By William J. Marks Jr
A pragmatic consultant to using this really new remedy for the motor indicators of assorted circulation disorders.
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Extra info for Deep Brain Stimulation Management
A wide range of targeting techniques is currently used. In a recent survey of 36 North American DBS centers,18 most sites used the stereotactic frame (Leksell, CRW, or Compass) for initial targeting and intraoperative electrode guidance, but a few used the frameless stereotactic technique. The frame-based and frameless techniques require preoperative imaging using MRI and/or MRI/CT fusion techniques for initial anatomical targeting. The frame-based targeting uses fiducial markers on the frame as a guide, and thus the targeting is performed on the day of surgery.
Cambridge University Press 2011. Chapter 4: Principles of neurostimulation and neuromodulators relate directly to the electrical effects of DBS on neural elements. In the case of neurotransmitters, the depolarization due to action potentials arriving at the axonal terminals at the synapse generates the release of neurotransmitters. There is considerable evidence that DBS-related changes in neurotransmitters and neuromodulators are unlikely to fully explain the DBS mechanisms of action. The time course of neurotransmitter and neuromodulator release is too coarse relative to the time scale of the DBS effect.
Stimulation may be through any one or several electrodes on the lead in a monopolar (unipolar) mode or through any pair of electrodes in a bipolar mode. Thus, stimulation through different electrodes or combinations of electrodes will result in a different topography of electrical field. Intraoperative DBS test stimulation may be done through a dipole across all the contacts (designating the most distal electrode, 0, as negative and the most proximal electrode, 3, as positive), but some clinicians may choose to assess the therapeutic window across each electrode in a monopolar fashion in the operating room.