Deep brain stimulation programming : principles and practice

著者

書誌事項

Deep brain stimulation programming : principles and practice

Erwin B. Montgomery Jr

Oxford University Press, 2010

大学図書館所蔵 件 / 全1件

この図書・雑誌をさがす

注記

Includes bibliographical references and index

内容説明・目次

内容説明

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.

目次

Abbreviations Chapter 1. Introduction Principles of Effective and Efficient Programming Proximate Effects and Distal Interventions: What the Brain Sees versus What You See The Basis of DBS Effects Commentary 1.1, The Case for Deep Brain Stimulation Commentary 1.2, The Future of Deep Brain Stimulation Chapter 2. Principles of DBS Electronics Chapter 3. Principles of Electrophysiology Therapeutic Mechanisms Versus Delivery of Therapy Commentary 3.1, Sorting out DBS and Pharmacotherapy Commentary 3.2, Antidromic Activation as a Mechanism of DBS Action Controlling the Flow of Electrical Charges Current Intensity in Monopolar and Bipolar Electrode Configurations Commentary 3.3, The DBS System Chapter 4. DBS Safety The Potential Psychosocial Consequences of DBS Chapter 5. The Issue of DBS Frequency Commentary 5.1, Emergence of Therapeutic Low-Frequency DBS Chapter 6. Approaches to Programming Optimizing Battery Life The Special Case of the U-Shaped Response Commentary 6.1. The Paradox of Worsening Function with Increasing Strength of DBS: The U-shaped Response Optimizing Therapeutic Effects and Minimizing Side Effects An Algorithm for Selecting Electrode Configurations Chapter 7. Approach to Subthalamic Nucleus DBS for Parkinson's Disease Regional Anatomy of the Subthalamic Nucleus Side Effects Created by the Position of the DBS Lead Relative to the Subthalamic Nucleus Approach to Subthalamic Nucleus DBS for Parkinson's Disease Chapter 8. Approach to Globus Pallidus Internal Regional anatomy of the Globus Pallidus Internal Segment Side Effects Resulting from the Position of the DBS Lead Relative to the Globus Pallidus Interna Approaches to Globus Pallidus Interna DBS for Parkinson's Disease Treating Dystonia with DBS of the Globus Pallidus Interna Treating Hyperkinetic Disorders. Chapter 9. Approach to Thalamic DBS Regional Anatomy of the Ventral Intermediate Thalamus Side Effects Resulting from the Position of the DBS Lead Relative to the Ventral Intermediate Thalamus Effects of DBS on Speech and Swallowing An Approach to Thalamic DBS for Tremor Chapter 10. Helpful Programming Hints Conduct a Monopolar Survey Always Increase the Voltage to Clarify Any Side Effects Check Therapeutic Impedances on Commercial IPGs Confirm that the Parameters under Patient Control are within Safe Limits Systematically Document all Clinical Responses to all DBS Stimulation Parameters and Electrode Configurations Always Reset Counters and Trouble-Shoot Inconsistent Responses Advise Patents to Take Their DBS Devices with Them to Emergency Rooms or Doctor's Visits Be Patient and Persistent! When in Doubt, Turn the Pulse Generator Off and Wait Trouble Shooting Chapter 11. The Basic Unit of Information in the Brain Commentary 11.1, The Curious Case When Inhibition is not Inhibition Chapter 12. What DBS Tells Us about Physiology and Pathophysiology Chapter 13. Variability in the Latency of Responses to DBS Chapter 14. Oscillator Basics Chapter 15. Paradoxes in DBS Appendix 1. Index to Side DBS Effects, by Side Effect and Site of Stimulation Appendix 2. Aids to Programming: Paper Documentation Parkinson's Disease Cerebellar Outflow Tremor or Essential Tremor Dystonia Dyskinesia Tourette's Syndrome Appendix 3. Aid to Programming: Algorithm and Check List for Electrode Configurations References Glossary Index

「Nielsen BookData」 より

詳細情報

ページトップへ