This book provides a state-of-the-art overview of our current understanding of deep brain stimulation (DBS) for the treatment of neurological and psychiatric disorders. With a broad multidisciplinary scope, it presents contributions from leading experts in the field from Europe and America, who share not only their knowledge, but their experience as well. The book focuses both on basic and theoretical aspects of DBS, as well as clinical and practical aspects. It follows an evidence-based approach, and where possible offers clinical recommendations based on published guidelines. It starts with a general section, which discusses basic principles and general considerations. This is followed a sections dedicated to neurological disorders, and psychiatric disorders, in which only accepted indications are discussed. All experimental indications are discussed in the final chapter. The text is supplemented with numerous illustrations. Intended for medical specialists and residents involved in the treatment of patients with DBS, it also appeals to other professionals working with DBS patients, such as psychologists, nurses, physiotherapists, as well as basic and clinical neuroscientists.
Connectomic Deep Brain Stimulation (DBS) covers this highly efficacious treatment option for movement disorders such as Parkinson’s Disease, Essential Tremor and Dystonia. The book examines its impact on distributed brain networks that span across the human brain in parallel with modern-day neuroimaging concepts and the connectomics of the brain. It asks several questions, including which cortical areas should DBS electrodes be connected in order to generate the highest possible clinical improvement? Which connections should be avoided? Could these connectomic insights be used to better understand the mechanism of action of DBS? How can they be transferred to individual patients, and more. This book is suitable for neuroscientists, neurologists and functional surgeons studying DBS. It provides practical advice on processing strategies and theoretical background, highlighting and reviewing the current state-of-the-art in connectomic surgery. Written to provide a "hands-on" approach for neuroscience graduate students, as well as medical personnel from the fields of neurology and neurosurgery Includes preprocessing strategies (such as co-registration, normalization, lead localization, VTA estimation and fiber-tracking approaches) Presents references (key articles, books and protocols) for additional detailed study Provides data analysis boxes in each chapter to help with data interpretation
A comprehensive survey of the state of current practice, this new edition of Brain Stimulation Therapies for Clinicians provides thoroughly updated information on the growing list of electrical stimulation therapies now in use or under study, including electroconvulsive therapy (ECT), vagus nerve stimulation (VNS), transcranial magnetic stimulation (TMS), deep brain stimulation (DBS), cortical stimulation (CS), and transcranial direct current stimulation (TDCS), as well as new coverage of promising treatments such as low intensity focused ultrasound pulsation (LIFUP) and temporal interference stimulation (TI). After a brief course on the fundamentals of electricity and a refresher on neuroanatomy, the text explores how electricity works within biological systems before progressing to the chapters on individual therapies, which cover the history and evolution of the treatment, the techniques involved, clinical indications, side effects, and an up-to-date review of the evidence base supporting its use. The book is designed to help the reader cut through the initially daunting "alphabet soup" (e.g., ECT, TMS) by providing a clear and straightforward analysis of the prevailing techniques -- an indispensable resource for both clinicians and patients seeking in-depth knowledge of these acronyms and methods. The book's noteworthy features are many: Refinements in treatment protocols since the last edition are discussed in detail. For example, the sections on ECT cover advances such as focal electrically administered seizure therapy (FEAST) and magnetic seizure therapy (MST), while the TMS chapter covers theta burst and recent approval for obsessive-compulsive disorder. The underlying science is addressed in the initial review of electricity and physics, information that is foundational to these treatment modalities, but that clinicians do not encounter in the medical school curriculum. The section also addresses the parameters for brain stimulation and how to determine the right dose. A separate chapter is devoted to low intensity focused ultrasound pulsations (LIFUP) and temporally interfering (TI) electric fields, emerging treatments that have the potential to noninvasively stimulate focal locations deep in the brain without surgery or the implantation of hardware. The section on using DBS for treatment-resistant Parkinson's disease (PD) is thorough, authoritative, and a boon to clinicians assessing the viability and efficacy of treatment options for their PD patients. The new edition retains the amusing, but always informative sidebars highlighting the history of brain experimentation and applications of brain stimulation techniques Written in a down-to-earth, accessible style by authors at the forefront of progress in the field, Brain Stimulation Therapies for Clinicians is a rigorous, evidence based review of clinical data that focuses on what we know, what we don't know, and the strength of the evidence.
