Talk:Deep brain stimulation

Perhaps add section on possible use to treat drug addiction?

I found this through a google search. Would it be ok to add to the article? I would but I'm not sure how to phrase it. Xanikk999 (talk) 20:27, 19 May 2019 (UTC)

https://www.ncbi.nlm.nih.gov/pubmed/30064320 Xanikk999 (talk) 20:27, 19 May 2019 (UTC)

@Xanikk999: That's a good quality review and quite suitable for use in this article. The full text is available at https://thejns.org/focus/view/journals/neurosurg-focus/45/2/article-pE11.xml but you need to be careful only to use the conclusions from the "Human Studies" sections if you want to summarise them without having to qualify them as "research using animal studies" (which is generally not useful in our medical articles).

The article itself is badly organised, as much of the content under Research ought to be relocated to Medical use where the use is clearly documented in secondary sources. I'll have a go at some of that reorganisation. Perhaps you'd like to add something about treatment of drug addiction to its own subsection of Research? --RexxS (talk) 10:32, 25 May 2019 (UTC)

Parkinson's disease

I've removed the following section as it overstates the evidence and makes biomedical claims based on primary sources in breach of WP:MEDRS. @Alexmar983 and MatteoVissani: The Parkinson's disease article discusses the use of DBS using the following secondary sources:

• The National Collaborating Centre for Chronic Conditions, ed. (2006). "Surgery for Parkinson's disease". Parkinson's Disease. London: Royal College of Physicians. pp. 101–11. ISBN 978-1-86016-283-1. Archived from the original on 24 September 2010. {{cite book}}: Unknown parameter |deadurl= ignored (|url-status= suggested) (help)
• Bronstein JM, Tagliati M, Alterman RL, Lozano AM, Volkmann J, Stefani A, Horak FB, Okun MS, Foote KD, Krack P, Pahwa R, Henderson JM, Hariz MI, Bakay RA, Rezai A, Marks WJ, Moro E, Vitek JL, Weaver FM, Gross RE, DeLong MR (February 2011). "Deep brain stimulation for Parkinson disease: an expert consensus and review of key issues". Archives of Neurology. 68 (2): 165. doi:10.1001/archneurol.2010.260. PMC 4523130. PMID 20937936.
• Dallapiazza RF, Vloo PD, Fomenko A, Lee DJ, Hamani C, Munhoz RP, Hodaie M, Lozano AM, Fasano A, Kalia (2018) Considerations for Patient and Target Selection in Deep Brain Stimulation surgery for Parkinson’s disease. In: Stoker TB, Greenland JC, editors. Parkinson’s disease: Pathogenesis and clinical aspects. Brisbane: Codon Publications. {{pmid:30702838}}

It is possible to add useful content to this article while adhering to our sourcing guidelines. --RexxS (talk) 19:48, 24 May 2019 (UTC)

There is a large body of literature demonstrating the benefit of DBS in Parkinson's disease. Specifically, various studies have shown a sustained general improvement after DBS implant in quality of life, tremor, dyskinesias, motor scores in patients whose motor symptoms were no-drug responsive . DBS effects have also been maintained for more than 10 years in recently documented long-term follow-up studies. There are two main anatomic targets for PD: the Subthalamic nucleus and the Internal globus pallidus. It is becoming more accepted that the Internal Globus Pallidus is more favorable in patients with more axial symptoms, gait issues, depression, and word fluency problems, whereas Subthalamic Nucleus is often favored in those with higher medication requirements. However, many DBS centers still will preferentially use the target for which they have greater experience.

Current DBS systems for Parkinson's Disease are programmed to emit pulses of electrical current in fairly simple, repetitive patterns using preprogrammed parameters in a so-called Open loop system. These settings remain unchanged and independent of any outside variables or feedback. However, in a similar fashion to the way modern cardiac pacemakers can change output patterns depending upon input from sensors of heart rhythm, DBS devices are being developed that can utilize input from brain activity through a so-called Closed loop system. This emerging technology is still early in the development cycle, but potential applications are multifold. A major limitation, however, is still determining what the brain activity or “input signal” is to trigger the appropriate change in the DBS system. For Parkinson's Disease, basal ganglia Neural oscillation primarily in the Beta wave range (13–30 Hz) are actively being studied (as of 2012) as the indicator of the changing Parkinson's Disease clinical state and used as the input signal to control the DBS system .

