596 Index. quality of life, GPi DBS effects, 501 DYT1 gene, 73

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1 Index A Activities-specific balance confidence (ABC) scale, 335 Air embolism, after DBS, Alzheimer s disease, 292 Anterior cingulate cortex (ACC), 44, 50 Anterior commissure (AC), 100 Aripiprazole, 327 Aspiny striatal neurons, 6 Attention deficit hyperactivity disorder (ADHD), 322 Atypical parkinsonism (AP), DBS in diagnosis of MSA, diagnosis of the syndrome, features suggestive of an AP disorder, 292 future targets for, subthalamic nucleus (STN) DBS, 299 Axonal spikes, 113 B Bartholow, Roberts, 65 Basal ganglia (BG) integration across Cortico-BG circuits, 43 pallidal complex and SN, SNr, pathways of the GP/SNr, 46 role of, in parallel circuit and integrative network, SN, SNc and VTA, STN, striato-nigro-striatal network, striatum, functional organization of frontal cortical striatal projections, structures and connectivity, thalamo-cortico-thalamic interface, Basal ganglia thalamocortical network consequences of abnormalities dystonia, 17 effects of lesions, 15 hemiballism, 17 Parkinson s disease or parkinsonism, between cortical neurons, 5 dopamine receptors (D1-D5) in, 12 effect of DBS, general structure, 4 5 inputs to basal ganglia cortico-and thalamo-subthalamic projections, 10 sensorimotor corticostriatal projections, 7 8 thalamostriatal projections, 8 10 intrinsic connections direct and indirect pathways, dopaminergic projections, intrinsic neuronal organization of nuclei GABAergic projection neurons, 7 SNc neurons, 7 SNr neurons, 7 striatum, 5 7 output projections nigrofugal pathways, 13 pallidofugal pathways, role in motor control, segregation, anatomic concept of, 5 sensorimotor portion of, 5 Beck Depression Inventory, 87 Behr s syndrome, 224 Ben-Gun method, 117 Biochemical studies, of DBS mechanisms, 154 Bipolar stimulations, 479 Bipolar testing, 481 Blood oxygenation level-dependent (BOLD)-fMRI, 180 Botulinum toxin injection, 322 Burke Fahn Marsden (BFM) scale,

2 594 Index C Calbindin (CaBP), 41 Center of gravity (CoG) sway, 336 Centromedian-parafascicular complex (CM-Pf), 323, 325 Cholinergic interneurons, 12 Clinical applications, of DBS, Clonazepam, 322 Clonidine, 322, Clozapine, 327 Cognitive testing tools, 88 Complications and management, in DBS air embolism, damage to lead or lead extender due to patient manipulation of the IPG, electrolysis and gas production, 145 inadvertent thermal lesioning, 145 infections, long-term hardware-related, misplaced electrodes, 142 postoperative cognitive decline in patients with Parkinson s disease (PD), 146 reasons for failure of device, sterile clear fluid collections, stroke, Computer modeling, of DBS mechanisms, Cortex-basal ganglia-thalamic-cortical circuits, 4 Cortico-subthalamic projection, 10 D Deep brain stimulation (DBS), 3, 50. See also Microelectrode recordings affective effects of depth electrode stimulation, CAPSIT criteria, 84 case histories, circuit, combination with alternative technologies, commonly used tools for cognitive testing, 88 complications and management air embolism, damage to lead or lead extender due to patient manipulation of the IPG, electrolysis and gas production, 145 inadvertent thermal lesioning, 145 infections, long-term hardware-related, misplaced electrodes, 142 postoperative cognitive decline in patients with Parkinson s disease (PD), 146 reasons for failure of device, sterile clear fluid collections, stroke, components and materials used, cost effectiveness of, 503 in depression adverse effects, 516 background, mechanisms, simulation technique, 515 technical aspects, devices daily living, lead technology, simulation technology, dystonia clinical results, 306 complications of therapy, 312 dystonia-plus syndromes and other exceptional cases, 310 evaluation of the efficacy of treatment, 306 focal and segmental, generalized, management and practical issues, neuropsychological performance and mood, 312 patient selection, 313 safety, 312 secondary, stimulation arrest and safety, 313 emerging applications clinical applications, epilepsy, 576 for epilepsy, 73 approaches to, deep brain targets for, globus pallidus (GPi) adverse events, 285 clinical results of patients treated for PD, 280, 282 effect against cardinal features of PD and off disability, effect in the On medication state, functional imaging, treatment for PD, hardwares, 466 history of, 70, importance of multidisciplinary assessment prior to, 83 invasive testing, issues and recommendations, mechanisms of biochemical studies, 154 computer modeling, effect on neuronal activity, effect on the network, imaging, 154 methodologies, neural recordings, therapeutic,

