Abstract
The anatomical connections of the anterior lobe of the cerebellum with the reticular formation in the brainstem, upper motor neurons and the limbic system, as well as the results of experimental and clinical observations indicate that this region is a proper area for modulation of certain types of central motor disorders but also of limbic functions. Through a direct stereotacticaly suboccipital approach electrodes were introduced into the anterior lobe of the cerebellum in four patients (3 females and one male, 24, 29, 45 and 19 years old, respectively) suffering from cerebral palsy and being confined to a wheelchair with severe spastic choreoathetoid movements, with minimal hand function, but in good mental state. After a period of test stimulation (up to 10 days), the pulse generators were implanted and chronic high-frequency stimulation was applied (for 37, 58, 9 and 32 months, respectively). In agreement with our previous experience (transtentorial approach in 30 patients), noticeable improvements in spasticity were immediate and a gradual reduction in choreoatetoid movements was observed in the following days to weeks. Improvements in speech, swallowing, respiration, posture, ambulation, and mood states were combined with development of new motor skills. Caution with the proper positioning of the electrode in the target and the selection of optimal program for stimulation are of paramount importance.
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References
Cooper IS, Riklan M, Amin I (1976) Chronic cerebellar stimulation in cerebral palsy. Neurology 26: 744–753
Davis R (2000) Cerebellar stimulation for cerebral palsy spasticity, function, and seizures. Arch Med Res 31: 290–299
Galanda M, Zoltan O (1987) Motor and psychological responses to deep cerebellar stimulation in cerebral palsy (Correlation with organization of cerebellum into zones). Acta Neurochir Suppl 39: 129–131
Galanda M, Horvath S (1997) Different effect of chronic electrical stimulation of the region of the superior cerebellar peduncle and the nucleus ventralis intermedius of the thalamus in the treatment of movement disorders. Stereotact Funct Neurosurg 69: 116–120
Galanda M, Horvath S (2003) Effect of stereotactic high-frequency stimulation in the anterior lobe of the cerebellum in cerebral palsy: a new suboccipital approach. Stereotact Funct Neurosurg 80: 102–107
Groenewegen HJ, Voogd J (1977) The parasagittal zonation within the olivocerebellar projection. I. Climbing fiber distribution in the vermis of cat cerebellum. J Comp Neurol 174: 417–488
Haines DE (1981) Zones in the cerebellar cortex. Their organization and potential relevance to cerebellar stimulation. J Neurosurg 55: 254–264
Heath RG (1977) Modulation of emotion with a brain pacemaker. Treatment for intractable psychiatric illness. J Nerv Ment Dis 165: 300–317
Moruzzi G (1950) Effects at different frequencies of cerebellar stimulation upon postural tonus and myotatic reflexes. EEG Clin Neurophys 2: 463
Oscarsson O (1979) Functional units of the cerebellum-sagittal zones and microzones. Trends Neurosci 2: 143–145
Penn RD, Gottlieb GL, Agarwal GC (1978) Cerebellar stimulation in man. Quantitative changes in spasticity. J Neurosurg 48: 779–786
Voogd J (1969) The importance of fiber connections in the comparative anatomy of the mammalian cerebellum. In: Llinas R (ed) Neurobiology of cerebellar evolution and development. AMA Education and Research Foundation, Chicago, pp 493–514
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© 2007 Springer-Verlag
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Galanda, M., Horvath, S. (2007). Stereotactic stimulation of the anterior lobe of the cerebellum in cerebral palsy from a suboccipital approach. In: Sakas, D.E., Simpson, B.A. (eds) Operative Neuromodulation. Acta Neurochirurgica Supplements, vol 97/2. Springer, Vienna. https://doi.org/10.1007/978-3-211-33081-4_27
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DOI: https://doi.org/10.1007/978-3-211-33081-4_27
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-33080-7
Online ISBN: 978-3-211-33081-4
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