scholarly journals Carl Wilhelm Sem-Jacobsen: Aerospace Neurophysiology and Deep Brain Stimulation Pioneer

Neurology ◽  
2021 ◽  
pp. 10.1212/WNL.0000000000013149
Author(s):  
Espen Dietrichs
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Us Military ◽  
Subthalamic Stimulation ◽  
The Us ◽  
Mind Control ◽  
The Usa ◽  
Office Of Strategic Services ◽  
Underground Resistance ◽  
Deep Brain

The Norwegian physician Carl Wilhelm Sem-Jacobsen (1912-1991) was a pioneer in deep brain stimulation and aerospace neurophysiology, but for several reasons his story has remained untold. During WW2 he collaborated with a renowned military underground resistance group against the Nazi occupants, then had to flee to neutral Sweden. He returned to participate in the liberation of Northern Norway as a Captain in the US Special Forces also working with the OSS (Office of Strategic Services – precursor for CIA) and received a citation from General Eisenhower for his contributions. Sem-Jacobsen then spent several years in the USA training in psychiatry and clinical neurophysiology at the Mayo Clinic. He constructed his own medical technical devices, was among the first to develop deep brain stimulation, and made the smallest EEG- and EKG recording systems yet produced, also used by the American astronauts walking on the Moon. But he was more an inventor than a researcher and few of his observations were published in peer-review medical journals. He built his own neurophysiological institute for neurosurgery, deep brain recordings and deep brain stimulation in Oslo’s main psychiatric hospital, but was sponsored by US military forces and NASA. He knew CIA Director William E. Colby personally, and rumours soon flourished that Sem-Jacobsen conducted secret mind-control experiments for American authorities and the CIA. These accusations were investigated, and long after his death he was officially absolved by a Hearing Committee appointed by the Norwegian Government. Nevertheless all his personal files were burnt by his family who was still harassed by investigative journalists. Sem-Jacobsen also documented some of his work on film, but the whereabouts of these films have remained unknown. I searched for them for several years and recently discovered numerous films and photos in an old barn in rural Norway. These films and photos document in-action neurophysiology recordings in divers, pilots, and astronauts, and they show how Sem-Jacobsen in collaboration with experienced neurosurgeons in Oslo conducted the very first trials with deep brain stimulation in patients with Parkinson’s Disease. He apparently even tried subthalamic stimulation as early as in the 1950s.

scholarly journals Comparing two randomized deep brain stimulation trials for Parkinson’s disease

2020 ◽  
Vol 132 (5) ◽  
pp. 1376-1384 ◽  
Author(s):  
Günther Deuschl ◽  
Kenneth A. Follett ◽  
Ping Luo ◽  
Joern Rau ◽  
Frances M. Weaver ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Life Quality ◽  
Veterans Affairs ◽  
Best Medical Treatment ◽  
Significant Difference ◽  
The Us ◽  
Deep Brain

OBJECTIVESeveral randomized studies have compared the effect of deep brain stimulation (DBS) of the subthalamic nucleus with the best medical treatment in large groups of patients. Important outcome measures differ between studies. Two such major studies, the life-quality study of the German Competence Network for Parkinson’s disease (LQ study) and the US Veterans Affairs/National Institute of Neurological Disorders and Stroke trial (VA/NINDS trial), were compared here in order to understand their differences in outcomes.METHODSUnless otherwise noted, analyses were based on those subjects in each study who received a DBS implant (LQ study 76 patients, VA/NINDS trial 140 patients) and who had data for the measurement under consideration (i.e., no imputations for missing data), referred to hereafter as the “as-treated completers” (LQ 69 patients, VA/NINDS 125 patients). Data were prepared and analyzed by biostatisticians at the US Department of Veterans Affairs Cooperative Studies Program Coordinating Center, the Coordinating Center for Clinical Trials Marburg, and Medtronic, under the direction of two authors (G.D. and K.A.F.). Data were extracted from the respective databases into SAS data sets and analyzed using SAS software. Analyses were based on the 6-month follow-up data from both studies because this was the endpoint for the LQ study.RESULTSPre-DBS baseline demographics differed significantly between the studies, including greater levodopa responsiveness (LDR) in the LQ study population than in the VA/NINDS group. After DBS, LQ subjects demonstrated greater improvement in motor function (Unified Parkinson’s Disease Rating Scale, Motor Examination [UPDRS-III]), activities of daily living (ADLs), and complications of therapy. Medication reduction and improvements in life quality other than ADLs were not significantly different between LQ and VA/NINDS subjects. When the two populations were compared according to pre-DBS LDR, the “full responders” to levodopa (≥ 50% improvement on UPDRS-III with medication) in the two studies showed no significant difference in motor improvement with DBS (LQ 18.5 ± 12.0–point improvement on UPDRS-III vs VA/NINDS 17.7 ± 15.6–point improvement, p = 0.755). Among levodopa full responders, ADLs improved slightly more in the LQ group, but scores on other UPDRS subscales and the Parkinson’s Disease Questionnaire-39 were not significantly different between the two studies.CONCLUSIONSThis comparison suggests that patient selection criteria, especially preoperative LDR, are the most important source of differences in motor outcomes and quality of life between the two studies.

