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Biomedical subjects

K Bötzel

Publications and source records attributed to K Bötzel.

At least 19 recordsLinked to original sources
PubMed2006

[First experiences in deep brain stimulation for cervical dystonia].

BACKGROUND: Cervical dystonia results in severe disability and cannot be effectively treated with medication. Repeat injections of botulinum toxin into the dystonic neck muscles can relieve the symptoms in most patients. When this treatment fails (mostly due to antibody formation), deep brain stimulation can be considered. PATIENTS AND METHODS: We report our experiences with eight patients who were treated with bilateral deep brain stimulation of the globus pallidus interna for cervical dystonia. The mean observation period was 31 months. RESULTS: Six of eight patients experienced relief from symptoms a few days after the implantation. Improvement of symptoms was a mean of 60% during the 1st year. There were no complications. CONCLUSION: In this and in other studies with small numbers of patients, deep brain stimulation has shown a good effect on cervical dystonia. According to our results, the patients who benefit most are those with no dystonic shoulder involvement and who have a tonic rather than clonic symptomatology. It seems probable that deep brain stimulation will become the therapy of choice for otherwise intractable cervical dystonia.

Adult↗
PubMed2004

[Parkinson's disease--new horizons].

New information about the pathology and genetics of Parkinson's disease opens up new possibilities for treatment. A key role is played by a pathologically folded protein, the distribution of which in the brain permits new conclusions about the stage of the disease. Gene mutations in affected families provide further clues as to the pathological process. In addition to symptom control, future treatment strategies will be aimed in particular at slowing down the underlying pathological process, and will therefore go in the direction of neuroprotection and neurorestoration. Dopamine agonists that can slow cell degeneration are already the first-line treatment in patients under 70 years of age.

Aged↗
PubMed2001

Contraversive eye deviation during deep brain stimulation of the globus pallidus internus.

Clinical signs help determine correct electrode positioning during stereotactic implantation for chronic high-frequency pallidal stimulation in Parkinson's diease (PD). The authors describe a patient who had marked, sustained, contraversive eye deviation caused by stimulation during pallidal surgery. The underlying mechanism is probably an excitation of fibers in the internal capsule by volume-conducted current spread. Such conjugate eye deviation is thus not necessarily an indication of incorrect electrode placement.

Electric Stimulation Therapy↗
PubMed2001

Postural reflexes evoked by tapping forehead and chest.

We investigated whether a tap with a reflex hammer to the forehead can elicit responses in the leg muscles and whether vestibular stimulation is the crucial prerequisite for eliciting these responses. We also measured the postural changes caused by the tap and by the compensatory, presumably reflex-like reactions of the subject. Tap-evoked activity of leg muscles was easily elicited during upright stance in normal subjects and was also seen in two subjects without vestibular function. The pattern of muscle activation clearly showed a counteraction to the tap-evoked perturbation of stance. Taps applied to the chest elicited similar reflexes. Since these two conditions imply a different activation of the vestibular apparatus, the vestibular input alone cannot account for the observed leg muscle reflexes. We suggest that multisensory reflex pathways that integrate vestibular and proprioceptive inputs account for these reflexes.

Adult↗
PubMed2000

[Gliomatosis cerebri: two case reports with atypical clinical and neuroradiologic findings].

The diagnosis of the rare disease Gliomatosis cerebri requires the correlation of clinical, radiological, and pathological findings. We report on two patients with intravitally diagnosed gliomatosis cerebri. Due to the unusually high malignancy of the tumor cells, diagnosis was complicated by atypical findings such as gadolinium enhancement in MRI and raised intracranial pressure. The clinical course, differential diagnosis, and literature are summarized briefly.

Biopsy↗
PubMed1999

Dipole source analysis in persistent mirror movements.

To elucidate the pathomechanism underlying persistent mirror movements (MM), we modelled the origin of electric brain activity associated with these movements. Movement-related cortical potentials (MRCP) in a group of subjects affected by persistent mirror movements were compared with those of a control group. The data of the normal subjects were best explained with two bilaterally active electric sources in the sensorimotor cortices with a clear preponderance of the hemisphere contralateral to the movement. In contrast, the MM subjects presented a fairly symmetric source activity in both hemispheres during unilateral intended movements. In the control group, the source representing the activity of the motor cortex ipsilateral to the moving finger reduced activity before the beginning of the movement; this was interpreted as an inhibition of the ipsilateral motor cortex during unilateral movement. In the MM group, however, this inhibition was not seen. Furthermore, while normal subjects demonstrated no relevant activity of an additional source placed near midline motor structures (supplementary motor area; SMA), subjects with MM showed considerable activity of this dipole source. These findings suggest that subjects with persistent MM have abnormal bilateral activation of the primary motor areas, probably together with an additional activation of mesial motor structures. This assumption fits well with the observation of an incomplete decussation of the pyramidal tract. The bilateral activation is then explained as a compensatory strategy in order to achieve sufficient force in the innervated target muscles.

