Jr Montgomery

Deep Brain Stimulation Programming (eBook, PDF)

Mechanisms, Principles and Practice

• Format: PDF

Produktbeschreibung

Deep brain stimulation programming (DBS) continues to grow as an effective therapy for a wide range of neurological and psychiatric disorders, helping patients reach optimal control of their disorder. With the technique finding so much success, the next question is how to make the complexities of post-operative programming cost-effective, especially when traditional medications and treatments can no longer do the job. The second edition of Deep Brain Stimulation Programming is fully revised and up-to-date with the latest technologies and focuses on post-operative programing, which no other text does. This book provides programmers with a foundation of the brain as an electrical device, focusing on the mechanisms by which neurons respond to electrical stimulation, how to control the stimulation and the regional anatomy, and the many variations that influence a patient's response to DBS. Dr. Montgomery explores new techniques of programming; including those based on stimulation frequency, closed-loop DBS, and the roles of oscillators in DBS; and new technological advances that make pre-existing theories of pathophysiology obsolete. Key Features of the Second Edition Include ? Highlights post-operative deep brain stimulation; ? Includes the most recent discoveries in deep brain stimulation programming; ? Highly illustrated with figures for absorption of key programming and techniques; ? Provides an appendix of additional resources available through the Greenville Neuromodulation Center.

---

Dieser Download kann aus rechtlichen Gründen nur mit Rechnungsadresse in A, B, BG, CY, CZ, D, DK, EW, E, FIN, F, GR, HR, H, IRL, I, LT, L, LR, M, NL, PL, P, R, S, SLO, SK ausgeliefert werden.

Produktdetails

• Verlag: Oxford University Press
• Seitenzahl: 208
• Erscheinungstermin: 7. Oktober 2016
• Englisch
• ISBN-13: 9780190259617
• Artikelnr.: 48793451

Autorenporträt

Dr. Montgomery is a Movement Disorders Neurologist with a special interest in Parkinson's disease. He has conducted research in motor neurophysiology, particularly the role of the basal ganglia-thalamic-cortical system and the pathophysiology of Parkinson's disease for over 40 years. For the last 20 years, he has focused on deep brain stimulation in its clinical use and its underlying physiological mechanisms.

Inhaltsangabe

* Table of Contents
* Preface to the Second Edition
* Preface to the First Edition
* Abbreviations
* Chapter 1. Introduction
* The Fundamentals Still Pertain
* Principles of Effective and Efficient Programming
* The Basis of DBS Effects
* Chapter 2. Principles of DBS Electronics
* Electricity
* Electronics
* Note Regarding Impedances
* Chapter 3. Principles of Electrophysiology
* Therapeutic Mechanisms versus Delivery of Therapy
* The Neuron
* Neuronal Electronics
* Voltage Gated Ionic Conductance Channels and Action Potentials
* Downstream Secondary Issues
* Chapter 4. Controlling the Flow of Electrical Charges
* Orientation of the Lines of Electrical Force
* Orthodromic and Antidromic Conduction of Action Potentials
* Axon Diameter
* Electrode Configurations
* Current Intensity in Monopolar and Bipolar Electrode Configurations
* Segmented DBS Leads
* Chapter 5. DBS Safety
* The Range of Safety Concerns
* Injury Secondary to Electricity
* Medical Complications
* Adverse Effects Related to Activation of Neural Networks
* The Potential Psychosocial Consequences of DBS
* Chapter 6. Nervous System Responses to DBS
* Knowledge of Nervous System Responses versus Knowledge of Therapeutic
Mechanisms
* Effects Mediated by Voltage-Gated Ionic Conductance Channels in the
Neuronal Membrane
* Post-Hyperpolarization Rebound Excitation, Depolarization Blockade,
and Neurotransmitter Exhaustion
* Dissociation of Effects on Action Potential Initiating Segment,
Dendrites, and Cell Bodies
* Network Effects of DBS
* Critically Important Caveats Concerning Interpretation of Nervous
System Responses to DBS
* Reentry Propagations and Resonance
* Synchronization Among Neurons
* Interactions Between DBS Pulse in Intrinsic Neuronal Mechanisms
* Effects on Behaviorally Related Intrinsic Neuronal Dynamic
* Temporal Evolution of Nervous System Responses
* Chapter 7. DBS Effects on Motor Control
* Orchestration of Motor Unit Activities
* Orchestration of Motor Unit Recruitment and De-Recruitment over
Different Time Scales
* Lessons to be Learned
* Chapter 8. Pathophysiological Mechanisms
* The Globus Pallidus Interna Rate Theory
* Excessively High Beta Oscillations
* Excessive Synchronization of Neuronal Activities
* Excessive Bursting
* The Systems Oscillators Theory
* Chapter 9. Approaches to Programming
* Battery Life
* DBS Contact Nomenclature
* Prior to DBS Programming
* When to Program DBS
* Conceptual Approaches
* The Growing Importance of Monopolar Surveys
* Detection of a Response is Critical
* Programming for Optimal Benefit in the Absence of Adverse Effects
* Programming to Prevent Adverse Effects
* Exiting the DBS Programming Session
* Chapter 10. Clinical Assessments
* Clinical Assessments by Disease
* Clinical Assessment of Corticospinal and Corticobulbar Stimulation
* Clinical Assessment of Speech, Language and Swallowing
* Hints to Clinical Evaluations
* Chapter 11. Approach to Subthalamic Nucleus
* Regional Anatomy of the Subthalamic Nucleus
* Adverse Effects Created by the Position of the DBS Lead Relative to
the STN
* Approach to STN DBS for Parkinson's Disease
* Chapter 12. Approach to Globus Pallidus Internal
* Regional Anatomy of the Globus Pallidus Internal (GPi) Segment
* Adverse Effects Resulting from the Position of the DBS Lead Relative
to the GPi
* Approaches to GPi DBS for Parkinson's Disease
* Treating Dystonia with DBS of the Globus Pallidus Interna
* Treating Hyperkinetic Disorders
* Chapter 13. Approach to Thalamic DBS
* Regional Anatomy of the Ventral Intermediate Thalamus
* Adverse Effects Resulting from the Position of the DBS Lead Relative
to the Ventral
* Effects of DBS on Speech and Swallowing
* An Approach to Thalamic DBS for Tremor
* Chapter 14. Algorithm for Selecting Electrode Configurations and
* Stimulation Parameters
* Chapter 15. Helpful Programming Hints
* Use of Constant-Voltage DBS (to be discouraged)
* 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, Family Members and Caregivers to Take Their DBS
Controlling 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 16. Oscillator Basics
* Chapter 17. Discrete Neural Oscillators
* Importance of Neural Oscillators in Nervous System Function
* Continuous harmonic oscillators
* Discrete Oscillators
* Single Reentrant Discrete Oscillator
* Interactions Among Discrete Oscillators
* Discrete Neural Oscillators
* Oscillators with multiple realistic neurons
* The Systems (Discrete) Oscillators Theory
* Appendix of Supplemental Material
* Glossary
* References