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Deep Brain Stimulation Programming for Movement Disorders

  • Chapter
Deep Brain Stimulation in Neurological and Psychiatric Disorders

Part of the book series: Current Clinical Neurology ((CCNEU))

Abstract

The clinical success of deep brain stimulation (DBS) for treating advanced movement disorders is crucially dependent on the quality of postoperative neurological management. A well-implanted lead in an appropriately selected patient is useless without the application of proper stimulation settings. DBS therapy introduces in many cases a delicate balance of electrical and pharmacological treatment that requires a critical understanding of the principles of pulse generator programming. While the countless number of possible setting combinations seems to make programming a complicated and time-consuming endeavor, a systematic approach can prove invaluable in optimizing DBS therapy. This chapter outlines the general principles of stimulation, including the parameters that may be modulated to optimize therapy. We also review the common steps required to select optimal DBS contacts independent of the anatomical target and general troubleshooting guidelines. Programming issues relative to individual brain targets are addressed, which include the elements of anatomy, contact selection, medication adjustment (when appropriate), and specific stimulation-related side effects.

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Authors and Affiliations

  1. Department of Neurology, Mount Sinai School of Medicine, New York, NY, USA

    Ioannis U. Isaias & Michele Tagliati

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  1. Ioannis U. Isaias
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  2. Michele Tagliati
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Editors and Affiliations

  1. Parkinson's Disease and Movement Disorders Center, Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA

    Daniel Tarsy MD  & Daniel Tarsy MD  & 

  2. Neuromodulation Research Center, Lerner Research Institute, The Cleveland Clinic Foundation, Cleveland, OH, USA

    Jerrold L. Vitek MD, PhD

  3. Department of Neurosurgery, University of California, San Francisco, CA, USA

    Philip A. Starr MD, PhD

  4. Departments of Neurology and Neurosurgery, McKnight Brain Institute, University of Florida, Gainesville, FL, USA

    Michael S. Okun MD

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Isaias, I.U., Tagliati, M. (2008). Deep Brain Stimulation Programming for Movement Disorders. In: Tarsy, D., Vitek, J.L., Starr, P.A., Okun, M.S. (eds) Deep Brain Stimulation in Neurological and Psychiatric Disorders. Current Clinical Neurology. Humana Press. https://doi.org/10.1007/978-1-59745-360-8_20

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  • DOI: https://doi.org/10.1007/978-1-59745-360-8_20

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