WILLIAM OMAR CONTRERAS LOPEZ
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- Neurosurgical treatment for dystonia: Long-term outcome in a case series of 80 patients(2014) MARTINEZ, Jairo Alberto Espinoza; PINSKER, Marcus O.; ARANGO, Gabriel J.; GARCIA, Xiomara; V, Oscar Andres Escobar; FURLANETTI, Luciano; REITHMEIER, Thomas; ARANDA, Inigo Alonso Aguirre; MARIN, Jorge Humberto; LOPEZ, William Omar ContrerasIntroduction: In this study, we assessed the outcomes of patients with dystonia who underwent surgery treatment following the same algorithm. Patients and methods: Eighty consecutive patients with dystonia were submitted to neurosurgical management by means of intrathecal pump implantation, pallidotomy or deep brain stimulation (GPi or VIM). These patients included 48 patients with primary dystonia and 32 patients with secondary dystonia. Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS) was used to access pre- and postoperative outcomes. Patients were followed from 12 to 114 months. Results: Mean improvement in BFMDRS score among patients with PrD was 87.54% and 42.21% for SeD. Hemidystonic patients in both groups (PrD, SeD) showed a mean improvement in BFMDRS of 71.05% with GPiDBS. Patients with SeD due to previous perinatal insults showed a mean improvement in BFMDRS of 41.9%, with better results in purely dyskinetic patients (mean improvement of 61.2%). Conclusion: Use of the proposed algorithm facilitated surgical decision planning, which translated in improved diagnostic rates, earlier interventions, appropriate management plans, and outcomes for both groups (PrD, SeD). Therefore, neuroimaging findings had a positive prognostic significance in the response to treatment in patients with primary dystonia compared with patients with secondary dystonia or distortion of basal ganglia anatomy. However, further studies in this line are warranted.
conferenceObject Characteristic activity pattern obtained by MER to demarcate the borders between the caudal zona incerta and STN for stereotactic treatment of post-traumatic tremor(2014) FONOFF, E. T.; LOPEZ, W. O. Contreras; REIS, P. R.; NEVILLE, I.; NAVARRO, J.; JACOBSEN, M. T.conferenceObject Simultaneous bilateral MER-guided stereotactic implantation of deep brain stimulation electrodes(2014) FONOFF, E. T.; CONTRERAS, W. O.; GHILARDI, Lopez M.; CURY, R. G.; MARTINEZ, R. C. R.; AZEVEDO, A.; BARBOSA, E. R.; NAVARRO, J.; TEIXEIRA, M. J.- Intrathecal Morphine Therapy in the Management of Status Dystonicus in Neurodegeneration Brain Iron Accumulation Type 1(2014) LOPEZ, William Omar Contreras; SCHROEDER, Humberto Kluge; NEVILLE, Iuri Santana; TEIXEIRA, Manoel Jacobsen; BARBOSA, Danilo Costa; MONACO, Bernardo Assumpcao de; FONOFF, Erich TalamoniNeurodegeneration with brain iron accumulation type 1 (NBIA-1) is a rare disorder characterized by progressive extrapyramidal dysfunction and dementia. NBIA-1 encompasses typical iron brain accumulation, mostly in the globus pallidus with secondary dementia, spasticity, rigidity, dystonia, and choreoathetosis. Treatment remains mostly symptomatic and is challenging. We present the case of a 14-year-old boy diagnosed with NBIA-1, presenting intractable progressive generalized dystonia leading to unresponsive status dystonicus (SD). The patient received a SynchroMed II (model 8637) programmable system pump (Medtronic (R), Inc.) implant with an Ascenda intrathecal catheter for intrathecal morphine therapy (IMT). The initial dose of morphine was 1.0 mg/day. Overall, we observed no complications with IMT treatment and important improvement of the patient's motor function with stabilization of his incapacitating dystonia and his quality of life. On the Global Dystonia Severity Rating Scale, he presented 52% improvement, 30% improvement on the Unified Dystonia Rating Scale, and 38% improvement on the Fahn-Marsden Rating Scale after 10 months, when the dose was 1.7 mg/day. IMT should be considered as a potential palliative treatment in the management of intractable dystonia and SD secondary to NBIA-1. (C) 2015 S. Karger AG, Basel
- Embryonic stem cells in neurology - current clinical transplantation trials in Parkinson's (PD) and Huntington's (HD) disease(2014) LOPEZ, William Omar Contreras; NIKKHAH, Guido; MACIACZYK, Jaroslaw
- Listenmee (R) and Listenmee (R) smartphone application: Synchronizing walking to rhythmic auditory cues to improve gait in Parkinson's disease(2014) LOPEZ, William Omar Contreras; HIGUERA, Carlos Andres Escalante; FONOFF, Erich Talamoni; SOUZA, Carolina de Oliveira; ALBICKER, Ulrich; MARTINEZ, Jairo Alberto EspinozaEvidence supports the use of rhythmic external auditory signals to improve gait in PD patients (Arias 82 Cudeiro, 2008; Kenyon & Thaut, 2000; McIntosh, Rice & Thaut, 1994; McIntosh et al., 1997; Morris, lansek, & Matyas, 1994; Thaut, McIntosh, 82 Rice, 1997; Suteerawattananon, Morris, Etnyre, Jankovic, & Protas, 2004; Willems, Nieuwboer, Chavert, & Desloovere, 2006). However, few prototypes are available for daily use, and to our knowledge, none utilize a smartphone application allowing individualized sounds and cadence. Therefore, we analyzed the effects on gait of Listenmee (R), an intelligent glasses system with a portable auditory device, and present its smartphone application, the Listenmee app (R), offering over 100 different sounds and an adjustable metronome to individualize the cueing rate as well as its smartwatch with accelerometer to detect magnitude and direction of the proper acceleration, track calorie count, sleep patterns, steps count and daily distances. The present study included patients with idiopathic PD presented gait disturbances including freezing. Auditory rhythmic cues were delivered through Listenmee (R). Performance was analyzed in a motion and gait analysis laboratory. The results revealed significant improvements in gait performance over three major dependent variables: walking speed in 38.1%, cadence in 28.1% and stride length in 44.5%. Our findings suggest that auditory cueing through Listenmee (R) may significantly enhance gait performance. Further studies are needed to elucidate the potential role and maximize the benefits of these portable devices.