Current Concepts in Movement Disorder Management

Current Concepts in Movement Disorder Management
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Описание книги

This book summarizes the current state of movement disorder management and the role of surgical therapies as an alternative to medication. Following a chapter on the history of movement disorder surgery, leaders in their fields describe the pathophysiology, functional neuroanatomy, clinical presentation, and medical management of Parkinson’s disease, dystonia, and essential tremor. This is followed by chapters on the spectrum of movement disorder surgery itself, from the lesioning procedures of radiofrequency ablation, stereotactic radiosurgery, and high-frequency ultrasound to the modulatory procedures of “asleep”, image-guided deep brain stimulation (DBS) and “awake”, microelectrode-guided DBS. The final chapters focus on closed-loop DBS, drug-delivery, gene therapy, and other emerging neurosurgical therapies, highlighting long-standing experimental strategies that are reaching exciting phases of clinical translation. This volume is a valuable tool for accessing the wide spectrum of concepts that currently define this dynamic field.

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Группа авторов. Current Concepts in Movement Disorder Management

Progress in Neurological Surgery

Current Concepts in Movement Disorder Management

Contents

Series Editor’s Note

Preface

The History of Movement Disorder Brain Surgery

Abstract

The Pre Stereotactic Era

The Early Era of Stereotactic Brain Surgery

The Era of Spreading Stereotactic Techniques

The Era of Decline of Stereotactic Surgery

The Early Transplant Era

The Era of Advanced Stereotactic Imaging and Mapping

The Deep Brain Stimulation Era

The Era of Radiosurgery

The Evolution of Frameless Technologies and Intraoperative MRI

Conclusions

References

Pathophysiologic Basis of Movement Disorders

Abstract

Introduction

Relevant Brain Circuit Anatomy

Basal Ganglia Circuits

Cerebellar Circuits and Cerebello-Basal Ganglia Interactions

Parkinson’s Disease

Rate Model of Basal Ganglia Disorders

Pattern Changes in Parkinsonism

Extrastriatal Dopamine Loss

Other Structural Changes Contributing to the Motor Disturbance in PD

Dystonia

Basal Ganglia Dysfunction in Dystonia

Cerebellar and Cortical Abnormalities in Dystonia

Essential Tremor

Conclusions

References

Clinical Presentation and Prognosis of Common Movement Disorders

Abstract

Introduction

Parkinsonian Syndromes

Parkinson Disease

Secondary Parkinsonism

Atypical Parkinsonian Syndromes

Tremor

Essential Tremor

Other Causes of Action Tremor

Dystonia

Tics and Tourette Syndrome

Conclusion

References

Medical Management of Movement Disorders

Abstract

Parkinson’s Disease

Early Stage

MAO-B Inhibitors

DAs

Levodopa

Advanced Stage

COMT Inhibitors

Apomorphine

Levodopa/Carbidopa Intestinal Gel

Essential Tremor

Beta-Blockers

Anticonvulsants and Benzodiazepines

Neuroleptics

Botulinum Toxin Injections

Dystonia

Chorea

References

Functional Anatomy of Basal Ganglia Circuits with the Cerebral Cortex and the Cerebellum

Abstract

Cortico-Basal Ganglia-Thalamo-Cortical Circuits

Cortico-Striatal Inputs

Basal Ganglia Outputs to the Primary Motor Cortex (M1)

Basal Ganglia Outputs to Premotor Cortical Areas

Basal Ganglia Outputs to the Frontal Eye Field

Basal Ganglia Outputs to the Prefrontal Cortex

Basal Ganglia Outputs to the Posterior Parietal and the Temporal Cortex

Macro-Architecture of Cortico-Basal Ganglia-Thalamo-Cortical Loops

Implications for Basal Ganglia Disorders

The Basal Ganglia are Interconnected with the Cerebellum

Implications for Basal Ganglia Disorders

References

Diffusion Tensor Imaging of the Basal Ganglia for Functional Neurosurgery Applications

Abstract

Introduction

DTI Imaging: Atlas versus Patient-Based Targeting

Diffusion Tensor Model: Brief Principles of Diffusion Imaging and Tractography Algorithms Available

DTI of the Basal Ganglia

Subthalamic Nucleus

Connectivity Studies

Targeting

Globus Pallidus

Thalamus

Use of DTI in Movement Disorder Surgery: Implications for Non-Invasive Surgical Methods

Conclusions

References

Patient Evaluation and Selection for Movement Disorders Surgery: The Changing Spectrum of Indications

Abstract

Patient Evaluation and Selection for DBS in PD

Classical Indication of DBS in PD: Balancing the Risks and Benefits

Implications of the Earlystim Study on the Time Point of DBS Surgery

The Right Target: STN versus GPi

ICD and DDS: Indication or Contraindication for DBS?