Adolescent↗
PubMed1997

Topography and dipole analysis of reafferent electrical brain activity following the Bereitschaftspotential.

The cerebral events related to limb movements can be studied noninvasively with the method of evoked potentials. In this study, a brain potential is analysed that follows the onset of a simple finger movement. Because this potential occurred after active as well as after passive movements, its previously alleged reafferent somatosensory nature is confirmed in this study. Detailed topographic analysis revealed that this potential has the same polarity and merges with the preceeding Bereitschaftspotential (BP; in the active movement) at central electrodes, whereas at parietal electrodes polarity is opposite to the BP. In individual subjects, the maximum of the BP and the peak of the reafferent potential are separated by a small gap, previously described as pre-motion positivity. A comparison with the N20 potential of the electrically evoked somatosensory potential showed similar potential topography, albeit opposite polarity. The dipole analysis supported the view that the reafferent and the electrically evoked potentials are likely to arise from the same cortical area, namely the primary somatosensory cortex.

Adult↗
PubMed1997

[Measuring saccades in endocrine orbitopathy].

Thyroid-associated ophthalmopathy (TAO) is evaluated mainly by orthoptic examination and morphometric parameters such as ultrasound, CT scanning or magnetic resonance imaging. Inflammatory changes of the extraocular muscles lead to an impairment of eye movement. Recent evidence suggests that saccades are altered by changes to the extraocular muscles. Although of potential interest, this phenomenon has so far received little attention. To determine the role of saccades as a potential diagnostic tool for assessing the function of the affected muscles, we have begun to analyze saccadic parameters in patients with TAO. Preliminary results of this study are reported in the present paper. For registration of both horizontal and vertical eye movements, we used the "Ober-2-Apparatus," which uses the infrared technique. Horizontal and vertical saccades with an amplitude of 10 degrees were analyzed in 20 healthy persons and 30 patients suffering from TAO. Patients showed changes in the quality of saccades, such as the appearance of glissades and additional correctional saccades as well as quantitative changes, such as an increase in the maximum speed and latency. Our current data suggest the presence of saccadic alterations in TAO. Our ongoing studies are designed to evaluate whether characteristic changes can be assigned to certain stages of the disease and whether assessment of saccadic changes in a promising tool for early detection and functional follow-up in patients with TAO.

Adult↗
PubMed1997

[Functional eye muscle changes in endocrine orbitopathy].

BACKGROUND: To determine the functional changes in the extraocular muscles in patients with thyroid-associated ophthalmopathy (TAO). PATIENTS AND METHODS: Horizontal saccades with an amplitude of 20 degrees were carried out over a period of 2 min. Eight patients with acute TAO and five patients with chronic TAO were compared with ten age-matched healthy individuals. Ocular movements were recorded using the "Ober 2" system based on infrared technology. For evaluation of fatigue effects, the parameters of the first five and the last five saccades were analysed. RESULTS: A significant difference of four and five, respectively, out of nine tested saccadic variables including maximum velocity (Vmax) was found both before and after fatigue. In comparison to normal subjects, patients with chronic TAO revealed mildly increased reduction of Vmax after fatigue. Results in patients with acute TAO were related to the action of the most severely affected muscle. On active contraction of the medial rectus muscle (adducting saccades), Vmax was not significantly decreased after fatigue. On passive elongation of the medial rectus muscle (abducting saccades), however, Vmax was initially markedly decreased and increased significantly after fatigue. CONCLUSIONS: Functional changes of extraocular muscles in patients with TAO can be demonstrated by saccadic analysis. The inverse change in velocity after fatigue in acute disease indicates an improvement of muscle elasticity during exertion and strongly supports the concept that early impairment of bulbar motility in active TAO results from contracture of myofilaments. Thus, analysis of the fatigue effect may help to differentiate between acute and chronic disease.

Graves Disease↗
PubMed1995

Frontal and parietal premovement slow brain potentials in Parkinson's disease and aging.

During the anticipation of a stimulus that induces a predetermined pattern of behavior, a slowly increasing negative electric potential can be recorded from the human scalp at central and parietal electrodes and has been named contingent negative variation (CNV). We used a simple and a choice reaction time paradigm to investigate premovement potentials in patients with Parkinson's disease (PD) and in normal controls. There was a clear CNV in young subjects whereas it was negligible in the elderly control subjects and absent in the patients. In addition, we found a slowly increasing positive frontal potential. In normals the steepness of this potential decreased with the complexity of the task (simple vs. choice) and with age. This difference was abolished in the patients: If a slowly increasing positivity was observed at all, it was, on average, larger in the choice task. Reaction times of the patients were disproportionally prolonged in the simple compared to the complex task. These findings support the hypothesis that storing or initiating a simple preprogrammed motor response is more impaired in PD than selecting and initiating a motor response of a more complex task. The electrophysiological recordings suggest that impaired activation of the frontal lobes may be responsible for this deficit.

Age Factors↗