Deep Brain Stimulation for Neurological Disorders
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1 Deep Brain Stimulation for Neurological Disorders
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3 Toru I t a k u ra Editor Deep Brain Stimulation for Neurological Disorders Theoretical Background and Clinical Application
4 Editor Toru Itakura, MD, PhD Department of Neurological Surgery Koyo Hospital, Wakayama Japan ISBN ISBN (ebook) DOI / Springer Cham Heidelberg Dordrecht London New York Library of Congress Control Number: Springer International Publishing Switzerland 2015 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, specifically the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on microfilms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifically for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher's location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (
5 Preface Chronic electrical stimulation of the brain has become standard surgical therapy for Parkinson s disease and other neurological disorders. Numerous scientific papers have demonstrated that patients with Parkinson s disease who receive deep brain stimulation show excellent outcomes without serious complications. Recently, this surgical intervention has been applied to many other neurological diseases such as involuntary movements, intractable pain and psychiatric disorders, including depression and obsessive-compulsive disorder. The number of neurosurgeons embarking on this new surgery has recently increased owing to the outstanding development of surgical techniques in the electrical stimulation of the brain. For young neurosurgeons, an introductory textbook is essential for good progress in skills and for safe and accurate surgery in this area. The aim of this book, therefore, is to show the complete range of knowledge requisite to the scientific background of the diseases as well as to explain the detailed surgical techniques necessary. The target audience for this endeavor is young neurosurgeons, neurologists, psychiatrists and other medical staff interested in this operation. In editing this volume, I have listed outstanding scientists and international experts in the field. The book is divided into two main parts: the basic background of brain stimulation, and clinical studies on deep brain stimulation. The first part will discuss the anatomical and functional scientific background concerning the basal ganglia, thalamus and other related brain structures of movement disorders, pain, epilepsy and psychiatric diseases. The second part describes clinical studies of brain stimulation on symptoms, and surgical techniques in movement disorders and psychiatric diseases. It is a great honor to publish this updated book on electrical brain stimulation. It is sincerely hoped that it will contribute to the development of this type of surgery for various neurological disorders. I also hope that the book will contribute to the rescue of the lives of sufferers and to the development in the quality of life of patients with various neurological disorders. Wakayama, Japan Toru Itakura, MD, PhD v
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7 Contents 1 Functional Circuitry of the Basal Ganglia Atsushi Nambu 2 Mechanism of DBS: Inhibition, Excitation, or Disruption? Atsushi Nambu and Satomi Chiken 3 Symptoms and Signs of Parkinson s Disease and Other Movement Disorders Hidefumi Ito 4 Intraoperative Microelectrode Recording Kazutaka Kobayashi and Yoichi Katayama 5 Instrument of Brain Stimulation Takamitsu Yamamoto, Chikashi Fukaya, Atsuo Yoshino, and Yoichi Katayama 6 Surgical Technique of Brain Stimulation Hiroki Nishibayashi and Toru Itakura 7 Stimulation of Subthalamic Nucleus for Parkinson s Disease Takashi Agari and Isao Date 8 Stimulation of Globus Pallidus Mitsuhiro Ogura 9 Thalamic Stimulation for Parkinson s Disease: Clinical Studies on DBS Yasushi Miyagi 10 Deep Brain Stimulation for Dystonia Takaomi Taira 11 Deep Brain Stimulation for Essential Tremor Ryoma Morigaki and Satoshi Goto 12 Spinal Cord Stimulation for Intractable Pain Gustavo Polo, Patrick Mertens, and Marc Sindou 13 Deep Brain Stimulation for Psychiatric Disorders Nir Lipsman and Andres M. Lozano vii
8 viii Contents 14 Deep Brain Stimulation for Epilepsy: Evidence for Limbic Network Disruption via Chronic Anterior Nucleus of the Thalamus and Hippocampus Stimulation Paul Koch and Gordon Baltuch 15 Complications of Deep Brain Stimulation Kenji Sugiyama Index
9 Contributors Takashi Agari, MD, PhD Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan Gordon Baltuch, MD, PhD Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA Satomi Chiken, PhD Division of System Neurophysiology, National Institute for Physiological Sciences, Okazaki, Japan Isao Date, MD, PhD Department of Neurological Surgery, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama, Japan Chikashi Fukaya, MD, PhD Division of Applied System Neuroscience, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan Satoshi Goto, MD, PhD Department of Motor Neuroscience and Neurotherapeutics, Institute of Health Bioscience, Graduate School of Medical Science, University of Tokushima, Tokushima City, Tokushima Prefecture, Japan Toru Itakura, MD, PhD Department of Neurological Surgery, Koyo Hospital, Wakayama, Japan Hidefumi Ito, MD, PhD Department of Neurology, Wakayama Medical University, Wakayama, Japan Yoichi Katayama, MD, PhD Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan Kazutaka Kobayashi, MD, PhD Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan Paul Koch, MD Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA Nir Lipsman, MD, PhD Department of Neurosurgery, Toronto Western Hospital, Toronto, ON, Canada ix
10 x Contributors Andres M. Lozano, MD, PhD Department of Neurosurgery, Toronto Western Hospital, Toronto, ON, Canada Patrick Mertens, MD, PhD Neurological Hospital Lyon, Lyon, France Yasushi Miyagi, MD, PhD Department of Stereotactic and Functional Neurosurgery, Kaizuka Hospital, Fukuoka, Japan Ryoma Morigaki, MD Department of Motor Neuroscience and Neurotherapeutics, Institute of Health Bioscience, Graduate School of Medical Science, University of Tokushima, Tokushima City, Tokushima Prefecture, Japan Atsushi Nambu, MD, PhD Division of System Neurophysiology, National Institute for Physiological Sciences, Okazaki, Japan Hiroki Nishibayashi, PhD, MD Department of Neurological Surgery, Wakayama Medical University Hospital, Wakayama, Japan Mitsuhiro Ogura, MD, PhD Department of Neurological Surgery, Wakayama Medical University, Wakayama, Japan Gustavo Polo, MD, MSc Department of Neurosurgery, Neurological Hospital Lyon, Lyon, France Marc Sindou, MD, PhD Neurological Hospital Lyon, Lyon, France Kenji Sugiyama, MD, PhD Department of Neurosurgery, Hamamatsu University School of Medicine, Hamamatsu, Shizuoka, Japan Takaomi Taira, MD, PhD Department of Neurosurgery, Tokyo Women s Medical University, Tokyo, Japan Takamitsu Yamamoto, MD, PhD Division of Applied System Neuroscience, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan Atsuo Yoshino, MD, PhD Division of Neurosurgery, Department of Neurological Surgery, Nihon University School of Medicine, Tokyo, Japan
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