Mr L. Zrinzo


Mr Ludvic Zrinzo MD PhD FRCSEd

Mr Zrinzo holds the post of Consultant and Senior Lecturer in Neurosurgery at the Unit of Functional Neurosurgery.

Having qualified in Medicine from the University of Malta, Mr Zrinzo moved to London to pursue a career in Neurosurgery. His interest in Functional Neurosurgery commenced when visiting the Neurosurgical Department in Lund, Sweden as a medical student and developed further while pursuing an MSc in Clinical Neuroscience at UCL Institute of Neurology, for which he was awarded a Distinction.

Mr Zrinzo pursued two Stereotactic and Functional Fellowships, at Queen Square, London and at the University of California, Los Angeles (UCLA) under the aegis of Professors Marwan Hariz and Antonio DeSalles, respectively.

He was awarded a PhD by the UCL Institute of Neurology for work on “MRI Guided and MRI Verified Deep Brain Stimulation: Accuracy, Safety and Efficacy”.

This clinically relevant research has improved the accuracy of anatomical targeting during DBS procedures and has helped introduce several new brain targets and indications for DBS to the National Hospital. He also has a busy General Neurosurgical practice. Current interests include DBS in severe refractory forms of Tourette syndrome, obsessive-compulsive disorder, cluster headache and other trigeminal autonomic cephalalgias.

Publications

2012

Anzak A, Tan H, Pogosyan A, Foltynie T, Limousin P, Zrinzo L, Hariz M, Ashkan K, Bogdanovic M, Green AL, Aziz T, Brown P, “Subthalamic Nucleus Activity Optimizes Maximal Effort Motor Responses in Parkinson's Disease.” Brain, published online 2012

Litvak V, Eusebio A, Ashwani J, Oostenveld R, Barnes G, Foltynie T, Limousin P, Zrinzo L, Hariz MI, Friston K, Brown P, “Movement-Related Changes in Local and Long-Range Synchronization in Parkinson's Disease Revealed by Simultaneous Magnetoencephalography and Intracranial Recordings.” Journal of Neuroscience 32, no. 31: 10541–10553.

Zrinzo L, “Deep Brain Stimulation: Linking Structure and Function in Awake and Anesthetized Patients.” Clinical Neurophysiology, published online 2012

Zrinzo L, Foltynie T, Limousin P, Hariz MI: Reducing hemorrhagic complications in functional neurosurgery: a large case series and systematic literature review, J Neurosurg 2012 Jan.;116(1):84–94.

Zrinzo, L: Pitfalls in precision stereotactic surgery. Surgical neurology international 2012; 3(1), S53–S61.

Thevathasan W, Pogosyan A, Hyam JA, Jenkinson N, Foltynie T, Limousin P, Bogdanovic M, Zrinzo L, Green AL, Aziz TZ, Brown P. Alpha oscillations in the pedunculopontine nucleus correlate with gait performance in parkinsonism. Brain 2012 Jan

Edwards T, Zrinzo L, Limousin P, Foltynie T. Deep brain stimulation in the treatment of chorea. Mov Disord 2012 27, no. 3: 357–363.

2011

Lambert C, Zrinzo L, Nagy Z, Lutti A, Hariz M, Foltynie T, Draganski B, Ashburner J, Frackowiak R. Confirmation of functional zones within the human subthalamic nucleus: Patterns of connectivity and sub-parcellation using diffusion weighted imaging. NeuroImage 2011 Dec.;

Massey LA, Miranda MA, Zrinzo L, Al-Helli O, Parkes HG, Thornton JS, So P-W, White MJ, Mancini L, Strand C, Holton JL, Hariz MI, Lees AJ, Revesz T, Yousry TA. High resolution MR anatomy of the subthalamic nucleus: Imaging at 9.4T with histological validation. NeuroImage 2011 Oct

Nakajima T, Zrinzo L, Foltynie T, Aviles Olmos I, Taylor C, Hariz MI, Limousin P: MRI-guided subthalamic nucleus deep brain stimulation without microelectrode recording: Can we dispense with surgery under local anaesthesia? Stereotactic and functional neurosurgery 2011;89(5):318–325.

