Neurostimulation E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 411

Veröffentlichungsjahr: 2013

Beschreibung

Could neurostimulation be a management option for your patients?

Neurostimulation techniques present real management options for patients with a range of neurologic and psychiatric disorders, such as movement disorders, pain, and depression. They should be actively considered when conventional medical approaches have failed or are inappropriate. But for many clinicians, these new methods pose many questions. What are the available modalities? How do they work? Which patients might benefit from them? How do I explain the processes to patients? How do I monitor my patient’s progress after implantation?

Neurostimulation: Principles and Practice provides a concise, easy-to-read fusion of the clinical applications of implanted neurostimulators. It demystifies selection and referral criteria, maximizing therapy, programming the implanted neuromodulators, monitoring progress, and troubleshooting problems associated with neurostimulation.

Neurostimulation: Principles and Practice covers the modalities available for your patients: 

• Deep brain stimulation
• Motor cortex stimulation
• Vagus nerve stimulation
• Spinal cord stimulation
• Peripheral nerve stimulation 

Written by an international cast of experts, Neurostimulation: Principles and Practice sets the stage for you to provide real clinical benefit to your patients who might receive, or are already using, neurostimulators.

Leseprobe

Table of Contents

Dedication

Title page

Copyright page

List of Contributors

Preface

Part 1: Deep Brain Stimulation

Chapter 1: Deep Brain Stimulation: Mechanisms of Action

Introduction

Importance of pathophysiological theories

The neuronal response to deep brain stimulation

Neural responses to deep brain stimulation

Higher order effects of deep brain stimulation

The hypothesis offered here

Chapter 2: Overview of Deep Brain Stimulation Components

Deep brain stimulation components

Chapter 3: Deep Brain Stimulation in Parkinson's Disease: Subthalamic Nucleus

Introduction

Rationale for neurostimulation of subthalamic nucleus

Referral criteria to select the ideal patient

Contraindications

Outcome

Stimulation parameters

Potential side effects and complications

Conclusions

Chapter 4: Deep Brain Stimulation in Parkinson's Disease: Pallidal (globus pallidus pars interna)

Introduction

Rationale of globus pallidus pars interna deep brain stimulation in Parkinson's disease

Patient selection and referral criteria

Targeting

Programming parameters

Complications of globus pallidus pars interna deep brain stimulation

Chapter 5: Deep Brain Stimulation of the Pedunculopontine Nucleus for Parkinson's Disease

Introduction and background

Characterization of the pedunculopontine nucleus

Rationale for targeting the pedunculopontine nucleus

Results from recent clinical studies of pedunculopontine nucleus stimulation

Limitations of current studies

Potential complications and adverse effects

Conclusions

Chapter 6: Deep Brain Stimulation in Tremor

Introduction

Patient selection

Rationale for targets

Device programming and patient assessment

Assessment and evidence

Complications

Conclusions

Chapter 7: Deep Brain Stimulation in Dystonia

Introduction

Target and rationale

Assessment scales

Referral criteria and patient selection

Surgical procedure

Programming parameters

Complications, side effects, monitoring, and troubleshooting

Conclusions

Chapter 8: Deep Brain Stimulation in Epilepsy

Introduction

Referral criteria

Rationale for deep brain stimulation in epilepsy

Assessment methods

Evidence level to date

Most common programming settings

Potential side effects and complications

Conclusions

Chapter 9: Deep Brain Stimulation in Obsessive Compulsive Disorders

Introduction

Rationale of deep brain stimulation in obsessive compulsive disorder

Deep brain stimulation targets in obsessive compulsive disorders

Patient selection and assessments

Evidence level to date

Most common programming settings

Potential side effects and complications

Conclusions

Chapter 10: Deep Brain Stimulation in Treatment of Refractory Major Depression

Introduction

Diagnostic criteria in major depression disorder

Deep brain stimulation

Surgical candidates

The rationale for deep brain stimulation in treatment of refractory major depression

Conclusions

Chapter 11: Deep Brain Stimulation in Pain Syndromes

Introduction

Referral criteria

Rationale of deep brain stimulation for pain

Assessment methods

Evidence of efficacy

Most common stimulator settings

Potential side effects and complications

Chapter 12: Deep Brain Stimulation in Cluster Headache

Introduction

Rationale of deep brain stimulation in chronic cluster headache

Referral criteria

Most common programming parameters

Evidence to date

Conclusions

Part 2: Vagus Nerve Stimulation

Chapter 13: Mechanism of Action and Overview of Vagus Nerve Stimulation Technology

