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Article ; Online: MR-Guided High-Intensity Focused Ultrasound Lesioning: MRgHIFU Breathing Life in the Lost Art of Lesioning for Movement Disorders.

Zibly, Zion / Averbuch, Shay

2020 Volume 68, Issue Supplement, Page(s) S202–S205

Abstract: Magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU) is a well-established technology that has been developed during the last decade and is currently used in the treatment of a diverse range of neurodegenerative brain disorders and ... ...

Abstract	Magnetic resonance-guided high-intensity focused ultrasound (MRgHIFU) is a well-established technology that has been developed during the last decade and is currently used in the treatment of a diverse range of neurodegenerative brain disorders and neuropsychiatric diseases. This innovative noninvasive technology uses nonionizing ultrasound waves to heat and thus ablate brain tissue in selected targets. In comparison with other lesioning and surgical techniques, MRgHIFU has the following advantages: noninvasive, an immediate clinical outcome with no risk of long-standing ionizing radiation injury, no need for general anesthesia, and no device implantation.
MeSH term(s)	Brain ; High-Intensity Focused Ultrasound Ablation ; Humans ; Magnetic Resonance Imaging ; Movement Disorders ; Ultrasonography
Language	English
Publishing date	2020-12-13
Publishing country	India
Document type	Journal Article
ZDB-ID	415522-1
ISSN	1998-4022 ; 0028-3886
ISSN (online)	1998-4022
ISSN	0028-3886
DOI	10.4103/0028-3886.302452
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Article ; Online: Emerging Technologies and Indications of Neuromodulation and Increasing Role of Non Invasive Neuromodulation.

Zibly, Zion / Averbuch, Shay / Deogaonker, Milind

Neurology India

2020 Volume 68, Issue Supplement, Page(s) S316–S321

Abstract: Altering the enormous complex connectivity and output of the central nervous system is one of the most fascinating development in medical technologies. It harbors the ability to treat and modulate different neurological disorders and diseases such as ... ...

Abstract	Altering the enormous complex connectivity and output of the central nervous system is one of the most fascinating development in medical technologies. It harbors the ability to treat and modulate different neurological disorders and diseases such as Parkinson's disease, Alzheimer's disease and even help with drug delivery to treat unreachable areas of brain via opening of the blood brain barrier. Evolution of neuromodulation techniques has been significant in last few years. They have become less invasive and more focused. Newer neuromodulation techniques consist of invasive, minimally invasive and non-invasive technologies. The decision to use one of these technologies depends on the indication and the targeted area within the central or peripheral nervous system. In the last decade technological advances and the urge to minimize the surgical and the long term complications of hardware implantation, have pushed the neurosurgical community to increase the use of non-invasive neuromodulation technics. In this article, we will discuss the different emerging technologies in neuromodulation and the increasing role of non-invasive neuromodulation.
MeSH term(s)	Alzheimer Disease ; Blood-Brain Barrier ; Brain ; Humans ; Nervous System Diseases/therapy ; Parkinson Disease/therapy
Language	English
Publishing date	2020-12-14
Publishing country	India
Document type	Journal Article
ZDB-ID	415522-1
ISSN	1998-4022 ; 0028-3886
ISSN (online)	1998-4022
ISSN	0028-3886
DOI	10.4103/0028-3886.302453
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Article ; Online: Neuromodulation for Refractory Angina, Heart Failure and Peripheral Vascular Disease.

Zibly, Zion / Abofani, Hannan / Rennert, Noa

Neurology India

2020 Volume 68, Issue Supplement, Page(s) S297–S301

Abstract: Use of spinal cord stimulation (SCS) has expanded beyond pain control. There are increasing indications in which SCS is being used. The understanding of central and peripheral neural pathways and their controlling influences on peripheral organs is ... ...