scholarly journals Immediate and sustained relief of levodopa-induced dyskinesias after dorsal relocation of a deep brain stimulation lead

2004 ◽  
Vol 17 (1) ◽  
pp. 39-42 ◽  
Author(s):  
Ron L. Alterman ◽  
Jay L. Shils ◽  
Mark Gudesblatt ◽  
Michele Tagliati
Keyword(s):  
Electrical Stimulation ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
High Frequency ◽  
Resonance Imaging ◽  
Dopaminergic Medication ◽  
Subthalamic Stimulation ◽  
The Right ◽  
Medication Changes ◽  
Deep Brain

The authors demonstrate that high-frequency electrical stimulation dorsal to the subthalamic nucleus (STN) can directly suppress levodopa-induced dyskinesias. This 63-year-old woman with idiopathic Parkinson disease underwent surgery for placement of bilateral subthalamic deep brain stimulation (DBS) electrodes to control progressive rigidity, motor fluctuations, and levodopa-induced dyskinesias. The model 3389 DBS leads were implanted with microelectrode guidance. Magnetic resonance imaging confirmed proper placement of the leads. Postoperatively the patient exhibited improvement in all of her parkinsonian symptoms; however, her right leg dyskinesias had not improved. Based on their previous experiences treating levodopa-induced dyskinesias with subthalamic stimulation through the more dorsally located contacts of the model 3387 lead, the authors withdrew the implanted 3389 lead 3 mm. Following relocation of the lead they were able to suppress the right leg dyskinesias by using the most dorsal contacts. The patient's dopaminergic medication intake increased slightly. These findings indicate that electrical stimulation dorsal to the STN can directly suppress levodopa-induced dyskinesias independent of dopaminergic medication changes. The 3389 lead may provide inadequate coverage of the subthalamic region for some patients.

Changing Practice Patterns of Deep Brain Stimulation in Parkinson’s Disease and Essential Tremor in the USA

2012 ◽  
Vol 90 (1) ◽  
pp. 25-29 ◽  
Author(s):  
Julie G. Pilitsis ◽  
Anthony Burrows ◽  
Mary Linton Peters ◽  
Julie Sargent ◽  
Sing Chau Ng ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Essential Tremor ◽  
Brain Stimulation ◽  
Practice Patterns ◽  
Changing Practice ◽  
The Usa ◽  
Deep Brain

Deep Brain Stimulation

2020 ◽  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Iterative Process ◽  
Clinical Symptoms ◽  
Perioperative Complications ◽  
Freezing Of Gait ◽  
Subthalamic Stimulation ◽  
Programming Techniques ◽  
Deep Brain

The fundamental principles of deep brain stimulation treatment are derived from decades of empirical and experiential observations. Through a case-based approach, this book is an effort to distill the expertise of clinical teams who are at the frontlines of managing patients with deep brain stimulation. The vast majority of patients with tremors, Parkinson disease, dystonia and other hyperkinetic disorders treated with DBS obtain significant relief of their neurological symptoms with conventional programming techniques that are outlined at the beginning of each section in this book. However, perioperative complications, stimulation induced side-effects and unexpected clinical symptoms such as freezing of gait after globus pallidus implantation for dystonia (Case 20), persistent dyskinesia after subthalamic stimulation (Case 17), and erosion of device hardware (Case 24) warrant unconventional and creative troubleshooting techniques to improve surgical outcomes while being constantly cognizant of their impact on the patient. Each case in the book is illustrative of the iterative process of managing deep brain stimulation patients who have entrusted their health to specialists who are not only determined to improve their quality of life regardless of the complexity of the clinical scenario but also share their invaluable observations with readers who may someday face a similar challenge when treating their patients.

scholarly journals Deep brain stimulation for obesity: rationale and approach to trial design

2015 ◽  
Vol 38 (6) ◽  
pp. E8 ◽  
Author(s):  
Allen L. Ho ◽  
Eric S. Sussman ◽  
Arjun V. Pendharkar ◽  
Dan E. Azagury ◽  
Cara Bohon ◽  
...  
Keyword(s):  
Morbid Obesity ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Trial Design ◽  
Maladaptive Behavior ◽  
Inclusion Criteria ◽  
Ethical Considerations ◽  
Reward Circuitry ◽  
The Us ◽  
Deep Brain

Obesity is one of the most serious public health concerns in the US. While bariatric surgery has been shown to be successful for treatment of morbid obesity for those who have undergone unsuccessful behavioral modification, its associated risks and rates of relapse are not insignificant. There exists a neurological basis for the binge-like feeding behavior observed in morbid obesity that is believed to be due to dysregulation of the reward circuitry. The authors present a review of the evidence of the neuroanatomical basis for obesity, the potential neural targets for deep brain stimulation (DBS), as well as a rationale for DBS and future trial design. Identification of an appropriate patient population that would most likely benefit from this type of therapy is essential. There are also significant cost and ethical considerations for such a neuromodulatory intervention designed to alter maladaptive behavior. Finally, the authors present a consolidated set of inclusion criteria and study end points that should serve as the basis for any trial of DBS for obesity.

