Download or read book Optimization and Quantification of Stimulation Parameters in Subthalamic Nucleus Deep Brain Stimulation for Parkinson s Disease written by and published by . This book was released on 2014 with total page 254 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book Brain Stimulation written by Günther Deuschl and published by Elsevier Inc. Chapters. This book was released on 2013-11-11 with total page 50 pages. Available in PDF, EPUB and Kindle. Book excerpt: Deep brain stimulation is one of the most effective treatments of Parkinson’s disease (PD). This report summarizes the state of the art as at January 2013. Stimulation of the subthalamic nucleus is the most commonly used approach. It improves the core motor symptoms better than medication in patients with advanced disease. It also improves the majority of nonmotor symptoms, such as mood, impulse control disorders, sleep, and some autonomic dysfunctions. Quality of life (QoL) is improved significantly more than with medication. Long-term data show that the treatment is effective for up to 10 years, but the late appearance of l-dopa-resistant symptoms is seemingly not influenced. Internal globus pallidus (GPi) stimulation is less well studied but seems to have similar short-term efficacy. Importantly l-dopa use cannot be reduced with GPi DBS, which is a major disadvantage for patients suffering from medication side-effects, although gait may be influenced more positively. Although short-term QoL improvement seems to be similar to that for subthalamic nucleus (STN) DBS – gait and speech may be better improved – long-term data are rare for GPi DBS. Thalamic stimulation in the ventral intermediate nucleus (VIM) is applied only in tremor-dominant elderly patients. The treatment improves the dopa-sensitive symptoms and effectively reduces fluctuations leading to an overall QoL improvement. Although most of the controlled studies have been on advanced PD, the recently published EARLYSTIM study suggests that even patients with a very short duration of their fluctuations and dyskinesia are doing significantly better with neurostimulation in terms of QoL and all major motor outcome parameters.
Download or read book Brain Stimulation written by Anna Castrioto and published by Elsevier Inc. Chapters. This book was released on 2013-11-11 with total page 44 pages. Available in PDF, EPUB and Kindle. Book excerpt: Deep brain stimulation has become an established treatment for advanced Parkinson’s disease. Its postoperative management is a delicate phase, dedicated to finding the optimal balance between stimulation and dopaminergic treatment. Postoperative management can be divided into an acute phase, aimed at the selection of the best stimulation contact, and a stabilization phase, aimed at the progressive adjustment of stimulation parameters and medications. A good knowledge of the electrophysiological anatomy of the target and surrounding structures, of the potential consequences of dopaminergic treatment modifications, and of the time course and interactions between stimulation and medication effects is mandatory for optimal outcome. This chapter focuses on the main strategies for the acute and chronic management of stimulation parameters and medication in the three main nuclei targeted in Parkinson’s disease, namely the subthalamic nucleus, the ventral intermediate thalamic nucleus, and the internal part of the globus pallidus.
Download or read book Trends in Clinical Deep Brain Stimulation written by Marcus L. F. Janssen and published by MDPI. This book was released on 2021-03-17 with total page 246 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book covers the current trends in clinical deep brain stimulation (DBS) research. This collection of papers from experts in the field provides state of the art knowledge and future perspectives in clinical DBS research. A range of topics involved in DBS is presented, ranging from high resolution imaging, electrophysiology and personalized medicine, in a broad range of brain disorders.
Download or read book Deep Brain Stimulation for Parkinson s Disease written by Gordon H. Baltuch and published by CRC Press. This book was released on 2007-03-19 with total page 374 pages. Available in PDF, EPUB and Kindle. Book excerpt: 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
Download or read book 20 Things to Know about Deep Brain Stimulation written by Erwin B. Montgomery, Jr. and published by Oxford University Press. This book was released on 2015-01-02 with total page 297 pages. Available in PDF, EPUB and Kindle. Book excerpt: Twenty Things to Know About Deep Brain Stimulation is an extensive and in-depth critical analysis of the field of Deep Brain Stimulation (DBS) from what many may consider a revolutionary perspective. This book demonstrates the unique nature and incredible promise of DBS and shows how it is unparalleled as a therapeutic intervention. Dr. Montgomery provides an epistemic analysis of the presuppositions, assumptions and fallacies underlying current clinical understanding of DBS as well as the physiology and pathophysiology affected by DBS. Reviews of the safety and efficacy for a number of conditions, patient selections and issues in the post-operative management are also included. Given the revolutionary potential and the complexity of DBS in an ever changing healthcare delivery context, the ethics of DBS are discussed in detail.