Anzak A, Gaynor L, Beigi M, Limousin P, Hariz M, Zrinzo L, Foltynie T, Brown P, Jahanshahi M: A Frequency specific role of Subthalamic Nucleus in Switching in Verbal Fluency, 2011 Dec.;232(2):136–142.

Zrinzo L, Yoshida F, Hariz MI, Thornton J, Foltynie T, Yousry TA, Limousin P: Clinical Safety of Brain Magnetic Resonance Imaging with Implanted Deep Brain Stimulation Hardware: Large Case Series and Review of the Literature, World neurosurgery 76 (1): 164–172, 2011

Boertien T, Zrinzo L, Kahan J, Jahanshahi M, Hariz M, Mancini L, Limousin, Foltynie T: Functional imaging of subthalamic nucleus deep brain stimulation in Parkinson's disease. Mov disord 2011 26, no. 10: 1835–1843.

Martínez-Fernández R, Zrinzo L, Aviles-Olmos I, Hariz M, Martinez-Torres I, Joyce E, Jahanshahi M, Limousin P, Foltynie T: Deep brain stimulation for Gilles de la Tourette syndrome: A case series targeting subregions of the globus pallidus internus. Mov disord 2011 26, 10: 1922–1930.

Ruge D, Tisch S, Hariz MI, Zrinzo L, Bhatia KP, Quinn NP, Jahanshahi M, Limousin P, Rothwell JC: Deep brain stimulation effects in dystonia: Time course of electrophysiological changes in early treatment. Mov disord, 2011 26, 10: 1913–1921.

Zrinzo L, Zrinzo LV, Massey LA, Thornton J, Parkes HG, White M, Yousry T, Strand C, Revesz T, Limousin P;, Hariz MI, Holton J: Targeting of the pedunculopontine nucleus by an MRI-guided approach: a cadaver study. J Hist Neurosci, published online May 2011

Zrinzo L, Holl EM, Petersen EA, Limousin P, Foltynie T, Hariz MI: Skewering the Subthalamic Nucleus via a Parietal Approach. Stereotactic and functional neurosurgery 89:70-75, 2011

Zrinzo L: Seeing Is Believing: Imaging and Stereotactic Functional Neurosurgery. World Neurosurg 75:22-24, 2011

Foltynie T, Zrinzo L, Martinez-Torres I, Tripoliti E, Petersen E, Holl E, Aviles-Olmos I, Jahanshahi M, Hariz M, Limousin P: MRI-guided STN DBS in Parkinson’s disease without microelectrode recording: efficacy and safety. J Neurol Neurosurg Psychiatr, 82:358-363, 2011

Tripoliti E, Zrinzo L, Martinez-Torres I, Frost E, Pinto S, Foltynie T, Holl E, Petersen E, Roughton M, Hariz MI, Limousin P: Effects of subthalamic stimulation on speech of consecutive patients with Parkinson disease. Neurology 76:80-86, 2011

Matharu MS, Zrinzo L: Deep brain stimulation in cluster headache. Expert review of neurotherapeutics 11:473-475, 2011

Litvak V, Jha A, Eusebio A, Oostenveld R, Foltynie T, Limousin P, Zrinzo L, Hariz MI, Friston KJ, Brown P: Resting oscillatory cortico-subthalamic connectivity in patients with Parkinson's disease. Brain 134:359-374, 2011

Hariz G, Nakajima T, Limousin P, Foltynie T, Zrinzo L, Jahanshahi M, Hamberg K: Gender distribution of patients with Parkinson's disease treated with subthalamic deep brain stimulation; a review of the 2000-2009 literature. Parkinsonism Relat Disord 17:146-149, 2011

Cavanna AE, Eddy CM, Mitchell R, Pall H, Mitchell I, Zrinzo L, Foltynie T, Jahanshahi M, Limousin P, Hariz MI, Rickards H: An approach to deep brain stimulation for severe treatment-refractory Tourette syndrome: the UK perspective. Br J Neurosurg 25:38-44, 2011

