Warren Marks1, Laurie Bailey2, Terence D Sanger3. 1. Cook Children's Medical Center, Fort Worth, TX, USA; University of North Texas Health Science Center, Fort Worth, TX, USA. Electronic address: warren.marks@cookchildrens.org. 2. Cook Children's Medical Center, Fort Worth, TX, USA; University of North Texas Health Science Center, Fort Worth, TX, USA. 3. University of Southern California, Dept. Biomedical Engineering, 1042 Downey Way, DRB 140, Los Angeles, CA 90089-1111, USA; Child Neurology and Movement Disorders, Children's Hospital Los Angeles, Div. Neurology, 4650 Sunset Blvd., MS 82 Los Angeles, CA 90027, USA. Electronic address: terry@sangerlab.net.
Abstract
BACKGROUND: Interactive neuromodulation represents the evolving frontier in surgical treatment of a variety of disorders involving the sensory organs and nervous system. Building on the advances of pioneering neurologists and neurosurgeons, progress has been made since the introduction of deep brain stimulation (DBS). Microelectrode recording has greatly aided our understanding of the underlying pathogenesis of movement disorders and the effects of electrical stimulation. The introduction of image - guided systems to provide targeted, controlled neuro-stimulation to specific brain areas is an emerging technique for implantation and may have special appeal for pediatric patients. RATIONALE/AIM: DBS is generally accepted as a treatment for some forms of childhood dystonia. Its potential role in other pediatric movement disorders is less well established. This is important, as most forms of dystonia begin in childhood or adolescence and many are inadequately responsive to current pharmacotherapy and other interventions. Nonetheless, many aspects of deep brain stimulation need clarification. CONCLUSION: This can only be accomplished through an organized platform for data sharing that will allow questions to be asked and hopefully answered, with the ultimate goal of developing evidence based practice based guidelines elucidating the role of DBS in pediatric patients.
BACKGROUND: Interactive neuromodulation represents the evolving frontier in surgical treatment of a variety of disorders involving the sensory organs and nervous system. Building on the advances of pioneering neurologists and neurosurgeons, progress has been made since the introduction of deep brain stimulation (DBS). Microelectrode recording has greatly aided our understanding of the underlying pathogenesis of movement disorders and the effects of electrical stimulation. The introduction of image - guided systems to provide targeted, controlled neuro-stimulation to specific brain areas is an emerging technique for implantation and may have special appeal for pediatric patients. RATIONALE/AIM: DBS is generally accepted as a treatment for some forms of childhood dystonia. Its potential role in other pediatric movement disorders is less well established. This is important, as most forms of dystonia begin in childhood or adolescence and many are inadequately responsive to current pharmacotherapy and other interventions. Nonetheless, many aspects of deep brain stimulation need clarification. CONCLUSION: This can only be accomplished through an organized platform for data sharing that will allow questions to be asked and hopefully answered, with the ultimate goal of developing evidence based practice based guidelines elucidating the role of DBS in pediatric patients.
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