Download or read book Deep Brain Stimulation written by Peter Bain and published by OUP Oxford. This book was released on 2009-03-05 with total page 232 pages. Available in PDF, EPUB and Kindle. Book excerpt: Deep brain stimulation (DBS) is increasingly used for the treatment of patients with severe Parkinson's disease and other movement disorders, but the technique and science behind it is still poorly understood by most clinicians. This book is intended to provide an overview of the use of deep brain stimulation for movement disorders and provide an introduction to the developing arena of DBS for psychiatric disease. The first part of the book covers the varying surgical techniques involved in implanting electrodes into various deep nuclei within the brain. The neurophysiological techniques involved in this process and the complex issue of programming the implanted stimulator in order to optimise therapeutic efficacy and minimise stimulation induced adverse effects. The second part of the book describes how to select appropriate patients for DBS and describes the results of DBS treatment for Parkinson's disease, dystonia and various tremors, as well as psychiatric conditions. Edited by three of the world's leading experts in the DBS field, this pocketbook will provide neurologists, trainees and specialist nurses with an overview of the therapeutics use of DBS
Download or read book Brain Stimulation written by Pierre Pollak and published by Elsevier Inc. Chapters. This book was released on 2013-11-11 with total page 25 pages. Available in PDF, EPUB and Kindle. Book excerpt: Proper selection of patients who will reliably benefit from deep brain stimulation (DBS) is critical to its success. This requires careful evaluation that should be delivered by an expert multidisciplinary team involving a movement disorder neurologist, a neurosurgeon, a neuropsychologist, and a psychiatrist. The most suitable candidates for DBS suffer from Parkinson’s disease with motor fluctuations and/or dyskinesias that are not adequately controlled with optimized medical therapy, or with medication-refractory tremor. During the best on-motor periods, gait difficulties, instability, and speech problems should be minimal, reflecting an excellent response to levodopa in the ideal candidate. The cognitive, psychiatric, and behavioral status must be normal or minimally affected, with the exception of dopamine agonist drug-induced impulse control disorders, which are usually improved after successful surgery and drug withdrawal. Moreover, the patients have no serious comorbidities. Most patients corresponding to this profile suffer from a relatively young onset of Parkinson’s disease, and are aged less than 70 years at the time of surgery. Indeed, most patients fall outside this ideal description, and the medical art is to appreciate for each patient the extent to which the alterations of these features can be accepted. Eventually, patients make their own decision from detailed information of their individualized risks and benefits of DBS. Patient expectations, cooperation, and familial support are also important considerations.
Download or read book Brain Stimulation written by Valerie Voon and published by Elsevier Inc. Chapters. This book was released on 2013-11-11 with total page 24 pages. Available in PDF, EPUB and Kindle. Book excerpt: Deep brain stimulation targeting the subthalamic nucleus or globus pallidus internus are highly effective for the symptomatic treatment of Parkinson’s disease. The assessment and management of psychiatric issues is relevant to preoperative patient selection and to optimal postoperative outcomes. This chapter reviews the evidence on psychiatric symptoms in the perioperative state including suicidal behaviors, depression, anxiety, mania, apathy, and impulse control disorders.
Download or read book Deep Brain Stimulation Programming written by Erwin B. Montgomery (Jr.) and published by Oxford University Press. This book was released on 2010-04-13 with total page 200 pages. Available in PDF, EPUB and Kindle. Book excerpt: The book is a guide to the principles of electronics, electrophysiology and regional neuroanatomy that allows the rational use of Deep Brain Stimulation. Practical issues are addressed and algorithms and tools are provided. Also, how DBS is leading to new and revolutionary theories of brain function and dysfunction are described.
