Deep Brain Stimulation in Neurological and Psychiatric Disorders (Current Clinical Neurology)

597 Pages·2008·18.57 MB·English

by  Daniel Tarsy

Deep Brain Stimulation in Neurological
and Psychiatric Disorders
Current Clinical Neurology
Daniel Tarsy, md, Series Editor
Deep Brain Stimulation in Neurological and Psychiatric Disorders, edited by Daniel Tarsy, Jerrold L. Vitek,
Philip A. Starr, and Michael S. Okun, 2008
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Deep Brain Stimulation
in Neurological and
Psychiatric Disorders
Edited by
Daniel Tarsy, MD
Parkinson’s Disease and Movement Disorders Center,
Department of Neurology,
Beth Israel Deaconess Medical Center,
Harvard Medical School,
Boston, MA
Jerrold L. Vitek, MD, PhD
Neuromodulation Research Center,
Lerner Research Institute,
The Cleveland Clinic Foundation,
Cleveland, OH
Philip A. Starr, MD, PhD
Department of Neurosurgery,
University of California,
San Francisco, CA
Michael S. Okun, MD
Departments of Neurology and Neurosurgery,
McKnight Brain Institute,
University of Florida,
Gainesville, FL
Editors
Daniel Tarsy Jerrold L. Vitek
Beth Israel Deaconess Medical Center The Cleveland Clinic Foundation
Harvard Medical School Cleveland, OH
Boston, MA
Philip A. Starr Michael S. Okun
University of California University of Florida
San Francisco, CA Gainesville, FL
Series Editor
Daniel Tarsy
ISBN: 978-1-58829-952-9 e-ISBN: 978-1-59745-360-8
DOI: 10.1008/978-1-59745-360-8
Library of Congress Control Number: 2007941161
© 2008 Humana Press, a part of Springer Science+Business Media, LLC
All rights reserved. This work may not be translated or copied in whole or in part without the written
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USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connec-
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While the advice and information in this book are believed to be true and accurate at the date
of g oing to press, neither the authors nor the editors nor the publisher can accept any legal
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express or implied, with respect to the material contained herein.
Cover illustration: Photo courtesy of Jeffrey T. Joseph, MD, PhD, Division of Neuropathology,
Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA.
Printed on acid-free paper
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Preface
Chronic deep brain stimulation (DBS) has been a rapidly evolving area of
neurotherapeutics since its initial introduction for the treatment of Parkinson’s
disease and essential tremor in the 1990s. For these conditions, DBS is now
considered accepted therapy for patients failing to adequately respond to med-
ical treatment. Since the 1990s, new clinical indications, anatomic targets, and
technologies have contributed to an expanding role for DBS in the treatment
of other movement disorders such as dystonia and Tourette syndrome as well
as for other neurologic disorders such as epilepsy and cluster headache. Early
experience has also been reported for psychiatric syndromes, such as obses-
sive–compulsive disorder and depression. Experience with DBS in psychiatric
disorders is very limited but is reviewed in this volume as neuropsychiatric
indications are expected to grow in coming years.
Because of the rapidly increasing application of DBS for neurologic and
psychiatric indications and the recruitment of increasing numbers of neuro-
logic, neurosurgical, and psychiatric clinicians to the field, it is appropriate to
provide a resource that updates the underlying scientific background, describes
methodologies and standards of treatment, and provides information on new
technologies essential for clinical success and to advance the field. Deep Brain
Stimulation in Neurological and Psychiatric Disorders begins with reviews
of the functional anatomy and physiology of motor and nonmotor aspects
of the basal ganglia and their connections, which underlie the application of
DBS to neurological and psychiatric disorders. This is followed by proposed
mechanisms of action of DBS based on functional neuroimaging, molecular,
modeling, and neurophysiologic studies in animals and man. Discussions of
patient selection, preoperative assessment, operative complications, and brain
targeting are followed by chapters concerning microelectrode mapping as well
as new and emerging brain imaging alternatives for target localization inside
the operating room.