Abstract	Use of spinal cord stimulation (SCS) has expanded beyond pain control. There are increasing indications in which SCS is being used. The understanding of central and peripheral neural pathways and their controlling influences on peripheral organs is better understood now. The concept of stimulating the spinal cord and modulating central pathways with SCS is already established. Different studies have shown the benefit with SCS on visceral pain control, improving quality of live in severe peripheral vascular disease and even assist in controlling the vago-sympathetic balance. We will discuss the art of implantation. Patient selection and stimulation with respect to current clinical data.
MeSH term(s)	Angina Pectoris ; Heart Failure/therapy ; Humans ; Pain Management ; Peripheral Vascular Diseases ; Spinal Cord ; Spinal Cord Stimulation ; Treatment Outcome
Language	English
Publishing date	2020-12-13
Publishing country	India
Document type	Journal Article
ZDB-ID	415522-1
ISSN	1998-4022 ; 0028-3886
ISSN (online)	1998-4022
ISSN	0028-3886
DOI	10.4103/0028-3886.302461
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Article ; Online: Are LRRK2 p.G2019S or GBA1 variants associated with long-term outcomes of deep brain stimulation for Parkinson's disease?

Anis, Saar / Goldberg, Tomer / Shvueli, Ethan / Kozlov, Yuval / Redlich, Yonatan / Lavi, Naama / Lavie, Inbar / Sosero, Yuri Ludwig / Gan-Or, Ziv / Ungar, Lior / Zibly, Zion / Greenbaum, Lior / Fay-Karmon, Tsvia / Hassin-Baer, Sharon

Parkinsonism & related disorders

2024 , Page(s) 106008

Abstract: Background: Deep brain stimulation (DBS) is a well-established treatment option for individuals with advanced Parkinson's disease (PD). The potential influence of the LRRK2 p.G2019S or GBA1 variants on its lasting efficacy and adverse effects should be ... ...

Abstract	Background: Deep brain stimulation (DBS) is a well-established treatment option for individuals with advanced Parkinson's disease (PD). The potential influence of the LRRK2 p.G2019S or GBA1 variants on its lasting efficacy and adverse effects should be better characterized. Methods: We conducted a retrospective single-center case-control study involving PD patients who were carriers of a GBA1 variant (GBA1-PD), the LRRK2 p.G2019S variant (LRRK2-PD), and non-carriers (Nc-PD). All participants underwent DBS and were followed up for at least a year. Assessments before surgery and at 1, 2, 3, 5, and 10 years post-DBS included the following: the Movement Disorder Society's Unified PD Rating Scale (MDS-UPDRS) Part III, Hoehn and Yahr scale, Levodopa Equivalent Daily Dose (LEDD) and non-motor symptoms (psychotic episodes, depressive symptoms, and cognitive decline). Results: The sample was composed of 103 patients (72 males, mean age at DBS surgery 61.5 ± 8.7 years, mean postoperative follow-up 7.0 ± 4.1 years). Of these, 19 were LRRK2-PD, 20 GBA1-PD, and 64 were Nc-PD. No significant differences in motor outcomes were observed between the groups. Compared to the Nc-PD patients, the GBA1-PD patients were at increased risk of both psychotic episodes [hazard ratio (HR) 2.76 (95 % CI: 1.12-6.80), p = 0.027], and cognitive decline [HR 2.28 (95 % CI: 1.04-5.00), p = 0.04]. Conclusion: LRRK2 and GBA1 variant status did not affect the motor outcomes of DBS in PD patients. However, GBA1-PD patients were at increased risk for psychosis and cognitive decline. Further studies are required to determine the role of genetic stratification in referral to DBS.
Language	English
Publishing date	2024-01-12
Publishing country	England
Document type	Journal Article
ZDB-ID	1311489-x
ISSN	1873-5126 ; 1353-8020
ISSN (online)	1873-5126
ISSN	1353-8020
DOI	10.1016/j.parkreldis.2024.106008
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Zs.A 4553: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (2.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 420: Show issues

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Article ; Online: Statistical learning in epilepsy: Behavioral and anatomical mechanisms in the human brain.

Aljishi, Ayman / Sherman, Brynn E / Huberdeau, David M / Obaid, Sami / Khan, Kamren / Lamsam, Layton / Zibly, Zion / Sivaraju, Adithya / Turk-Browne, Nicholas B / Damisah, Eyiyemisi C

Epilepsia

2024 Volume 65, Issue 3, Page(s) 753–765

Abstract: Objective: Statistical learning, the fundamental cognitive ability of humans to extract regularities across experiences over time, engages the medial temporal lobe (MTL) in the healthy brain. This leads to the hypothesis that statistical learning (SL) ... ...

