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Related Concept Videos

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Psychosurgery, the surgical alteration or permanent removal of brain tissue to alleviate severe psychological conditions, stands as one of the most radical and controversial treatments in the history of mental health care. Its development and application have evolved significantly, marked by dramatic shifts in scientific understanding and ethical perspectives.
Historical Development of Psychosurgery
In the 1930s, Portuguese neurologist Antonio Egas Moniz introduced a surgical procedure designed...
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Related Experiment Video

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Intra-Operative Behavioral Tasks in Awake Humans Undergoing Deep Brain Stimulation Surgery
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Streamlining deep brain stimulation surgery by reversing the staging order.

Craig G van Horne1, Scott W Vaughan, Carla Massari

  • 1Department of Neurosurgery, St. Elizabeth's Medical Center, Brighton, Massachusetts; and.

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|March 10, 2015
PubMed
Summary

Reversing the surgical sequence for deep brain stimulation (DBS) implantation reduces patient anxiety and speeds up therapy initiation. This modified approach allows for quicker programming and symptom management following DBS surgery.

Keywords:
CRW = Cosman-Roberts-WellsDBS = deep brain stimulationanesthesiadeep brain stimulationfunctional neurosurgeryneuronavigation

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Area of Science:

  • Neurosurgery
  • Neurology
  • Biomedical Engineering

Background:

  • Deep brain stimulation (DBS) is a recognized therapy for various neurological conditions.
  • Current DBS surgical and stimulation implementation protocols lack standardization, potentially impacting patient experience and treatment timelines.

Purpose of the Study:

  • To evaluate a reversed surgical sequencing for staged deep brain stimulation (DBS) system implantation.
  • To assess the impact of this reversed sequence on patient anxiety, comfort, and the time to therapeutic stimulation.

Main Methods:

  • A modified two-stage surgical approach was implemented in over 140 cases.
  • Stage I involved general anesthesia for pulse generator/lead extension implantation and bur hole placement.
  • Stage II, under local anesthesia 1-7 days later, included microelectrode recording and electrode placement.

Main Results:

  • The reversed sequencing minimized patient anxiety and discomfort.
  • Therapeutic DBS therapy was typically initiated on the same day as lead implantation, within 48 hours of the second stage.
  • Patients tolerated the procedures, receiving a complete implanted system.

Conclusions:

  • Reversed sequencing of DBS implantation is a safe and effective alternative to standard protocols.
  • This approach facilitates earlier initiation of therapeutic stimulation, potentially improving symptom management.
  • The modified procedure enhances patient tolerance and reduces the overall time to effective treatment.