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Surgical Strategy for Directional Deep Brain Stimulation.
Masuda, Hiroshi; Shirozu, Hiroshi; Ito, Yosuke; Fukuda, Masafumi; Fujii, Yukihiko.
Afiliação
  • Masuda H; Division of Functional Neurosurgery, Nishiniigata National Hospital.
  • Shirozu H; Division of Functional Neurosurgery, Nishiniigata National Hospital.
  • Ito Y; Division of Functional Neurosurgery, Nishiniigata National Hospital.
  • Fukuda M; Division of Functional Neurosurgery, Nishiniigata National Hospital.
  • Fujii Y; Department of Neurosurgery, Brain Research Institute, Niigata University.
Neurol Med Chir (Tokyo) ; 62(1): 1-12, 2022 Jan 15.
Article em En | MEDLINE | ID: mdl-34719582
Deep brain stimulation (DBS) is a well-established treatment for drug-resistant involuntary movements. However, the conventional quadripole cylindrical lead creates electrical fields in all directions, and the resulting spread to adjacent eloquent structures may induce unintended effects. Novel directional leads have therefore been designed to allow directional stimulation (DS). Directional leads have the advantage of widening the therapeutic window (TW), compensating for slight misplacement of the lead and requiring less electrical power to provide the same effect as a cylindrical lead. Conversely, the increase in the number of contacts from four to eight and the addition of directional elements has made stimulation programming more complex. For these reasons, new treatment strategies are required to allow effective directional DBS. During lead implantation, the directional segment should be placed in a "sweet spot," and the orientation of the directional segment is important for programming. Trial-and-error testing of a large number of contacts is unnecessary, and efficient and systematic execution of the programmed procedure is desirable. Recent improvements in imaging technologies have enabled image-guided programming. In the future, optimal stimulations are expected to be programmed by directional recording of local field potentials.
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Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Estimulação Encefálica Profunda Limite: Humans Idioma: En Revista: Neurol Med Chir (Tokyo) Ano de publicação: 2022 Tipo de documento: Article País de publicação: Japão

Texto completo: 1 Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Estimulação Encefálica Profunda Limite: Humans Idioma: En Revista: Neurol Med Chir (Tokyo) Ano de publicação: 2022 Tipo de documento: Article País de publicação: Japão