Brain Stimulation

Brain Stimulation

First published on November 11, 2013

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  • Authors: Andres M Lozano, Mark Hallett
  • Hardcover ISBN: 9780444534972

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Description

The field of brain stimulation is expanding rapidly, with techniques such as DBS, TMS, and tDCS moving from the research community into clinical diagnosis and treatment. Clinical applications include treating disorders such as Parkinson's disease, dystonia, and even depression. The chapters of Brain Stimulation are written by leading international researchers and clinical specialists include coverage of techniques, modes of action and applications in physiology and therapeutics. The combination of research and clinical coverage will be of interest to neurologists, neurosurgeons, psychiatrists, neuroscientists, and health care workers.

Key Features

  • A comprehensive introduction and overview of deep brain stimulation (DBS)
  • Coverage of DBS, transcranial magnetic stimulation (TMS) and transcranial direct current stimulation (tDCS)
  • Details the basic science and research utility of DBS and clinical application

Readership

Neurologists, Neuroscience research workers

Table of Contents

  • Handbook of Clinical Neurology 3rd Series

    Foreword

    Preface

    References

    Contributors

    Section 1: Deep brain stimulation

    Chapter 1. Principles of electrical stimulation of neural tissue

    Abstract

    Introduction

    Fundamentals of electrical stimulation of neural tissue

    Polarity of stimulation

    Current–distance relationship

    Strength–duration relationship

    Frequency of stimulation

    Considerations for nondamaging stimulation

    Closing remarks

    References

    Chapter 2. Deep brain stimulation in animal models

    Abstract

    Background

    Electrodes for deep brain stimulation in animal models

    Surgery for deep brain stimulation in animal models

    Stimulation parameters of deep brain stimulation in animal models

    Evaluation of electrodes tips in animal models of deep brain stimulation

    Problems encountered during the development of deep brain stimulation in animal models

    Examples of the contribution of deep brain stimulation in animal models to clinical practice

    Conclusion

    References

    Chapter 3. Deep brain stimulation surgical techniques

    Abstract

    Introduction

    Brain atlases: Relating anatomy and radiography

    Coordinate systems and registration

    Frame systems

    Frameless systems – principles and technique

    Image fusion and target localization

    Microelectrode recording and lead placement

    Interventional mri for dbs placement

    Pulse generator placement

    Complications

    Conclusion

    References

    Chapter 4. Deep brain stimulation: how does it work?

    Abstract

    Introduction

    Neural responses to deep brain stimulation

    Therapeutic mechanism of deep brain stimulation

    Therapeutic targets of deep brain stimulation

    References

    Chapter 5. Computational modeling of deep brain stimulation

    Abstract

    Deep brain stimulation

    Patient-specific models

    Modeling neurostimulation

    Deep brain stimulation models

    Clinical application of deep brain stimulation models

    Conclusion

    Acknowledgments

    References

    Chapter 6. Therapeutic stimulation versus ablation

    Abstract

    Introduction

    Chronic pain: ablation versus stimulation?

    Movement disorders

    Psychiatric indications

    Ethics of ablation versus deep brain stimulation

    Reasons for popularity of deep brain stimulation

    Reasons for decline of ablative procedures

    Pros and cons of dbs versus ablation in functional neurosurgery

    Conclusion

    Acknowledgments

    References

    Chapter 7. Magnetic resonance imaging safety of deep brain stimulator devices

    Abstract

    Introduction

    The MRI environment: basic physics of potential interactions with implanted DBS devices

    Experimental studies

    In vivo studies

    Recommendations and conclusion

    References

    Chapter 8. Brain stimulation and functional imaging with fMRI and PET

    Abstract

    Introduction to functional imaging

    Deep brain stimulation and functional imaging

    Transcranial magnetic stimulation and functional imaging

    Future directions

    References

    Chapter 9. Deep brain stimulation for Parkinson’s disease – patient selection

    Abstract

    Introduction

    The ideal parkinson's disease candidate for deep brain stimulation

    Contraindications for neurosurgery

    Previous therapies for parkinson's disease

    Features of parkinson's disease

    Personal, professional, and social issues

    Conclusion

    References

    Chapter 10. Clinical outcome of deep brain stimulation for Parkinson’s disease

    Abstract

    Introduction

    The targets of deep brain stimulation

    Measuring the compound motor effects of DBS

    Motor effects

    Effects on specific motor symptoms of advanced parkinson's disease

    Nonmotor effects

    Quality of life

    Adverse events

    Patients qualifying for deep brain stimulation and outcome predictors

    Timing of the intervention

    Choosing the target

    Conclusion

    References

    Chapter 11. Postoperative management of deep brain stimulation in Parkinson’s disease

