Sinopsis

Deep brain stimulation (DBS) is a widely used therapy for movement disorders such as Parkinson's disease, essential tremor, and dystonia. Its therapeutic success has led to the application of DBS for an increasing spectrum of conditions. However, the fundamental relationships between neural activation, neurochemical transmission, and clinical outcomes during DBS are not well understood.

Drawing on the clinical and research expertise of the Mayo Clinic Neural Engineering Laboratories, this book addresses the history of therapeutic electrical stimulation of the brain, its current application and outcomes, and theories about its underlying mechanisms. It reviews research on measures of local stimulation–evoked neurochemical release, imaging research on stimulation-induced neural circuitry activation, and the state of the art on closed-loop feedback devices for stimulation delivery.

Features

Introduces DBS as a therapeutic application and a research tool
Is basic enough for those new to the field and complete enough for those with clinical or research interests in DBS
Introduces the history and biophysical fundamentals of neural stimulation
Summarizes ethical considerations for DBS and its application and outcomes in 11 different disorders
Reviews current theories of DBS therapeutic action, as well as the cellular and molecular mechanisms of neuromodulation and recent research on novel devices for stimulation delivery and measurement of brain activity

Contents

INTRODUCTION TO DEEP BRAIN STIMULATION

Overview of the History and Application of Deep Brain Stimulation
Kendall H. Lee, Penelope S. Duffy, and Charles D. Blaha

Biophysical Fundamentals of Neural Excitation
Susanne Loffler and J. Luis Luján

Motor Circuit Activity in Parkinson’s Disease
Allan J. Bieber

Neuroimaging in Deep Brain Stimulation
Hoon-Ki Min, Erika Ross, and Megan Settell

Ethical Considerations in the Use of Deep Brain Stimulation
Alexander Fiksdal, Osama A. Abulseoud, and Richard R. Sharp

CLINICAL APPLICATIONS

Deep Brain Stimulation for Parkinson’s Disease
Bryan T. Klassen

Deep Brain Stimulation for Tremor
Andrea C. Adams

Deep Brain Stimulation for Dystonia
Nicholas D. Child and Bryan T. Klassen

Deep Brain Stimulation for Obsessive-Compulsive Disorder
Prakriti Gaba and Charles D. Blaha

Deep Brain Stimulation for Touret te’s Syndrome
Hoon-Ki Min, Megan Settell, and Paola Testini

Deep Brain Stimulation for Treatment-Resistant Depression
Yesul Kim, Katheryn M. Wininger, and Susannah J. Tye

Deep Brain Stimulation for Chronic Pain
Grant W. Mallory and Prakriti Gaba

Deep Brain Stimulation for Medically Refractory Epilepsy
William S. J. Gibson and Penelope S. Duffy

Deep Brain Stimulation for Memory Dysfunction
Erika K. Ross, Kevin F. Bieniek, and Hoon-Ki Min

Deep Brain Stimulation for Cluster Headache
Cong Zhi Zhao

Functional Electrical Stimulation for the Treatment of Spinal Cord Injury
Peter J. Grahn, Aldo A. Mendez Ruiz, Jan T. Hachmann, and J. Luis Luján

RESEARCH ON MECHANISMS OF DBS AND NEUROMODULATION

Theories of Deep Brain Stimulation Mechanisms
Charles D. Blaha

The Role of Astrocytes in Deep Brain Stimulation
Su-Youne Chang and Kendall H. Lee

Electrochemical Measurement of Neurochemical Concentrations
Kevin E. Bennet, Charles D. Blaha, and Kendall H. Lee

Electrodes for Neural Stimulation and Monitoring
Jonathan R. Tomshine and Kevin E. Bennet

Closed-Loop Control Systems for Deep Brain Stimulation Therapy
James K. Trevathan and J. Luis Lujan

Molecular and Cellular Neuromodulation for Central Nervous System Injury and Regeneration
Lucas P. Carlstrom
Editor(s) Bio

Kendall H. Lee is a stereotactic and functional neurosurgeon at Mayo Clinic with internationally recognized expertise in deep brain stimulation. His MD and PhD are from Yale University. He is a professor in the Departments of Neurosurgery, Physiology & Biomedical Engineering, and Physical Medicine and Rehabilitation. He is director of the Neural Engineering Laboratories, focused on understanding the mechanisms of action of DBS and developing novel devices for neuromodulation.

Penelope S. Duffy is an associate director of the Neural Engineering Laboratories at Mayo Clinic with a PhD from the University of Minnesota. Dr. Duffy had a 27-year research and clinical career in neurologically based communication disorders and is the author of a graduate textbook on right hemisphere cognitive impairments. She has scientific papers in that area and in deep brain stimulation, and two books in the trade press.

Allan J. Bieber is an associate professor of Neurologic Surgery, associate director of the Neural Engineering Laboratories and of the Neurobiology of Disease Graduate Program in the Mayo Clinic College of Medicine. His PhD is in cellular and developmental biology from Harvard Medical School.

Reviews

"Kendall Lee and colleagues have curated an approachable and comprehensive overview of deep brain stimulation (DBS), with topics ranging from the biophysics of neural stimulation to applications of DBS for both established and emerging clinical indications, including memory dysfunction. Also notable are discussions of active research, such as closed loop stimulation and in vivo neurochemical monitoring. This text provides an invaluable companion for clinicians, neuroscientists, engineers, and others with an interest in the current practice and frontiers of DBS."
—Dr. Emad Eskandar, Massachusetts General Hospital, Harvard Medical School, USA

"The field of therapeutic deep brain stimulation is undergoing explosive growth, fueled by its early success in movement disorders and promise for many other common and debilitating brain disorders. Yet the mechanisms underlying its effects remain mysterious. This book covers diverse topics of relevance for current practitioners as well as newcomers to the field, including theoretical and mechanistic aspects, results of important clinical trials, and potential new brain targets and new indications."
—Dr. Philip A. Starr, University of California, San Francisco, USA

"This book is an important reference to the field of stereotactic and functional neurosurgery and covers the most important aspects of clinical practice and research in deep brain stimulation. It will be of great interest to those who are new to this field as well as experienced clinicians and investigators. Among many important topics, the book covers biophysical fundamentals of electrical stimulation, anatomy and physiology of neural networks relevant to movement disorders, chronic pain and behavioral disorders, ethical considerations, current indications of deep brain stimulation, and many areas of active clinical investigation."
—Dr. André Machado, Cleveland Clinic, USA

"This book provides a comprehensive, up-to-date description of deep brain stimulation, including its history, scientific basis, and clinical application across a vast array of neurological disorders. Although the authors are primarily from a single institution, they have done a terrific job of summarizing the state of the art, including the victories, the disappointments, and the opportunities where breakthroughs are likely next to occur. This book has tremendous value for the novice and experienced practitioner alike."
—Dr. Jonathan Miller, University Hospitals, USA