Long-Term Efficacy and Safety of Chronic Globus Pallidus Internus Stimulation in Different Types of Primary Dystonia

Background: Deep brain stimulation (DBS) of the globus pallidus internus (GPi) offers a very promising therapy for medically intractable dystonia. However, little is known about the long-term benefit and safety of this procedure. We therefore performed a retrospective long-term analysis of 18 patients (age 12-78 years) suffering from primary generalized (9), segmental (6) or focal (3) dystonia (minimum follow-up: 36 months). Methods: Outcome was assessed using the Burke-Fahn-Marsden (BFM) scores (generalized dystonia) and the Tsui score (focal/segmental dystonia). Follow-up ranged between 37 and 90 months (mean 60 months). Results: Patients with generalized dystonia showed a mean improvement in the BFM movement score of 39.4% (range 0 68.8%), 42.5% (range -16.0 to 81.3%) and 46.8% (range-2.7 to 83.1%) at the 3- and 12-month, and long-term follow-up, respectively. In focal/ segmental dystonia, the mean reduction in the Tsui score was 36.8% (range 0-100%), 65.1% (range 16.7-100%) and 59.8% (range 16.7-100%) at the 3- and 12-month, and long-term follow-up, respectively. Local infections were noted in 2 patients and hardware problems (electrode dislocation and breakage of the extension cable) in 1 patient. Conclusion: Our data showed Gpi-DBS to offer a very effective and safe therapy for different kinds of primary dystonia, with a significant long-term benefit in the majority of cases. Copyright (c) 2008 S. Karger AG, Base

Hyperfine dependent atom-molecule loss analyzed by the analytic solution of few-body loss equations

We prepare mixtures of ultracold $^{39}$K atoms in various hyperfine spin states and $^{23}$Na$^{39}$K molecules in an optical dipole trap at a fixed magnetic field and study inelastic two-body atom-molecule collisions. We observe atom-molecule losses that are hyperfine dependent with a two-body loss rate far below the universal limit. We analyze the two-body loss dynamics based on the derivation of general and easy applicable analytic solutions for the differential equations describing the loss of an arbitrary number $\gamma$ of particles in a single collisional event

Beyond Born-Oppenheimer approximation in ultracold atomic collisions

We report on deviations beyond the Born-Oppenheimer approximation in the potassium inter-atomic potentials. Identifying three up-to-now unknown $d$-wave Feshbach resonances, we significantly improve the understanding of the $^{39}$K inter-atomic potentials. Combining these observations with the most recent data on known inter- and intra-isotope Feshbach resonances, we show that Born-Oppenheimer corrections can be determined from atomic collisional properties alone and that significant differences between the homo- and heteronuclear case appear

A pathway to ultracold bosonic 23Na39K ground state molecules

We spectroscopically investigate a pathway for the conversion of 23Na39K Feshbach molecules into rovibronic ground state molecules via stimulated Raman adiabatic passage. Using photoassociation spectroscopy from the diatomic scattering threshold in the a 3Σ+ potential, we locate the resonantly mixed electronically excited intermediate states |B1Π, v=8⟩ and |c3Σ+, v=30⟩ which, due to their singlet-triplet admixture, serve as an ideal bridge between predominantly a 3Σ+ Feshbach molecules and pure X 1Σ+ ground state molecules. We investigate their hyperfine structure and present a simple model to determine the singlet-triplet coupling of these states. Using Autler-Townes spectroscopy, we locate the rovibronic ground state of the 23Na39K molecule (X1Σ+, v=0, N=0⟩) and the second rotationally excited state N = 2 to unambiguously identify the ground state. We also extract the effective transition dipole moment from the excited to the ground state. Our investigations result in a fully characterized scheme for the creation of ultracold bosonic 23Na39K ground state molecules

Cerebellar potentiation and learning a whisker-based object localization task with a time response window

Whisker-based object localization requires activation and plasticity of somatosensory and motor cortex. These parts of the cerebral cortex receive strong projections from the cerebellum via the thalamus, but it is unclear whether and to what extent cerebellar processing may contribute to such a sensorimotor task. Here, we subjected knock-out mice, which suffer from impaired intrinsic plasticity in their Purkinje cells and long-term potentiation at their parallel fiber-to-Purkinje cell synapses (L7-PP2B), to an object localization task with a time response window (RW). Water-deprived animals had to learn to localize an object with their whiskers, and based upon this location they were trained to lick within a particular period ("go" trial) or refrain from licking ("no-go" trial). L7-PP2B mice were not ataxic and showed proper basic motor performance during whisking and licking, but were severely impaired in learning this task compared with wild-type littermates. Significantly fewer L7-PP2B mice were able to learn the task at long RWs. Those L7-PP2B mice that eventually learned the task made unstable progress, were significantly slower in learning, and showed deficiencies in temporal tuning. These differences became greater as theRWbecame narrower. Trained wild-type mice, but not L7-PP2B mice, showed a net increase in simple spikes and complex spikes of their Purkinje cells during the task. We conclude that cerebellar processing, and potentiation in particular, can contribute to learning a whisker-based object localization task when timing is relevant. This study points toward a relevant role of cerebellum- cerebrum interaction in a sophisticated cognitive task requiring strict temporal processing

Aortic stiffness in aortic stenosis assessed by cardiovascular MRI: a comparison between bicuspid and tricuspid valves

Objectives To compare aortic size and stiffness parameters on MRI between bicuspid aortic valve (BAV) and tricuspid aortic valve (TAV) patients with aortic stenosis (AS). Methods MRI was performed in 174 patients with asymptomatic moderate-severe AS (mean AVAI 0.57 ± 0.14 cm2/m2) and 23 controls on 3T scanners. Valve morphology was available/analysable in 169 patients: 63 BAV (41 type-I, 22 type-II) and 106 TAV. Aortic cross-sectional areas were measured at the level of the pulmonary artery bifurcation. The ascending and descending aorta (AA, DA) distensibility, and pulse wave velocity (PWV) around the aortic arch were calculated. Results The AA and DA areas were lower in the controls, with no difference in DA distensibility or PWV, but slightly lower AA distensibility than in the patient group. With increasing age, there was a decrease in distensibility and an increase in PWV. After correcting for age, the AA maximum cross-sectional area was higher in bicuspid vs. tricuspid patients (12.97 [11.10, 15.59] vs. 10.06 [8.57, 12.04] cm2, p < 0.001), but there were no significant differences in AA distensibility (p = 0.099), DA distensibility (p = 0.498) or PWV (p = 0.235). Patients with BAV type-II valves demonstrated a significantly higher AA distensibility and lower PWV compared to type-I, despite a trend towards higher AA area. Conclusions In patients with significant AS, BAV patients do not have increased aortic stiffness compared to those with TAV despite increased ascending aortic dimensions. Those with type-II BAV have less aortic stiffness despite greater dimensions. These results demonstrate a dissociation between aortic dilatation and stiffness and suggest that altered flow patterns may play a role. Key Points • Both cellular abnormalities secondary to genetic differences and abnormal flow patterns have been implicated in the pathophysiology of aortic dilatation and increased vascular complications associated with bicuspid aortic valves (BAV). • We demonstrate an increased ascending aortic size in patients with BAV and moderate to severe AS compared to TAV and controls, but no difference in aortic stiffness parameters, therefore suggesting a dissociation between dilatation and stiffness. • Sub-group analysis showed greater aortic size but lower stiffness parameters in those with BAV type-II AS compared to BAV type-I