References

RexxS fine. I ask expert users on itwikipedia about this content, the student will problably be asked to work there. You can leave this in the talk page. Have a nice evening.--Alexmar983 (talk) 22:09, 24 May 2019 (UTC)

@Alexmar983: It's a pity that your response to a genuine concern about the work produced by one of your students is to walk away and leave it for others to clean up. --RexxS (talk) 23:40, 24 May 2019 (UTC)

I did not arrive to evaluate the article yet, you RexxS cleaned it up. You could have left it there with a warning (which is possible) and I would have cleaned it up in a different way, instead you made this choice. You knew I was online this week end, I told you so. So you could decide if a statement which is not wrong in the end could remain few more hours in addition to the weeks it was there with no issue despite the visits (whihc include competent eyes), and you decided to remove it. There are thousands of similar assertions that are still in ns0, so this was not a crucial point, but it was your choice. Now I am avaliable to fix a text in ns0, that is what I was going to do, and I never skipped any resposnability about that but when you remove it, in this scenario now I have to add a text in ns0 from zero again, and this is clearly less urgent. Now since I know users on other wikipedias that are more proactive than you in these situations, I can fix this there in less time. I think it's a matter of trust, they don't think these passages this way are necessary to improve the sitation, and it actually provides a better working environment. I can assure however that in the event you will feel more trust, you will discover how present and available I am. Have a nice day.--Alexmar983 (talk) 00:19, 25 May 2019 (UTC)

@Alexmar983: Nobody has to wait on your schedule to fix problems, and you should not expect them to. The badly-sourced, misleading content has been on display to the public for more than long enough with no sign of your or anybody else doing anything about it. Only now that it has been moved to this talk page, do you bother to make an appearance. I do not believe that you have any intention of fixing the problems that this course has created, as there is no evidence of you taking these issues seriously or of fixing any issues pointed out to you. No matter how you work on other Wikipedias, here on English Wikipedia we demand the highest levels of sourcing for medical articles, and your students are not exempt from that requirement. They are more than welcome to read WP:MEDRS until they grasp what it requires; to search for and study relevant secondary sources (I've offered three above); and to add content that properly reflects what the reliable secondary sources say. It beggars belief that they were not coached to do that in the first place. --RexxS (talk) 10:18, 25 May 2019 (UTC)

RexxS I have already showed this content to one doctor offwiki (somebody with a previous publication career) in view of the final evalutation and (s)he did not describe it as missourced and misleading. tthe only comment was thatthe student could use a newer sources, if I rememer. As a scientist, I value peer reviewed, so I was condifent that I did not provide a bad service to the reader, which is the core point. The rest can be fixed but this was solid. Than, there is my evaluation of the wiki work and for the reasons you know already this for many of these excercise comes now. You have decided to depict me as a person who does not care, but for those who read, I did not "bother to appear" because he moved to the talk page. I told him clearly this was the week end I was revising the student content (after a final series of time consuming problems), and I would have been here no matter what. You decided to assume the worst about me and do this an a Friday evening. I told you how these social unnecessary consuming steps always affect the content, and this is a universal process common to all wikipedias.

Now instead of revising a text like I would have done and I told you I would have done, since you removed it I have two options. One is to interact with a person who has decided I don't care, the other one is that I do what I was going to do in any case with people who have trust. In the interest of my students, the second option is the best. Plus, it also balances the time I have spent interacting with you, which was unnecessarly tense. They will have the advice of people who are expert, have a medical degree, wrote dozens of quality articles sometimes better than enwikipedia (enwiki evaluation does not trasfer on itwiki, your top article are evaluated lower) and they have a different attitude, so I will go for it. Why shouldn't I? You will describe me as somebody who does not care in any case, you put it very clearly.--Alexmar983 (talk) 10:50, 25 May 2019 (UTC)

