UID:
almafu_9959739786202883
Format:
1 online resource (176 pages)
Edition:
1st ed.
ISBN:
1-63853-528-0
,
1-62623-798-0
Content:
The one-stop resource on deep brain stimulation for functional neurosurgeons! Deep brain stimulation (DBS) is used to modulate dysfunctional circuits in the brain with stimulation pulses applied to specific target areas of the brain. Globally, DBS procedures have been most commonly performed for Parkinson's disease and essential tremor, but there are now new and growing research efforts studying DBS for psychiatric disorders and epilepsy. Deep Brain Stimulation: Techniques and Practices written by the Society for Innovative Neuroscience in Neurosurgery along with Dr. William S. Anderson and distinguished experts presents the latest DBS approaches. The book begins with a history of DBS, general frame-based techniques, patient selection primarily for movement disorders, multidisciplinary collaboration, and ethical considerations. Subsequent chapters detail diverse technologies and disease-specific treatment for Parkinson's disease, essential tremor, dystonia, OCD, epilepsy, major depression, Tourette syndrome, emerging psychiatric indications, and pediatric applications. Key highlights Lead placement techniques utilizing currently available customized platforms and robotics Microelectrode recording and image-based direct targeting with MRI and CT to enhance lead placement Lesioning methods including radiofrequency, and MR-guided focused ultrasound Discussion of recent innovations in tractography to delineate white matter tracts in the brain and closed loop stimulation DBS has helped thousands of patients with intractable conditions, allowing for a programmable therapy with durable treatment effect. This remarkable guide provides the essentials for functional neurosurgeons to pursue intraoperative research opportunities in this growing subspecialty and incorporate DBS into clinical practice.
Note:
Deep Brain Stimulation: Techniques and Practices -- Title Page -- Copyright -- Contents -- Preface -- Contributors -- 1 Introduction to Deep Brain Stimulation: History, Techniques, and Ethical Considerations -- 1.1 Introduction -- 1.2 History of Deep Brain Stimulation -- 1.3 Ablative Procedures -- 1.4 Operative Techniques -- 1.4.1 Frame-based versus Frameless Approaches -- 1.4.2 Microelectrode Recording and Intraoperative Monitoring -- 1.4.3 Description of Surgical Procedure -- 1.5 Multidisciplinary Committees -- 1.6 Ethics -- 1.7 Conclusion -- References -- 2 Customized Platform-Based Stereotactic DBS Lead Placement Technique (FHC STarFix, Medtronic Nexframe, and Robotic System Placement) -- 2.1 Background -- 2.2 Frame versus Imaging-based Coordinate Systems -- 2.2.1 Surgical Targeting Fixture (STarFix) Platform -- 2.2.2 Nexframe -- 2.2.3 Robotic Assisted Placement -- 2.3 System Comparison -- References -- 3 Microelectrode Recording Methods -- 3.1 Introduction -- 3.2 The Rationale for Mapping -- 3.3 Microelectrode Technology and Technique -- 3.3.1 Ventral Thalamus -- 3.3.2 Globus Pallidus -- 3.3.3 Subthalamic Nucleus -- 3.4 Controversies and Complications -- 3.5 Summary -- References -- 4 Intraoperative Imaging-Based Lead Implantation -- 4.1 Introduction -- 4.2 Evolution of Lead Implantation in the Asleep Patient -- 4.3 Intraoperative-CT-verified DBS -- 4.4 Intraoperative-MRI or Interventional-MRI-guided DBS -- 4.4.1 iMRI Environment -- 4.4.2 MRI Sequences for Anatomic Targeting -- 4.4.3 ClearPoint Workflow -- 4.5 Patient Selection for DBS Under General Anesthesia -- 4.6 Future Directions -- References -- 5 Lesioning Methods for Movement Disorders -- 5.1 Introduction -- 5.2 Pallidotomy -- 5.3 Ventral Thalamotomy -- 5.4 Stereotactic Surgical Technique -- 5.5 Radiosurgical Lesioning Procedures.
