Essential Neuromodulation

Jeff Arle, MD, PhD, FAANSDr. Arle is currently the Associate Chief of Neurosurgery at Beth Israel Deaconess Medical Center in Boston, the Chief of Neurosurgery at Mt. Auburn Hospital in Cambridge, and an Associate Professor of Neurosurgery at Harvard Medical School. He received his BA in Biopsychology from Columbia University in 1986 and his MD and PhD from the University of Connecticut in 1992. His dissertation work for his doctorate in Biomedical Sciences was in computational modeling in the Cochlear Nucleus. He then went on to do a residency in neurosurgery at the University of Pennsylvania, incorporating a double fellowship in movement disorder surgery and epilepsy surgery under Drs. Patrick Kelly, Ron Alterman, and Werner Doyle, finishing in 1999. He edited the companion text Essential Neuromodulation with Dr. Shils, the first edition published by Elsevier in 2011. He has now practiced in the field of functional neurosurgery for 17 years and is experienced in all areas of neuromodulation from deep brain stimulators to vagus nerve, spinal cord, peripheral nerve, and motor cortex stimulators, contributing frequent peer-reviewed publications and numerous chapters to the literature on many aspects of the neuromodulation field. He currently serves as an associate editor at the journals Neuromodulation and Neurosurgery, is the co-chair of the Research and Scientific Policy Committee for the International Neuromodulation Society, and is on the Board of Directors for the International Society for Intraoperative Neurophysiology. His longstanding research interests are in the area of computational modeling in the understanding and improved design of devices used in neuromodulation treatments. Jay L. Shils, Ph.D., D.ABNM, FASNM, FACNS is currently the director of intraoperative neurophysiological monitoring at Rush University Medical School and an Associate Professor in the department of Anesthesiology at Rush Medical Center. He received his Bachelor of Science degree in electrical engineering from Syracuse University, and both his masters and PhD in Bio-Engineering at The University of Pennsylvania using with his thesis dissertation subject – “The Bispectrum of the Human Electroencephalogram” to investigate interactions in the visual system and study EEG in epilepsy. Dr. Shils has been involved in intraoperative neuromonitoring since 1994 specializing in microelectrode neurophysiology for movement disorders. Dr. Shils is the co-editor of two neuromodulation related books which is one of his primary interests and the first edition of this book. Dr, Shils is a past president of the ASNM and the ISIN and is the founding secretary of the ISIN. Dr. Shils is the present secretary of the ASNM. Over the years Dr. Shils has presented at over 100 national and international has published on MER, DBS, neuromodulation, and intraoperative monitoring techniques.

Part I: The Neuromodulation Approach
1. The Neuromodulation Approach

Part II: Regions of Application
2. Cerebral – Surface
3. Cerebral – Deep
4. Spinal – Extradural
5. Peripheral Nerve
6. Imaging, frameless targeting and techniques

Part III: The Neuromodulation Therapy Interface
7. The Electrode – Materials and Configurations
8. The Electrode – Principles of the Neural Interface
9. The Electrode – Principles of the Neural Interface
10. Device Materials, Handling, and Upgradability
11. Electronics
12. Power
13. New waveforms – advantages and applications

Part IV: Placing Neuromodulation in the Human Body
14. Surgical Techniques
15. Trials and Their Applicability
16. Limiting Morbidity
17. Intraoperative Physiology techniques to inform targeting

Part V: Troubleshooting and Repair
18. Intraoperative Evaluation

Part VI: Postoperative Management
19. Programming – DBS Programming
20. Programming – SCS
21. Safety Concerns and Limitations

Part VII. The End User
22. Expectations and Outcomes
23. Neuromodulation Perspectives