Patient Evaluation and Selection for DBS in Tremor. Essential Tremor

Multiple Sclerosis Tremor

Patient Evaluation and Selection for DBS in Dystonia

Primary Generalized and Segmental Dystonia

Myoclonus Dystonia and Tardive Dystonia

Secondary Dystonia

References

Image-Guided, Asleep Deep Brain Stimulation

Abstract

Safety of aDBS Implantation

Accuracy of aDBS Implantation

Efficacy of aDBS Implantation

Conclusions

References

Stereotactic Radiofrequency Lesioning for Movement Disorders

Abstract

Introduction

Very Basic Keys to Successful Lesioning

Macrostimulation

Lesioning Parameters

Thalamotomy for Tremor

Thalamotomy for Focal Dystonia

Pallidotomy for Segmental or Generalized Dystonia

Cure or Control

Bilateral Lesioning

Other Targets

Conclusions

References

Magnetic Resonance-Guided High Intensity Focused Ultrasound for Treating Movement Disorders

Abstract

Introduction

Indications

MRgFUS Procedure for Movement Disorders. Surgical Procedure for MRgFUS

MRgFUS for Movement Disorders

Controversial Issues. Skull-Related Factors: Skull Density Ratio and Skull Volume in the Treatment Area

MR-Induced Vertigo

Limitation of the Treatment Area According to the Transducer Frequency

Conclusion

References

Radiosurgical Thalamotomy

Abstract

Introduction: Physiology of Tremor and Initial Treatments

Beyond Medical Therapy for Tremors

History and Technique of GKRS Thalamotomy

Advantages and Disadvantages of GKRS

Efficacy of GK Thalamotomy

Complications after GK Thalamotomy

Conclusions

References

Radiosurgical Pallidotomy for Parkinson’s Disease

Abstract

Method for GKP

Long-Term Results for GKP

Unilateral GKP

Bilateral GKP

Complications

Discussion

Is GKP Safe?

Is GKP Effective?

Comparison of GKP, RPF, and DBS

References

Radiosurgical Subthalamic Nucleotomy

Abstract

The Subthalamic Nucleus as a Target in Movement Disorders

Radiosurgery as a Tool for Stereotactic Lesioning in Movement Disorders

STN Radiosurgery

Conclusions

References

Frameless Functional Stereotactic Approaches

Abstract

Introduction

Accuracy of Stereotactic Systems, Targeting Errors

Phantom Accuracy Studies

Clinical Accuracy Studies

Clinical Outcomes Using Stereotactic Systems

Procedural Review of Frameless Systems

Nexframe

STarFix

Clearpoint

Conclusion

References

Deep Brain Stimulation: Interventional and Intraoperative MRI Approaches

Abstract

Introduction

Principles and Shortcomings of Traditional Stereotaxis

Strategies for Optimizing Accuracy and Precision

Rationale for an iMRI DBS Approach

Conclusions

References

Thalamic Deep Brain Stimulation

Abstract

References

Deep Brain Stimulation of the Subthalamic Nucleus and Globus Pallidus for Parkinson’s Disease

Abstract

Introduction

Patient Selection for DBS

Cost Effectiveness of DBS

Long-Term Outcomes

Differential Effects of STN and GPi DBS for PD

Differential Effects of STN and GPi DBS for Dystonia

Targeting the STN and GPi

Placement of DBS Electrodes without Microelectrode Recording

Conclusions

References

Current and Expected Advances in Deep Brain Stimulation for Movement Disorders

Abstract

Introduction

Patient Selection

Target Selection

Planning and Operative Techniques

Hardware

Stimulation Parameters

MR-Guided Focused Ultrasound

Conclusion

References

Adaptive Brain Stimulation for Movement Disorders

Abstract

Introduction

Parkinson’s Disease

Parkinsonian and Essential Tremor

Tremor Amplitude

Tremor Phase

Dystonia

Potential Biomarkers of Dystonia

Potential Adaptive Stimulation Strategies for Dystonia

Conclusions

References

Drug Delivery for Movement Disorders

Abstract

Introduction

Glial Cell-Line Derived Neurotrophic Factor

Preclinical Studies of GDNF Delivery for PD

Intraventricular Administration of GDNF in Rodents

Intraventricular Administration of GDNF in Non-Human Primates

Clinical Trials of Intraventricular Infusion of GDNF for PD

Localized Intraparenchymal Delivery of GDNF in Rodents

Intraputamenal Delivery of GDNF in Non-Human Primate Studies

Chronic Intraputamenal Infusion of GDNF and Related Toxicity

Clinical Trials of Intraputamenal Delivery of GDNF

A Multicenter Randomized Controlled Trial of Intraputamenal GDNF Infusion for PD

Convection-Enhanced Delivery of GDNF to the Brain

Rationale for Chronic Intermittent CED

References

Gene Therapy for Parkinson’s Disease

Abstract

The Need for Gene Therapy in Movement Disorders

Scientific Background. Preclinical Research

Viral Vectors

Delivery Platform

Clinical Experience. Therapeutic Strategies

Glutamic Acid Decarboxylase

AADC

Tyrosine Hydroxylase, AADC, and Cyclohydrolase 1

Neurotrophins

Conclusion

References

Author Index

Subject Index

Отрывок из книги

Vol. 33

Series Editor

.....

Radiosurgical Subthalamic Nucleotomy

Régis, J.; Carron, R.; Witjas, T. (Marseille)

.....

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