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ACCELEROMETRY DURING ABLATIVE THALAMIC SURGERY FOR PARKINSONIAN TREMOR

ACCELEROMETRY DURING ABLATIVE THALAMIC SURGERY FOR PARKINSONIAN TREMOR. Authors: J. Ciurea V. Nestianu*, Ileana Simoca, Dept. of Neurosurgery, University Hospital “ Bagdasar Arseni”, Bucharest, Romania * Dept. of Neurophysiology, University of Medicine Craiova, Romania.

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ACCELEROMETRY DURING ABLATIVE THALAMIC SURGERY FOR PARKINSONIAN TREMOR

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  1. ACCELEROMETRY DURING ABLATIVE THALAMIC SURGERY FOR PARKINSONIAN TREMOR Authors: J. Ciurea V. Nestianu*, Ileana Simoca, Dept. of Neurosurgery, University Hospital “ Bagdasar Arseni”, Bucharest, Romania * Dept. of Neurophysiology, University of Medicine Craiova, Romania

  2. Tremor assessment during thalamotomy for Parkinson disease under the effects of electrical stimulation Comparison accelerometer vs. neurologist assessment OBJECTIVE

  3. Total number of patients: 8 Stereotactic target Vim Gender: 5 men and 3 women. Age The mean age was 52 years Range between 32 to 68 years. All patients exhausted drug therapy or did not respond or tolerate it. PATIENTS AND METHOD

  4. The following parameters were recorded during electrical stimulation of the target : Frequency (Hz) Amplitude Occurrence of tremor Comparison with neurological direct observation. The lowest stimulation tremor suppression electrical threshold was used to select the optimal lesion site. PATIENTS AND METHOD

  5. Improvement: United Parkinsonian Disease Rating Scale Schwalb & England Scale Hohen & Yahr Score. Tremor: Rest Positional Intention RESULTS

  6. Monitoring: EMG + standardized clinical tool - only groups of muscle and movements can affect the position of the electrode Acceleromerter + vectorial components of movement - the amplitude is a derivate and depends of frequency Optical – photocouple - diode and receiver +simple - only frequency, interference with other sources Piezo +sensitive -frequency response dependent on “crystal resonance” Video + state of art -three simultaneous cameras and a analysis soft, retrospective DEEP BRAIN ELECTRICAL STIMULATION AND TREMOR

  7. The 2 - 100 Hz stimulation DEEP BRAIN ELECTRICAL STIMULATION AND TREMOR

  8. EFFECT OF STIMULATION

  9. WATERFALL PRESENTATION OF ELECTRICAL STIMULATION EFFECTS

  10. Accelerometer vs. Observer

  11. Accelerometer sy. identification - earlier than clinical observer

  12. IS TREMOR MONITORING NECESSARY? IS TREMOR MONITORING USEFUL? TREMOR MONITORING IS AN OBJECTIVE AND EFFICIENT METHOD. CONCLUSION

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