scholarly journals Subthalamic stimulation impairs stopping of ongoing movements

Brain ◽  
2020 ◽  
Author(s):  
Roxanne Lofredi ◽  
Georg Cem Auernig ◽  
Friederike Irmen ◽  
Johanna Nieweler ◽  
Wolf-Julian Neumann ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Right Hemisphere ◽  
Inferior Frontal Gyrus ◽  
Motor Area ◽  
Subthalamic Stimulation ◽  
The Right ◽  
Deep Brain

Abstract The subthalamic nucleus is part of a global stopping network that also includes the presupplementary motor area and inferior frontal gyrus of the right hemisphere. In Parkinson’s disease, subthalamic deep brain stimulation improves movement initiation and velocity, but its effect on stopping of ongoing movement is unknown. Here, we examine the relation between movement stopping and connectivity of stimulation volumes to the stopping network. Stop and go times were collected in 17 patients with Parkinson’s disease on and off subthalamic stimulation during visually cued initiation and termination of continuous, rotational movements. Deep brain stimulation contacts were localized; the stimulation volume computed and connectivity profiles estimated using an openly available, normative structural connectome. Subthalamic stimulation significantly increased stop times, which correlated with the connectivity of the stimulation volume to presupplementary motor area and inferior frontal gyrus of the right hemisphere. The robustness of this finding was validated using three separate analysis streams: voxel-wise whole-brain connectivity, region of interest connectivity and a tract-centred method. Our study sheds light on the role of the fronto-subthalamic inhibitory triangle in stopping of ongoing movements and may inspire circuit based adaptive stimulation strategies for control of stopping impairment, possibly reflected in stimulation-induced dyskinesia.

How Parkinson’s patients in the USA perceive deep brain stimulation in the 21st century: Results of a nationwide survey

2022 ◽  
Vol 95 ◽  
pp. 20-26
Author(s):  
Daniel Alfonso ◽  
Laura Y. Cabrera ◽  
Christos Sidiropoulos ◽  
Fei Wang ◽  
Harini Sarva
Keyword(s):  
Deep Brain Stimulation ◽  
21St Century ◽  
Brain Stimulation ◽  
Nationwide Survey ◽  
The Usa ◽  
Deep Brain

scholarly journals Opto-activation of cortical somatostatin interneurons alleviates parkinsonian symptoms

2018 ◽  
Author(s):  
Marie Vandecasteele ◽  
Sébastien Valverde ◽  
Charlotte Piette ◽  
Giuseppe Gangarossa ◽  
Willy Derousseaux ◽  
...  
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Pyramidal Neurons ◽  
Pyramidal Cells ◽  
Symptomatic Treatment ◽  
Eligibility Criteria ◽  
Less Invasive ◽  
Subthalamic Stimulation ◽  
Deep Brain

AbstractDeep brain stimulation of the subthalamic nucleus is a symptomatic treatment of Parkinson’s disease but benefits only to a minority of patients due to stringent eligibility criteria. To investigate new targets for less invasive therapies, we aimed at elucidating key mechanisms supporting deep brain stimulation efficiency. Here, using in vivo electrophysiology, optogenetics and modeling, we found that subthalamic stimulation normalizes pathological hyperactivity of motor cortex pyramidal cells, while concurrently activating somatostatin and inhibiting parvalbumin interneurons. In vivo opto-activation of cortical somatostatin interneurons alleviates motor symptoms in a parkinsonian mouse model. A mathematical model highlights how the decrease in pyramidal neurons activity can restore information processing capabilities. Overall, these results demonstrate that activation of cortical somatostatin interneurons may constitute a less invasive alternative than subthalamic stimulation.One-sentence SummaryDeep brain stimulation recruits cortical somatostatin interneurons, and their opto-activation is beneficial in Parkinson’s.

Deep Brain Stimulation for Intractable OCD

2017 ◽  
Author(s):  
Wayne K. Goodman ◽  
Nigel Kennedy ◽  
Kyle Lapidus ◽  
Brian H. Kopell
Keyword(s):  
Deep Brain Stimulation ◽  
Brain Stimulation ◽  
Closed Loop ◽  
Behavioral Therapy ◽  
Adequate Treatment ◽  
Predictors Of Response ◽  
The Us ◽  
Ablative Procedures ◽  
The Brain ◽  
Deep Brain

This chapter discusses the use of deep brain stimulation (DBS) for intractable OCD. In contrast to ablative procedures, DBS has the advantages of being reversible (explantable) and adjustable. In 2010, the FDA approved a Humanitarian Device Exemption (HDE) for ventral capsule/ventral striatum DBS in intractable OCD, based upon the device’s safety and its probable benefit, for up to 4,000 people a year in the US. DBS is only suitable for adult patients who remain severely ill despite multiple medication trials and adequate treatment with cognitive behavioral therapy. Further research is needed to further test the efficacy of DBS in OCD, compare targets, identify predictors of response, and optimize programming. Future DBS systems may take advantage of closed loop technology in which feedback from the brain is used to adjust stimulation automatically according to the patient’s changing needs.

Sign in / Sign up

Export Citation Format

Share Document