3 Index 595 Deep brain stimulation (DBS) (Continued) medically intractable cluster headache clinical outcomes, complications, device programming, 554 documentation of electrode locations, 553 indications for, 549 mechanisms, pre-and postoperative evaluation, surgical technique, time course for stimulation-induced relief, 556 neuropsychological issues in areas of functioning assessed, depression, neurobehavioral outcomes in, dystonia, neurobehavioral outcomes in, epilepsy, neurobehavioral outcomes in, ET, neurobehavioral outcomes in, evaluation of patients, interpretative and practical challenges for the neuropsychologist, methods of neuropsychological evaluation for, MS, neurobehavioral outcomes in, 428 OCD, neurobehavioral outcomes in, 429 other conditions, neurobehavioral outcomes in, 430 overview, PD, neurobehavioral outcomes in, purposes of neuropsychological evaluation for, TS, neurobehavioral outcomes in, 430 noninvasive active testing, noninvasive testing, obsessive compulsive behavior (OCB) capsular, complications and adverse effects, description of acute effects, long-term follow-up, neurosurgical intervention, postoperative contact selection, randomized double blind crossover, for OCD, 73 74, for pain, 65 patient selection in dystonia, in essential tremor (ET), in neuropsychiatric disorders, 92 in PD, possible complications, 89 potential interactions, for primary depressive illness, programming for movement disorders amplitude, basic approach to, electrode configuration, frequency, future directions, 390 issues related to GPi, issues related to STN, issues related to targets, pulse width, stimulation parameters, published and reported adverse events, responsiveness of PD Symptoms with, 86 risk factors age, 89 imaging, medical co-morbidities, 90 patients with prior ablative surgery, 90 subthalamic nucleus (STN) adverse events, 285 aspects of gait, 261 balance, bladder functions, 264 clinical results of patients treated for PD, 279 cognitive effects, 262 dysarthria/hypophonia and weight gain effects, 267 dyskinesias, 259, 267 effect against cardinal features of PD and off disability, effect in the On medication state, effects on motor aspects, effects on nonmotor aspects, group of behaviors, indications and contraindications, motor fluctuations, postural instability, 268 psychiatric complications, quality of life, rationale, sexual functions, 264 side effects and complications, sleep, 264 subthalamotomy vs., system, technical alternatives in implantation procedure interventional MRI, localization using peri-operative and intra-operative imaging, Medtronic NexFrame, StarFix micro Targeting Platform, surgical navigation systems, testing methodology, of thalamus, general experience of VL DBS for MS, head tremor, Off-label vs. Experimental use of DBS and insurance coverage, selected studies of, ,

4 596 Index Deep brain stimulation (DBS) (Continued) surgical issues unique to non-et and non-pd tremor, 224 as symptomatic, 225 thalamotomy vs., for treatment of Parkinson s disease (PD) tremor, for tremors other than MS, 224 unilateral vs. bilateral stimulation, 209 voice tremor, Tourette s syndrome (TS) clinical and surgical evaluation, neuroanatomical basis for, other considerations, 329 reports on deep brain stimulation in patients, 330 treatment of postural stability and gait disorders in PD clinical assessments and quantitative measures, effect on PPN, effects, long-term effects of STN and GPi DBS on, 353 for tremor, 71 types of motor fluctuations, vs. psychosurgery, Dementia with Lewy bodies, 292 Depression background, deep brain stimulation (DBS) adverse effects, 516 background, mechanisms, simulation technique, 515 technical aspects, pathophysiology, 513 phenomenology, treatment resistance, 512 Depression, neurocircuitry of, Diagnostic and Statistical Manual of Mental Disorders (DSM-IV TR), 322 Diagnostic Confidence Index (DCI), 327 Direct and indirect striatofugal projections, 10 Dopamine (DA) cells in striatum, functional correlates of the cells, 43 neurons, 37, 42 receptors, 37 transporter (DAT), 42 Dopaminergic projections, Dorsal pallidal segments, 39 Dorsolateral prefrontal cortex (DLPFC), Dyskinesias, 259 Dystonia, 3, 17, 73, DBS in, neurobehavioral outcomes after DBS, quality of life, GPi DBS effects, 501 DYT1 gene, 73 E Electricity, therapeutic use on brain development modern era of DBS, stimulation between , stimulation between , stimulation up to 1700, use by ancient Greeks, 63 Electroconvulsive therapy (ECT), 402 Electromyography (EMG) software, 482 Enkephalin (ENK), 37 Entopeduncular nucleus (EPN), 4 Epilepsy DBS anterior nucleus of the thalamus, effects of, 565 approaches to, caudate nucleus, effects of, 565 centromedian nucleus of thalamus, effects of, 565 cerebellar nuclei, effects of, 565 deep brain targets for, hippocampus and amygdala, effects of, locus coeruleus stimulation in humans, effects of, 566 neurobehavioral outcomes after DBS, stimulation of the STN, effects of, 566 overview, treatment approaches, Essential tremor (ET), thalamic DBS effects on quality of life, Extended Disability Status Scale (EDSS) scale, 216 External globus pallidus (GPe), 4, Extracellular recordings. See Microelectrode recordings F Faradic current, 65 Fibers, 39, 51 GPi, 40 FLASQ-PD, 85 [ 18 F] Fluorodeoxyglucose (FDG)-PET technique, 180 Focal and segmental dystonia, FOG, DBS effects on, Functional imaging, of DBS globus pallidus (GPi) for generalized dystonia, for PD, subthalamic nucleus (STN ) acute, in a resting state visualized by, L-dopa effects, motor tasks, use and purpose of, 180 ventral intermediate nucleus (VIM) of essential tremor, of Parkinsonian tremor,

