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Alexey V. Dimov, Ajay Gupta, Brian H. Kopell, and Yi Wang

T he subthalamic nucleus (STN) is a deep gray matter structure that is located in the midbrain and known to be involved in regulation of cognitive and motor functions. 19 , 22 Due to the latter, the STN has been a primary target in deep brain stimulation (DBS) to improve parkinsonian symptoms. 7 , 31 , 47 Success of DBS is critically dependent on accurate placement of the stimulation electrodes. 48 However, precise targeting of the STN is a challenging task due to its small size, oblique orientation, and variations in anatomical location. 16 , 21 , 28 , 35

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Han Yan, Eric Toyota, Melanie Anderson, Taylor J. Abel, Elizabeth Donner, Suneil K. Kalia, James Drake, James T. Rutka, and George M. Ibrahim

complications such as hardware failure, deep infection, hoarseness, dysphasia, and torticollis have been described in children. 36 The responsive neurostimulation (RNS) system was approved by the FDA in 2003 for use in patients 18 years or older with DRE. Studies have demonstrated that adults can benefit from moderate seizure reduction, 14 , 17 but this new therapy has not yet been thoroughly studied in children. Deep brain stimulation (DBS) is a therapeutic option that delivers electrical stimulation in order to modulate cortical excitability, thereby reducing the

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Sanjeet S. Grewal, Erik H. Middlebrooks, Timothy J. Kaufmann, Matthew Stead, Brian N. Lundstrom, Gregory A. Worrell, Chen Lin, Serhat Baydin, and Jamie J. Van Gompel

F or patients with medically refractory focal epilepsy, surgical interventions include resection, ablation, or neuromodulation. The latter can be performed through vagus nerve stimulation, 31 responsive neurostimulation, 3 chronic subthreshold cortical stimulation, 16 , 22 and deep brain stimulation (DBS). 21 While many sites have been tested for DBS, including the centromedian nucleus of the thalamus (CMT), 21 the most rigorously studied site is the anterior nucleus of the thalamus (ANT). 7 Targeting the ANT has traditionally been accomplished using

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Robert J. Coffey

Pereira and colleagues present a well-documented case series of patients treated using thalamic deep brain stimulation (DBS) to treat pain that arose from two very different kinds of neurological injuries: preganglionic brachial plexus avulsion (BPA) and phantom limb pain consequent to peripheral nerve injuries after limb amputation. 6 To the authors' credit, they briefly discuss the apparent contradiction between the published findings of single-institution case series, including their own, and the decisions of DBS device manufacturers not to pursue

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J. Richard Toleikis, Leo Verhagen Metman, Julie G. Pilitsis, Andrei Barborica, Sandra C. Toleikis, and Roy A. E. Bakay

T he effect of DBS for the treatment of various movement disorders has been attributed to a number of mechanisms. 17 , 42 , 43 , 62 Modeling studies, 22 , 29 , 53 functional neuroimaging using positron emission tomography, 4 , 15 , 23 , 37 , 61 single photon emission CT 14 , 35 or functional MR imaging 3 , 49 , 57 and transcranial magnetic stimulation have been used to advance our understanding of network modifications induced by DBS. Perhaps the most direct method to study the effect of DBS on its target structure is offered by intraoperative MER

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James J. Zhou, Tsinsue Chen, S. Harrison Farber, Andrew G. Shetter, and Francisco A. Ponce

providers. 14 , 22 , 28 , 46 , 47 Deep brain stimulation (DBS) for the treatment of medically refractory epilepsy was pioneered in the 1970s and 1980s, with early studies on the effects of cerebellar and anterior thalamic stimulation in patients with epilepsy. 8 , 9 , 50 Since then, a growing body of literature has further supported the safety and efficacy of established targets such as the anterior nucleus of the thalamus (ANT), while simultaneously exploring alternative targets such as the centromedian nucleus of the thalamus (CMT), and the hippocampus (HCP). 6 , 24

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Katherine Leaver, Aaron Viser, Brian H. Kopell, Roberto A. Ortega, Joan Miravite, Michael S. Okun, Sonya Elango, Deborah Raymond, Susan B. Bressman, Rachel Saunders-Pullman, and Marta San Luciano

optimal candidacy for deep brain stimulation (DBS). Other features such as greater postural instability and gait disorder 3 may augur a less positive response. How these factors influence DBS candidacy and response is not well described. DBS can improve motor performance in patients with IPD, specifically alleviating the cardinal symptoms of tremor, rigidity, and bradykinesia and addressing motor fluctuations and dyskinesias. 8–10 DBS is less efficacious for freezing of gait and balance disorders. 11 The most common brain targets for PD are the subthalamic nucleus

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Alastair J. Martin, Paul S. Larson, Nathan Ziman, Nadja Levesque, Monica Volz, Jill L. Ostrem, and Philip A. Starr

I ntraoperative MRI has been used for a range of neurosurgical procedures such as tumor resection monitoring, biopsy, and laser ablation. 6 Over the past 10 years, we have pioneered the use of interventional (i)MRI techniques to implant deep brain stimulation (DBS) electrodes. 10 , 11 , 16 Precise electrode placement within a selected brain region is necessary to achieve efficacy, which is traditionally done with frame-based or “frameless” neuronavigation-guided stereotaxy supported by invasive physiological testing including microelectrode recording

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Andreas Nowacki, Ines Debove, Frédéric Rossi, Janine Ai Schlaeppi, Katrin Petermann, Roland Wiest, Michael Schüpbach, and Claudio Pollo

D eep brain stimulation (DBS) is an effective treatment for essential tremor (ET) in patients who do not tolerate or respond to medication. 20 The classical target for DBS treatment of ET is the ventrolateral thalamus (or ventral intermediate nucleus [Vim] according to Hassler 15 ). 4 Thalamic DBS has been demonstrated to improve tremor severity up to 48%–57%. 3 , 14 , 19 , 29 However, the optimal site is still a matter of debate, and other targets have been suggested for both lesioning and DBS. The posterior subthalamic area (PSA) includes the zona incerta

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Craig G. van Horne, Jorge E. Quintero, Julie A. Gurwell, Renee P. Wagner, John T. Slevin, and Greg A. Gerhardt

time. In this paper we describe the delivery of a peripheral nerve graft to the substantia nigra and the subsequent safety and adverse event profile of the procedure. We chose to investigate the safety and tolerability of peripheral nerve grafts in participants who had been selected clinically as good candidates for deep brain stimulation (DBS) surgery. There are several advantages to this approach. First, participants received the full benefit of the DBS therapy. The implant procedure and follow-up design was purposefully designed to not interfere with the DBS