Deep brain stimulation (DBS) is a surgical procedure used to treat various neurological pathologies, being its greatest use in movement disorders. The FDA first approved deep brain stimulation in 1997 to treat essential tremor, in 2002 it was approved for Parkinson's disease, in 2003 for dystonia and in 2009 for obsessive compulsive disorder. However, until recently this technique began to be implemented for the treatment of other neurological diseases. To conduct research on the different neurological diseases where deep brain stimulation is used articles were chosen from Pubmed, Google Scholar, Redalyc and Scielo databases, references from the last 10 years to date were taken. The keywords that were written in the search engine were ECP/ECP + the required pathology. 75 references were found on the use of DBS in the following pathologies: Parkinson's disease, Alzheimer's, refractory epilepsy, depression, obsessive–compulsive disorder, Gilles Tourette syndrome, aggressiveness, addictions, anorexia nervosa, restless legs syndrome, headache, dystonia, essential tremor and obesity. The use of DBS is growing as technology advances, increasingly focused on neurological diseases, psychosurgery and even systemic diseases, however, its use is only approved by the FDA for some movement disorders, including Parkinson's disease, Dystonia, essential tremor and OCD. La estimulación cerebral profunda (ECP) es un procedimiento quirúrgico utilizado para tratar diversas patologías neurológicas, siendo su mayor uso en los trastornos del movimiento. La FDA aprobó por primera vez la estimulación cerebral profunda en 1997 para tratar el temblor esencial, en 2002 fue aprobada para la enfermedad de Parkinson, en 2003 para la distonía y en 2009 para el trastorno obsesivo compulsivo. No obstante, hasta hace poco tiempo se empezó a implementar esta técnica para el tratamiento de otras enfermedades neurológicas. Para realizar esta investigación sobre las diferentes enfermedades neurológicas en las que se utiliza la estimulación cerebral profunda se eligieron artículos de las bases de datos Pubmed, Google Scholar, Redalyc y Scielo, se tomaron referencias de los últimos 10 años a la fecha. Las palabras claves que se escribieron en el buscador fueron ECP/ECP + + la patología requerida. Se encontraron 75 referencias sobre el uso de ECP en las siguientes patologías: enfermedad de Parkinson, Alzheimer, epilepsia refractaria, depresión, trastorno obsesivo-compulsivo, síndrome de Gilles Tourette, agresividad, adicciones, anorexia nerviosa, síndrome de piernas inquietas, cefalea, distonía, temblor esencial y obesidad. El uso de ECP crece a medida que avanza la tecnología, cada vez más enfocado en enfermedades neurológicas, psicocirugía e incluso enfermedades sistémicas, sin embargo, su uso solo está aprobado por la FDA para algunos trastornos del movimiento, incluida la enfermedad de Parkinson, la distonía, el temblor esencial y TOC. 

Deep brain stimulation in neurological diseases and other pathologies

La epilepsia es un trastorno neurologico que afecta al 1-2% de la poblacion. A pesar de los tratamientos disponibles (farmacoterapia, cirugia resectiva, estimulacion del nervio vago...), hay un subgrupo importante de pacientes que continua teniendo crisis incapacitantes. La estimulacion cerebral profunda esta experimentando un incremento exponencial de sus indicaciones y se dispone de experiencia amplia en el campo de los movimientos anormales. El tratamiento de la epilepsia mediante estimulacion cerebral profunda podria ser una nueva terapia aplicable al subgrupo de pacientes resistentes a otros tratamientos. Los experimentos con modelos animales, y el avance en los conocimientos neurofisiologicos de los procesos que gobiernan la genesis de la epilepsia, han dado pie a la seleccion de diversas dianas cerebrales para la estimulacion. El talamo, por ser un centro fundamental de relevo en los circuitos corticotalamicos y corticoestriado-talamocorticales, ha sido objeto de estudio con esta finalidad. Los estudios realizados en pacientes epilepticos han tenido distintos grados de efectividad, si bien los estudios controlados no permiten conclusiones definitivas sobre cual es su papel en el tratamiento de la epilepsia. Probablemente la seleccion de pacientes mas adecuada favorezca la realizacion de estudios con conclusiones mas determinantes. Es preciso realizar mas estudios aleatorizados controlados para extraer conclusiones fidedignas y evidencia cientifica sobre su eficacia.