5 Index 597 G GABAergic neurons, 4 5, 7, 38, 45 Gait disorder, DBS effects act of sit-to-stand, 345 initiation, long-term effects, 353 treatment of PPN, walking, Galen, 64 Galvani, Luigi, 64 Generalized dystonia, Gilbert, William, 63 Globus pallidus (GPi) altered sensory feedback, effect of DBS, 341 anatomy, DBS, functional imaging for generalized dystonia, for PD, DBS treatment for Parkinson s disease (PD) patients ADL scores off medication/on stimulation, 248 adverse events, 249 clinical results of patients treated, 280, 282 effect against cardinal features of PD and off disability, effect in the On medication state, impact on quality of life, status of, unilateral vs. bilateral stimulation, dystonia, external perturbations, effect of DBS, 341 medical adjustments, 389 optimal contact selection, 388 quality of life and DBS, 499 during quiet stance, effect of DBS, 341 rationale for targeting, 326 stimulantion-related adverse events, GP/SNr pathways, 46 H Haloperidol, 322, 327 Hamilton Anxiety Rating Scale, Hamilton Depression Rating Scale, 87 Head tremor DBS, Heath, Robert, 68 Hemiballism, 17 Huntington s disease, 7 I Imaging, of DBS mechanisms, 154 Implantable pulse generator (IPG), 475 IMRI technique, 108 Infection, after DBS, Internal globus pallidus (GPi), 4, 72, 90 microelectrode recording, Intra-operative microelectrode recording anesthesia, 118 setup and procedure, single- vs. multitrajectory recording, 117 stimulation, Intrinsic neuronal organization, of nuclei GABAergic projection neurons, 7 SNc neurons, 7 SNr neurons, 7 striatum, 5 7 Invasive testing, L Largus, Scribbonius, 64 Lateral habenular nucleus, 4 Levodopa, 16, 68, 84, 324 Levodopa Equivalent Dose (LDED), Lormetazepam, 328 M Mattis Dementia Rating Scale (MDRS), 87 Medically intractable cluster headache DBS clinical outcomes, complications, device programming, 554 documentation of electrode locations, 553 indications for, 549 mechanisms, pre-and postoperative evaluation, surgical technique, time course for stimulation-induced relief, 556 evidence for hypothalamic involvement in, 548 overview, Medium spiny neurons (MSNs), 37 Medtronic Kinetra Model 7428 Neurostimulator, 578 Medtronic Soletra Model 7426 Neurostimulator, 578 Meige syndrome, 91 Methylphenidate, 322 MPTP-induced toxicity, 42 Microelectrode recordings benefits and risks, methods electronic equipment, intra-operative procedure, microelectrodes, physiology, target specific strategies internal globus pallidus (GPi), nucleus ventrointermedius thalami (VIM), subthalamic nucleus (STN), tetrodes, use of, Micro Targeting Platform (MTP), 104 Mini Mental State Exam (MMSE), 87

