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Hariz, Marwan
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Publications (10 of 106) Show all publications
Blomstedt, P. & Hariz, M. (2019). Closed loop stimulation for tremor was invented in 1980 [Letter to the editor]. Brain Stimulation, 12(4), 1072-1073
Open this publication in new window or tab >>Closed loop stimulation for tremor was invented in 1980
2019 (English)In: Brain Stimulation, ISSN 1935-861X, E-ISSN 1876-4754, Vol. 12, no 4, p. 1072-1073Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Deep brain stimulation, Tremor, Adaptive stimulation, History
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-161571 (URN)10.1016/j.brs.2019.03.075 (DOI)000472482500032 ()30979640 (PubMedID)
Available from: 2019-07-25 Created: 2019-07-25 Last updated: 2019-07-25Bibliographically approved
Akram, H., Hariz, M. & Zrinzo, L. (2019). Connectivity derived thalamic segmentation: Separating myth from reality [Letter to the editor]. NeuroImage: Clinical, 22, Article ID UNSP 101758.
Open this publication in new window or tab >>Connectivity derived thalamic segmentation: Separating myth from reality
2019 (English)In: NeuroImage: Clinical, ISSN 0353-8842, E-ISSN 2213-1582, Vol. 22, article id UNSP 101758Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Deep brain stimulation, Tremor, Thalamus, Connectivity, Diffusion, Vim, Movement disorders, Essential tremor, Parkinson's disease, Thalamotomy, Tractography
National Category
Radiology, Nuclear Medicine and Medical Imaging
Identifiers
urn:nbn:se:umu:diva-160638 (URN)10.1016/j.nicl.2019.101758 (DOI)000470123000047 ()30987841 (PubMedID)
Available from: 2019-06-20 Created: 2019-06-20 Last updated: 2019-06-20Bibliographically approved
Zrinzo, L., Wilson, J., Hariz, M., Joyce, E., Morris, J. & Schmidt, U. (2019). Exploring every ethical avenue. Commentary: The Moral Obligation to Prioritize Research Into Deep Brain Stimulation Over Brain Lesioning Procedures for Severe Enduring Anorexia Nervosa. Frontiers in Psychiatry, 10, Article ID 326.
Open this publication in new window or tab >>Exploring every ethical avenue. Commentary: The Moral Obligation to Prioritize Research Into Deep Brain Stimulation Over Brain Lesioning Procedures for Severe Enduring Anorexia Nervosa
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2019 (English)In: Frontiers in Psychiatry, ISSN 1664-0640, E-ISSN 1664-0640, Vol. 10, article id 326Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Frontiers Media S.A., 2019
Keywords
deep brain stimulation, stereotactic ablation, capsulotomy, neurosurgery for psychiatric disease, medical ethics, anorexia nervosa, autonomy
National Category
Psychiatry
Identifiers
urn:nbn:se:umu:diva-159375 (URN)10.3389/fpsyt.2019.00326 (DOI)000467432500001 ()31133900 (PubMedID)
Available from: 2019-06-12 Created: 2019-06-12 Last updated: 2019-06-12Bibliographically approved
Kiss, Z. H. T. & Hariz, M. (2019). "New and improved" DBS batteries?. Brain Stimulation, 12(4), 833-834
Open this publication in new window or tab >>"New and improved" DBS batteries?
2019 (English)In: Brain Stimulation, ISSN 1935-861X, E-ISSN 1876-4754, Vol. 12, no 4, p. 833-834Article in journal, Editorial material (Other academic) Published
Place, publisher, year, edition, pages
Elsevier, 2019
National Category
Neurology Neurosciences
Identifiers
urn:nbn:se:umu:diva-161577 (URN)10.1016/j.brs.2019.05.009 (DOI)000472482500001 ()31109834 (PubMedID)
Available from: 2019-07-25 Created: 2019-07-25 Last updated: 2019-07-25Bibliographically approved
Rzesnitzek, L., Hariz, M. & Krauss, J. K. (2019). The Origins of Human Functional Stereotaxis: A Reappraisal. Stereotactic and Functional Neurosurgery, 97(1), 49-54
Open this publication in new window or tab >>The Origins of Human Functional Stereotaxis: A Reappraisal
2019 (English)In: Stereotactic and Functional Neurosurgery, ISSN 1011-6125, E-ISSN 1423-0372, Vol. 97, no 1, p. 49-54Article, review/survey (Refereed) Published
Abstract [en]

In order to shed light on the first application of human functional stereotactic neurosurgery, whether it was in the realm of movement disorders, as has been claimed repeatedly, or in the realm of psychiatry, a review of the original scholarly literature was conducted. Tracking and scrutinising original publications by Spiegel and Wycis, the pioneers of human stereotactic neurosurgery, it was found that its origin and the very incentive for its development and first clinical use were to avoid the side effects of frontal leucotomy. The first applications of functional stereotactic neurosurgery were in performing dorsomedial thalamotomies in psychiatric patients; it was only later that the stereotactic technique was applied in patients with chronic pain, movement disorders and epilepsy. Spiegel and Wycis' first functional stereotactic operations were for obsessive-compulsive disorder, schizophrenia, and other psychiatric conditions.

