Intraoperative Neurophysiological Monitoring for Deep Brain Stimulation

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.Preface ; 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 DBS Algorithm ; Appendix B - Ventral Intermediate Thalamus DBS Algorithm ; Appendix C - Globus Pallidus Interna DBS Algorithm ; Appendix D - Microelectrode Recording Form for Subthalamic Nucleus DBS ; 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