Intraoperative Neurophysiological Monitoring for Deep Brain Stimulation: Principles, Practice and Cases

ISBN : 9780199351008

Erwin B. Montgomery, Jr.
416 ページ
186 x 256 mm

Thorough understanding of electricity, electronics, biophysics, neurophysiology, and neuroanatomy renders more tractable otherwise complex electrophysiologically-based targeting. The textbook integrates these subjects in a single resource. Ultimately, electrophysiological monitoring required controlling the movement of electrons in electronic circuits. Thus, the textbook begins with fundamental discussions of electrons, the forces moving electrons, and the electrical circuits controlling these forces. The forces that allow recording and analysis also permeate the environment producing interference, such as noise and artifact. The textbook discusses noise and artifact and the measures to avoid or suppress them. The textbook discusses interpretive principles and methods for translating electrophysiological information collected along a trajectory into an understanding of the trajectory's functional-anatomical location, as well as its optimal location and direction. Forms included allow one to document observations, consult algorithms, and interpret data. Other discussions cover safe brain stimulation, correct interpretation of patient responses, procedures of targeted neurological examinations to assess patients' condition in response to stimulation and any surgical consequences, various aspects and limitations of image-based surgical planning, and principles governing use of electrode-guiding mechanical devices.


Chapter 1 - Importance of Intraoperative Neurophysiological Monitoring
Chapter 2 - Preparations for Intraoperative Neurophysiological Monitoring
Chapter 3 - Basic Concepts of Electricity and Electronics
Chapter 4 - Electrode Recordings: Neurophysiology
Chapter 5 - Microelectrode and Semi-Microelectrode Recordings: Electronics
Chapter 6 - Noise and Artifact
Chapter 7 - Microelectrode Recordings: Neuronal Characteristics and Behavioral Correlations
Chapter 8 - Microstimulation and Macrostimulation
Chapter 9 - The Subthalamic Nucleus
Chapter 10 - The Globus Pallidus Interna Nucleus
Chapter 11 - The Ventral Intermediate Nucleus of the Thalamus
Chapter 12 - Clinical Assessments During Intraoperative Neurophysiological Monitoring
Chapter 13 - Cases
Chapter 14 - Future Intraoperative Neurophysiological Monitoring
Appendix A - Subthalamic Nucleus Deep Brain Stimulation Algorithm
Appendix B - Ventral Intermediate Thalamus Deep Brain Stimulation Algorithm
Appendix C - Globus Pallidus Interna Deep Brain Stimulation Algorithm
Appendix D - Microelectrode Recording Form for Subthalamic Nucleus Deep Brain Stimulation
Appendix E - Microelectrode Recording Form for Globus Pallidus Interna
Appendix F - Microelectrode Recording Form for Ventral Intermediate Thalamus
Appendix G - Intraoperative Macrostimulation for Clinical Effect in Parkinson's Disease
Appendix H - Intraoperative Macrostimulation for Clinical Effect in Tremor Disorders
Appendix I - Intraoperative Macrostimulation for Clinical Effect on Dystonia
Appendix J - Intraoperative Macrostimulation for Clinical effect on Tics
Appendix K - Intraoperative Macrostimulation for Clinical Effect on Dyskinesia


Erwin B. Montgomery, Jr., M.D Medical Director, Greenville Neuromodulation Center The Greenville Neuromodulation Scholar in Neuroscience and Philosophy, Thiel College