    Abstract

    Introduction

    General programming strategy

    Stimulation parameters

    Battery replacement

    Initial programming session

    Stabilization period and beyond

    Subthalamic nucleus stimulation

    Deep brain stimulation of the globus pallidus interna

    Deep brain stimulation of the ventral intermediate thalamic nucleus

    Concluding remarks

    References

    Chapter 12. Psychiatric considerations in deep brain stimulation for Parkinson’s disease

    Abstract

    Introduction

    Pathophysiology

    Suicidal behaviors

    Depression

    Apathy

    Hypomania and mania

    Anxiety

    Impulse control disorders

    Conclusion

    References

    Chapter 13. Deep brain stimulation for essential tremor

    Abstract

    Introduction

    Deep brain stimulation

    Clinical studies

    DBS of non-vim areas for tremor control in patients with essential tremor

    Summary

    References

    Further Reading

    Chapter 14. Deep brain stimulation for dystonia

    Abstract

    Introduction

    How effective is DBS in the treatment of dystonia?

    GPi DBS in generalized and segmental primary dystonia (including cervical dystonia)

    GPi DBS in focal dystonia: blepharospasm, meige syndrome, upper limb dystonia

    Long-term follow-up

    Persistence of beneficial effect after the stimulator has been switched off

    Predictive factors of outcome

    Other types of dystonia with good outcome

    Tardive dystonia

    Dystonia with less predictible outcomes: status dystonicus and secondary dystonia

    Safety and adverse effects

    Current practice and future directions

    Conclusion

    Acknowledgments

    References

    Chapter 15. Role of deep brain stimulation in the treatment of secondary dystonia–dyskinesia syndromes

    Abstract

    Introduction

    Methods

    Results

    DBS for secondary dystonia: presentation of studies

    Discussion

    Conclusion

    References

    Chapter 16. Deep brain stimulation for other tremors, myoclonus, and chorea

    Abstract

    Introduction

    Deep brain stimulation in huntington’s disease

    Deep brain stimulation in hemiballism–hemichorea

    Deep brain stimulation in tardive dyskinesia

    Deep brain stimulation in holmes tremor

    Deep brain stimulation in posttraumatic tremor

    Deep brain stimulation for tremor associated with multiple sclerosis

    Thalamic deep brain stimulation in orthostatic tremor

    Deep brain stimulation in myoclonus

    Summary and conclusions

    References

    Chapter 17. Deep brain stimulation for epilepsy

    Abstract

    Introduction

    Sites of brain stimulation for epilepsy

    Conclusion

    Acknowledgments and disclosures

    References

    Chapter 18. Deep brain stimulation for major depression

    Abstract

    The need for new treatment options in therapy-resistant depression

    Targets under research in therapy-resistant depression

    Efficacy, side-effects, and neurobiological changes

    Case studies, new targets, and new indications

    Quality standards

    Conclusion

    References

    Chapter 19. Deep brain stimulation in obsessive–compulsive disorder: neurocircuitry and clinical experience

    Abstract

    Background and historical context

    Circuitry of OCD: translation to deep brain stimulation

    DBS in OCD: experience with various potential targets

    Conclusion: OCD as a neuropsychiatric illness

    References

    Chapter 20. Deep brain stimulation for Tourette syndrome

    Abstract

    Introduction

    Deep brain stimulation

    Conclusion and future directions

    References

    Chapter 21. Deep brain stimulation in addiction due to psychoactive substance use

    Abstract

    Introduction

    Epidemiological significance

    Neurobiology of reward and addiction

    Stereotactic lesional procedures

    Animal models

    Deep brain stimulation of the nucleus accumbens for treating substance dependence in humans