Place, publisher, year, edition, pages
S. Karger, 2019
Keywords
Psychosurgery, Functional neurosurgery, Leucotomy, Thalamotomy, Stereotaxy, History, Stereotactic surgery
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-159643 (URN)10.1159/000496157 (DOI)000467683300008 ()30759450 (PubMedID)
Available from: 2019-06-03 Created: 2019-06-03 Last updated: 2019-06-03Bibliographically approved
Akram, H., Dayal, V., Mahlknecht, P., Georgiev, D., Hyam, J., Foltynie, T., . . . Zrinzo, L. (2018). Connectivity derived thalamic segmentation in deep brain stimulation for tremor. NeuroImage: Clinical, 18, 130-142
Open this publication in new window or tab >>Connectivity derived thalamic segmentation in deep brain stimulation for tremor
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2018 (English)In: NeuroImage: Clinical, ISSN 0353-8842, E-ISSN 2213-1582, Vol. 18, p. 130-142Article in journal (Refereed) Published
Abstract [en]

The ventral intermediate nucleus (VIM) of the thalamus is an established surgical target for stereotactic ablation and deep brain stimulation (DBS) in the treatment of tremor in Parkinson's disease (PD) and essential tremor (ET). It is centrally placed on a cerebello-thalamo-cortical network connecting the primary motor cortex, to the dentate nucleus of the contralateral cerebellum through the dentato-rubro-thalamic tract (DRT). The VIM is not readily visible on conventional MR imaging, so identifying the surgical target traditionally involved indirect targeting that relies on atlas-defined coordinates. Unfortunately, this approach does not fully account for individual variability and requires surgery to be performed with the patient awake to allow for intraoperative targeting confirmation. The aim of this study is to identify the VIM and the DRT using probabilistic tractography in patients that will undergo thalamic DBS for tremor. Four male patients with tremor dominant PD and five patients (three female) with ET underwent high angular resolution diffusion imaging (HARDI) (128 diffusion directions, 1.5 mm isotropic voxels and b value = 1500) preoperatively. Patients received VIM-DBS using an MR image guided and MR image verified approach with indirect targeting. Postoperatively, using parallel Graphical Processing Unit (GPU) processing, thalamic areas with the highest diffusion connectivity to the primary motor area (M1), supplementary motor area (SMA), primary sensory area (S1) and contralateral dentate nucleus were identified. Additionally, volume of tissue activation (VTA) corresponding to active DBS contacts were modelled. Response to treatment was defined as 40% reduction in the total Fahn-Tolosa-Martin Tremor Rating Score (FTMTRS) with DBS-ON, one year from surgery. Three out of nine patients had a suboptimal, long-term response to treatment. The segmented thalamic areas corresponded well to anatomically known counterparts in the ventrolateral (VL) and ventroposterior (VP) thalamus. The dentate-thalamic area, lay within the M1-thalamic area in a ventral and lateral location. Streamlines corresponding to the DRT connected M1 to the contralateral dentate nucleus via the dentate-thalamic area, clearly crossing the midline in the mesencephalon. Good response was seen when the active contact VTA was in the thalamic area with highest connectivity to the contralateral dentate nucleus. Non-responders had active contact VTAs outside the dentate-thalamic area. We conclude that probabilistic tractography techniques can be used to segment the VL and VP thalamus based on cortical and cerebellar connectivity. The thalamic area, best representing the VIM, is connected to the contralateral dentate cerebellar nucleus. Connectivity based segmentation of the VIM can be achieved in individual patients in a clinically feasible timescale, using HARDI and high performance computing with parallel GPU processing. This same technique can map out the DRT tract with clear mesencephalic crossing.