6 598 Index Monopolar impedances and currents, Monopolar stimulations, 479 Montgomery Asberg Depression Rating Scale, 87 Montreal procedure, 65 Motor fluctuations, Movement disorders, 3 affective changes after DBS, MP35N, 475 MRI environment, potential interactions artifacts, gradient-induced currents, 462 RF field, static field interactions, MSN. See Medium spiny neurons (MSNs) Multiple sclerosis (MS), Multiple system atrophy (MSA), 255, 292 globus pallidus DBS, published case reports of, STN DBS in with features of PD, with typical MSA, 298 N Neural recordings, examining DBS mechanisms, Neuronal activity, effect of DBS computer models, neurochemical and gene expression studies, recordings in downstream nuclei, recordings in the stimulated nucleus, Neurostimulation, NexFrame, , Nigro-collicular fibers, 13 Nigrofugal pathways, 13 Nigro-tegmental projections, 13 Nitric oxide synthase (NOS), 38 Noninvasive active testing, Noninvasive testing, O Obsessive compulsive behavior (OCB), 322 capsulotomy for, 532 deep brain stimulation (DBS), capsular, complications and adverse effects, description of acute effects, long-term follow-up, neurosurgical intervention, postoperative contact selection, randomized double blind crossover, neurobehavioral outcomes after DBS, 429 treatment options, 532 Obsessive compulsive Disorder (OCD), neurocircuitry of, [ 15 O]H 2 O PET, 180 Olanzapine, 327 Orbital frontal cortex (OFC), 44 45, 50 P Pallidal complex, Pallidofugal pathways, PAN. See Phasically active neurons (PANs) Pantothenate kinase associated neurodegeneration (PANK2), Parkinsonism-plus syndromes. See Atypical parkinsonism (AP), DBS in Parkinson s disease, 3, 15 16, 40, 50, 68 DBS treatment of globus pallidus (GPi) ADL scores off medication/on stimulation, 248 adverse events, 249 impact on quality of life, status of, unilateral vs. bilateral stimulation, DBS treatment of subthalamic nucleus (STN) aspects of gait, 261 balance, bladder functions, 264 cognitive effects, 262 dysarthria/hypophonia and weight gain effects, 267 dyskinesias, 259, 267 effects on motor aspects, effects on nonmotor aspects, group of behaviors, indications and contraindications, motor fluctuations, postural instability, 268 psychiatric complications, quality of life, rationale, sexual functions, 264 side effects and complications, sleep, 264 subthalamotomy vs., idiopathic, 300 neurobehavioral outcomes after DBS, quality of life GPi DBS effects, 499 predictive indicators, STN DBS effects, thalamic DBS effects, 499 thalamic deep brain stimulation adverse effects, background, importance, patient selection, problem of progressive parkinsonism after, 232 results,

7 Index 599 treatment of postural stability and gait disorders of clinical assessments and quantitative measures, effect DBS on the PPN, effect of DBS, long-term effects of STN and GPi DBS on, 353 Pars compacta (SNc), Pars reticulata (SNr), 38 40, 120, 156 Parvicellular reticular formation, 4 Patient selection, for DBS role of neurologist, role of neuropsychologist, role of neurosurgeon, 88 role of psychiatrist, PD. See Parkinson s disease Pedunculopontine nucleus (PPN), 4, 10, 16 Pergolide, 327 Peri-operative and intra-operative imaging, in DBS, Pharmacologic dopamine replacement therapy, 16 Phasically active neurons (PANs), T Philips Intera MRI, 107 Pimozide, 327 Pool, J. Lawrence, 66 Posterior commissure (PC), 100, 326, 550, 557 Postural stability clinical assessments, effect of DBS instability in PD, long-term effects, 353 long-term or adaptive changes, 343 treatment of PPN, underlying pathophysiology and theories, effect of medication, quantitative measures of kinematics-3-d motion analysis, 337 posturography, voluntary movement, Posturography, Primary depressive illness, Progressive supranuclear palsy, 292 Propofol Target Controlled Infusion, 328 Psychostimulants, 322 Psychosurgery, Q Quality of life DBS effect on multiple sclerosis (MS), dystonia, GPi DBS effects on, 501 GPi DBS effects in PD, 499 predictive indicators in PD, STN DBS effects in PD, subthalamic nucleus (STN), thalamic DBS effects in PD, 499 R RCBF SPECT, 180 Repetitive transcranial magnetic stimulation (rtms), Risperidone, 327 S Self-injurious behavior (SIB), 322 Sensorimotor corticostriatal projections, 7 8 SF-36 scale, 307, 309 SN. See Substantia nigra (SN) SNc. See Pars compacta (SNc) SNc neurons, 7 SNc-v neurons, 11 SNr. See Pars reticulata (SNr) SNr neurons, 7 Spiegel, Ernest, 67 Spiegel-Wycis device, 67 StarFix micro Targeting Platform, 101, Static electricity, 63 Status dystonicus, 310 StealthStation, 100 Sterile clear fluid collection, after DBS, STN. See Subthalamic nucleus (STN) Striato-nigro-striatal network, Striatum, 5 7 afferent connections, dorsolateral, 33 functional organization of frontal cortical striatal projections, intrinsic cells of, ventral, 38 Stroke, after DBS, avoidance, management of, 139 Stryker Navigation System, 100 Substance P (SP), 37 Substantia nigra (SN), Subthalamic nucleus (STN), 4, 40 41, 72 73, 107 altered sensory feedback, effect of DBS, 341 anatomy, 379 DBS with features of PD, in other forms of AP, 299 with typical MSA, 298 DBS, functional imaging acute, in a resting state visualized by, chronic state, L-dopa effects, local and distant effects of, 183 motion-related fmri activity, effects on, motion-related rcbf, effects on, motor tasks, motor tasks, in PET and SPECT, rcbf in cognitive tasks, effects on, 188