    Deep brain stimulation of the subthalamic nucleus in substance-related addictions in humans

    Hypotheses regarding the effects of deep brain stimulation on addictions

    Conclusion

    References

    Chapter 22. Evaluating the potential of deep brain stimulation for treatment-resistant anorexia nervosa

    Abstract

    Background: disease burden and scope

    Neuroimaging

    Neurocircuitry

    Rationale for deep brain stimulation treatment and target selection

    Neuromodulation in anorexia

    Neurosurgical interventions (lesions and dbs) in anorexia

    Ethics and deep brain stimulation in anorexia nervosa

    Conclusion

    References

    Chapter 23. Deep brain stimulation for pain

    Abstract

    Introduction

    Patient selection

    Basic science

    Surgical technique

    Clinical assessment

    Evidence

    Discussion

    Conclusion

    Acknowledgments

    References

    Chapter 24. Central thalamic deep brain stimulation for support of forebrain arousal regulation in the minimally conscious state

    Abstract

    Historical efforts to apply thalamic brain stimulation in the severely injured brain placed in a modern context

    Proof of concept in a single-subject study of central thalamic deep brain stimulation

    Neuronal mechanisms underpinning the rationale of CT-DBS in the severely injured brain

    Directions for development of CT/DBS for MCS: preferable neuronal substrates, behavioral profiles, and goals of the intervention

    Acknowledgments

    References

    Chapter 25. Deep brain stimulation for cognitive disorders

    Abstract

    Background

    Previous deep brain stimulation trials in disorders with cognitive disturbances

    Other observations and future prospects

    Conclusion

    References

    Chapter 26. Ethics guidance for neurological and psychiatric deep brain stimulation

    Abstract

    Introduction

    Ethical challenges in movement disorders

    Specific ethical challenges of psychiatric dbs and emerging areas of investigation

    Conclusion

    Acknowledgments

    References

    Section 2: Superficial brain stimulation

    Chapter 27. Transcranial electric and magnetic stimulation: technique and paradigms

    Abstract

    Introduction

    Transcranial electric stimulation

    Transcranial magnetic stimulation

    Conclusions and future directions

    References

    Chapter 28. Epidural and subdural stimulation

    Abstract

    Introduction

    History

    Mechanism of action

    Stimulation parameters

    Surgical technique

    Summary

    References

    Chapter 29. Physics of effects of transcranial brain stimulation

    Abstract

    Introduction

    Relationship between electric field and current density

    Low-frequency dielectric properties of head tissues

    Effect of tissue heterogeneity and anisotropy

    The quasistatic approximation

    Focality in transcranial stimulation

    The electric field induced in transcranial magnetic stimulation

    The electric field in transcranial current stimulation

    Conclusion

    References

    Chapter 30. Biological effects of non-invasive brain stimulation

    Abstract

    Introduction

    Single-pulse stimulation

    Transcranial electrical stimulation

    Magnetic stimulation

    Paired-pulse transcranial magnetic stimulation

    Repetitive stimulation of the motor cortex

    Overall view

    References

    Chapter 31. Central motor conduction time

    Abstract

    Introduction

    Methods used to measure central motor conduction time

    Effects of anthropometric factors on central motor conduction time

    Clinical utility of central motor conduction time

    Conclusion

    References

    Chapter 32. Pharmaco-transcranial magnetic stimulation studies of motor excitability

