Abstract
This chapter explains how chronic electrical deep brain stimulation (DBS) has supplanted neuroablation as the primary neuromodulatory technique and has become a standard treatment for medically refractory essential tremor, Parkinson's disease, and primary dystonia. The treatment of obsessive-compulsive disorder (OCD) with DBS has been approved in the USA and pivotal trials of DBS for epilepsy and major depressive disorder (MDD) are either completed or in progress. The mechanisms underlying pain relief via stimulation at these sites appear to be different yet are still not completely understood. Hosobuchi proposed that pain relief derived from PVG/PAG stimulation is mediated by opioid release following the observation that stimulation-induced analgesia at this site is blocked with naloxone. Tremor is a rhythmic, involuntary oscillation of the musculature that can affect the head, extremities, and/or trunk. By its very nature, epilepsy would appear to be the ideal disorder to treat with electrical neurostimulation and, in particular, intermittent responsive stimulation. Toward that end, neurosurgeons have targeted a number of deep cerebral, cerebellar, and brainstem sites with the hope of controlling seizure disorders.
Original language | English |
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Title of host publication | Essential Neuromodulation |
Publisher | Elsevier Inc. |
Pages | 47-72 |
Number of pages | 26 |
ISBN (Print) | 9780123814098 |
DOIs | |
State | Published - 2011 |