/pdf/estimulacion-cerebral-profunda-talamica-para-la-epilepsia-8ikf1bc35r.pdf

Estimulación cerebral profunda talámica para la epilepsia resistente

La epilepsia es un trastorno neurologico que afecta a alrededor de un 1-2% de la poblacion. Se han desarrollado diversas estrategias terapeuticas, utiles para el control de las crisis en la mayoria de los casos. A pesar del gran desarrollo de farmacos antiepilepticos, de la posibilidad de reseccion de los focos epileptogenos en pacientes seleccionados y de la estimulacion vagal, existe un subgrupo de pacientes con mal control de sus crisis, para los que se estan llevando a cabo diversas lineas de investigacion en busca de nuevas alternativas de tratamiento. La estimulacion cerebral profunda del talamo ha surgido como otra posibilidad terapeutica para pacientes que permanecen incapacitados; su utilidad es objeto de varios estudios, y aun no se ha establecido su eficacia y seguridad con suficiente evidencia cientifica. Existen otras dianas susceptibles de estimulacion cerebral profunda como tratamiento para la epilepsia resistente. Los experimentos con modelos animales y estudios preliminares en humanos han mostrado resultados esperanzadores con estimulacion cerebral profunda en el cerebelo, nucleo subtalamico, sustancia negra, hipocampo y corteza cerebral, entre otros. A continuacion se muestran los estudios realizados en nucleos cerebrales extratalamicos que mostraron eficacia en la epilepsia farmacorresistente. Los estudios han mostrado distintos grados de efectividad, y es preciso realizar ensayos controlados para establecer conclusiones definitivas sobre su eficacia.

/pdf/estimulacion-cerebral-profunda-para-la-epilepsia-resistente-4imp4wiere.pdf

Estimulación cerebral profunda para la epilepsia resistente:: dianas extratalámicas



With the rapid development of advanced artificial intelligence technologies which have been applied in varying types of applications, especially in the medical field. Cancer is one of the biggest problems in medical sciences. If cancer can be detected and treated early, the possibility of a cure will be greatly increased. Malignant skin cancer is one of the cancers with the highest mortality rate, which cannot be diagnosed in time only through doctors’ experience. We can employ artificial intelligence algorithms to detect skin cancer at an early stage, for example, patients are determined whether suffering from skin cancer by detecting skin damage or spots.



We use the real HAM10000 image dataset to analyze and predict skin cancer.



(1) We introduce a lightweight attention module to discover the relationships between features, and we fine-tune the pre-trained model (i.e., ResNet-50) on the HAM10000 dataset to extract the hidden high-level features from the images; (2) we integrate these high-level features with generic statistical features, and use the SMOTE oversampling technique to augment samples from the minority classes; and (3) we input the augmented samples into the XGBoost model for training and predicting.



The experimental results show that the accuracy, sensitivity, and specificity of the proposed SkinDet (Skin cancer detector based on transfer learning and feature fusion) model reached 98.24%, 97.84%, and 98.13%. The proposed model has stronger classification capability for the minority classes, such as dermato fibroma and actinic keratoses.



The experimental results show that the accuracy, sensitivity and specificity of the proposed SkinDet (Skin cancer detector based on transfer learning and feature fusion) model reached 98.24%, 97.84% and 98.13%. The proposed model has stronger classification capability for the minority classes, such as dermato fibroma and actinic keratoses.



SkinDet contains a lightweight attention module and can extract the hidden high-level features of the images by fine-tuning the pretrained model on the skin cancer dataset. In particular, SkinDet integrates high-level features with statistical features and augments samples of these minority classes. Importantly, SkinDet can be applied to classify the samples into minority classes.


A Skin Cancer Detector Based on Transfer Learning and Feature Fusion

/pdf/protocol-and-algorithm-for-diagnosis-treatment-and-early-2lul2nkg.pdf

Protocol and algorithm for diagnosis, treatment and early referral of lower limb ulcers

Cluster headache is included in the group of trigeminal autonomic cephalalgias. Although the pathophysiology of cluster headache has not yet been sufficiently established, the theory of a central origin tells us that this headache is produced by hypothalamic dysfunction. More than 50 patients have been treated with deep brain stimulation of the posterior nucleus of the hypothalamus from 2001. The results show clinical improvement in more than 60% of the cases, opening a promising issue for the treatment of the cluster headache persistent after medical treatment. The surgical target that have been used until now is based on the origin of the cluster headache in the hypothalamic dysfunction. Nevertheless, It has still some open questions as the lack of proving the posterior nucleus of the hypothalamus is the real origin of the cluster headache, the lack of consensus about the anatomy of the surgical target and the variability of the structures stimulated with the surgery. The aim of this article is a review of the target used and propose another surgical target based on physiopathological concepts to explain the improvement with the deep brain stimulation in these patients.

Revisión de la diana para la estimulación cerebral profunda de la cefalea en racimos crónica

Design and Application of Automated Algorithms for Diagnosis and Treatment Optimization in Neurodegenerative Diseases

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Revisión de la diana para la estimulación cerebral profunda de la cefalea en racimos crónica

Design and Application of Automated Algorithms for Diagnosis and Treatment Optimization in Neurodegenerative Diseases