolerate the medications and long years of suffering brought on by their condition.


A patient's two-sided deep brain stimulation of the tremor bundles

Medical Center - University of Freiburg/Volker Arnd Coenen

A Freiburg research team led by Prof. Dr. Volker Arnd Coenen, medical director of the Division of Stereotactic and Functional Neurosurgery at the Medical Center – University of Freiburg, has now succeeded in more accurately determining the position of the particular bundle of nerve fibers in the brain that deep brain stimulation needs to activate.

In the long term, the scientists hope this will allow surgeons to conduct deep brain stimulation to patients under general anesthesia, while at the same time reducing the risk of bleeding. The Freiburg researchers published the results of their study in the renowned journal Neurosurgery.

In their study on treating tremor-dominant Parkinson’s disease and essential tremor diseases by means of deep brain stimulation, the scientists compared the current method for detecting the fiber bundle with diffusion tensor tractography.

“This imaging technique produces images that are so precise that it is possible to determine the position of the fiber bundle in the brain with a margin of error of less than two millimeters. This reduces the amount of paths the electrodes need to take on the way to the target tissue in the brain, lowering the risk of vascular bleeding,” says Prof. Coenen.

Up to now, it was only possible to determine the target area indirectly on the basis of atlas data. The surgeons opens the skulls of fully conscious patients and conduct deep brain stimulation, steering the electrode toward regions in which they suspect that stimulation will lead to a reduction in the tremors.

If the point does not react to the stimulation, they remove the electrode and then direct it to another point via a new path from the surface. Each test increases the risk of damage to blood vessels and thus of vascular bleeding. The new method will make the operation safer for patients, as it will enable the surgeons to create a highly precise image of the tremor-reducing bundle structure directly.

The Freiburg researchers will soon begin two clinical studies applying this technology to essential tremor and Parkinson’s disease. The goal of the studies is to corroborate the findings from the current study.

Diffusion tensor tractography is an imaging technique that measures the diffusion of water molecules in body tissue with the help of magnetic resonance imaging (MRI) and represents it in spatially resolved form. It is particularly suitable for studying the brain because the diffusion behavior in the tissue undergoes characteristic changes in several diseases, allowing scientists to infer the course of the large bundles of nerve fibers. Diffusion tensor tractography has already been proven effective at detecting a new target site for stimulating the brain to treat depression, the medial forebrain bundle.

Deep brain stimulation influences and breaks up abnormal oscillations of nerve tissue with fine electric impulses. It requires the implantation of a brain pacemaker. The advantage of deep brain stimulation is that it provides constant, uninterrupted stimulation. When it is turned off, however, the symptoms return within minutes. Patients remain awake for most of the operation in which the neurostimuator is implanted, because “they help us to control the positioning of the electrodes,” says Prof. Coenen.

“We send a test impulse during the operation – when we’re at the right location, the patient’s symptoms, for instance trembling of the hands, are reduced immediately.” Currently, neurostimulation is not seen as a viable alternative until all other possible forms of therapy have been exhausted. But Prof. Coenen is confident: “Deep brain stimulation will gain importance as a therapy for various disorders.”

A tremor is defined as an involuntary, rhythmically repeating contraction of muscle groups that work in opposition to each other. The so-called physiological tremor can be measured, but it is almost impossible to see. A tremor only becomes visible when it appears as a symptom of a dis-ease, such as Parkinson’s disease.

The original publication, entitled “Modulation of the Cerebello-thalamo-cortical Network in Thalam-ic Deep Brain Stimulation for Tremor: A Diffusion Tensor Imaging Study,” is already available online and will also appear in the print version of Neurosurgery in December.
DOI: 10.1227/NEU0000000000000540

Contact:
Prof. Dr. Volker Arnd Coenen
Medical Director
Division of Stereotactic and Functional Neurosurgery
Phone: +49 (0)761 270-50630
volker.coenen@uniklinik-freiburg.de

Inga Schneider | idw - Informationsdienst Wissenschaft
Further information:
http://www.uniklinik-freiburg.de

Further reports about: Deep Diffusion Neurosurgery Parkinson’s Stereotactic Tremors bleeding symptoms technique

More articles from Health and Medicine:

nachricht NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures
17.11.2017 | National Institute of Standards and Technology (NIST)

nachricht High speed video recording precisely measures blood cell velocity
15.11.2017 | ITMO University

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: A “cosmic snake” reveals the structure of remote galaxies

The formation of stars in distant galaxies is still largely unexplored. For the first time, astron-omers at the University of Geneva have now been able to closely observe a star system six billion light-years away. In doing so, they are confirming earlier simulations made by the University of Zurich. One special effect is made possible by the multiple reflections of images that run through the cosmos like a snake.

Today, astronomers have a pretty accurate idea of how stars were formed in the recent cosmic past. But do these laws also apply to older galaxies? For around a...

Im Focus: Visual intelligence is not the same as IQ

Just because someone is smart and well-motivated doesn't mean he or she can learn the visual skills needed to excel at tasks like matching fingerprints, interpreting medical X-rays, keeping track of aircraft on radar displays or forensic face matching.

That is the implication of a new study which shows for the first time that there is a broad range of differences in people's visual ability and that these...

Im Focus: Novel Nano-CT device creates high-resolution 3D-X-rays of tiny velvet worm legs

Computer Tomography (CT) is a standard procedure in hospitals, but so far, the technology has not been suitable for imaging extremely small objects. In PNAS, a team from the Technical University of Munich (TUM) describes a Nano-CT device that creates three-dimensional x-ray images at resolutions up to 100 nanometers. The first test application: Together with colleagues from the University of Kassel and Helmholtz-Zentrum Geesthacht the researchers analyzed the locomotory system of a velvet worm.

During a CT analysis, the object under investigation is x-rayed and a detector measures the respective amount of radiation absorbed from various angles....

Im Focus: Researchers Develop Data Bus for Quantum Computer

The quantum world is fragile; error correction codes are needed to protect the information stored in a quantum object from the deteriorating effects of noise. Quantum physicists in Innsbruck have developed a protocol to pass quantum information between differently encoded building blocks of a future quantum computer, such as processors and memories. Scientists may use this protocol in the future to build a data bus for quantum computers. The researchers have published their work in the journal Nature Communications.

Future quantum computers will be able to solve problems where conventional computers fail today. We are still far away from any large-scale implementation,...

Im Focus: Wrinkles give heat a jolt in pillared graphene

Rice University researchers test 3-D carbon nanostructures' thermal transport abilities

Pillared graphene would transfer heat better if the theoretical material had a few asymmetric junctions that caused wrinkles, according to Rice University...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Ecology Across Borders: International conference brings together 1,500 ecologists

15.11.2017 | Event News

Road into laboratory: Users discuss biaxial fatigue-testing for car and truck wheel

15.11.2017 | Event News

#Berlin5GWeek: The right network for Industry 4.0

30.10.2017 | Event News

 
Latest News

NASA detects solar flare pulses at Sun and Earth

17.11.2017 | Physics and Astronomy

NIST scientists discover how to switch liver cancer cell growth from 2-D to 3-D structures

17.11.2017 | Health and Medicine

The importance of biodiversity in forests could increase due to climate change

17.11.2017 | Studies and Analyses

VideoLinks
B2B-VideoLinks
More VideoLinks >>>