Abstract	Objective: Statistical learning, the fundamental cognitive ability of humans to extract regularities across experiences over time, engages the medial temporal lobe (MTL) in the healthy brain. This leads to the hypothesis that statistical learning (SL) may be impaired in patients with epilepsy (PWE) involving the temporal lobe, and that this impairment could contribute to their varied memory deficits. In turn, studies done in collaboration with PWE, that evaluate the necessity of MTL circuitry through disease and causal perturbations, provide an opportunity to advance basic understanding of SL. Methods: We implemented behavioral testing, volumetric analysis of the MTL substructures, and direct electrical brain stimulation to examine SL across a cohort of 61 PWE and 28 healthy controls. Results: We found that behavioral performance in an SL task was negatively associated with seizure frequency irrespective of seizure origin. The volume of hippocampal subfields CA1 and CA2/3 correlated with SL performance, suggesting a more specific role of the hippocampus. Transient direct electrical stimulation of the hippocampus disrupted SL. Furthermore, the relationship between SL and seizure frequency was selective, as behavioral performance in an episodic memory task was not impacted by seizure frequency. Significance: Overall, these results suggest that SL may be hippocampally dependent and that the SL task could serve as a clinically useful behavioral assay of seizure frequency that may complement existing approaches such as seizure diaries. Simple and short SL tasks may thus provide patient-centered endpoints for evaluating the efficacy of novel treatments in epilepsy.
MeSH term(s)	Humans ; Epilepsy, Temporal Lobe ; Magnetic Resonance Imaging ; Brain ; Epilepsy ; Hippocampus ; Seizures
Language	English
Publishing date	2024-01-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	216382-2
ISSN	1528-1167 ; 0013-9580
ISSN (online)	1528-1167
ISSN	0013-9580
DOI	10.1111/epi.17871
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Zs.A 517: Show issues			Location: Je nach Verfügbarkeit (siehe Angabe bei Bestand) bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular Jg. 1995 - 2021: Lesesall (1.OG) ab Jg. 2022: Lesesaal (EG)
Zs.MO 475: Show issues

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Article ; Online: The rat rotenone model reproduces the abnormal pattern of central catecholamine metabolism found in Parkinson's disease.

Landau, Regev / Halperin, Reut / Sullivan, Patti / Zibly, Zion / Leibowitz, Avshalom / Goldstein, David S / Sharabi, Yehonatan

Disease models & mechanisms

2022 Volume 15, Issue 1

Abstract: Recent reports indicate that Parkinson's disease (PD) involves specific functional abnormalities in residual neurons - decreased vesicular sequestration of cytoplasmic catecholamines via the vesicular monoamine transporter (VMAT) and decreased aldehyde ... ...

Abstract	Recent reports indicate that Parkinson's disease (PD) involves specific functional abnormalities in residual neurons - decreased vesicular sequestration of cytoplasmic catecholamines via the vesicular monoamine transporter (VMAT) and decreased aldehyde dehydrogenase (ALDH) activity. This double hit builds up the autotoxic metabolite 3,4-dihydroxyphenylacetaldehyde (DOPAL), the focus of the catecholaldehyde hypothesis for the pathogenesis of PD. An animal model is needed that reproduces this abnormal catecholamine neurochemical pattern. Adult rats received subcutaneous vehicle or the mitochondrial complex 1 inhibitor rotenone (2 mg/kg/day via a minipump) for 10 days. Locomotor activity was recorded, and striatal tissue sampled for catechol contents and catechol ratios that indicate the above abnormalities. Compared to vehicle, rotenone reduced locomotor activity (P=0.002), decreased tissue dopamine concentrations (P=0.00001), reduced indices of vesicular sequestration (3,4-dihydroxyphenylacetic acid (DOPAC)/dopamine) and ALDH activity (DOPAC/DOPAL) (P=0.0025, P=0.036), and increased DOPAL levels (P=0.04). The rat rotenone model involves functional abnormalities in catecholaminergic neurons that replicate the pattern found in PD putamen. These include a vesicular storage defect, decreased ALDH activity and DOPAL build-up. The rat rotenone model provides a suitable in vivo platform for studying the catecholaldehyde hypothesis.
MeSH term(s)	3,4-Dihydroxyphenylacetic Acid/metabolism ; Animals ; Catecholamines ; Dopamine/metabolism ; Parkinson Disease/pathology ; Rats ; Rotenone/pharmacology
Chemical Substances	Catecholamines ; Rotenone (03L9OT429T) ; 3,4-Dihydroxyphenylacetic Acid (102-32-9) ; Dopamine (VTD58H1Z2X)
Language	English
Publishing date	2022-01-24
Publishing country	England
Document type	Journal Article ; Research Support, N.I.H., Intramural
ZDB-ID	2451104-3
ISSN	1754-8411 ; 1754-8403
ISSN (online)	1754-8411
ISSN	1754-8403
DOI	10.1242/dmm.049082
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Article ; Online: Magnetic resonance imaging analysis predicts nanoparticle concentration delivered to the brain parenchyma.

