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David Moser, Eyal Zadicario, Gilat Schiff, and Daniel Jeanmonod

T he therapeutic application of focused ultrasound in functional neurosurgery requires refined target reconstructions and precise targeting accuracy measurements within the millimeter domain. Because targets are in normal tissue, coordinates have to be established for each target on the basis of a stereotactic atlas of the human brain. Such an atlas uses internal landmarks to position a coordinate system onto the brain, allowing the placement of any desired target inside the brain. We use the Stereotactic Atlas of the Human Thalamus and Basal Ganglia , 1

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Mark Hornyak, Richard L. Rovit, Arlene Stolper Simon, and William T. Couldwell

Irving S. Cooper was a pioneer in the field of functional neurosurgery. During his very productive and controversial career, he proposed the surgical treatment of Parkinson disease (PD) by ligating the anterior choroidal artery to control tremor and rigidity. Subsequently, he developed seminal techniques for chemopallidectomy and cryothalamectomy for PD. He also attempted to use electrical stimulation of the cerebellum or the thalamus to treat spasticity. Cooper continued his work on brain stimulation until his death in 1985. He made video recordings of nearly all of his patients during his tenure (1977–1985) at New York Medical College.

Cooper's clinical video recordings were reviewed, and selected footage was compiled into a video history of Cooper's surgical management of various movement disorders. Included are pre-, post-, and some intraoperative recordings that Cooper made to document his treatment of patients with PD, tremor, Wilson disease, cerebral palsy, chorea, dystonia musculorum deformans, and some rarer entities.

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Derrick A. Dupré, Nestor Tomycz, Michael Y. OH, and Donald Whiting

the coming decades. 62 Because of the consequences of this pandemic for society, investigators have intensified programs geared toward alleviating the burden of this debilitating disease. Thanks to recent advances in molecular genetics and functional neuroimaging, functional neurosurgery is one of the most recently developed tools used to treat morbid obesity. Deep brain stimulation (DBS) in particular has been shown to improve symptoms in neurological disorders such as Parkinson’s disease, essential tremor, and dystonia in both adults and children. 15 , 47

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Diego Ferrández-Sempere and José Eiras-Ajuria

The use of scalable templates representing the basal ganglia, as an aid in electrophysiological mapping, is a common practice among stereotactic functional neurosurgeons. The authors describe the procedure to create vectorial templates, based on the Atlas For Stereotaxy of the Human Brain by Schaltenbrand and Wahren, using inexpensive commercially available vectorial software.

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Marwan I. Hariz, Patric Blomstedt, and Ludvic Zrinzo

often working “in isolation” from other specialists. 35 The aim of the present review was to look for the seeds of what was to become one of the most rapidly expanding and most promising techniques in the field of functional stereotactic neurosurgery, and to establish if some of the contemporary claims related to the history of DBS can be substantiated. Methods We examined available publications on chronic stimulation of subcortical structures published between the dawn of human stereotactic functional neurosurgery in 1947 98 and the seminal paper of Benabid

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Yücel Kanpolat, Ali Savas, Sükrü Çaglar, Cüneyt Temiz, and Serdar Akyar

This study was presented at the XIIth Congress of the European Society for Stereotactic and Functional Neurosurgery, Milan, 1996.

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David S. Xu and Francisco A. Ponce


The aim of this article is to review the authors’ and published experience with deep brain stimulation (DBS) therapy for the treatment of patients with Alzheimer’s disease (AD) and Parkinson’s disease dementia (PDD).


Two targets are current topics of investigation in the treatment of AD and PDD, the fornix and the nucleus basalis of Meynert. The authors reviewed the current published clinical experience with attention to patient selection, biological rationale of therapy, anatomical targeting, and clinical results and adverse events.


A total of 7 clinical studies treating 57 AD patients and 7 PDD patients have been reported. Serious adverse events were reported in 6 (9%) patients; none resulted in death or disability. Most studies were case reports or Phase 1/2 investigations and were not designed to assess treatment efficacy. Isolated patient experiences demonstrating improved clinical response after DBS have been reported, but no significant or consistent cognitive benefits associated with DBS treatment could be identified across larger patient populations.


PDD and AD are complex clinical entities, with investigation of DBS intervention still in an early phase. Recently published studies demonstrate acceptable surgical safety. For future studies to have adequate power to detect meaningful clinical changes, further refinement is needed in patient selection, metrics of clinical response, and optimal stimulation parameters.

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Maya Harary, David J. Segar, Kevin T. Huang, Ian J. Tafel, Pablo A. Valdes, and G. Rees Cosgrove

associated with PD ( Fig. 5 ). 18 Their early studies also included forays into treatment of involuntary movement associated with cerebral palsy and pain syndromes. 20 Fig. 5. Science and Mechanics magazine cover featuring Meyers and Fry’s work, April 1963. Copyright elapsed, figure in public domain. By the second half of the 20th century, the ability to create focal lesions using FUS was established. However, since it required a craniotomy to avoid surface tissue damage and distortion of US beams by the skull, it was more invasive than the other methods of functional

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Charles G. diPierro, Paul C. Francel, Theodore R. Jackson, Toshifumi Kamiryo, and Edward R. Laws Jr.

Some of the earliest successful frame-based stereotactic interventions directed toward the thalamus and basal ganglia depended on identifying the anterior commissure (AC) and posterior commissure (PC) in a sagittal venticulogram and defining the intercommissural line that connects them in the midsagittal plane. The AC-PC line became the essential landmark for the localization of neuroanatomical targets in the basal ganglia and diencephalon and for relating them to stereotactic atlases.

Stereotactic functional neurosurgery has come to rely increasingly on magnetic resonance (MR) imaging guidance, and methods for accurately determining the AC-PC line on MR imaging are being developed. Our technique uses MR sequences that minimize geometric distortion and registration error, thereby maximizing accuracy in AC-PC line determinations from axially displayed MR data. The techniques are based on our experience with the Leksell G-frame, but can be generalized to other MR imaging-based stereotactic systems.

This methodology has been used in a series of 62 stereotactic procedures in 47 adults (55 pallidotomies and seven thalamotomies) with preliminary results equivalent or superior to results reported using microelectrode recordings. The measurements of the AC-PC line reported here compare favorably with those based on ventriculography and computerized tomography previously reported. The methodology reported here is critical in maintaining the accuracy and utility of MR imaging as its role in modern stereotaxy expands. Accurate parameters such as these aid in ensuring the safety, efficacy, and reproducibility of MR-guided stereotactic procedures.

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Marc Zanello, Johan Pallud, Nicolas Baup, Sophie Peeters, Baris Turak, Marie Odile Krebs, Catherine Oppenheim, Raphael Gaillard, and Bertrand Devaux

into 2 distinct departments: one of conventional neurosurgery and the other devoted to stereotactic and functional neurosurgery. 44 Talairach became head of the latter department. Despite his retirement in 1980, he pursued his research and published his third and fourth stereotactic atlases in 1988 and 1993. 47 , 48 He died at Sainte-Anne Hospital in March 2007, in a patient room that had been his office in the past. 30 Modern Times Alain Jaubert counted 23 French Neurosurgery Departments that had performed 300–350 psychosurgical interventions in 1976. 25 Thus it