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        New Message Board Archives >> Medications, Treatments, Therapies 2005 >> Fresh Research - New Hypothalamic Implant Study
        
(Message started by: floridian on Feb 4^th, 2005, 9:41am)

Title: Fresh Research - New Hypothalamic Implant Study
Post by floridian on Feb 4^th, 2005, 9:41am

Continued trials on implanting electrical 'pace-makers' for the hypothalamus, with positive/mixed results. This type of surgery is a last resort - these researchers report 3 patient improved greatly, while there was one surgery related death in a group of six patients.

Quote:

Brain. 2005 Feb 2; [Epub ahead of print]

Hypothalamic stimulation in chronic cluster headache: a pilot study of efficacy and mode of action.

Schoenen J, Di Clemente L, Vandenheede M, Fumal A, De Pasqua V, Mouchamps M, Remacle JM, de Noordhout AM. University Department of Neurology, University of Liege, Liege, Belgium; University Department of Neuroanatomy, University of Liege, Liege, Belgium.

Summary We enrolled six patients suffering from refractory chronic cluster headache in a pilot trial of neurostimulation of the ipsilateral ventroposterior hypothalamus using the stereotactic coordinates published previously. After the varying durations needed to determine optimal stimulation parameters and a mean follow-up of 14.5 months, the clinical outcome is excellent in three patients (two are pain-free; one has fewer than three attacks per month), but unsatisfactory in one patient, who only has had transient remissions. Mean voltage is 3.28 V, diplopia being the major factor limiting its increase. When the stimulator was switched off in one pain-free patient, attacks resumed after 3 months until it was turned on again. In one patient the implantation procedure had to be interrupted because of a panic attack with autonomic disturbances. Another patient died from an intracerebral haemorrhage that developed along the lead tract several hours after surgery; there were no other vascular changes on post-mortem examination. After 1 month, the hypothalamic stimulation induced resistance against the attack-triggering agent nitroglycerin and tended to increase pain thresholds at extracephalic, but not at cephalic, sites. It had no detectable effect on neurohypophyseal hormones or melatonin excretion. We conclude that hypothalamic stimulation has remarkable efficacy in most, but not all, patients with treatment-resistant chronic cluster headache. Its efficacy is not due to a simple analgesic effect or to hormonal changes. Intracerebral haemorrhage cannot be neglected in the risk evaluation of the procedure. Whether it might be more prevalent than in deep-brain stimulation for movement disorders remains to be determined.

Title: Re: Fresh Research - New Hypothalamic Implant Stud
Post by JJA on Feb 4^th, 2005, 10:07am

Quote:

When the stimulator was switched off in one pain-free patient, attacks resumed after 3 months

This is interesting. It could help explain why episodics go painfree for months/years.

Jesse

Title: Re: Fresh Research - New Hypothalamic Implant Stud
Post by vig on Feb 4^th, 2005, 10:58am

but a death in the family :'([smiley=huh.gif]

Title: Re: Fresh Research - New Hypothalamic Implant Stud
Post by Langa on Feb 4^th, 2005, 11:03am

1 death out of 6 patients is not a good number... :-[

Title: Re: Fresh Research - New Hypothalamic Implant Stud
Post by Rock_Lobster on Feb 4^th, 2005, 11:14am

How did they get at the Hypo? I thought it was hidden pretty well. A probe between the lobes? Or with a skill-saw up the snout?

Title: Re: Fresh Research - New Hypothalamic Implant Stud
Post by floridian on Feb 4^th, 2005, 12:01pm

Quote:

How did they get at the Hypo? I thought it was hidden pretty well. A probe between the lobes? Or with a skill-saw up the snout?

Probe between the lobes, I believe. I took a physiological psychology class (with lab) in 1980 .... we did hypothalamic lesions and implants on rats --- for that, it was basically drill and insert. The success rate for the class was pathetic, but we were amateurs. Maybe my clusters are karmic payback for the pain that I inflicted.

Title: Re: Fresh Research - New Hypothalamic Implant Stud
Post by JJA on Feb 4^th, 2005, 12:20pm

Yep, they drill a hole in the skull and just poke through the rest. It's just brain.

Jesse