Deep Brain Stimulation Indications and Applications

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.

INTRODUCTION TO DEEP BRAIN STIMULATIONOverview of the History and Application of Deep Brain StimulationKendall H. Lee, Penelope S. Duffy, and Charles D. BlahaBiophysical Fundamentals of Neural ExcitationSusanne Loffler and J. Luis LujánMotor Circuit Activity in Parkinson’s DiseaseAllan J. BieberNeuroimaging in Deep Brain StimulationHoon-Ki Min, Erika Ross, and Megan SettellEthical Considerations in the Use of Deep Brain StimulationAlexander Fiksdal, Osama A. Abulseoud, and Richard R. SharpCLINICAL APPLICATIONSDeep Brain Stimulation for Parkinson’s DiseaseBryan T. KlassenDeep Brain Stimulation for TremorAndrea C. AdamsDeep Brain Stimulation for DystoniaNicholas D. Child and Bryan T. KlassenDeep Brain Stimulation for Obsessive-Compulsive DisorderPrakriti Gaba and Charles D. BlahaDeep Brain Stimulation for Touret te’s SyndromeHoon-Ki Min, Megan Settell, and Paola TestiniDeep Brain Stimulation for Treatment-Resistant DepressionYesul Kim, Katheryn M. Wininger, and Susannah J. TyeDeep Brain Stimulation for Chronic PainGrant W. Mallory and Prakriti GabaDeep Brain Stimulation for Medically Refractory EpilepsyWilliam S. J. Gibson and Penelope S. DuffyDeep Brain Stimulation for Memory DysfunctionErika K. Ross, Kevin F. Bieniek, and Hoon-Ki MinDeep Brain Stimulation for Cluster HeadacheCong Zhi ZhaoFunctional Electrical Stimulation for the Treatment of Spinal Cord InjuryPeter J. Grahn, Aldo A. Mendez Ruiz, Jan T. Hachmann, and J. Luis LujánRESEARCH ON MECHANISMS OF DBS AND NEUROMODULATIONTheories of Deep Brain Stimulation MechanismsCharles D. BlahaThe Role of Astrocytes in Deep Brain StimulationSu-Youne Chang and Kendall H. LeeElectrochemical Measurement of Neurochemical ConcentrationsKevin E. Bennet, Charles D. Blaha, and Kendall H. LeeElectrodes for Neural Stimulation and MonitoringJonathan R. Tomshine and Kevin E. BennetClosed-Loop Control Systems for Deep Brain Stimulation TherapyJames K. Trevathan and J. Luis LujanMolecular and Cellular Neuromodulation for Central Nervous System Injury and RegenerationLucas P. Carlstrom

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.