Pediatric Brain Stimulation

Pediatric Brain Stimulation

Mapping and Modulating the Developing Brain

1st Edition - May 4, 2016

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  • Editors: Adam Kirton, Donald Gilbert
  • Hardcover ISBN: 9780128020012
  • eBook ISBN: 9780128020388

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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.

Key Features

  • Provides an overview of recent findings and knowledge of pediatric brain stimulation and the developing brain
  • Edited by renowned leaders in the field of pediatric brain stimulation
  • Presents a great resource for basic and clinical scientists and practitioners in neuroscience, neurology, neurosurgery, and psychiatry


Clinicians, researchers, and professionals in neurology, neurosurgery, neuroscience, and psychiatry

Table of Contents

    • List of Contributors
    • Foreword
    • Preface
    • Section I. Fundamentals of Nibs in Children
      • Chapter 1. TMS Basics: Single and Paired Pulse Neurophysiology
        • Introduction
        • How Does TMS Work?
        • Neuronal Structures Activated by TMS
        • TMS Neurophysiology
        • TMS Reliability
        • TMS Safety
      • Chapter 2. Assessing Normal Developmental Neurobiology With Brain Stimulation
        • Introduction
        • Normal Developmental Neurobiology
        • TMS-Evoked Parameters That Reflect Neuromotor Maturation
        • Assessing Neurophysiologic Functioning With Brain Stimulation in Development and Developmental Disorders
        • Outlook
      • Chapter 3. Neuroplasticity Protocols: Inducing and Measuring Change
        • Background (In Vitro and Animal Work)
        • Overview of Repetitive Transcranial Magnetic Stimulation (rTMS)
        • Types of rTMS
        • Study Design Considerations
        • Conclusion
      • Chapter 4. Therapeutic rTMS in Children
        • Introduction: From Biomarker of Plasticity and Excitability to Inducer of Therapeutic Changes?
        • Methods: Types of Repetitive Transcranial Magnetic Stimulation (rTMS)
        • Most Common Repetitive TMS Methods
        • Brief Overview of Clinical Trials and Indications in Young Adults
        • Brief Overview of Registered Clinical Trials Involving Children
        • Brief Overview of Published Clinical Trials Involving Children
        • Where to Next With rTMS Treatment in Children?
      • Chapter 5. Transcranial Direct-Current Stimulation (tDCS): Principles and Emerging Applications in Children
        • Introduction
        • Principles and Cortical Effects of Transcranial Direct-Current Stimulation
        • tDCS Methodology: Electrodes, Current, and Protocols
        • tDCS Dosage: Computational Modeling Evidence
        • tDCS Dosage: Neurophysiology Evidence
        • tDCS in Healthy Children to Enhance Motor Learning
        • Safety, Adverse Events, and Tolerability
        • Clinical Application of tDCS
        • Summary
      • Chapter 6. Insights Into Pediatric Brain Stimulation Protocols From Preclinical Research
        • Stimulating the Immature Brain
        • The Immature Brain Is Hyperexcitable
        • Inhibitory Control Develops With Age
        • GABAergic Dysmaturity in Neurodevelopmental Disease
        • Synaptic Plasticity Considerations in the Developing Brain
        • Relevance to Translational Brain Stimulation
        • Conclusion
      • Chapter 7. Pediatric Issues in Neuromodulation: Safety, Tolerability and Ethical Considerations
        • Brain Stimulation Techniques Used in Children
        • Direct Effects of Brain Stimulation in Children
        • Developmental Neuroplasticity
        • Side Effects of Stimulation
        • Ethical Application of Neuromodulation in Children
        • Neuro-Enhancement in Healthy Individuals
        • Advisements for Safe Administration of NIBS in Children
        • Conclusions
    • Section II. Nibs in Pediatric Neurological Conditions
      • Chapter 8. TMS Applications in ADHD and Developmental Disorders
        • Introduction
        • Key Considerations for TMS Research in Children With Developmental Disorders
        • TMS in Developmental Disorders: Practical Considerations and Representative Results
      • Chapter 9. TMS Mapping of Motor Development After Perinatal Brain Injury
        • Introduction
        • Developmental Aspects
        • Functional Aspects
        • Functional Imaging
        • MR Tractography
        • Clinical Relevance I: Functional Therapy
        • Clinical Relevance II: Epilepsy Surgery
        • Perspective: Brain Stimulation
      • Chapter 10. The Right Stimulation of the Right Circuits: Merging Understanding of Brain Stimulation Mechanisms and Systems Neuroscience for Effective Neuromodulation in Children
        • Introduction
        • Focal Stimulation to Known Circuits: Lessons From Deep Brain Stimulation for Parkinson’s Disease
        • Brain Stimulation in Pediatric Hemiparesis: Which Circuits?
        • Targeting Motor Cortex: Which Stimulation Modality?