Download or read book Deep Brain Stimulation written by Shilpa Chitnis and published by Oxford University Press, USA. This book was released on 2020 with total page 271 pages. Available in PDF, EPUB and Kindle. Book excerpt: Deep Brain Stimulation addresses the practical tips required to program and manage deep brain stimulation devices in the clinic. The number of deep brain stimulation devices worldwide will soon eclipse 200,000 and is an approved surgical treatment for medically refractory neurological movementdisorders such as Parkinson disease, tremors, and dystonia. It is, therefore, inevitable that clinicians and nurses will require the necessary tools, and exemplary real-life cases, to manage these complex patients. This book offers a case-based approach to common and uncommon neurologic problemsrelated to deep brain stimulator problems. Each case is a clinical pearl, accompanied by a discussion as well as practical tips to improve patient management.
Download or read book Parkinson s Disease Classification Monitoring and Optimization of Deep Brain Stimulation written by Syed Aamir Ali Shah and published by . This book was released on 2021 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt: Parkinson's disease (PD) alters the brain's anatomy when dopamine releasing neurons die in basal ganglia neural pathways. The resulting alterations force synchronized neuronal activity in beta frequency components in subthalamic nucleus (STN). This synchronization affects the chaotic behavior of the brain activities, which induce motor related impairments in patient's limbs. This can be seen in the electroencephalogram (EEG) signals of PD patients. Deep brain stimulation (DBS) is the therapy of choice in later stage of disease when the side-effects of medication supersede its benefits. In this research work, we utilize the relationship between chaotic systems and brain for the analysis of EEG signals of PD patients. The overall objective is to develop a framework that can monitor, analyze the chaotic behavior, and optimize the stimulation of various regions of the brain to restore normal state. The first component of the overall objective is to monitor the activities of brain regions. In this component, we use embedding reconstruction, a tool from chaos theory, to highlight PD-related alterations in dynamical properties of EEG and present it as a potentially reliable bio-marker for PD related classification. Additionally, there is a strong synchronization between amplitude of higher frequency components and phase of beta components for PD patients. This information is used to improve the performance of this classification. We apply embedding reconstruction to design a new architecture of a deep neural network called Dynamical system Generated Hybrid Network. We report that this network outperforms the state of the art in terms of classification accuracy of 99.2. (+0:52%) with approximately 24% of the computational resources. The second component is a step towards analysis of chaotic behavior of brain in which we investigate the use of recurrent neural networks to adapt the chaotic characteristics of chaotic time series. We define three unique topologies of long short-term memory (LSTM) network and analyze those for chaotic parameter estimation in seven different test cases. We show that the deep LSTM networks are capable of modeling the chaotic behavior of a wide range of parameters and that the network performs the best when the architecture is driven by chaotic attributes of the time series data. To mimic the behavior of brain regions, the third component of the overall objective, we utilize a neural reservoir of spatially distributed spiking neurons to our advantage. This reservoir is inspired by the anatomy and operations of biological brain. It provides a testing platform for final component of the overall objective. The final component is to restore the brain activities using DBS. In this component, we propose a simulation framework to define an optimized DBS stimulus using EEG signals. The objective of this framework is to provide simulation environment inspired by realistic brain. This framework utilizes spiking neurons, similar to realistic neurons, distributed in a reservoir which is inspired by real brain anatomy. This reservoir is trained via spike-time-dependent-plasticity algorithm which is inspired by biologically realistic neural learning process. This reservoir is initially set to OFF-medication state. Then, the synaptic changes are optimized in such a way that the reservoir is forced to drift from OFF-medication state to ON-medication state. The stimulus signal is generated by accumulating the variations in synaptic weights in neural reservoir in target brain region. For validation we analyze this signal and show that the application of this signal as stimulus results in local field potential (LFP) of STN region neurons with increased chaotic level compared to LFP without stimulation using SIM4LIFE simulation software. Individually, each objective is a complete research problem. Combined, they form a closed loop process for brain's monitoring and administration for PD patients.
