This important book discusses today’s most current and cutting-edge applications of Deep Brain Stimulation (DBS). The book 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 and neurophysiologic studies in animals and man.

To date more than eighty thousand patients worldwide have received deep brain stimulation (DBS), mainly in order to alleviate symptoms of treatment-resistant disorders such as tremor associated with Parkinson’s disease, essential tremor, chronic pain, epilepsy, obsessive compulsive disorder, major depression and Tourette syndrome. The number of indications for neurological and psychiatric conditions using this technology is rapidly increasing, raising important societal and ethical issues that cannot be dealt with by scientists and clinicians on their own, but need discussions among all possible stakeholders on questions such as: what are the comprehensive risks and benefits of this technology? what is the real impact on patients’ life, in terms of health, quality of life and personal identity? This Research Topic provides an overview of potentials and limitations of deep brain stimulation as used to treat neurological and psychiatric conditions, bringing together Mini Reviews, Perspectives and Opinion papers from key stakeholders interested in the development and social impact of this technology. It is also a continuation of the debate that started among scientists, clinicians, patients, sociologists, journalists, philosophers and other experts during the “brains in dialogue on deep brain stimulation” workshop that was organized in September 2010 in Warsaw, Poland, by the FP7 project bid – brains in dialogue (www.neuromedia.eu) coordinated by the Interdisciplinary Laboratory of SISSA (Trieste, Italy).

Deep brain stimulation (DBS) is now a firmly established treatment for movement disorders, and an increasing body of evidence supports DBS in the treatment of other neurological and psychiatric disorders. This essential reference guide outlines a practical approach to the use of this paradigm-shifting therapy and covers key aspects of DBS practice. Chapters describe how to implement a DBS program and select appropriate patients, device programming to achieve optimal symptom control, and long-term management of patients. Thoroughly revised, this third edition includes additional chapters on managing patients with emerging applications of DBS. An entire chapter is dedicated to troubleshooting common problems with the therapy as many 'failures' are preventable and addressable. With contributions from experts in the field, this is a must-have reference guide for any clinician working with DBS patients.

This book provides a state-of-the-art overview of our current understanding of deep brain stimulation (DBS) for the treatment of neurological and psychiatric disorders. With a broad multidisciplinary scope, it presents contributions from leading experts in the field from Europe and America, who share not only their knowledge, but their experience as well. The book focuses both on basic and theoretical aspects of DBS, as well as clinical and practical aspects. It follows an evidence-based approach, and where possible offers clinical recommendations based on published guidelines. It starts with a general section, which discusses basic principles and general considerations. This is followed a sections dedicated to neurological disorders, and psychiatric disorders, in which only accepted indications are discussed. All experimental indications are discussed in the final chapter. The text is supplemented with numerous illustrations. Intended for medical specialists and residents involved in the treatment of patients with DBS, it also appeals to other professionals working with DBS patients, such as psychologists, nurses, physiotherapists, as well as basic and clinical neuroscientists.

The potential efficacy of non-invasive brain stimulation procedures for the management of specific symptoms in diverse neurological and psychiatric conditions has been tested in the past decade or so. For example, repetitive transcranial magnetic stimulation (rTMS) over prefrontal areas has been extensively investigated as a treatment for patients with medication-resistant depression and has been shown to be associated with improvement of mood. Similarly, non-invasive stimulation techniques have been applied to various symptoms of Parkinson's disease such as bradykinesia and dyskinesias, with variables degrees of success reported. However, attempts to expand previously observed clinical improvements to other neurological disorders (e.g. Tourette's syndrome, autism, epilepsy) has been controversial. In trying to bypass potential confounding elements, researchers aim to target neural populations altered in disease to either increase or decrease their corrupted baseline activity. In addition, a complementary approach is to extend stimulation protocols that results enhanced behavior in healthy participants. This Frontiers Research Topic on non-invasive brain stimulation and enhancement of function tries to combine a series of articles from researchers who used non-invasive brain stimulation to aim improvement of either a motoric, cognitive or behavioral nature investigated behaviorally, physiologically or using brain imaging techniques in clinical populations. Investigation of the relation between enhancement of function in healthy populations and clinical improvement in patients with neurological or psychiatric disorders needs further consideration.

This book examines present developments and the future possibilities of deep brain stimulation therapy for patients with therapy-refractory psychiatric disorders. Presents clinical applications and animal research, and offers a chapter on ethical issues.

Neuromodulation is among the fastest-growing areas of medicine, involving many diverse specialties and affecting hundreds of thousands of patients with numerous disorders worldwide. It can briefly be described as the science of how electrical, chemical, and mechanical interventions can modulate the nervous system function. A prominent example of neuromodulation is deep brain stimulation (DBS), an intervention that reflects a fundamental shift in the understanding of neurological and psychiatric diseases: namely as resulting from a dysfunctional activity pattern in a defined neuronal network that can be normalized by targeted stimulation. The application of DBS has grown remarkably and more than 130,000 patients worldwide have obtained a DBS intervention in the past 30 years—most of them for treating movement disorders. This Frontiers Research Topics provides an overview on the current discussion beyond basic research in DBS and other brain stimulation technologies. Researchers from various disciplines, who are working on broader clinical, ethical and social issues related to DBS and related neuromodulation technologies, have contributed to this research topic.

The one-stop resource on deep brain stimulation for functional neurosurgeons! Deep brain stimulation (DBS) is used to modulate dysfunctional circuits in the brain with stimulation pulses applied to specific target areas of the brain. Globally, DBS procedures have been most commonly performed for Parkinson's disease and essential tremor, but there are now new and growing research efforts studying DBS for psychiatric disorders and epilepsy. Deep Brain Stimulation: Techniques and Practices written by the Society for Innovative Neuroscience in Neurosurgery along with Dr. William S. Anderson and distinguished experts presents the latest DBS approaches. The book begins with a history of DBS, general frame-based techniques, patient selection primarily for movement disorders, multidisciplinary collaboration, and ethical considerations. Subsequent chapters detail diverse technologies and disease-specific treatment for Parkinson's disease, essential tremor, dystonia, OCD, epilepsy, major depression, Tourette syndrome, emerging psychiatric indications, and pediatric applications. Key highlights Lead placement techniques utilizing currently available customized platforms and robotics Microelectrode recording and image-based direct targeting with MRI and CT to enhance lead placement Lesioning methods including radiofrequency, and MR-guided focused ultrasound Discussion of recent innovations in tractography to delineate white matter tracts in the brain and closed loop stimulation DBS has helped thousands of patients with intractable conditions, allowing for a programmable therapy with durable treatment effect. This remarkable guide provides the essentials for functional neurosurgeons to pursue intraoperative research opportunities in this growing subspecialty and incorporate DBS into clinical practice.