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Advances in technical aspects of deep brain stimulation surgery
Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, NY, New York, United States.
Department of Neurosurgery, Zucker School of Medicine at Hofstra/Northwell, NY, New York, United States.
Department of Neurosurgery, New York University Grossman School of Medicine, NY, New York, United States.
Center for Brain Circuit Therapeutics, Department of Neurology, Brigham & Women's Hospital, Harvard Medical School, MA, Boston, United States; MGH Neurosurgery, Center for Neurotechnology and Neurorecovery (CNTR), Department of Neurology, Massachusetts General Hospital, Harvard Medical School, MA, Boston, United States; Movement Disorder and Neuromodulation Unit, Department of Neurology, Charité, Universität zu Berlin, Berlin, Germany.
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2023 (Engelska)Ingår i: Stereotactic and Functional Neurosurgery, ISSN 1011-6125, E-ISSN 1423-0372, Vol. 101, nr 2, s. 112-134Artikel, forskningsöversikt (Refereegranskat) Published
Abstract [en]

Background: Deep brain stimulation has become an established technology for the treatment of patients with a wide variety of conditions, including movement disorders, psychiatric disorders, epilepsy, and pain. Surgery for implantation of DBS devices has enhanced our understanding of human physiology, which in turn has led to advances in DBS technology. Our group has previously published on these advances, proposed future developments, and examined evolving indications for DBS.

Summary: The crucial roles of structural MR imaging pre-, intra-, and post-DBS procedure in target visualization and confirmation of targeting are described, with discussion of new MR sequences and higher field strength MRI enabling direct visualization of brain targets. The incorporation of functional and connectivity imaging in procedural workup and their contribution to anatomical modelling is reviewed. Various tools for targeting and implanting electrodes, including frame-based, frameless, and robot-assisted, are surveyed, and their pros and cons are described. Updates on brain atlases and various software used for planning target coordinates and trajectories are presented. The pros and cons of asleep versus awake surgery are discussed. The role and value of microelectrode recording and local field potentials are described, as well as the role of intraoperative stimulation. Technical aspects of novel electrode designs and implantable pulse generators are presented and compared.

Ort, förlag, år, upplaga, sidor
S. Karger, 2023. Vol. 101, nr 2, s. 112-134
Nyckelord [en]
Deep brain stimulation, Neuroimaging, Review, Surgical technique
Nationell ämneskategori
Neurovetenskaper Neurologi
Identifikatorer
URN: urn:nbn:se:umu:diva-205741DOI: 10.1159/000529040ISI: 000940265300001PubMedID: 36809747Scopus ID: 2-s2.0-85149267013OAI: oai:DiVA.org:umu-205741DiVA, id: diva2:1743862
Tillgänglig från: 2023-03-16 Skapad: 2023-03-16 Senast uppdaterad: 2023-06-19Bibliografiskt granskad

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Blomstedt, PatricHariz, Marwan

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Stereotactic and Functional Neurosurgery
NeurovetenskaperNeurologi

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