Eusebio A, Thevathasan W, Doyle Gaynor L, Pogosyan A, Bye E, Foltynie T, Zrinzo L, Ashkan K, Aziz T, Brown P: Deep brain stimulation can suppress pathological synchronisation in parkinsonian patients. JNNP 82(5):569–573, 2011

2010

Holl EM, Petersen EA, Foltynie T, Martinez-Torres I, Limousin P, Hariz MI, Zrinzo L: Improving Targeting in Image-Guided Frame-Based Deep Brain Stimulation. Neurosurgery (2010) vol. 67 (2 Suppl Operative) pp. 437-47

Pogosyan A, Yoshida F, Chen CC, Martinez-Torres I, Foltynie T, Limousin P, Zrinzo L, Hariz M, Brown P: Parkinsonian Impairment Correlates With Spatially Extensive Subthalamic Oscillatory Synchronisation. Neuroscience 171:245-257, 2010

Hariz MI, Blomstedt P, Zrinzo L: Deep Brain Stimulation between 1947 and 1987; the untold story. Neurosurg Focus, 2010; vol. 29 (2) pp. E1

Petersen EA, Holl EM, Martinez-Torres I, Foltynie T, Limousin P, Hariz MI, Zrinzo L: Minimizing Brain Shift In Stereotactic Functional Neurosurgery. Neurosurgery (2010) vol. 67 (3 Suppl Operative) pp. ons213-21

Aström M, Tripoliti E, Hariz M, Zrinzo L, Martinez-Torres I, Limousin P, Wårdell K: Patient-Specific Model-Based Investigation of Speech Intelligibility and Movement during Deep Brain Stimulation. Stereotact Funct Neurosurg, 2010; 88(4): 224-233

Yoshida F, Martinez-Torres I, Pogosyan A, Holl E, Petersen E, Chen CC, Foltynie T, Limousin P, Zrinzo L, Hariz M, Brown P: Value of subthalamic nucleus local field potentials recordings in predicting stimulation parameters for deep brain stimulation in Parkinson's disease. J Neurol Neurosurg Psychiatr, 81:885-889, 2010

Matharu M, Zrinzo L: Deep Brain Stimulation in Cluster Headache: Hypothalamus or Midbrain Tegmentum? Current Pain and Headache Reports, 2010; 14(2): 151-9

Zrinzo L, Zrinzo LV, Hariz MI: Neuromodulation: Anatomical Precision Is Neither Tedious Nor Outdated. Neuromodulation, 2010; 13(1): 70-71

Litvak V, Eusebio A, Jha A, Oostenveld R, Barnes GR, Penny WD, Zrinzo L, Hariz MI, Limousin P, Friston KJ, Brown P. Optimized beamforming for simultaneous MEG and intracranial local field potential recordings in deep brain stimulation patients. Neuroimage, 2010; 50(4): 1578-88

Zrinzo L. The role of imaging in the surgical treatment of movement disorders. Neuroimag Clin N Am, 2010; 20(1): 125-40

2010

Petersen EA, Holl EM, Martinez-Torres I, Foltynie T, Limousin P, Hariz MI, Zrinzo L: Minimizing Brain Shift In Stereotactic Functional Neurosurgery, Neurosurgery 67, no. 3: ons213–21; discussion ons221.

Matharu M, Zrinzo L: Deep Brain Stimulation in Cluster Headache: Hypothalamus or Midbrain Tegmentum? Current Pain and Headache Reports Current Pain and Headache Reports 14, no. 2: 151–159.

Zrinzo L, Zrinzo LV, Hariz MI: Neuromodulation: Anatomical Precision Is Neither Tedious Nor Outdated. Neuromodulation (2010) vol. 13 (1) pp. 70-71

Litvak V, Eusebio A, Jha A, Oostenveld R, Barnes GR, Penny WD, Zrinzo L, Hariz MI, Limousin P, Friston KJ, Brown P. Optimized beamforming for simultaneous MEG and intracranial local field potential recordings in deep brain stimulation patients. Neuroimage. 2010 Jan 4. [Epub ahead of print]

Zrinzo L. The role of imaging in the surgical treatment of movement disorders. Neuroimaging Clin N Am. 2010 Feb;20(1):125-40. Review.