The lack of understanding by both your doctor friend and yourself of the requirements of sourcing for medical articles on the English Wikipedia is not surprising. Nevertheless, you should actually read WP:MEDRS before commenting further. I'll just draw your attention to the opening paragraph that unambiguously states "... all biomedical information must be based on reliable, third-party published secondary sources, and must accurately reflect current knowledge. Being peer-reviewed is a necessary, but not sufficient condition for being suitable for use in Wikipedia. Unfortunately, your failure to alert your student to the necessity of using secondary sources for biomedical claims did result in providing a bad service to the reader, and your confidence in yourself was misplaced. You can take up the issue at WT:WPMED or at WP:RSN if you're not able to accept what I've explained to you, but you'll get the same answers there: we don't write medical content based only on trials and studies – which is exactly the mistake that your student made. Take some responsibility for your actions, please, and make some effort to fix the problems you've caused, rather than wasting everybody's time with excuses. That is the best option for you to take. Put the encyclopedia first, and learn how to properly source medical articles according to the conventions agreed by the editing community here, instead of denigrating our standards with false comparisons. If you want to be seen as somebody who cares, you need to demonstrate it, not just talk about it. --RexxS (talk) 11:10, 25 May 2019 (UTC)

RexxS I know what the page says. I pointed out simply that if the text is not wrong, you can keep it as it was already for weeks and as fix the sources one day later. Removing the text is a mechanical action, but it's not the substantial process that encourage the quality. For example on other projects or fields, they will never do something like that under these circumstances, they discuss about the sources if the text is fine (and it was fine), that's why their quality is higher on the long term. In this case you could have it fixed in the week end, with no real practical difference, you opted for this approach against the information you had because of you mistrust, and you will see that this has no practical effect of the quality than the alternative.

In addition to that, you stuffed all these passages it with personal comments while you know, because it was told to you, that people editing medical content were not supposed to be at the lesson because I did not put it as target yet I was there as much as I could to be sure the contatn was medically correct before I had time to revise it in detail. So I am demostantring it even right now that I am responsabile, I also gave you a clear solution for the future, I am revising the content right now and I am talking to you not because I like ti but because you interacted with me with a tone and accusations that requires my comment. Do you really expect people to be tretaed like you did and not answer? If I wish you now meet all people like you in life, am I bad?

Try a different approach next time, you get something else. Take some responsability for your action too. Your confidence in yourself and your mthod is misplaced in this case, the result you will get are a consequence of that. You could have had a person available and caring if you only you had trust and simply listened to the expalanations instead of treatung them like childish excuses, you decided to act the way you did, accusing in ways you had no need to do. Now that you proved you have no trust and you applied a brutal solution, you made me free to spend my time with people that in this context listen and care and focus on content and are not stuck in what I would call a loop of social patterns.

Your solution of Friday evening is the one that will be applied, content will therefore be improved somewhere else during this week end. in the future I will stop every student who wish to edit about these topics, as I should have done but I did not because I do care about the students and I try to help and follow them, and I was expected to have more time in the following days when I started to revise (but than life has its own patterns). And BTW I will show this very same talk pages to future students, so you can be assured I take a lot of transaparent responsability. Have a nice afternoon.--Alexmar983 (talk) 12:18, 25 May 2019 (UTC)

The text was misleading and did not have the secondary sources to back it up. I don't care what standards you apply on other Wikipedias; on the English Wikipedia, we revert poor content and take it to the talk page to discuss – which is exactly what I've done here. There is no need for badly-sourced material to sit on display to the public while editors discuss it, and that is why the English Wikipedia's medical content has an unparalleled reputation for quality in both the short and long term. Your assertion about encouraging quality is completely wrong. Leaving poor quality material to be fixed weeks later, or perhaps never, has the opposite effect of what you claim.

"you opted for this approach against the information you had because of you mistrust" You have no basis for attributing bad-faith reasons to my actions, when it is abundantly clear that moving controversial content to the talk page is normal procedure here. You should retract that unfounded personal attack immediately. Don't deflect the criticisms of the problems you were responsible for onto others.