    Abstract

    Introduction

    Motor threshold

    Motor evoked potential amplitude

    Cortical silent period

    Short-interval intracortical inhibition

    Intracortical facilitation

    Short-interval intracortical facilitation

    Long-interval intracortical inhibition

    Short-latency afferent inhibition

    Summary

    References

    Chapter 33. Treating the depressions with superficial brain stimulation methods

    Abstract

    Introduction

    Why brain stimulation and depression

    Electroconvulsive therapy

    Transcranial magnetic stimulation and repetitive TMS

    Transcranial direct current stimulation

    Transcranial electrical stimulation

    Vagus nerve stimulation

    Epidural and subdural stimulation

    Conclusion and next steps

    References

    Chapter 34. Other therapeutic psychiatric uses of superficial brain stimulation

    Abstract

    Introduction

    Anxiety disorders

    Post-traumatic stress disorder

    Obsessive–compulsive disorder

    Panic disorder

    Generalized anxiety disorder

    Attention-deficit/hyperactivity disorder

    Catatonia

    Schizophrenia

    Bipolar disorder

    Discussion

    References

    Chapter 35. Pain

    Abstract

    Introduction

    Mechanisms of action

    Epidural motor cortex stimulation

    Repetitive transcranial magnetic stimulation of the motor cortex

    Transcranial direct current stimulation of the motor cortex

    Other cortical targets

    Conclusion

    References

    Chapter 36. Tinnitus: therapeutic use of superficial brain stimulation

    Abstract

    Introduction: Terminology and epidemiology

    Pathophysiology

    Methodological considerations

    Brain stimulation for the treatment of tinnitus

    Auditory brain stimulation

    Concluding remark

    References

    Chapter 37. Parkinson’s disease

    Abstract

    Background

    Rationale for noninvasive brain stimulation

    Pathophysiology of motor disturbance of parkinson's disease

    Therapeutic studies of noninvasive brain stimulation in parkinson's disease

    Physiological effects of noninvasive brain stimulation in parkinson's disease

    Current concepts of noninvasive brain stimulation in parkinson's disease

    Outlook for noninvasive brain stimulation in parkinson's disease

    References

    Chapter 38. Dystonia

    Abstract

    Introduction

    Writer's Cramp

    Blepharospasm

    Conclusion

    References

    Chapter 39. Epilepsy

    Abstract

    Introduction

    Transcranial magnetic stimulation in seizure suppression

    Safety of TMS in epilepsy

    TMS as a diagnostic instrument in epilepsy

    Spike provocation by TMS

    Transcranial direct current stimulation in epilepsy

    Conclusion

    References

    Chapter 40. Noninvasive brain stimulation in neurorehabilitation

    Abstract

    Introduction

    Poststroke reorganization

    Physiological mechanisms of reorganization

    Noninvasive brain stimulation in neurorehabilitation

    Conclusion

    References

    Chapter 41. Plasticity

    Abstract

    Terms and physiology

    Models of plasticity in the naive central nervous system

    Modulation of stimulation-induced plasticity by concomitant experimental physiological manipulation

    Modulation of stimulation-induced plasticity by prior experience or behavior

    Modulation of effects of subsequent training through stimulation-induced plasticity

    References

    Chapter 42. Parkinson’s disease

    Abstract

    Standard measures of motor cortex excitability using transcranial magnetic stimulation

    Premovement facilitation of motor evoked potentials

    Transcallosal inhibition and mirror movements

    Cerebellum and tremor

    Effects of deep brain stimulation on cortical excitability

    Motor cortex plasticity

    Levodopa-induced dyskinesia and cortical plasticity

    Plasticity: conclusions

    References

    Chapter 43. Transcranial magnetic stimulation in dystonia

    Abstract

    Introduction

    Transcranial magnetic stimulation and dystonia pathophysiology

    Transcranial magnetic stimulation and diagnostic applications

    Transcranial magnetic stimulation and therapeutic applications

    References

    Chapter 44. Noninvasive brain stimulation in Huntington’s disease

    Abstract

    Introduction

    Brainstem excitability and plasticity in huntington's disease

    Primary motor cortex excitability and plasticity in huntington's disease

    Conclusion

    References

    Chapter 45. Utility of transcranial magnetic stimulation in delineating amyotrophic lateral sclerosis pathophysiology

    Abstract

    Introduction

    The effects of single-pulse TMS on motor function

    Stimulus–response curves

    Central motor conduction time

    Cortical silent period

    Paired-pulse TMS and motor function

    Short-interval intracortical inhibition and intracortical facilitation

    Peristimulus time histograms

    Contribution of TMS to the understanding of amyotrophic lateral sclerosis pathogenesis

    An excitotoxic paradigm

    Diagnostic utility of TMS in amyotrophic lateral sclerosis

    Future clinical utility of TMS

    Conclusion

    Acknowledgments

    References

    Chapter 46. Superficial brain stimulation in multiple sclerosis

    Abstract

    Introduction

    Diagnostic applications of superficial brain stimulation in multiple sclerosis

    Monitoring and prediction of the course of multiple sclerosis

    Evaluations of functions other than direct corticospinal connection by superficial brain stimulation

