Advanced in neurostimulation for focal dystonia.pptx

Here is a concise summary of the presentation **"Advances in Neurostimulation for Focal Dystonia"** under 4000 characters:

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### **Advances in Neurostimulation for Focal Dystonia**

#### **What is Focal Dystonia?**
A neurological movement disorder characterized by **involuntary muscle contractions** in specific body regions, affecting motor function and daily life.

#### **Primary Goal of the Study**
To evaluate advancements in neurostimulation techniques for focal dystonia, focusing on:
- **Deep Brain Stimulation (DBS)**
- **Transcranial Magnetic Stimulation (TMS)**
- **Transcranial Direct Current Stimulation (tDCS)**

Key assessment areas: **effectiveness, mechanism of action, challenges, and future potential**.

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### **Pathophysiology of Focal Dystonia**
- **Dysfunction in brain regions:** Basal ganglia, sensorimotor cortex, cerebellum.
- **Key features:**
- Abnormal neural plasticity
- Excessive cortical excitability
- Disrupted motor control circuits

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### **Neurostimulation Techniques**

#### **1. Deep Brain Stimulation (DBS)**
**What it is:** A surgical procedure implanting electrodes in specific brain regions.
**Target Areas:**
- **Globus Pallidus Internus (GPi):** Effective for primary dystonia.
- **Subthalamic Nucleus (STN):** Alternative target in some cases.

**Mechanism:**
- Modulates dysfunctional basal ganglia circuits.
- Disrupts maladaptive plasticity, normalizing neural activity.

**Benefits:**
- Significant symptom reduction and improved motor function.

**Challenges:**
- Invasive procedure requiring precise patient selection.
- Variable success in secondary dystonia cases.

**Future Directions:**
- Adaptive closed-loop DBS for real-time stimulation adjustments.

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#### **2. Transcranial Magnetic Stimulation (TMS)**
**What it is:** A non-invasive technique using electromagnetic stimulation to regulate neural circuits.

**Mechanism:**
- **Low-frequency TMS:** Suppresses hyperactive motor regions.
- **High-frequency TMS:** Enhances neural function.

**Clinical Applications:**
- Stimulation of the **motor cortex or premotor cortex** can reduce symptoms.

**Challenges:**
- High variability in patient response.
- Effects are temporary, requiring repeated sessions.

**Future Directions:**
- Combining TMS with neuroimaging for optimized treatment.

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#### **3. Transcranial Direct Current Stimulation (tDCS)**
**What it is:** A non-invasive technique applying weak direct current to the scalp.

**Mechanism:**
- **Anodal tDCS:** Enhances cortical excitability.
- **Cathodal tDCS:** Suppresses hyperactive motor areas.

**Clinical Evidence:**
- Preliminary studies show potential benefits for motor symptom relief.

**Challenges:**
- Inconsistent findings across studies.
- Need for standardized stimulation protocols.

**Future Directions:**
- Combining tDCS with rehabilitation therapies.

1. Advances In Neurostimulation For Focal Dystonia Presented by: Mansi, 5th yr student. Poltava State Medical University Poltava, Ukraine

2. What Is Focal Dystonia? A neurological movement disorder Causes- involuntary muscle contractions in specific body regions Impact on Patients Affects - motor function and quality of life Challenges with daily activities, work, and social life.

3. Primary Goal Evaluate advancements in neurostimulation techniques for focal dystonia. We are focusing on the three techniques: Deep brain stimulation (DBS) Transcranial magnetic stimulation (TMS) Transcranial direct current stimulation (tDCS) Areas of assessment includes: Effectiveness in symptom relief Mechanism of action Challenges and future potential.

4. Materials And Methods Research Methodology Systematic review of existing literature Data Sources Clinical trials, meta-analyses, case studies Databases PubMed ScienceDirect Clinical Neurophysiology Comparative Analysis Evaluates neurostimulation techniques based on effectiveness, safety, and feasibility

5. Focal Dystonia - Pathophysiology Neurological Basis Dysfunction in the Basal ganglia Sensorimotor cortex Cerebellum Key Features: Abnormal neural plasticity Excessive cortical excitability Disrupted motor control circuits

6. Deep Brain Stimulation (DBS) What is DBS? Surgical implantation of electrodes in specific brain regions Target Areas Globus Pallidus Internus (GPi) – Effective for primary dystonia Subthalamic Nucleus (STN) – Alternative target in some cases

7. Mechanism Of DBS Mechanism of Action Modulates dysfunctional basal ganglia circuits Hypothesized to disrupt maladaptive plasticity and normalize oscillatory activity

8. Clinical Efficancy, Challanges And Future Direction Of DBS Proven Benefits Significant symptom reduction in primary dystonia Improved motor function and quality of life Factors Influencing Outcomes Patient selection Electrode placement Stimulation parameters Limitations of DBS Invasive procedure Requires precise patient evaluation Variable success in secondary dystonia cases Future Improvements Adaptive closed-loop DBS: Dynamically adjusts stimulation in real-time Enhanced neural feedback for personalized therapy

9. Transcranial Magnetic Stimulation (TMS) What is TMS? Non-invasive electromagnetic stimulation of neural circuits Uses repetitive TMS (rTMS) to regulate cortical activity Mechanism of Action Alters cortical excitability and synaptic plasticity Low-frequency TMS: Suppresses hyperactive motor regions High-frequency TMS: Enhances neural function

10. Clinical Applications of TMS Promising Results Stimulation of primary motor cortex or premotor cortex can reduce dystonic symptoms Challenges High variability in patient response Effects are temporary and require repeated sessions Future Perspectives Combining TMS with neuroimaging techniques to optimize treatment

11. Transcranial Direct Current Stimulation (TDCS) What is tDCS? Non-invasive technique using weak direct current applied to the scalp Mechanism of Action Anodal tDCS: Enhances cortical excitability Cathodal tDCS: Suppresses hyperactive motor areas Potential Benefits May contribute to symptom relief in focal dystonia

12. Clinical Evidence for tDCS Preliminary Studies Shows potential benefits for motor symptom improvement Limitations Inconsistent findings across studies Need for standardized stimulation protocols Future Directions Combining tDCS with rehabilitation therapies Optimization of stimulation parameters for long-term effects

13. Conclusion & Future Directions Neurostimulation as a promising alternative Offers hope for patients resistant to conventional therapies DBS: Most established intervention And has long-term efficacy but requires surgery. TMS: Effective but requires continuous sessions, future: Personalized stimulation. tDCS: Non-invasive with potential for improvement, future: Combination with rehabilitation therapy