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5.6 Laser Interstitial Thermal Therapy with MR Thermography -- 5.7 MR-guided Focused Ultrasound -- 5.8 Conclusion -- References -- 6 Computational Modeling and Tractography for DBS Targeting -- 6.1 Introduction -- 6.2 Computational Modeling Techniques -- 6.2.1 Volume of Tissue Activated -- 6.2.2 Whole-Brain Network Models -- 6.2.3 Beyond Conventional Stimulation -- 6.3 Advanced Imaging Techniques -- 6.3.1 Diffusion-Weighted Imaging and Tractography -- 6.3.2 Advancements in Anatomic Imaging -- 6.4 Future Applications of Computational Modeling and Advanced Imaging -- References -- 7 Closed-Loop Stimulation Methods: Current Practice and Future Promise -- 7.1 Introduction -- 7.2 Approaches to Closed-Loop Neuromodulation -- 7.2.1 Considerations for Designing an Optimal System -- 7.2.2 Sources of Feedback Signals -- 7.2.3 Control Systems and Stimulation Paradigms -- 7.3 Existing Technology Platforms and Clinical Data -- 7.3.1 Adaptive Deep Brain Stimulation -- 7.3.2 Closed-Loop Stimulation for Epilepsy -- 7.3.3 Closed-Loop Vagal Nerve Stimulation -- 7.3.4 Closed-Loop Spinal Cord Stimulation -- 7.4 Outstanding Questions and New Horizons -- 7.4.1 Effects of Closed-Loop Stimulation on the Underlying Mechanism of DBS -- 7.4.2 Accelerating Improvements in Control Algorithms Using Machine Learning -- 7.4.3 Using Multiple Feedback Signals -- 7.5 Conclusion -- References -- 8 Parkinson's Disease Application -- 8.1 Introduction -- 8.2 Patient Selection -- 8.3 Goals of Treatment -- 8.4 Target Selection -- 8.4.1 Less Frequently Used Targets -- 8.5 Benefits of DBS -- 8.6 Risks of DBS -- 8.7 Techniques -- 8.7.1 Frame-based Implantation -- 8.7.2 Frameless Implantation -- 8.7.3 Stereotactic Targeting: Subthalamic nucleus -- 8.7.4 Stereotactic Targeting: Globus Pallidus Pars Interna -- 8.7.5 Target Confirmation -- 8.8 After Surgery -- 8.9 Summary and Conclusion.
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References -- 9 Essential Tremor Application -- 9.1 Presentation -- 9.1.1 Classification of Essential Tremor -- 9.1.2 Tremor Severity -- 9.2 Genetics -- 9.3 Pathophysiology and Tremor Circuitry -- 9.4 Diagnostic Testing -- 9.4.1 Testing and Grading Scales for Essential Tremor -- 9.5 The Medical Management of Essential Tremor -- 9.6 Surgical Management of Essential Tremor -- 9.6.1 Surgical Patient Selection -- 9.6.2 Tremor Evaluation -- 9.6.3 Quality of Life -- 9.6.4 Comorbidities -- 9.6.5 Strength of Support System -- 9.7 Surgical Interventions -- 9.7.1 Deep Brain Stimulation - Stereotactic Frame -- 9.7.2 Target and Trajectory Planning -- 9.7.3 Intraoperative Recordings and Mapping -- 9.7.4 Postoperative Management and Complications -- 9.7.5 Complications -- 9.7.6 Deep Brain Stimulation - Frameless Techniques -- 9.8 Minimally Invasive Techniques -- 9.8.1 Gamma Knife Thalamotomy -- 9.8.2 High-Frequency Focused Ultrasound -- 9.9 Future directions -- 9.9.1 Image-Guided DBS Based on DTI versus Awake MER-Guided DBS -- References -- 10 Deep Brain Stimulation for Dystonia-Clinical Review and Surgical Considerations -- 10.1 Introduction -- 10.2 Classification and Examination of Dystonias -- 10.2.1 Axis I-Clinical Considerations -- 10.2.2 Axis II-Etiological Considerations -- 10.2.3 Rating Scales -- 10.3 Medical Management -- 10.3.1 Physical and Supportive Therapy -- 10.3.2 Pharmacological Considerations -- 10.3.3 Botulinum Injections -- 10.4 Surgical Treatment -- 10.4.1 Deep Brain Stimulation -- 10.4.2 Postoperative Complications -- 10.4.3 Stimulation Side Effects -- 10.5 Outcomes and DBS Programming -- 10.5.1 Primary Generalized Dystonia -- 10.5.2 Focal Dystonia/Cervical Dystonia -- 10.5.3 Secondary Dystonia -- 10.5.4 Postulates on Mechanism of Action -- 10.5.5 DBS Programming and Stimulation Parameters -- 10.6 Conclusion -- References.