    Conclusion

    Acknowledgments

    References

    Chapter 47. Brain stimulation in migraine

    Abstract

    Introduction

    Pathophysiology of migraine: the neurostimulation insight

    Noninvasive neurostimulation for the treatment of migraine

    Conclusion

    References

    Chapter 48. Dementia

    Abstract

    Introduction

    Cortical reactivity measures, plasticity, and functional connectivity

    Studies on cortical excitability, connectivity, and plasticity

    Pharmacological modulation of cortical excitability in dementia

    Therapeutic interventions

    Discussion

    References

    Chapter 49. Addiction

    Abstract

    Introduction

    The neurobiology of addiction: a brief overview

    Addiction and brain stimulation

    Nicotine and brain stimulation

    Alcohol and brain stimulation

    Cocaine and brain stimulation

    Cannabis and brain stimulation

    Ecstasy and brain stimulation

    Safety of brain stimulation techniques within addiction populations

    Future research applications

    Conclusion

    References

    Chapter 50. Tourette syndrome

    Abstract

    Introduction

    Depolarization thresholds: resting and active motor thresholds

    The cortical silent period

    Paired-pulse studies of inhibition: SICI and SAI

    Single pulse: input–output curves

    Repeated pulse: neuroplasticity

    References

    Chapter 51. Cerebellum

    Abstract

    Introduction

    Anatomy of cerebellocerebral connection

    Cerebellar stimulation – methodology

    Cerebellar transcranial magnetic stimulation in healthy subjects

    Cerebellar inhibition in neurological disorders

    Other investigations

    Methodological limitations

    Summary, outlook, and perspectives

    References

    Chapter 52. Transcranial magnetic stimulation and vision

    Abstract

    Introduction

    How can TMS contribute to the study of vision?

    Pioneering TMS studies on the visual system

    Phosphenes – visual percepts induced by TMS

    Stimulation site localization

    Recent TMS studies on visual motion perception

    TMS studies on object and face processing

    Chronometric TMS: tracing information flow between brain areas

    TMS studies on in neurological disorders affecting vision

    State dependency of TMS effects

    Revealing neuronal selectivity with state-dependent TMS

    Mechanisms underlying TMS-induced impairments in visual perception

    Impact of stimulation intensity on whether TMS impairs or facilitates perception

    Concluding remarks

    References

    Chapter 53. Transcranial magnetic stimulation techniques to study the somatosensory system: research applications

    Abstract

    Introduction

    Stimulation of primary somatosensory cortex (S1)

    Interaction of intermodal attentional and sensorimotor systems

    Stimulation of nonsomatosensory regions and the effect on somatosensory cortical processing

    Conclusion

    Acknowledgments

    References

    Chapter 54. Language

    Abstract

    Introduction

    Phonology

    The phonological loop in verbal working memory

    Semantics

    Grammar and syntax

    Figurative language

    Speech production: the speech arrest phenomenon

    Prosody

    Reading

    Conclusion

    References

    Chapter 55. Learning and memory

    Abstract

    Introduction

    Framing application of noninvasive brain stimulation in the context of neuropsychological definitions

    Understanding the neural mechanisms of learning and memory

    Using noninvasive brain stimulation as a diagnostic tool

    Modulating learning and memory

    Conclusion

    Acknowledgments

    References

    Chapter 56. Transcranial stimulation and cognition

    Abstract

    Introduction

    Transcranial magnetic stimulation

    Transcranial electrical stimulation

    Future directions: cognitive neurorehabilitation and noninvasive brain stimulation

    References

    Index

Product details

  • No. of pages: 784
  • Language: English
  • Copyright: © Elsevier 2013
  • Published: November 11, 2013
  • Imprint: Elsevier
  • Hardcover ISBN: 9780444534972

About the Authors

Andres M Lozano

Affiliations and Expertise

Department of Surgery, Faculty of Medicine, University of Toronto, Toronto, Canada

Mark Hallett

Affiliations and Expertise

School of Medicine and Health Sciences, George Washington University, Washington, DC, USA

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