        • Focal Stimulation Versus General Plasticity and Task-Specific Training
        • Challenges and Opportunities
      • Chapter 11. Therapeutic Brain Stimulation Trials in Children With Cerebral Palsy
        • Introduction
        • Scientific Evidence in Therapeutic Brain Stimulation in Children With CP: Summary of Current Interventional Trials
        • Trial Design
        • Conclusions
      • Chapter 12. Brain Stimulation in Children Born Preterm—Promises and Pitfalls
        • Introduction
        • The Motor Threshold
        • Short-Interval Intracortical Inhibition and Facilitation
        • Long-Interval Intracortical Inhibition and the Cortical Silent Period
        • Transcallosal Inhibition
        • Neuroplasticity Induced With Non-Invasive Brain Stimulation
        • Other Considerations
        • Where to Now?
      • Chapter 13. Brain Stimulation to Understand and Modulate the Autism Spectrum
        • Introduction
        • TMS Measures of ASD Pathophysiology
        • TMS as a Therapeutic Intervention in ASD
        • Conclusion
      • Chapter 14. Non-Invasive Brain Stimulation in Pediatric Epilepsy: Diagnostic and Therapeutic Uses
        • Introduction
        • Diagnostic Uses of TMS
        • Therapeutic Uses of TMS
        • Therapeutic Uses of Transcranial Direct-Current Stimulation
        • Conclusion
      • Chapter 15. Brain Stimulation in Pediatric Depression: Biological Mechanisms
        • Introduction
        • Preclinical
        • Neurophysiology
        • Neuroimaging
        • Peripheral Biomarkers
        • Neurocognition
        • Conclusion
      • Chapter 16. Brain Stimulation in Childhood Mental Health: Therapeutic Applications
        • Introduction
        • Applications
        • Discussion
        • Where Do We Stand and Where Do We Need to Go?
        • Conclusion
      • Chapter 17. Transcranial Magnetic Stimulation Neurophysiology of Pediatric Traumatic Brain Injury
        • Epidemiology and Clinical Spectrum of Traumatic Brain Injury
        • Outcome
        • Pathophysiology of Traumatic Brain Injury
        • Insights About TBI Using TMS: A Literature Review
        • Mild Traumatic Brain Injury
        • Severe Traumatic Brain Injury
        • Treatment Studies Using rTMS
        • TMS in Pediatric Mild Traumatic Brain Injury
        • Safety and Tolerability
        • Results
        • Summary
      • Chapter 18. Brain Stimulation Applications in Pediatric Headache and Pain Disorders
        • History of Neurostimulation in Headache and Pain
        • Pediatric Headache
        • Safety and Tolerability of Neurostimulation in Children
        • Pathophysiology of Head Pain and Migraine
        • Pediatric Data
        • Therapeutics
        • Future Avenues in Pediatric Brain Stimulation for Pain
    • Section III. Invasive Brain Stimulation in Children
      • Chapter 19. Deep Brain Stimulation in Children: Clinical Considerations
        • Historical Background
        • Primary Dystonias and DBS
        • Physiology of DBS Effect in Primary Dystonias
        • Efficacy of DBS on DYT-1-Positive and DYT-1-Negative Dystonias
        • Segmental Versus Generalized Dystonia and DBS
        • Effects of Switching DBS “Off”
        • DBS for Secondary Dystonias
        • DBS for Neurodegeneration With Brain Iron Accumulation (NBIA)
        • Primary and Secondary Dystonia Responses to DBS
        • Secondary Dystonias and Functional Imaging Before and After DBS
        • Patient Selection for DBS
        • Pooled Cohorts of DBS Data
        • Children With Dystonia and DBS
        • Technical Issues Influencing DBS Efficacy
      • Chapter 20. Deep Brain Stimulation Children – Surgical Considerations
        • Background
        • Technical Aspects of DBS
        • Clinical Indications
        • Treatment Efficacy
        • Physiology of Neuromodulation, Neuroplasticity, and Pediatric Considerations
        • Future Developments and Innovation
      • Chapter 21. Invasive Neuromodulation in Pediatric Epilepsy: VNS and Emerging Technologies
        • Introduction
        • Epilepsy in Children
        • Surgical Treatments for Epilepsy
        • Vagus Nerve Stimulation (VNS)
        • Trigeminal Nerve Stimulation
        • Intracranial Neurostimulation for Epilepsy
        • Conclusion
      • Chapter 22. Emerging Applications and Future Directions in Pediatric Neurostimulation
        • Transcranial MRI-Guided Focused Ultrasound
        • Robotics
        • Brain–Computer Interfaces (BCI)
        • Future Directions for Single- and Paired-Pulse TMS Studies
        • Brain Stimulation Biomarkers
        • Functional TMS
        • TMS for Biofeedback
        • Non-Invasive Low-Current Electrical Stimulation
        • Shifting Membrane Potentials With Transcranial Direct-Current Stimulation
        • Entraining or Disrupting Intrinsic Brain Oscillations With Transcranial Alternating-Current Stimulation
        • Conclusion
    • Index