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11 Deep Brain Stimulation for Obsessive Compulsive Disorder -- 11.1 Introduction -- 11.2 Development of Stereotactic Neurosurgery for OCD -- 11.3 OCD Pathophysiology -- 11.4 Development of Targets for DBS for OCD -- 11.5 Criteria for Candidacy -- 11.6 Efficacy of DBS for OCD -- 11.7 Adverse Events -- 11.8 Summary of Studies -- 11.9 Considerations for Trial Design -- 11.10 Future Directions -- 11.11 Conclusion -- References -- 12 Deep Brain Stimulation in Epilepsy -- 12.1 Introduction -- 12.2 Cerebellum -- 12.2.1 Cerebellar Cortex Stimulation -- 12.2.2 Deep Cerebellar Nuclei -- 12.3 The Thalamus -- 12.3.1 Centromedian Nucleus -- 12.3.2 Anterior Nucleus of the Thalamus -- 12.4 Basal Ganglia -- 12.4.1 Subthalamic Nucleus -- 12.4.2 Caudate Nucleus -- 12.5 Hippocampus -- 12.6 Responsive Neurostimulation -- 12.7 Conclusion -- References -- 13 Deep Brain Stimulation in Major Depression -- 13.1 Introduction -- 13.2 The Current State of DBS for Major Depression -- 13.2.1 Initial DBS Application to Depression: Targeting the Subcallosal Cingulate -- 13.2.2 Targeting the Nucleus Accumbens -- 13.2.3 Targeting the Ventral Capsule/Ventral Striatum -- 13.2.4 Targeting the Medial Forebrain Bundle -- 13.2.5 DBS for Bipolar Depression -- 13.2.6 Ongoing DBS trials -- 13.3 The Future of DBS for Major Depression -- 13.3.1 Depression is Heterogeneous and its Treatment is Susceptible to Placebo Response -- 13.3.2 Lessons from Randomized Controlled Trial Design -- 13.3.3 Confirming Functional Target Engagement-A Necessary Next Step? -- 13.3.4 Neuroethics of DBS for TRD -- 13.4 Conclusion -- References -- 14 Deep Brain Stimulation in Tourette Syndrome -- 14.1 Introduction -- 14.2 Epidemiology of Tourette Syndrome -- 14.3 Characteristics of Tourette Syndrome -- 14.3.1 Comorbidities -- 14.3.2 Tic Measurement Scales -- 14.4 Pathophysiology of Tourette Syndrome.
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14.5 Treatment for Tourette Syndrome -- 14.5.1 History of Lesioning -- 14.5.2 Deep Brain Stimulation for Tourette Syndrome -- 14.5.3 Selection Criteria -- 14.6 Surgical Flow and DBS Lead Placement -- 14.7 Postoperative Programming of the Pulse Generator for the DBS System -- 14.8 Future Directions -- References -- 15 Deep Brain Stimulation for Emerging Psychiatric Indications -- 15.1 Introduction -- 15.2 Anorexia Nervosa -- 15.3 Addiction and Substance Use Disorders -- 15.4 Aggressive and Self-Injurious Behavior -- 15.5 Post-traumatic Stress Disorder -- 15.6 Schizophrenia -- 15.7 Conclusion -- References -- 16 Intraoperative Research during Deep Brain Stimulation Surgery -- 16.1 Introduction -- 16.2 Formulating Hypotheses -- 16.3 Patient Selection and IRB Approval -- 16.4 Equipment and Setup -- 16.5 Behavioral Task Control -- 16.6 Data Analysis -- 16.7 Image-Based Reconstruction of Recording Sites -- 16.7.1 Image Acquisition Considerations -- 16.7.2 Reconstructing the Recording Locations -- 16.7.3 Additional Image-Based Analyses -- 16.7.4 Diffusion-Weighted Imaging Analysis -- 16.8 Limitations -- 16.9 Conclusion -- References -- 17 Deep Brain Stimulation: Techniques and Practice for Pediatrics Indications -- 17.1 Introduction -- 17.2 Pediatric Movement Disorders: Neurosurgical Emergencies -- 17.3 Dystonia -- 17.4 Spasticity -- 17.5 Tourette syndrome -- 17.6 Surgical Considerations -- 17.7 Illustrative Case of DBS Insertion -- 17.8 Further Directions -- 17.9 Some Pearls in Pediatric Functional Neurosurgery -- References -- 18 Establishing a Deep Brain Stimulation Practice -- 18.1 Introduction -- 18.2 What Do I ActuallyWant? -- 18.2.1 What Do I want: Joining a Program, or Starting a Program? -- 18.2.2 What Do I want: Teaching, Research, Surgery? -- 18.2.3 What Do I Want: My Schedule? -- 18.3 Practice Types -- 18.3.1 Practice Types: Private Practice.
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18.3.2 Practice Types: Hospital-Employed.
Additional Edition:
ISBN 1-62623-797-2
Language:
English
Keywords:
Electronic books.
DOI:
10.1055/b-006-160137
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