DBS for movement disorders, which remains the most common indication,
is reviewed in chapters on essential and other tremors, Parkinson’s disease,
atypical parkinsonism, dystonia, and Tourette syndrome. Postoperative man-
agement and treatment outcomes are reviewed in a series of chapters which
address immediate and delayed complications, a particularly important chapter
on programming. We have also included a discussion of DBS safety with
v
vi Preface
regard to MRI and other electronic devices, neuropsychological sequelae, and
quality of life. Finally, interesting new areas of DBS applications are addressed
by experts with experience in epilepsy, obsessive–compulsive disorder,
depression, and cluster headache.
We have gathered a group of experienced and recognized authors to review
the current state of DBS in neurologic and psychiatric disorders. We thank
them for providing a conservative and level-headed approach to the use of
DBS with emphasis on objective assessment of clinical outcomes, particularly
in the new and emerging applications. We greatly appreciate the efforts of
Richard Lansing and Michele Seugling at Humana Press, who have helped to
make this work a reality. We also wish to thank our understanding families,
without whose love and support this book would not have been possible.
Finally, we dedicate this book to our patients and their families, whose continued
courage and cooperation in the face of great personal adversity have allowed
this work to progress toward providing some measure of relief for their
difficult conditions.
Daniel Tarsy, MD
Jerrold L. Vitek, MD, PhD
Philip A. Starr, MD, PhD
Michael S. Okun, MD
Contents
Preface ...................................................................................................... v
Contributors ............................................................................................. xi
List of Color Plates .................................................................................. xv
Part I. Overview of Deep Brain Stimulation
1. Functional Anatomy and Physiology of the Basal Ganglia:
Motor Functions .............................................................................. 3
Yoland Smith and Thomas Wichmann
2. Functional Anatomy and Physiology of the Basal Ganglia:
Non-motor Functions ........................................................................ 33
Suzanne N. Haber
3. History of the Therapeutic Use of Electricity on the Brain
and the Development of Deep Brain Stimulation ............................. 63
Matthew A. Butler, Joshua M. Rosenow, and Michael S. Okun
4. Deep Brain Stimulation: Patient Selection in Parkinson’s Disease,
Other Movement Disorders, and Neuropsychiatric Disorders. ........ 83
Mustafa Saad Siddiqui, Thomas Ellis, Stephen S. Tatter,
Kelly D. Foote, and Michael S. Okun
5. Technical Alternatives in Performing Deep Brain
Stimulator Implantation .................................................................... 99
Paul S. Larson
6. Intra-operative Microrecording and Stimulation .............................. 111
Frank Steigerwald and Jens Volkmann
7. Complication Avoidance and Management
in Deep Brain Stimulation Surgery ................................................... 135
Philip A. Starr and Karl Sillay
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viii Contents
8. Mechanisms of Deep Brain Stimulation ......................................... 151
Svjetlana Miocinovic, Cameron C. McIntyre,
Marc Savasta, and Jerrold L. Vitek
9. Functional Imaging of Deep Brain Stimulation:
fMRI, SPECT, and PET ................................................................... 179
Robert Jech
Part II. Deep Brain Stimulation in Movement Disorders
10. Thalamic Deep Brain Stimulation and Essential Tremor .............. 205
Kelly E. Lyons and Rajesh Pahwa
11. Thalamic Deep Brain Stimulation for Other Tremors .................... 215
Erwin B. Montgomery, Jr.