There is no different approach to take with content that is so substandardly sourced. We start from the sources and summarise them to create content, not hunt around for sources to justify already written text.

I look forward to seeing the improvements in content that you have promised over this week end. I shall be more than happy to see you taking some positive action to improve the article, and you will have my thanks for doing so.

I am happy that you care about the students. But when editing Wikipedia, you have to ask whether your primary concern is the improvement of the encyclopedia or the benefit to your students. If the former is not your primary goal, then I suggest you ought not to be doing it. Please consider WP:EXTERNALREL: "While editing Wikipedia, an editor's primary role is to further the interests of the encyclopedia. When an external role or relationship could reasonably be said to undermine that primary role, the editor has a conflict of interest." --RexxS (talk) 13:13, 25 May 2019 (UTC)

the content was not considered misleadng by a doctor, nor poor and this has nothing to do with the difference between wikipedias. A doctor with ph.D. confirmed to me that the content was not misleading, which is the most important thing I could check in those frantic weeks. Than, I was here to fix the rest as soon as I told you I had more time, that is this week end.

If you always remove content this way, that's not a good strategy on the long term. It gives the impression of quality but not a real struggle to quality. If the problems are the sources (you can always find better reviews), warnings in the text inform the readers while keeping the content if it is not misledaing, this way people push more for a better text. I think I can express my comment (discussed with doctors in real life) that actually the unparalleled reputation for quality of enwikipedia in the medical field is not as structured as you think. It is globally good, but its excellence underperforms in some sectors. we even discussed about a publication comparing the excellence level in different wikimedia, who knows when we will ever write it down. In this case, you acted in a way that damaged the final content you can get. For example, you invested energy to depict the person as somebody who wasn't answering while he simply told you he was not online to do this.

You said yourself you don't trust me, it's normal that I analyze now your actions based on this. I excuse myself but when are you excusing yourself the way you treat me?

You can look forward to seeing the improvements in the content but as I told you, they will be somewhere else. That's what I have asked the students, it's up to them now. When the evaluation is over, it will be up to me if they don't. We have a plan but it's not here.

the last sentece is too much. I only said I care about the students too, not more. I was there to check the content asap with a doctor beacuse I care about the encylcopedia, if I care more about the students i would have checked with some user with a strong social role but maybe no medical degree. This way they would have been much more protected.--Alexmar983 (talk) 14:08, 25 May 2019 (UTC)

Nucleus basalis / Basal nucleus of Meynert

The image shows the electrode in the Basal nucleus of Meynert but the article only mentions the globus pallidus internus, thalamus, subthalamic nucleus and the pedunculopontine nucleus as targets. Why? Abductive (reasoning) 03:15, 28 November 2019 (UTC)

@Abductive: Because the scholarly source that article text is based on mentions only those targets. We need to either find another good image or another reliable secondary source that bridges the gap between image and text. Perhaps you know where to find one or the other? --RexxS (talk) 14:25, 28 November 2019 (UTC)

It seems to be in the trial phase for Lewy Body Dementia. I am removing it as it is not a common target and the sourcing is primary, per WP:MEDRS. Abductive (reasoning) 22:40, 28 November 2019 (UTC)

Development and/or History of the Procedure?

On other non-stub medical procedure Wikipedia pages, it is common-place to find the history and/or the development of said procedure (e.g., Lobotomy#History). Perhaps an inclusion of such a section would be relevant to this article as well. Sink Cat (talk) 03:40, 20 February 2023 (UTC)

Here you go:

• Schwalb JM, Hamani C (January 2008). "The history and future of deep brain stimulation" (PDF). Neurotherapeutics. 5 (1): 3–13. doi:10.1016/j.nurt.2007.11.003. PMID 18164479.
• Pycroft L, Stein J, Aziz T (2018). "Deep brain stimulation: An overview of history, methods, and future developments". Brain Neurosci Adv. 2: 2398212818816017. doi:10.1177/2398212818816017. PMC 7058209. PMID 32166163.

SandyGeorgia (Talk) 03:49, 20 February 2023 (UTC)