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Neurosurgical Forum: Letters to the Editor To The Editor Richard M. Lehman , M.D. Robert Wood Johnson Medical School New Brunswick, New Jersey 1162 1164 Abstract Reversibility and adaptability are preferred features of long-term therapeutic deep brain stimulation (DBS). In such therapy, a permanent stimulating electrode with four contact points is placed at the stimulation site and, generally speaking, bipolar stimulation is induced by various pairs of adjacent contact points on one electrode. The stimulation

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David S. Xu and Francisco A. Ponce

understanding the neurobiology of dementias, no treatments are currently available to significantly alter their natural history. An emerging avenue of therapy currently under investigation is deep brain stimulation (DBS), which has demonstrated an ability to engage and regulate dysfunctional neuronal circuits across multiple neural networks. Furthermore, cellular responses that occur after DBS may direct trophic effects to local neural tissue, potentially counteracting chronic degenerative disease processes. In this manuscript, we provide a summary of the current body of

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Nasir Raza Awan, Andres Lozano, and Clement Hamani

, Hamani C, Moro E, Lozano AM, Deep brain stimulation and movement disorder treatment, 369–373, 2009, 65 with permission from Elsevier. Movement Disorders Parkinson Disease The introduction of DBS as a therapeutic tool for advanced PD has revolutionized the clinical management of this condition. Due to its safety profile and efficacy, DBS evolved from a last-resort therapeutic option to a modality that is now routinely offered to patients. Over the years, surgical candidates and the outcome expected with this procedure became well established. In fact, there

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Kristian J. Bulluss, Erlick A. Pereira, Carole Joint, and Tipu Z. Aziz

I n the 1990s, publication of the long-term results of pallidotomy for advanced Parkinson's disease (PD) showing significant loss of dyskinesias, rigidity, and tremor led to a second resurgence of stereotactic surgery for PD. 11 However, the relatively high incidence of side effects in some series and the demonstration that bilateral subthalamic nucleus (STN) stimulation was effective and led to a significant reduction in drug requirement, unlike pallidal surgery, resulted in the procedure of choice becoming deep brain stimulation (DBS). With the

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Chikashi Fukaya, Yoichi Katayama, Toshikazu Kano, Takafumi Nagaoka, Kazutaka Kobayashi, Hideki Oshima, and Takamitsu Yamamoto

pallidus internus for control of primary generalized dystonia . Acta Neurochir Suppl 87 : 125 – 128 , 2003 9 Katayama Y , Kano T , Kobayashi K , Oshima H , Fukaya C , Yamamoto T : Difference in surgical strategies between thalamotomy and thalamic deep brain stimulation for tremor control . J Neurol 252 : 4 Suppl 17 – 22 , 2005 10 Krause M , Fogel W , Kloss M , Rasche D , Volkmann J , Tronnier V : Pallidal stimulation for dystonia . Neurosurgery 55 : 1361 – 1368 , 2004 10.1227/01.NEU.0000143331.86101.5E 11 Krauss JK

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Thomas L. Ellis and Andrew Stevens

stimulation may yield up to a 50% reduction in seizure frequency, 2 although most of these patients will not be completely seizure free. Deep brain stimulation is another example of neuromodulation. Given the significant experience and success of DBS for movement disorders 39 combined with its reversibility, programmability, and low risk of complications, there has been a resurgence of interest in using DBS devices for treating medically refractory epilepsy. Deep brain stimulation lead implantation within the ANT, as well as other CNS targets—including the CN

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Dan Piña-Fuentes, Martijn Beudel, Simon Little, Jonathan van Zijl, Jan Willem Elting, D. L. Marinus Oterdoom, Martje E. van Egmond, J. Marc C. van Dijk, and Marina A. J. Tijssen

basis is that dystonia is the result of abnormal activity in cortico-basal ganglia-thalamo-cortical (CBGTC) and cerebellar networks. 52 The treatment for the majority of dystonia subtypes only provides symptomatic relief, without addressing the underlying cause of the disease. Options currently available include oral medication (e.g., anticholinergic and antidopaminergic drugs, benzodiazepines, and baclofen), botulinum toxin (treatment of choice in focal dystonias), and deep brain stimulation (DBS). 4 DBS in Dystonia Given the limited efficacy and high prevalence of

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Matthew Moser, Shripadh Chitta, Patrick F. O’Brien, Andrew Caras, and Kathryn L. Holloway

. References 1 Bernstein JE , Kashyap S , Ray K , Ananda A . Infections in deep brain stimulator surgery . Cureus . 2019 ; 11 ( 8 ): e5440 . 31632885 2 Bjerknes S , Skogseid IM , Sæhle T , Dietrichs E , Toft M . Surgical site infections after deep brain stimulation surgery: frequency, characteristics and management in a 10-year period . PLoS One . 2014 ; 9 ( 8 ): e105288 . 10.1371/journal.pone.0105288 3 Jitkritsadakul O , Bhidayasiri R , Kalia SK , Hodaie M , Lozano AM , Fasano A . Systematic review of hardware

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Jason M. Schwalb, Howard A. Riina, Brett Skolnick, Jurg L. Jaggi, Tanya Simuni, and Gordon H. Baltuch

, Telfeian A , Baltuch GH , et al : Long-term deep brain stimulation in a patient with essential tremor: clinical response and postmortem correlation with stimulator termination sites in ventral thalamus. Case report. J Neurosurg 93 : 140 – 144 , 2000 Boockvar JA, Telfeian A, Baltuch GH, et al: Long-term deep brain stimulation in a patient with essential tremor: clinical response and postmortem correlation with stimulator termination sites in ventral thalamus. Case report. J Neurosurg 93: 140–144, 2000 4. Lozano A

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Tsinsue Chen, Zaman Mirzadeh, Kristina Chapple, Margaret Lambert, Rohit Dhall, and Francisco A. Ponce

the planned trajectory, or the shortest distance from Contact 1 to the planned trajectory. FIG. 1. Framelink image of ventral intermediate nucleus deep brain stimulation contact 1 placed to target with listed coordinates and calculated error. Figure is available in color online only. Functional Outcomes Assessment The Bain and Findley Tremor Activities of Daily Living (ADL) Questionnaire was mailed to patients postoperatively. 3 , 5 Patients were asked to complete the questionnaire based on preoperative and postoperative self-assessment. Of the 17