12. Thalamic Deep Brain Stimulation for Parkinson’s
Disease Tremor .............................................................................. 229
Daniel Tarsy, Efstathios Papavassiliou, Kelly E. Lyons,
and Rajesh Pahwa
13. Globus Pallidus Deep Brain Stimulation
for Parkinson’s Disease ................................................................... 243
Frances Weaver, Kenneth Follett, and Matthew Stern
14. Deep Brain Stimulation of the Subthalamic Nucleus
for the Treatment of Parkinson’s Disease ...................................... 253
Marcelo Merello
15. Deep Brain Stimulation of the Globus Pallidus
Pars Interna and Subthalamic Nucleus in Parkinson’s
Disease: Pros and Cons ................................................................. 277
Jorge Guridi, Maria C. Rodriguez-Oroz, and Jose A. Obeso
16. Deep Brain Stimulation in Atypical Parkinsonism ......................... 291
Ludy Shih and Daniel Tarsy
17. Deep Brain Stimulation in Dystonia ............................................... 305
Marie Vidailhet, David Grabli, and Emmanuel Roze
18. Deep Brain Stimulation in Tourette’s Syndrome ............................ 321
Linda Ackermans, Yasin Temel, and Veerle Visser-Vandewalle
19. The Role of Deep Brain Stimulation (DBS)
in the Treatment of Postural Instability and Gait
Disorders of Parkinson’s Disease .................................................... 333
Helen Bronte-Stewart
Contents ix
Part III. Postoperative Management in Patients Undergoing
Deep Brain Stimulation
20. Deep Brain Stimulation Programming
for Movement Disorders ................................................................. 361
Ioannis U. Isaias and Michele Tagliati
21. Neuropsychological Issues in Deep Brain Stimulation
of Neurological and Psychiatric Disorders ..................................... 399
Alexander I. Tröster, April B. McTaggart,
and Ines A. Heber
22. Deep Brain Stimulation Safety: MRI and Other
Electromagnetic Interactions .......................................................... 453
Kenneth B. Baker and Michael D. Phillips
23. Deep Brain Stimulation Fault Testing ............................................ 473
Jay L. Shils, Ron L. Alterman, and Jeffrey E. Arle
24. Quality of Life and Cost Effectiveness of Deep Brain
Stimulation in Movement Disorders .............................................. 495
Alan Diamond and Joseph Jankovic
Part IV. Deep Brain Stimulation in Other Indications
25. Deep Brain Stimulation in Depression:
Background, Progress, and Key Issues ........................................... 511
Benjamin D. Greenberg
26. Deep Brain Stimulation in Obsessive–Compulsive Disorder ......... 531
Loes Gabriëls, Kris van Kuyck, Marleen Welkenhuyzen,
Paul Cosyns, and Bart Nuttin
27. Deep Brain Stimulation for Medically Intractable
Cluster Headache ........................................................................... 547
Philip A. Starr and Andrew Ahn
28. Deep Brain Stimulation in Epilepsy ............................................... 561
William J. Marks, Jr.
29. The Future of Deep Brain Stimulation ............................................ 571
Julie G. Pilitsis and Roy A.E. Bakay
Index ........................................................................................................ 593
Contributors
Linda Ackermans, MD, Department of Neurosurgery, University Hospital
Maastricht, Maastricht, The Netherlands
Andrew Ahn, MD, PhD, Department of Neurology, University of California,
San Francisco, San Francisco, CA
Ron L. Alterman, MD, Department of Neurosurgery, Mount Sinai School of
Medicine, New York, NY
Jeffrey E. Arle, MD, PhD, Lahey Clinic, Neurosurgery, Tufts University School
of Medicine, Boston, MA
Roy A.E. Bakay, MD, Department of Neurosurgery, Rush University, Chicago, IL
Kenneth B. Baker, PhD, Department of Neurosciences, The Cleveland Clinic,
Cleveland, OH
Helen Bronte-Stewart, MD, MSE, Departments of Neurology and Neuro-
sciences and Neurosurgery, Stanford Movement Disorders Center, Stanford
University, Stanford, CA
Matthew A. Butler, MD, Movement Disorders Center, University of Florida,
Department of Neurology, McKnight Brain Institute, Gainesville, FL
Paul Cosyns, MD, PhD, Collaborative Antwerp Psychiatric Research Institute
(CAPRI), University of Antwerp, Department of Psychiatry, University
Hospital Antwerp, Antwerp, Belgium
Alan Diamond, DO, Colorado Neurological Institute, Englewood, CO
Thomas Ellis, MD, Departments of Neurology and Neurosurgery, Movement
Disorders Program, Wake Forest University School of Medicine, Winston-
Salem, NC
Kenneth Follett, MD, PhD, FACS, Department of Neurosurgery, University of
Nebraska Medical Center, Omaha, NE
Kelly D. Foote, MD, Departments of Neurology and Neurosurgery, Movement
Disorders Center, McKnight Brain Institute, University of Florida, Gainesville,
FL
xi