2009

Martinez-Torres I, Limousin P, Tisch S, Page R, Pinto A, Foltynie T, Bhatia KP, Hariz MI, Zrinzo L. Early and marked benefit with GPi DBS for Lubag syndrome presenting with rapidly progressive life-threatening dystonia. Mov Disord (2009) Aug 15;24(11):1710-2

Martinez-Torres I, Hariz MI, Zrinzo L, Foltynie T, Limousin P. Improvement of tics after subthalamic nucleus deep brain stimulation. Neurology. 2009 19;72(20):1787-9

Zrinzo L, van Hulzen AL, Gorgulho AA, Limousin P, Staal MJ, De Salles AA, Hariz MI. Avoiding the ventricle: a simple step to improve accuracy of anatomical targeting during deep brain stimulation. J Neurosurg. 2009 jun;110(6):1283-90

Sauleau P, Eusebio A, Thevathasan W, Yarrow K, Pogosyan A, Zrinzo L, Ashkan K, Aziz T, Vandenberghe W, Nuttin B, Brown P. Involvement of the subthalamic nucleus in engagement with behaviourally relevant stimuli. Eur J Neurosci. 2009 Mar;29(5):931-42

2008

Zrinzo L, Zrinzo LV. Surgical anatomy of the pedunculopontine and peripeduncular nuclei. Br J Neurosurg. 2008; 22 Suppl 1:S19-24

Aström M, Zrinzo L, Tisch S, Tripoliti E, Hariz MI, Wårdell K, Method for patient-specific finite element modelling and simulation of deep brain stimulation. Med Biol Eng Comput. 2009 Jan;47(1):21-8. Epub 2008 Oct 21

Tripoliti E, Zrinzo L, Martinez-Torres I, Tisch S, Frost E, Borrell E, Hariz MI, Limousin P, Effects of contact location and voltage amplitude on speech and movement in bilateral subthalamic nucleus deep brain stimulation. Mov Disord. 2008 23, 16: 2377–2383.

Zrinzo L, Zrinzo LV, Tisch S, Limousin PD, Yousry TA, Afshar F, Hariz MI, Stereotactic localization of the human pedunculopontine nucleus: atlas-based coordinates and validation of a magnetic resonance imaging protocol for direct localization. Brain. 2008 Jun;131(Pt 6):1588-98

Tisch S; Rothwell JC; Zrinzo L; Bhatia KP; Hariz M; Limousin P, Cortical evoked potentials from pallidal stimulation in patients with primary generalized dystonia. Mov Disord 2008 23, 2: 265–273.

2007

Zrinzo L, Zrinzo L, Hariz M. The pedunculopontine and peripeduncular nuclei: a tale of two structures. Brain. 2007 Jun;130(Pt 6):e73

Tisch S, Rothwell JC, Bhatia KP, Quinn N, Zrinzo L, Jahanshahi M, Ashkan K, Hariz M, Limousin P. Pallidal stimulation modifies after-effects of paired associative stimulation on motor cortex excitability in primary generalised dystonia. Exp Neurol. 2007 Jul;206(1):80-5.

Ashkan KA; Blomstedt P; Zrinzo L; Tisch S; Yousry T; Limousin-Dowsey P; Hariz M, Variability Of The Subthalamic Nucleus: The Case For Direct MRI Guided Targeting, Br J Neurosurg. 2007 Apr;21(2):197-200

2006

Zrinzo L, Crocker M, Zrinzo LV, Thomas DGT, Watkins L: Commercial Flight And Patients With Intracranial Mass Lesions: A Caveat, J Neurosurg, 2006; 105: 627 – 630

Tisch S, Limousin P, Rothwell JC, Asselman P, Zrinzo L, Jahanshahi M, Bhatia KP, Hariz M: Changes in forearm reciprocal inhibition following pallidal stimulation for dystonia, Neurol, 2006; 66:1091-1093

Chen CC; Pogosyan A, Zrinzo L, Tisch S; Limousin P, Ashkan K, Yousry T, Hariz M, Brown P: Intra-Operative Recordings Of Local Field Potentials Can Help Localise The Subthalamic Nucleus In PD Surgery, Exp Neurol 2006; 198: 214–221

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