In neurotechnology, deep brain stimulation (DBS) refers to a surgical treatment involving the implantation of a medical device called a brain pacemaker, which sends electrical impulses to specific parts of the brain. DBS in select brain regions has provided remarkable therapeutic benefits for otherwise treatment-resistant movement and affective disorders such as chronic pain, Parkinson's disease, tremor and dystonia. Despite the long history of DBS, its underlying principles and mechanisms are still not clear. While DBS has proven helpful for some patients, there is potential for serious complications and side effects. This book presents current research on this cutting-edge treatment. Success of functional stereotactic procedures is shown to depend on a variety of factors, including patient selection, methodology of choice and localisation of the target, and the experience of the neurosurgery team. Complications on the use of the procedure in the treatment of Parkinson's Disease are also presented. The use of Vagus nerve stimulation on treatment-resistant patients with major depression is discussed as well.
Author(s): Mark H. Rogers, Paul B. Anderson
Edition: 1
Publisher: Nova Biomedical Books
Year: 2009
Language: English
Pages: 219
Tags: Медицинские дисциплины;Неврология и нейрохирургия;
Deep Brain Stimulation: Applications, Complications and Side Effects......Page 3
Contents......Page 7
Preface......Page 9
Introduction......Page 15
Question One: Patient Selection......Page 16
Question Two: There Are Different Stereotactic Devices with Different Properties, Depending on the Type of Surgery in Question. Which Device is the Most Suitable for Deep Brain Stimulation Surgery?......Page 17
Question Three: What Is the Best Method for Placing the Stereotactic Ring in the Correct Position?......Page 19
Question Four: What Is the Best Radiological Procedure for Fixing the Target, CT, MRI or a Fusion of Images? How Are the Coordinates Calculated? Is There a Specific Computer Program or a Direct Method?......Page 21
Question Five: Which Is the Best Anesthesia for Functional Neurosurgery?......Page 24
Question Six: Neurophysiological Recordings in the Surgical Procedure. What Are the Advantages and Disadvantages of the Microelectrode and the Semi-Microelectrode?......Page 25
Question Seven: How Do You Implant the DBS? Is an Introductory Cannula Necessary? Is a Radiological Control Necessary? How Can We Check the Correct Positioning of the DBS in the Operating Room?......Page 31
Question Eight: When Is the Correct Moment for Radiological Control?......Page 35
Question Nine: What Are the Short-Term Complications in Deep Brain Stimulation Surgery?......Page 37
References......Page 39
Abstract......Page 45
Parkinson's Disease......Page 46
Dystonia......Page 47
Epilepsy......Page 48
Pain......Page 50
Psychiatric Disorders......Page 51
Current General Limitations of DBS......Page 53
Scientific and Technological Advances: Implications for Future Prospects of Therapeutic DBS......Page 54
References......Page 56
Abstract......Page 63
Current Applications......Page 64
Limits......Page 79
Future Prospects......Page 82
References......Page 86
Parkinson's Disease (PD) and Parkinsonism......Page 97
Pure Akinesia......Page 105
Dystonia......Page 106
Amyothophic Lateral Sclerosis......Page 107
Conclusions......Page 108
References......Page 109
Introduction......Page 113
Deep Brain Stimulation (DBS)......Page 114
Stimulation at Seizure Focus......Page 120
Adaptive Stimulation......Page 121
Conclusions......Page 122
References......Page 123
Psychosurgery of Obsessive-Compulsive Disorder: A New Indication for Deep Brain Stimulation?......Page 133
Introduction......Page 134
Brief Overview of the Pathophysiology of OCD......Page 135
Psychosurgical Treatments......Page 136
Conclusion......Page 141
References......Page 142
Abstract......Page 147
Background and Purpose......Page 148
Patients (Population)......Page 149
Surgical Procedure......Page 150
Electric Parameter Settings......Page 151
Discussion......Page 152
References......Page 156
Deep Brain Stimulation of the Subthalamus: Neuropsychological Effects......Page 159
References......Page 172
Abstract......Page 177
Introduction......Page 178
Materials and Methods......Page 179
Results......Page 181
Discussion......Page 184
Conclusion......Page 185
References......Page 186
Abstract......Page 191
Introduction......Page 192
The Surgical Procedure and the Implanted Device......Page 193
Clinical Efficacy Studies......Page 194
Side Effects, Compliance and Tolerability of VNS......Page 196
Current and Future Perspectives with VNS......Page 197
References......Page 198
Index......Page 203
