Deep Brain Stimulation for the Treatment of Dopa-Responsive Dystonia: A Case Report and Literature Review
WORLD NEUROSURGERY
Authors: Dong, Wenwen; Luo, Bei; Qiu, Chang; Jiang, Xu; Qu, Xuefeng; Zhang, Li; Liu, Weiguo; Yan, Jun; Zhang, Wenbin
Abstract
BACKGROUND: The aim of this study was to observe the improvement in patients with dopa-responsive dystonia (DRD) after deep brain stimulation (DBS) of the globus pallidus internus (GPi). CASE DESCRIPTION: A 27-year-old woman with a 22-year history of DRD underwent GPi DBS. The Burke-Fahn-Marsden Dystonia Rating Scale (BFMDRS), the Mini-Mental State Examination (MMSE), the Montreal Cognitive Assessment (MOCA), the Hamilton Anxiety Scale (HAMA), and the Hamilton Depression Scale (HAMD) were used to regularly assess changes in the patient's condition after DBS treatment. CONCLUSIONS: After 6 months of GPi DBS treatment, the total BFMDRS score patient was 5, a 94.28% improvement over the preoperative baseline score. In addition, the MMSE, MOCA, HAMA, and HAMD scores of the patient were 30, 30,1, and 2, respectively. Intelligence and cognitive levels of the patient did not change significantly compared with the preoperative baseline level, whereas anxiety and depression status of the patient improved compared with the preoperative status. GPi DBS treatment can significantly improve the symptoms of systemic dystonia in patients with DRD, and to a certain extent improve the anxiety and depression status of these patients. Therefore, we conclude that GPi DBS is an alternative safe and effective treatment for patients with DRD.
Hidden linkages between resources and economy: A "Beyond-GDP" approach using alternative welfare indicators
ECOLOGICAL ECONOMICS
Authors: Kalimeris, Panos; Bithas, Kostas; Richardson, Clive; Nijkamp, Peter
Abstract
Taking GDP as the standard economic indicator for economic welfare, recent Resources-Economy studies indicate the "dematerialization" of the economy, the so-called decoupling effect. This conclusion seems to alleviate concerns over resource scarcity and limits to growth, and feeds optimism for green growth and sustainability prospects. However, the validity of GDP as the sole and unambiguous measure of the ultimate outcome of the economy has been severely disputed. There is nowadays increasing interest in broader welfare measurements that capture more aspects of economic output and hence constitute better approximations of well-being. The present paper provides an overview of the above discussion and sets out to explore the relevance of three alternative welfare indicators - the Human Development Index (HDI), the Index of Sustainable Economic Welfare (ISEW) and the Genuine Progress Indicator (GPI) - as a basis for evaluating the dependency of welfare and its major engine, the economy, on natural resources. Increasing welfare appears to require a disproportionate use of resources. Strong and increasing dependency on resources at the global level and in giant countries such as China and India may have serious implications for current sustainability policies and the United Nations Sustainable Development Goals.