Plaksin, Michael / Bercovici, Tiran / Sat Toltsis, Gabriella Gabi / Grinfeld, Javier / Shapira, Boaz / Zur, Yuval / de Picciotto, Rafi / Zadicario, Eyal / Siddeeq, Mustaffa / Wohl, Anton / Zibly, Zion / Levy, Yoav / Cohen, Zvi R

Communications biology

2022 Volume 5, Issue 1, Page(s) 964

Abstract: Ultrasound in combination with the introduction of microbubbles into the vasculature effectively opens the blood brain barrier (BBB) to allow the passage of therapeutic agents. Increased permeability of the BBB is typically demonstrated with small- ... ...

Abstract	Ultrasound in combination with the introduction of microbubbles into the vasculature effectively opens the blood brain barrier (BBB) to allow the passage of therapeutic agents. Increased permeability of the BBB is typically demonstrated with small-molecule agents (e.g., 1-nm gadolinium salts). Permeability to small-molecule agents, however, cannot reliably predict the transfer of remarkably larger molecules (e.g., monoclonal antibodies) required by numerous therapies. To overcome this issue, we developed a magnetic resonance imaging analysis based on the ΔR
MeSH term(s)	Animals ; Antibodies, Monoclonal ; Brain/diagnostic imaging ; Drug Delivery Systems/methods ; Gadolinium ; Liposomes ; Magnetic Resonance Imaging/methods ; Nanoparticles ; Rats ; Salts
Chemical Substances	Antibodies, Monoclonal ; Liposomes ; Salts ; Gadolinium (AU0V1LM3JT)
Language	English
Publishing date	2022-09-15
Publishing country	England
Document type	Journal Article
ISSN	2399-3642
ISSN (online)	2399-3642
DOI	10.1038/s42003-022-03881-0
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Article ; Online: Targeting the vim by direct visualization of the cerebello-thalamo-cortical pathway in 3 T proton density MRI: correlation with focused ultrasound lesioning.

Páez-Nova, Maximiliano / Spiegelmann, Roberto / Korn-Israeli, Simon / Zibly, Zion / Illera-Rivera, Diego / Daza-Cordoba, Carmen / Alcazar-Daza, Juan Carlos / Garcia-Ballestas, Ezequiel

Neurosurgical review

2022 Volume 45, Issue 3, Page(s) 2323–2332

Abstract: Surgical targeting of the ventral intermediate nucleus of the thalamus (VIM) has been historically done using indirect strategies. Here we depict the cerebello-thalamo-cortical tract (CTCT) through 3 T proton density (PD) in a cohort of patients who ... ...

Abstract	Surgical targeting of the ventral intermediate nucleus of the thalamus (VIM) has been historically done using indirect strategies. Here we depict the cerebello-thalamo-cortical tract (CTCT) through 3 T proton density (PD) in a cohort of patients who underwent high-intensity focus ultrasound (HIFUS) thalamotomy. Forty-seven patients treated in our institution with MR-guided HIFUS VIM thalamotomy were included in this study. PD weighted 3 T MRI used for presurgical planning was compared with postoperative MRI obtained 1 month after surgery. Images were processed with ISTX software (Brain lab, Munich, Germany). The coordinates of the VIM lesion concerning the inter-commissural line (ICL) were annotated. Deterministic tractographies using three ROIs were used to verify the different tracts. The triangle seen in the 3 T PD sequence at the level of the mesencephalic-diencephalic junction was systematically recognized. The posterior angle of this triangle at the junction of the CTCT and the ZI was denominated as "point P." The area of this triangle corresponds to the posterior subthalamic area (PSA) harboring the Raprl fibers. The CTCT was visible from 1 to 2.5 mm below the ICL. The average center of the final HIFUS lesion (point F) was 11 mm from the medial thalamic border of the thalamus (14.9 mm from the midline), 6.4 mm anterior to PC, and 0.6 mm above the ICL. The FUS point was consistently 1-2 mm directly above point P. The anterior border of the external angle of this triangle (point P) can be used as an intraparenchymal point for targeting the ventral border of the VIM. Three ROIs placed in a single slice around this triangle are a fast way to originate tractography of the CTCT, lemniscus medialis, and pyramidal tract.
MeSH term(s)	Cerebellum ; Essential Tremor/diagnostic imaging ; Essential Tremor/surgery ; Humans ; Magnetic Resonance Imaging/methods ; Protons ; Thalamus/diagnostic imaging ; Thalamus/surgery
Chemical Substances	Protons
Language	English
Publishing date	2022-02-11
Publishing country	Germany
Document type	Journal Article
ZDB-ID	6907-3
ISSN	1437-2320 ; 0344-5607
ISSN (online)	1437-2320
ISSN	0344-5607
DOI	10.1007/s10143-022-01752-0
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Zs.A 1445: Show issues

