Introduction to the programming of deep brain stimulators

  title={Introduction to the programming of deep brain stimulators},
  author={Jens Volkmann and Jan Herzog and Florian Kopper and G Deuschl},
  journal={Movement Disorders},
The clinical success of deep brain stimulation (DBS) for treating Parkinson's disease, tremor, or dystonia critically depends on the quality of postoperative neurologic management. Movement disorder specialists becoming involved with this therapy need to acquire new skills to optimally adapt stimulation parameters and medication after implantation of a DBS system. In clinical practice, the infinite number of possible parameter settings in DBS can be reduced to few relevant combinations. In this… Expand
Deep Brain Stimulation Programming for Movement Disorders
This chapter outlines the general principles of stimulation, including the parameters that may be modulated to optimize therapy, and the common steps required to select optimal DBS contacts independent of the anatomical target and general troubleshooting guidelines. Expand
Deep Brain Stimulation
The clinical efficacy of DBS has preceded scientific understanding of its therapeutic mechanisms of action and a number of conflicting hypotheses are currently under investigation. Expand
The Future of Deep Brain Stimulation
This chapter reviews the current uses of DBS, the understanding of underlying neurophysiology, and of devices, followed by emerging applications, progress in device optimization, and the future of functional neurosurgery. Expand
An update on best practice of deep brain stimulation in Parkinson’s disease
An overview of the clinical effects of DBS, the criteria for patient, target, and device selection, and strategies for a structured programming approach are given. Expand
Deformable Physiological Atlas-Based Programming of Deep Brain Stimulators: A Feasibility Study
A computerized system to facilitate one of the bottlenecks of DBS therapy: the IPG (Internal Pulse Generator) programming and preliminary results presented in this study suggest that this approach facilitates the programming process by guiding the neurologist to the optimal contact. Expand
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This review highlights some of the rescue procedures that have been explored in suboptimal DBS cases for Parkinson’s disease, essential tremor, and dystonia. Expand
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An up-to-date overview of the principles of DBS, its neural mechanisms and its potential future applications is given. Expand
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Deep brain stimulation in the treatment of severe dystonia
Although this is a retrospective study dealing with dystonia of heterogeneous etiology, the results strongly suggest that GPi DBS has a better outcome than VLp DBS. Expand
Effect on parkinsonian signs and symptoms of bilateral subthalamic nucleus stimulation
The effect of electrical stimulation of the subthalamic nucleus was assessed in three patients with disabling akinetic-rigid Parkinson's disease and severe motor fluctuations and could induce ballism that was stopped by reduction of stimulation. Expand
Long-term suppression of tremor by chronic stimulation of the ventral intermediate thalamic nucleus
Reversibility and adaptability, allowing control of side-effects, make thalamic stimulation preferable to thalamotomy, especially when treatment of both sides of the brain is needed. Expand
Identification of the target neuronal elements in electrical deep brain stimulation
It is concluded that the primary targets of stimulation in both nuclei are most probably large myelinated axons, taking advantage of the difference in strength–duration time constant of largeMyelinatedAxons. Expand
Globus pallidus deep brain stimulation for generalized dystonia: Clinical and PET investigation
Altering basal ganglia function with GPi DBS reverses the overactivity of certain motor cortical areas present in dystonia. Expand
Pallidal and thalamic neurostimulation in severe tardive dystonia
A 70 year old woman presented with a 6 year history of medically refractory severe tardive dystonia. After informed consent, a bilateral stereotactic electrode placement targeting the ventralExpand
Does stimulation of the GPi control dyskinesia by activating inhibitory axons?
A 69‐year‐old woman with Parkinson's disease and levodopa‐induced dyskinesias had a deep brain stimulation electrode inserted into the right globus pallidus internus and postoperatively stimulation through macroelectrode contacts located in the posterior ventral pallidum controlled the patient's dysKinesias. Expand
Bilateral pallidal stimulation for cervical dystonia: dissociated pain and motor improvement.
Two patients with idiopathic cervical dystonia (ICD) with only mild motor improvement but marked amelioration of pain symptoms following bilateral DBS of the posteroventral GPi are reported. Expand
Pallidal stimulation for generalized dystonia. Report of three cases.
Three patients with generalized dystonia are described and their improvement after bilateral pallidal stimulation at follow-up times of between 6 and 18 months is described. Expand
Parkinson’s Disease and Movement Disorders
  • W. Weiner
  • Medicine
  • Current Clinical Practice
  • 2000
•Get comprehensive, current information on every aspect (including behavioral and psychologic concomitants) of all common and uncommon movement disorders, including Parkinson's disease, otherExpand