8 600 Index Subthalamic nucleus (STN), (Continued) DBS treatment for atypical parkinsonism, 299 DBS treatment for PD aspects of gait, 261 balance, bladder functions, 264 clinical results of patients, 279 cognitive effects, 262 dysarthria/hypophonia and weight gain effects, 267 dyskinesias, 259, 267 effect against cardinal features of PD and off disability, effect in the On medication state, effects on motor aspects, effects on nonmotor aspects, group of behaviors, indications and contraindications, motor fluctuations, postural instability, 268 psychiatric complications, quality of life, rationale, sexual functions, 264 side effects and complications, sleep, 264 subthalamotomy vs., electrophysiologic mapping, external perturbations, effect of DBS, 341 medication adjustments, optimal contact selection, quality of life and DBS, during quiet stance, effect of DBS, 341 stimulation-related adverse events, 383 target-related adverse events, therapeutic mechanisms, of DBS, Subthalamotomy, Sulpiride, 327 Superior colliculus, 4 T TANS. See Tonically active neurons (TANS) Tetrabenazine, 322 Thalamic deep brain stimulation general experience of VL DBS for MS, head tremor, Off-label vs. Experimental use of DBS and insurance coverage, and quality of life, rationale for targeting the medial portion, selected studies of, , surgical issues unique to non-et and non-pd tremor, 224 as symptomatic, 225 thalamotomy vs., for the treatment of Parkinson s disease (PD) tremor adverse effects, background, importance, patient selection, problem of progressive parkinsonism after, 232 results, for tremors other than MS, 224 unilateral vs. bilateral stimulation, 209 voice tremor, Thalamo-cortico-thalamic interface, Thalamostriatal projections, 8 10 Thalamotomy Pahwa and coworkers experiments, 212 Schuurman and colleagues experiments, 212 Tasker and colleagues experiments, 212 Theory of animal electricity, 64 Therapeutic mechanisms, of DBS, Tics, Tonically active neurons (TANS), 38 Toronto Western Spasmodic Torticollis Rating Scale (TWSTRS), 90, 306, 310 Tourette s syndrome (TS) clinical characteristics and prevalence, DBS clinical and surgical evaluation, neuroanatomical basis for, other considerations, 329 reports on deep brain stimulation in patients, 330 neurobehavioral outcomes after DBS, 430 targets, treatment of, neurosurgical, Tremor Activities of Daily Living Scale (TADLS), 500 Tyrosine hydroxylase-immunoreactive interneurons, 7 U Unified Parkinson s Disease Rating Scale (UPDRS), 71 72, 84 85, 118, , 268, 335, 343 Unilateral vs. bilateral stimulation, 209 V Vascular pathology, 292 VectorVision, 100 Ventral intermediate nucleus (VIM) adverse effect of DBS, DBS for treatment of PD tremor, DBS, functional imaging of essential tremor, of Parkinsonian tremor, microelectrode recording of, stimulation, for PD, 70, 72

9 Index 601 vs. thalamotomy, Ventral motor thalamic nuclei, 4 Ventral pallidum (VP), 39 Ventral tegmental area (VTA), 34, Ventrolateral nucleus of the thalamus (VL) DBS conundrum, general experience, for MS, long-term efficacy, for MS, published literature on the efficacy of, unique pre-operative and postoperative issues related to non-et and non-pd tremor, Voice tremor DBS, Volta, Allesandro, 64 Volta s pile, 64 Von Musschebroek, Pieter, 64 W Weinhold, Karl, 65 Wilson s disease, 91 Wycis, Henry, 67 X X-linked progressive dystonia-parkinsonism, 6 Y Yale Global Tic Severity Scale (YGTSS), 328 Young Mania Scale, 87