Download or read book Brain Stimulation written by Cameron C. Mcintyre and published by Elsevier Inc. Chapters. This book was released on 2013-11-11 with total page 21 pages. Available in PDF, EPUB and Kindle. Book excerpt: Deep brain stimulation (DBS) is an effective clinical treatment for several medically refractory neurological disorders. However, even after decades of clinical success, explicit understanding of the response of neurons to applied electric fields remains limited, and scientific definition of the therapeutic mechanisms of DBS remains elusive. In addition, it is presently unclear which electrode designs and stimulation paradigms are optimal for maximal therapeutic benefit and minimal side-effects with DBS. Detailed computer modeling of DBS has emerged recently as a powerful technique to enhance our understanding of the effects of DBS and to create a virtual testing ground for new stimulation strategies. This chapter summarizes the fundamentals of neurostimulation modeling, presents some scientific contributions of computer models to the field of DBS, and demonstrates the application of DBS modeling tools to augment the clinical utility of DBS.
Download or read book Deep Brain Stimulation DBS Applications written by Tipu Aziz and published by MDPI. This book was released on 2018-03-23 with total page 279 pages. Available in PDF, EPUB and Kindle. Book excerpt: This book is a printed edition of the Special Issue "Deep Brain Stimulation (DBS) Applications" that was published in Brain Sciences
Download or read book Towards the Next Generation of Deep Brain Stimulation Therapies Technological Advancements Computational Methods and New Targets written by George C. McConnell and published by Frontiers Media SA. This book was released on 2021-10-04 with total page 152 pages. Available in PDF, EPUB and Kindle. Book excerpt:
Download or read book The Clinical and Ethical Practice of Neuromodulation Deep Brain Stimulation and Beyond written by Markus Christen and published by Frontiers Media SA. This book was released on 2018-01-15 with total page 84 pages. Available in PDF, EPUB and Kindle. Book excerpt: Neuromodulation is among the fastest-growing areas of medicine, involving many diverse specialties and affecting hundreds of thousands of patients with numerous disorders worldwide. It can briefly be described as the science of how electrical, chemical, and mechanical interventions can modulate the nervous system function. A prominent example of neuromodulation is deep brain stimulation (DBS), an intervention that reflects a fundamental shift in the understanding of neurological and psychiatric diseases: namely as resulting from a dysfunctional activity pattern in a defined neuronal network that can be normalized by targeted stimulation. The application of DBS has grown remarkably and more than 130,000 patients worldwide have obtained a DBS intervention in the past 30 years—most of them for treating movement disorders. This Frontiers Research Topics provides an overview on the current discussion beyond basic research in DBS and other brain stimulation technologies. Researchers from various disciplines, who are working on broader clinical, ethical and social issues related to DBS and related neuromodulation technologies, have contributed to this research topic.
Download or read book Brain Stimulation written by David H. Benninger and published by Elsevier Inc. Chapters. This book was released on 2013-11-11 with total page 33 pages. Available in PDF, EPUB and Kindle. Book excerpt: In advanced Parkinson’s disease (PD), the emergence of symptoms refractory to conventional therapy poses therapeutic challenges. The success of deep brain stimulation (DBS) and advances in the understanding of the pathophysiology of PD have raised interest in noninvasive brain stimulation as an alternative therapeutic tool. The rationale for its use draws from the concept that reversing abnormalities in brain activity and physiology thought to cause the clinical deficits may restore normal functioning. Currently the best evidence in support of this concept comes from DBS, which improves motor deficits, and modulates brain activity and motor cortex physiology, although whether a causal interaction exists remains largely undetermined. Most trials of noninvasive brain stimulation in PD have applied repetitive transcranial magnetic stimulation (rTMS), targeting the motor cortex. Current studies suggest a possible therapeutic potential for rTMS and transcranial direct current stimulation (tDCS), but clinical effects so far have been small and negligible with regard to functional independence and quality of life. Approaches to potentiate the efficacy of rTMS include increasing stimulation intensity and novel stimulation parameters that derive their rationale from studies on brain physiology. These novel parameters are intended to simulate normal firing patterns or to act on the hypothesized role of oscillatory activity in the motor cortex and basal ganglia with regard to motor control and its contribution to the pathogenesis of motor disorders. Noninvasive brain stimulation studies will enhance our understanding of PD pathophysiology and might provide further evidence for potential therapeutic applications.