Product details

  • No. of pages: 500
  • Language: English
  • Copyright: © Academic Press 2016
  • Published: May 4, 2016
  • Imprint: Academic Press
  • Hardcover ISBN: 9780128020012
  • eBook ISBN: 9780128020388

About the Editors

Adam Kirton

Adam Kirton
Dr. Kirton is an attending Pediatric Neurologist at the Alberta Children’s Hospital and Associate Professor of Pediatrics and Clinical Neurosciences at the University of Calgary. His research focuses on perinatal stroke with two major aims. One is to understand why such strokes occur and develop means to prevent them. The other uses advanced technologies including neuroimaging and non-invasive brain stimulation to measure the response of the developing brain to early injury and generate new therapies. Dr. Kirton is a Heart and Stroke Foundation Clinician Scientist and received CIHR Foundations funding in 2015. He founded and directs the Calgary Pediatric Stroke Program, Alberta Perinatal Stroke Project, and ACH Pediatric Non-Invasive Brain Stimulation Laboratory.

Affiliations and Expertise

Calgary Pediatric Stroke Program Pediatric Neurologist, Alberta Children’s Hospital, Calgary, AB, Canada

Donald Gilbert

Donald Gilbert
Donald L. Gilbert, MD, earned his Bachelor of Arts at Princeton University, where he majored in philosophy. He subsequently earned his MD at the University of Michigan and spent a year at the National Institutes of Health as a Howard Hughes Medical Institute Research Scholar. Dr. Gilbert trained in pediatrics and pediatric neurology at Johns Hopkins in Baltimore and is board certified in neurology with special competence in child neurology. Dr. Gilbert has an MS in clinical research design and statistical analysis from the University of Michigan.

At Cincinnati Children's, Dr. Gilbert directs the Movement Disorders and Tourette Syndrome Clinics, which specializes in evaluation and pharmacologic treatment of tics, tremor, chorea, ataxia, dystonia, stereotypies, drug-induced movement disorders, paroxysmal movement disorders, and functional movement disorders Dr. Gilbert directs or participates in a number of single and multi-center studies into causes and treatments of Tourette syndrome and pediatric movement disorders. Dr. Gilbert also studies physiological mechanisms of motor control in Tourette Syndrome and Attention Deficit Hyperactivity Disorder in childhood at the Transcranial Magnetic Stimulation Laboratory at Cincinnati Children's.

Affiliations and Expertise

Division of Pediatrics, Cincinnati Children's Hospital Medical Center; Department of Pediatrics, University of Cincinnati; Cincinnati, OH, United States

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