Pediatric Brain Stimulation: Mapping and Modulating the Developing Brain presents the latest on this rapidly expanding field that has seen an exponential growth in publications over the past 10 years. Non-invasive modalities like TMS can painlessly map and measure complex neurophysiology in real patients. Neuromodulatory applications like rTMS and tDCS carry increasingly proven therapeutic applications. Rapidly advancing technological methodologies are increasing opportunities and indications. Despite all these benefits, applications in the more plastic developing brains of children are only just emerging. This book provides a comprehensive overview of brain stimulation in children. Chapters include Transcranial Magnetic Stimulation (TMS) fundamentals, brain stimulation in pediatric neurological conditions, and invasive brain stimulation. The main audience for this research will be those interested in applying brain stimulation technologies to advance clinical research and patient care, although a wide variety of clinicians and scientist will find this to be a valuable reference on brain stimulation with specific chapters on a variety of conditions.
Deep Brain Stimulation (DBS) is a remarkable therapy for an expanding range of neurological and psychiatric disorders. In many cases it is better than best medical therapy and succeeds even when brain transplants fail. Yet despite the remarkable benefits, many physicians and healthcare professionals seem hesitant to embrace this therapy. Post-operative programming of the DBS systems seems unfamiliar, even mysterious, and is viewed as difficult and time consuming. However, DBS programming is rational and can be efficient and effective if one understands the basing underlying concepts of electronics, electrophysiology, and the relevant regional anatomy. Even these principles can be relatively easy to grasp. The book helps the reader to obtain an intuitive understanding of the basic principles of electronics, electrophysiology and the relevant regional anatomy through the use of readily understood metaphors and numerous illustrations. In addition a number of tools are provided including algorithms to ensure efficient and thorough programming. Forms are provided to help with documentation. In addition, DBS related research provides a remarkable tool to understand how the brain works and what happens in diseases such as Parkinson's disease. Already long cherished theories of the pathophysiology of Parkinson's disease must be abandoned. Indeed, these DBS derived insights suggest fundamental revisions of theories of brain function are in order. The book provides an introduction to where some of the new theories may lead particularly with the growing awareness of the importance of oscillations in the brain's activities. The brain has more in common with electrical devices, such as computers, than it does to a stew of chemicals. DBS operates at the electrical level in the brain, which is fundamental to how the brain creates, manipulates and conveys information and may indeed be fundamental to the misinformation the results in the dysfunction related to disorders of the brain. For downloadable forms and other relevant material, please visit: http://www.uab.edu/DBS_PrinciplesAndPractice
The electrifying, forgotten history of Robert Heath's brain pacemaker, investigating the origins and ethics of one of today's most promising medical breakthroughs: deep brain stimulation The technology invented by psychiatrist Robert G. Heath in the 1950s and '60s has been described as among the most controversial experiments in US history. His work was alleged at the time to be part of MKUltra, the CIA's notorious "mind control" project. His research subjects included incarcerated convicts and gay men who wished to be "cured" of their sexual preference. Yet his cutting-edge research and legacy were quickly buried deep in Tulane University's archives. Investigative science journalist Lone Frank now tells the complete sage of this passionate, determined doctor and his groundbreaking neuroscience. More than fifty years after Heath's experiments, this very same treatment is becoming mainstream practice in modern psychiatry for everything from schizophrenia, anorexia, and compulsive behavior to depression, Parkinson's, and even substance addiction. Lone Frank uncovered lost documents and accounts of Heath's trailblazing work. She tracked down surviving colleagues and patients, and she delved into the current support for deep brain stimulation by scientists and patients alike. What has changed? Why do we today unquestioningly embrace this technology as a cure? How do we decide what is a disease of the brain to be cured and what should be allowed to remain unrobed and unprodded? And how do we weigh the decades of criticism against the promise of treatment that could be offered to millions of patients? Elegantly written and deeply fascinating, The Pleasure Shock weaves together biography, scientific history, and medical ethics. It is an adventure into our ever-shifting views of the mind and the fateful power we wield when we tinker with the self.
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.
Considered the largest breakthrough in the treatment of Parkinson's disease in the past 40 years, Deep Brain Stimulation (DBS) is a pioneering procedure of neurology and functional neurosurgery, forging enormous change and growth within the field. The first comprehensive text devoted to this surgical therapy, Deep Brain Stimulation for Parkinson's
Brain stimulation technologies are both tools to probe brain function and to provide therapeutic options for patients with neuropsychiatric disease where pharmacological options are not viable. Although the field has been in existence for over seventy years, research interest in brain stimulation has been on the rise particularly in the last two decades. Brain Stimulation: Methodologies and Interventions is an introduction to the field of brain stimulation technology and its applications. The book explores how brainstimulating technologies work in the context of brain pathways that mediate normal and abnormal brain function. Chapters cover neuroanatomy and activity dependent changes in neuronal function triggered by brain stimulation, as well as applications of brain stimulation technologies themselves, including noninvasive procedures that rely on convulsive or seizure therapeutics, and non-convulsive therapies such as magnetic and electrical brain stimulation. Authored by an international group of leaders in the field, Brain Stimulation is a valuable resource for both neuroscience researchers and clinicians.
