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Parkinson's Disease

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Brain surgeons must hit deep targets only a few millimeters wide, buried more than 10 cm inside the brain, with less than 1 mm error. — Amr Moursi, Finding 1mm in the Brain | Functional Neurosurgery Explained – Episode 1 · 0:00

How Electrical Stimulation Changes Brain Circuits | Functional Neurosurgery Explained – Episode 4
When you switch on deep brain stimulation — what actually happens inside the brain? Welcome to Episode 4 of "Functional Neurosurgery, Explained." In this episode, I use S‑T‑N D‑B‑S in Parkinson's disease as a model to trace exactly what a
video · Jul 2026
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Finding 1mm in the Brain | Functional Neurosurgery Explained – Episode 1
How do brain surgeons find a deep target only a few millimetres wide, buried more than 10 cm inside the brain – and hit it with less than 1 mm error? Welcome to Episode 1 of “Functional Neurosurgery, Explained”. In this episode, I break d
video · Jul 2026
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Frame-based systems remain the reference standard in DBS despite the availability of robotic and frameless systems. The Geometry of Precision | Frames in DBS – Functional Neurosurgery Explained – Episode 2 · 0:00

Decoding DBS Target Selection in Parkinson's Disease | Functional Neurosurgery Explained – Episode 5
#Parkinsons #neurosurgery #DBS More than thirty percent of all D‑B‑S failures trace back to one mistake — the wrong patient, or the wrong target, chosen long before the operation even began. Welcome to Episode 5 of "Functional Neurosurgery,
video · Jul 2026
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The Geometry of Precision | Frames in DBS – Functional Neurosurgery Explained – Episode 2
How do brain surgeons turn the head into a stable 3D coordinate system so we can place a DBS electrode within 1 mm of the target? Welcome to Episode 2 of “Functional Neurosurgery, Explained”. In this episode, I break down the core tools t
video · Jul 2026
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Exclusion criteria for DBS include dementia, untreated depression or psychosis, and atypical Parkinsonism like progressive supranuclear palsy and multiple system atrophy Movement Disorder Exam Questions for Neurosurgeons | MCQs, Concepts and Key Topics · 4:29

Movement Disorder Exam Questions for Neurosurgeons | MCQs, Concepts and Key Topics
Preparing for functional neurosurgery exam questions can be challenging, especially when the subject includes movement disorders, patient selection, surgical targets, stimulation, and clinical decision-making. In this new series, we will g
video9:40 · Jul 2026
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3 Eras of Parkinson's Surgery: Destroy → Modulate → Respond
From ablation, to DBS (Grenoble 1987), to adaptive stimulation that reads the brain's beta oscillations in real time. One section from Episode 3 of Functional Neurosurgery Explained — full episode: https://www.rfr.bz/yd06ce5f5 #shorts
video2:08 · Jul 2026
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Neuromodulation vs. Neuroablation | Functional Neurosurgery Explained – Episode 3
Why did brain surgeons stop destroying tissue to treat Parkinson's disease — and what do they do instead? Welcome to Episode 3 of "Functional Neurosurgery, Explained". In this episode, I trace the full evolution from neuroablation to neur
video · Jul 2026
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3 Eras of Parkinson's Surgery: Destroy → Modulate → Respond
Thalamotomy in the VIM silences tremor.
Host summaryThe host summarizing a resource — not the host's own clinical position0:23 ↗
Pallidotomy in the GPi eases rigidity, slowness, and dyskinesias.
Host summaryThe host summarizing a resource — not the host's own clinical position0:27 ↗
Ablative lesions are permanent and cannot be undone or adjusted as the disease progresses.
Host summaryThe host summarizing a resource — not the host's own clinical position0:33 ↗
In 1987 in Grenoble, Benabbi switched on high frequency stimulation above 100 hertz, and the tremor vanished instantly, reversibly.
Host summaryThe host summarizing a resource — not the host's own clinical position0:48 ↗
Stimulating the STN produced the same benefit as destroying it, so the benefit was never about the tissue.
Host summaryThe host summarizing a resource — not the host's own clinical position1:01 ↗
With DBS, the structure stays intact and the surgeon can adjust amplitude, frequency, pulse width, and treat both sides safely.
Host summaryThe host summarizing a resource — not the host's own clinical position1:08 ↗
The early STEM trial confirmed DBS beat medical therapy on quality of life.
Host summaryThe host summarizing a resource — not the host's own clinical position1:17 ↗
Adaptive DBS devices record local field potentials from the STN, watching for pathological beta oscillations.
Host summaryThe host summarizing a resource — not the host's own clinical position1:27 ↗
Pathological beta oscillations are a 13 to 30 Hz rhythm that suppresses movement.
Host summaryThe host summarizing a resource — not the host's own clinical position1:36 ↗
When beta appears, stimulation fires; when it fades, it eases off.
Host summaryThe host summarizing a resource — not the host's own clinical position1:40 ↗
Adaptive DBS results in less unnecessary current, longer battery life, and fewer side effects.
Host summaryThe host summarizing a resource — not the host's own clinical position1:45 ↗
Movement Disorder Exam Questions for Neurosurgeons | MCQs, Concepts and Key Topics
Functional neurosurgery is under-taught in basic training and most units don't do much of it
opinion0:29 ↗
Examiner expectations for functional neurosurgery are low and the basics are all you need
opinion0:36 ↗
Functional neurosurgery splits into three exam topics: movement disorders, pain surgery, and epilepsy
clinical0:49 ↗
Parkinson's disease has 4 cardinal features and bradykinesia is mandatory for the diagnosis
clinical1:28 ↗
Tremor responds best to deep brain stimulation in Parkinson's disease
clinical1:35 ↗
Gait freezing, speech and cognition respond poorly to deep brain stimulation
clinical1:44 ↗
Cognition can be worsened by deep brain stimulation
clinical1:48 ↗
Balance, speech, and postural instability all respond poorly to deep brain stimulation
clinical2:11 ↗
Subthalamic nucleus is the first choice target for deep brain stimulation in Parkinson's disease
guideline2:25 ↗
Globus pallidus internus is the second choice target for deep brain stimulation in Parkinson's disease
guideline2:29 ↗
When dyskinesia dominates, the globus pallidus internus is preferred because it smooths dyskinesia directly
clinical2:40 ↗
When tremor dominates, the ventral intermediate nucleus of the thalamus is the tremor target
clinical2:48 ↗
The anterior limb of the internal capsule is an obsessive compulsive disorder target, not a Parkinson's target
clinical3:19 ↗
Inclusion criteria for DBS include disease over 5 years, a meaningful levodopa response, disabling fluctuations, or refractory tremor
guideline4:12 ↗
Exclusion criteria for DBS include dementia, untreated depression or psychosis, and atypical Parkinsonism like progressive supranuclear palsy and multiple system atrophy
guideline4:29 ↗
The levodopa challenge predicts the response to deep brain stimulation, not severity
clinical4:51 ↗
Stimulation of the subthalamic nucleus roughly reproduces the patient's best medication on state, so a good levodopa response predicts a good stimulation response
clinical4:59 ↗
Atypical Parkinsonism doesn't respond to deep brain stimulation and is a contraindication
clinical5:48 ↗
At the subthalamic nucleus, medial spread hits the 3rd cranial nerve and red nucleus, giving diplopia
clinical6:22 ↗
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