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Article: Intrathecal baclofen pump implantation in a patient 2 years following a traumatic brain injury resulted in regained oratory capabilities.

Ungar, Lior / Sharma, Mayur / Zibly, Zion

Neurology India

2015 Volume 63, Issue 4, Page(s) 618–619

Language	English
Publishing date	2015-07
Publishing country	India
Document type	Letter
ZDB-ID	415522-1
ISSN	1998-4022 ; 0028-3886
ISSN (online)	1998-4022
ISSN	0028-3886
DOI	10.4103/0028-3886.162092
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Zs.A 698: Show issues

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Article ; Online: Sandwich technique, peripheral nerve stimulation, peripheral field stimulation and hybrid stimulation for inguinal region and genital pain.

Shaw, Andrew / Sharma, Mayur / Zibly, Zion / Ikeda, Daniel / Deogaonkar, Milind

British journal of neurosurgery

2016 Volume 30, Issue 6, Page(s) 631–636

Abstract: Objective: Ilioinguinal neuralgia (IG) and genitofemoral (GF) neuralgia following inguinal hernia repair is a chronic and debilitating neuropathic condition. Recently, peripheral nerve stimulation has become an effective and minimally invasive option ... ...

Abstract	Objective: Ilioinguinal neuralgia (IG) and genitofemoral (GF) neuralgia following inguinal hernia repair is a chronic and debilitating neuropathic condition. Recently, peripheral nerve stimulation has become an effective and minimally invasive option for the treatment of refractory pain. Here we present a retrospective case series of six patients who underwent placement of peripheral nerve stimulation electrodes using various techniques for treatment of refractory post-intervention inguinal region pain. Methods: Six patients with post-intervention inguinal, femoral or GF neuropathic pain were evaluated for surgery. Either octopolar percutaneous electrodes or combination of paddle and percutaneous electrodes were implanted in the area of their pain. Pain visual analog scores (VAS), surgical complication rate, preoperative symptom duration, degree of pain relief, preoperative and postoperative work status, postoperative changes in medication usage, and overall degree of satisfaction with this therapy was assessed. Results: All six patients had an average improvement of 62% in the immediate post-operative follow-up. Four patients underwent stimulation for IG, one for femoral neuralgia, and another for GF neuralgia. Peripheral nerve stimulation provided at least 50% pain relief in all the six patients with post-intervention inguinal region pain. 85% of patients indicated they were completely satisfied with the therapy overall. There was one treatment failure with an acceptable complication rate. Conclusion: Peripheral nerve or field stimulation for post-intervention inguinal region pain is a safe and effective treatment for this refractory and complex problem for patients who have exhausted other management options.
MeSH term(s)	Adult ; Electric Stimulation Therapy/methods ; Electrodes, Implanted ; Female ; Genitalia ; Hernia, Inguinal/complications ; Hernia, Inguinal/surgery ; Herniorrhaphy/adverse effects ; Humans ; Inguinal Canal ; Male ; Middle Aged ; Pain Measurement ; Pain, Intractable ; Pain, Postoperative/therapy ; Peripheral Nerves ; Retrospective Studies ; Treatment Outcome
Language	English
Publishing date	2016-12
Publishing country	England
Document type	Journal Article
ZDB-ID	639029-8
ISSN	1360-046X ; 0268-8697
ISSN (online)	1360-046X
ISSN	0268-8697
DOI	10.1080/02688697.2016.1199777
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