Mechanism of action

Overview of vagus nerve stimulation indications

Vagal nerve stimulation components

Chapter 14: Vagus Nerve Stimulation in Epilepsy

Introduction

The rationale for vagus nerve stimulation in epilepsy

Patient selection and referral criteria

Evidence to date

Common programming parameters

Vagal nerve stimulation-related complications and side effects

Conclusions

Chapter 15: Vagal Nerve Stimulation in Treatment of Refractory Major Depression

Introduction

Referral criteria

Assessment scales

Rationale for vagal nerve stimulation in treatment of refractory major depression

Programming parameters

Monitoring, troubleshooting, complications, and side effects

Conclusion

Part 3: Motor Cortex Stimulation

Chapter 16: Mechanism of Action and Overview of Motor Cortex Stimulation Components

Mechanism of action

Motor cortex stimulation components

Chapter 17: Motor Cortex Stimulation in Refractory Pain

Introduction

Indications and referral criteria

Mechanisms of action

Surgical procedure

Evidence base and results of motor cortex stimulation for pain

Conclusions

Part 4: Spinal Cord Stimulation

Chapter 18: Mechanism of Action and Overview of Spinal Cord Stimulation Components

Mechanism of action

Spinal cord stimulation components

Chapter 19: Spinal Cord Stimulation in Failed Back Surgery Syndrome

Introduction

Rationale for spinal cord stimulation

Referral criteria for spinal cord stimulation

General principles

Contraindications for spinal cord stimulation

Evidence for use of spinal cord stimulation in patients with failed back surgery syndrome

Complications

Future developments

Conclusions

Chapter 20: Spinal Cord Stimulation in Complex Regional Pain Syndrome

Introduction

History and taxonomy

Diagnosis and classification

Criteria for referral to spinal cord stimulation

Rationale of spinal cord stimulation in complex regional pain syndrome

Assessment methods

Evidence for spinal cord stimulation in complex regional pain syndrome

Most common programming settings

Potential side effects and complications

Conclusions

Chapter 21: Spinal Cord Stimulation in Other Indications

Introduction

Motor control

Vasoactive applications of spinal cord stimulation

Genitourinary effects of spinal cord stimulation

Other areas of spinal cord stimulation application

Conclusions

Part 5: Peripheral Nerve Stimulation

Chapter 22: Peripheral Nerve Stimulation in Head and Face Pain

Introduction

Historical perspectives and rationale of peripheral nerve stimulation

Indications for peripheral nerve stimulation in the head and face

Patient selection criteria

Hardware for peripheral nerve stimulation in the craniofacial region

Complications of peripheral nerve stimulation and their avoidance

Common programming parameters

Outcomes and conclusions

Chapter 23: Peripheral Nerve Stimulation in Pain of the Body and Extremities

Introduction

Indications and patient selection

Device choice

Procedural details

Evidence base

Common programming parameters

Conclusions

Appendix I: Principles of Programming of Neurostimulators

Appendix II: Troubleshooting Malfunctioning Neurostimulators

Loss of response

Narrow therapeutic window

Skin erosions and infections

Index

We dedicate this book to:

All healthcare professionals who decided to be involved in the care of patients who underwent neurostimulation.

Our teachers and mentors in functional neurosurgery, who enabled, empowered, and taught us the skills to implant neurostimulators and to take care of patients with neurostimulators.

Our students and fellows who made the jump onto functional neurosurgery to continue the art of functional neurosurgery in years to come.

All our patients for entrusting us to help them over the years via neurostimulation.

Our families for their support over the years, providing us with the best start in life, and education, and for their support during this project.

Professor Sam Eljamel

Professor Konstantin V. Slavin

This edition first published 2013

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Library of Congress Cataloging-in-Publication Data

Neurostimulation : principles and practice / edited by Sam Eljamel and Konstantin V. Slavin.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-1-118-34635-8 (hardback : alk. paper) – ISBN 978-1-118-34636-5 (ePub) – ISBN 978-1-118-34637-2 (ePDF) – ISBN 978-1-118-34638-9 (eMobi) – ISBN 978-1-118-34639-6 (ebook online product)

I. Eljamel, Sam. II. Slavin, Konstantin V.

[DNLM: 1. Central Nervous System Diseases–therapy. 2. Electric Stimulation Therapy. 3. Peripheral Nervous System Diseases–therapy. 4. Vagus Nerve Diseases–therapy. WL 300] RM871

615.8’45–dc23

2013003017

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Cover images: © 2013 St. Jude Medical, Inc. (main) and courtesy of Dr Alexander Green (inset)