Place, publisher, year, edition, pages
Elsevier, 2018
Keywords
Diffusion weighted imaging DWI, Connectivity, Parkinson's disease PD, Ventrointermedialis VIM, Dentato-rubro-thalamic tract DRT, Ventrolateral nucleus VL, Dentate nucleus Tremor, Deep brain stimulation DBS
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-151204 (URN)10.1016/j.nicl.2018.01.008 (DOI)000433169000013 ()29387530 (PubMedID)2-s2.0-85041484333 (Scopus ID)
Available from: 2018-09-03 Created: 2018-09-03 Last updated: 2018-09-03Bibliographically approved
Blomstedt, P., Stenmark Persson, R., Hariz, G.-M., Linder, J., Fredricks, A., Häggström, B., . . . Hariz, M. (2018). Deep brain stimulation in the caudal zona incerta versus best medical treatment in patients with Parkinson's disease: a randomised blinded evaluation. Journal of Neurology, Neurosurgery and Psychiatry, 89(7), 710-716
Open this publication in new window or tab >>Deep brain stimulation in the caudal zona incerta versus best medical treatment in patients with Parkinson's disease: a randomised blinded evaluation
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2018 (English)In: Journal of Neurology, Neurosurgery and Psychiatry, ISSN 0022-3050, E-ISSN 1468-330X, Vol. 89, no 7, p. 710-716Article in journal (Refereed) Published
Abstract [en]

Background: Several open-label studies have shown good effect of deep brain stimulation (DBS) in the caudal zona incerta (cZi) on tremor, including parkinsonian tremor, and in some cases also a benefit on akinesia and axial symptoms. The aim of this study was to evaluate objectively the effect of cZi DBS in patients with Parkinson's disease (PD).

Method: 25 patients with PD were randomised to either cZi DBS or best medical treatment. The primary outcomes were differences between the groups in the motor scores of the Unified Parkinson's Disease Rating Scale (UPDRS-III) rated single-blindly at 6 months and differences in the Parkinson's Disease Questionnaire 39 items (PDQ-39). 19 patients, 10 in the medical arm and 9 in the DBS arm, fulfilled the study.

Results: The DBS group had 41% better UPDRS-III scores off-medication on-stimulation compared with baseline, whereas the scores of the non-surgical patients off-medication were unchanged. In the on-medication condition, there were no differences between the groups, neither at baseline nor at 6 months. Subitems of the UPDRS-III showed a robust effect of cZi DBS on tremor. The PDQ-39 domains 'stigma' and 'ADL' improved only in the DBS group. The PDQ-39 summary index improved in both groups.

Conclusion: This is the first randomised blinded evaluation of cZi DBS showing its efficacy on PD symptoms. The most striking effect was on tremor; however, the doses of dopaminergic medications could not be decreased. cZi DBS in PD may be an addition to existing established targets, enabling tailoring the surgery to the needs of the individual patient.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2018
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-150375 (URN)10.1136/jnnp-2017-317219 (DOI)000438044100010 ()29386253 (PubMedID)
Available from: 2018-08-08 Created: 2018-08-08 Last updated: 2019-05-07Bibliographically approved
Martinez-Ramirez, D., Jimenez-Shahed, J., Leckman, J. F., Porta, M., Servello, D., Meng, F.-G., . . . Okun, M. S. (2018). Efficacy and Safety of Deep Brain Stimulation in Tourette Syndrome: The International Tourette Syndrome Deep Brain Stimulation Public Database and Registry. JAMA Neurology, 75(3), 353-359
Open this publication in new window or tab >>Efficacy and Safety of Deep Brain Stimulation in Tourette Syndrome: The International Tourette Syndrome Deep Brain Stimulation Public Database and Registry
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2018 (English)In: JAMA Neurology, ISSN 2168-6149, E-ISSN 2168-6157, Vol. 75, no 3, p. 353-359Article in journal (Refereed) Published
Abstract [en]

IMPORTANCE Collective evidence has strongly suggested that deep brain stimulation (DBS) is a promising therapy for Tourette syndrome.

OBJECTIVE To assess the efficacy and safety of DBS in a multinational cohort of patients with Tourette syndrome.

DESIGN, SETTING, AND PARTICIPANTS The prospective International Deep Brain Stimulation Database and Registry included 185 patients with medically refractory Tourette syndrome who underwent DBS implantation from January 1, 2012, to December 31, 2016, at 31 institutions in 10 countries worldwide.

EXPOSURES Patients with medically refractory symptoms received DBS implantation in the centromedian thalamic region (93 of 163 [57.1%]), the anterior globus pallidus internus (41 of 163 [25.2%]), the posterior globus pallidus internus (25 of 163 [15.3%]), and the anterior limb of the internal capsule (4 of 163 [2.5%]).

MAIN OUTCOMES AND MEASURES Scores on the Yale Global Tic Severity Scale and adverse events.