Cover design by Andy Meaden

List of Contributors

Editors

Sam Eljamel, MBBCh, MD, FRCS(Ed),(Ir),(SN)

Consultant Neurosurgeon, Centre for Neurosciences, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK

Konstantin V. Slavin, MD, FAANS

Head of Section of Stereotactic and Functional Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA

Contributors

Aviva Abosch, MD, PhD, FAANS

Neurosurgeon, Department of Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA

Sami Al-Nafi, MD

Fellow in Functional Neurosurgery, Department of Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA

Giovanni Broggi, MD

Neurosurgeon, Fondazione Instituto Neurologico “Carlo Besta”, Milan, Italy;

Department of Applied Neurosciences, Ludes University, Lugano, Switzerland

Patrick Carena, BSC

Deputy Head of Instrumentation, Medical Physics, Ninewells Hospital and Medical School, Dundee, UK

David Christmas, PhD

Consultant Psychiatrist, Advanced Interventions Service, Ninewells Hospital and Medical School, Dundee, UK

Roberto Cordella, MD

Department of Neurosurgery, Fondazione Instituto Neurologico “Carlo Besta”, Milan, Italy

Pravin Dandegaonkar, MBBS, MD, FRCA, FCARCSI

Fellow in Pain Medicine and Specialty Registrar, Ninewells Hospital and Medical school, Dundee, UK

Sam Eljamel, MBBCh, MD, FRCS(Ed),(Ir),(SN)

Consultant Neurosurgeon, Director of Functional Neurosurgery, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK

Angelo Franzini, MD

Department of Neurosurgery, Fondazione Instituto Neurologico “Carlo Besta”, Milan, Italy

Loes Gabriëls, PhD

Psychiatrist, KU Leuven, University Hospitals Leuven, Belgium

Gail Gillespie, MBChB, FRCA, FFPMRCA

Consultant in Anaesthesia and Pain Medicine, Regional Advisor in Pain Medicine for East of Scotland, Ninewells Hospital and Medical School, Dundee, UK

Eduardo Goellner, MD

Neurosurgeon, Hospital Mãe de Deus, Porto Alegre/RS, Brazil

Amit Goyal, MD

Fellow in Neurosurgery, University of Minnesota, Minneapolis, Minnesota, USA

Alexander Green, MD

Neurosurgeon, Department of Neurosurgery, John Radcliffe Hospital, Oxford, UK

Clement Hamani, MD

Neurosurgeon, Division of Neurosurgery, Toronto Western Hospital;

University Health Network and Behavioural Neurobiology Laboratory, Centre for Addiction and Mental Health, Toronto, Ontario, Canada

Yasuaki Harasaki, MD

Fellow, Department of Neurosurgery, University of Colorado, Denver, Colorado, USA

Paul E. Holtzheimer, III, MD

Psychiatrist, Departments of Psychiatry and Surgery, Geisel School of Medicine at Dartmouth, Dartmouth Hitchcock Medical Center, Lebanon, New Hampshire, USA

Christopher R. Honey, MD, DPhil, FRCS(C)

Neurosurgeon, Department of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada

Michael G. Kaplitt, MD, PhD, FAANS

Vice-Chairman for Research and Residency Director, Department of Neurological Surgery, Weill Cornell Medical College, New York, New York, USA

Antonios Mammis, MD

Resident, Department of Neurosurgery, University of Medicine and Dentistry of New Jersey, New Jersey Medical School, Newark, New Jersey, USA

Christine Matthews

Research Technician, Department of Psychiatry, University of Dundee, Dundee, UK

Keith Matthews, PhD

Psychiatrist, Division of Neuroscience (Psychiatry), Medical Research Institute, University of Dundee, Ninewells Hospital and Medical School, Dundee, UK

Giuseppe Messina, MD

Department of Neurosurgery, Fondazione Instituto Neurologico “Carlo Besta”, Milan, Italy

Erwin B. Montgomery Jr., MD

Neurologist, University of Alabama, Birmingham, Alabama, USA

Ian Morrison, PhD, MRCP (UK)

Consultant Neurologist, Ninewells Hospital and Medical school, Dundee, UK

Steven Ojemann, MD, FAANS

Neurosurgeon, Department of Neurosurgery, University of Colorado, Denver, Colorado, USA

Manish Ranjan, MBBS, MCh

Fellow, Department of Neurosurgery, University of British Columbia, Vancouver, British Columbia, Canada

Serge Y. Rasskazoff, MD, FRCS(C)

Neurosurgeon, Flint, Michigan, USA

Michael Schulder, MD, FAANS

Professor and Vice Chairman, Department of Neurosurgery, Hofstra North Shore—LIJ School of Medicine, New York, New York, USA