RESULTS The International Deep Brain Stimulation Database and Registry enrolled 185 patients (of 171 with available data, 37 females and 134 males; mean [SD] age at surgery, 29.1 [10.8] years [range, 13-58 years]). Symptoms of obsessive-compulsive disorder were present in 97 of 151 patients (64.2%) and 32 of 148 (21.6%) had a history of self-injurious behavior. The mean (SD) total Yale Global Tic Severity Scale score improved from 75.01 (18.36) at baseline to 41.19 (20.00) at 1 year after DBS implantation (P<.001). The mean (SD) motor tic subscore improved from 21.00 (3.72) at baseline to 12.91 (5.78) after 1 year (P <.001), and the mean (SD) phonic tic subscore improved from 16.82 (6.56) at baseline to 9.63 (6.99) at 1 year (P <.001). The overall adverse event rate was 35.4%(56 of 158 patients), with intracranial hemorrhage occurring in 2 patients (1.3%), infection in 4 patients with 5 events (3.2%), and lead explantation in 1 patient (0.6%). The most common stimulation-induced adverse effects were dysarthria (10 [6.3%]) and paresthesia (13 [8.2%]).

CONCLUSIONS AND RELEVANCE Deep brain stimulationwas associated with symptomatic improvement in patients with Tourette syndrome but also with important adverse events. A publicly available website on outcomes of DBS in patients with Tourette syndrome has been provided.

Place, publisher, year, edition, pages
American Medical Association, 2018
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-146451 (URN)10.1001/jamaneurol.2017.4317 (DOI)000427265700013 ()29340590 (PubMedID)
Note

En rättelse har publicerats: / A correction has been published:

Error in abstract. (2018). JAMA Neurology, 75(3), 384-384. doi:10.1001/jamaneurol.2018.0060

Available from: 2018-05-03 Created: 2018-05-03 Last updated: 2018-06-09Bibliographically approved
Huotarinen, A., Kivisaari, R. & Hariz, M. (2018). Laitinen's Subgenual Cingulotomy: Anatomical Location and Case Report. Stereotactic and Functional Neurosurgery, 96(5), 342-346
Open this publication in new window or tab >>Laitinen's Subgenual Cingulotomy: Anatomical Location and Case Report
2018 (English)In: Stereotactic and Functional Neurosurgery, ISSN 1011-6125, E-ISSN 1423-0372, Vol. 96, no 5, p. 342-346Article in journal (Refereed) Published
Abstract [en]

Background: The widespread use of deep brain stimulation (DBS) for movement disorders has renewed the interest in DBS for psychiatric disorders. Lauri Laitinen was a pioneer of stereotactic psychosurgery in the 1950s to 1970s, especially by introducing the subgenual cingulotomy. Our aim here was to verify the anatomical target used by Laitinen, to report on a patient who underwent this procedure, and to review the literature. Materials and Methods: The records of Helsinki University Hospital were searched for psychosurgical cases performed between 1970 and 1974. Alive consenting patients were interviewed and underwent a brain MRI. Results: We found 1 patient alive who underwent subgenual cingulotomy in 1971 for obsessive thoughts, anxiety, and compulsions, diagnosed at that time as "schizophrenia psychoneurotica." MRI showed bilateral subgenual cingulotomy lesions (254 and 160 mm(3), respectively). The coordinates of the center of the lesions in relation to the midcommissural point for the right and left, respectively, were: 7.1 and 7.9 mm lateral; 0.2 mm inferior and 1.4 mm superior, and 33.0 and 33.9 anterior, confirming correct subgenual targeting. The patient reported retrospective satisfactory results. Conclusions: The lesion in this patient was found to be in the expected location, which gives some verification of the correct placement of Laitinen's subgenus cingulotomy target.

Place, publisher, year, edition, pages
S. Karger, 2018
Keywords
Cingulotomy, Functional neurosurgery, Lesion, Psychosurgery, Stereotactic, Subgenual cingulum
National Category
Neurosciences Surgery
Identifiers
urn:nbn:se:umu:diva-155255 (URN)10.1159/000492058 (DOI)000454181200009 ()30278436 (PubMedID)
Available from: 2019-01-11 Created: 2019-01-11 Last updated: 2019-01-11Bibliographically approved
Blomstedt, P. & Hariz, M. (2018). The paper that wrote itself – A ghost story [Letter to the editor]. Movement Disorders, 33(9), 1509-1510
Open this publication in new window or tab >>The paper that wrote itself – A ghost story
2018 (English)In: Movement Disorders, ISSN 0885-3185, E-ISSN 1531-8257, Vol. 33, no 9, p. 1509-1510Article in journal, Letter (Refereed) Published
Place, publisher, year, edition, pages
John Wiley & Sons, 2018
National Category
Neurology
Identifiers
urn:nbn:se:umu:diva-153138 (URN)10.1002/mds.27467 (DOI)000447153500025 ()30199595 (PubMedID)2-s2.0-85054727411 (Scopus ID)
Available from: 2018-11-08 Created: 2018-11-08 Last updated: 2018-11-08Bibliographically approved
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