Konstantin V. Slavin, MD, FAANS

Head of Section of Stereotactic and Functional Neurosurgery, University of Illinois at Chicago, Chicago, Illinois, USA

Serenella Tolomeo

Postgraduate Student, Department of Psychiatry, University of Dundee, Dundee, UK

Catherine Young, RCN

Specialist Movement Disorders Nurse, Ninewells Hospital and Medical School, Dundee, UK

Ludvic Zrinzo, MD, PhD, FRCSEd(NS)

Neurosurgeon, Sobell Department of Motor Neuroscience & Movement Disorders, UCL Institute of Neurology, University College London;

Victor Horsley Department of Neurosurgery, National Hospital for Neurology and Neurosurgery, London, UK

Preface

Neurostimulation: Principles and Practice is intended to give a concise but comprehensive picture of the methods and devices which are now of use in neurostimulation to ameliorate the symptoms of Parkinson's disease (PD), tremor, dystonia, refractory epilepsy, chronic pain, depression and obsessive compulsive disorders. It should appeal to anyone training or working in the healthcare arena – whatever their particular discipline – who wants either a concise introduction to the subject, or a gentle reminder of stuff they might have forgotten. We have aimed the book at:

Movement disorder neurologists, movement disorder specialist nurses, epileptologists, epilepsy specialist nurses, and residents in neurology.Pain specialists, pain specialist nurses and residents in pain management.Physicians of all grades who care for patients with PD, tremor, dystonia, chronic pain, or any patients who had a neurostimulator implanted.Psychiatrists and psychiatric specialist nurses with an interest in treatment refractory depression and OCD, and residents in psychiatry.Neurosurgeons interested in neurostimulation and neurosurgical residents.Any healthcare professional interested to learn more about neurostimulation.

This book is divided into sections on deep brain, motor cortex, vagus nerve, spinal cord, and peripheral nerve stimulation. Each section covers approved and emerging applications with chapters on each diagnosis and target to make it easier for healthcare professionals to navigate the text quickly to the desired information.

Neurostimulation: Principles and Practice is a systematic approach to understanding the mechanism of action, rationale, indications, patients’ selection, targets, and programming of neurostimulators using common sense and the art of applying scientific knowledge to practice. No attempt is made to give detailed descriptions of surgical methods used to implant neurostimulators; these surgical methods have been adequately described in stereotactic books written specifically to neurosurgeons specializing in functional neurosurgery.

Contributors to this book were selected from around the globe because of their expertise and knowledge of each subject.

Professor Sam Eljamel

Centre for Neurosciences

Department of Neurosurgery

Ninewells Hospital & Medical School

Dundee, Scotland DD1 9SY, UK

Professor Konstantin V. Slavin

Department of Neurosurgery

University of Illinois at Chicago

912 S. Wood Street, M/C 799

Chicago, IL 60612, USA

Part 1

Deep Brain Stimulation

Chapter 1

Deep Brain Stimulation: Mechanisms of Action

Erwin B. Montgomery Jr.

University of Alabama, Birmingham, Alabama, USA

Introduction

Deep brain stimulation (DBS) is arguably the most effective treatment for movement disorders, such as Parkinson's disease (PD) and dystonia. DBS succeeds where all manner of pharmacological and biological therapies, such as neurotransplant, fail. Further, the range of disorders amenable to DBS is expanding rapidly, for example depression and epilepsy. At first, this may seem surprising, but that one would be surprised suggests a lack of appreciation that the brain is basically an electrochemical organ. The brain processes and transmits information electrically and, consequently, it should not be surprising that the brain's functions can be affected electrically. For example, while neurotransmitters, independently or affected by neuromodulators, result in changes in the electrical status in the post-synaptic neurons. The varying electrical changes induced by neurotransmitters are electrically integrated (processed) to produce new “information” that is subsequently encoded in the electric signal in the form of the axon potential train exiting the post-synaptic neuron. Further, changes in the neurotransmitter-induced post-synaptic electrical status produce further changes entirely independent of the neurotransmitter, such as post-excitatory depression of excitability due to deactivation of sodium (Na) conductance changes or post-inhibitory increases in excitability due to activation of Na conductance channels among other voltage-sensitive conductance changes. Thus, for example, inhibition of the ventrolateral (VL) thalamus by activity in the globus pallidus interna (GPi), for many neurons results in a net increased VL neuronal activity contrary to what would be expected based on the neurotransmitter released by GPi neurons onto VL neurons, that being gamma amino butyric acid (GABA) [1].