Thursday, February 5th
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Brain Control: Surgical
Technology for Fixing the Malfunctioning Brain
Eric E. Sabelman, PhD
Kaiser Permanente Medical Center
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Abstract: It is now possible to treat Parkinson's
Disease and similar movement disorders by implanting a multi-contact electrode
into the region of the brain that causes tremor and stiffness. Such Deep Brain
Stimulation (DBS) electrodes do not cure the disease, but relieve symptoms when
medication is no longer effective - the definition of a
"neuroprosthesis." Unlike older surgical treatments that simply
burned out the malfunctioning region, the stimulation parameters of the DBS
pulse generator can be tuned (varying contact selection and polarity, pulse
rate, width and amplitude) for best effect as the patient’s disease
progresses. Since DBS recipients may be given partial control over stimulation
parameters, the patient’s participation in determining long-term outcome
differs from other neurosurgery.
DBS surgery can be beneficial whenever a precise
causative location in the brain can be reached by a straight path without
passing through life-dependent structures. Thus, DBS is unsuitable for problems
that afflict the whole brain, like Alzheimer’s Disease. Surprisingly,
besides movement disorders, DBS targets have been identified for
neuropsychiatric syndromes: Tourette’s Disease, obsessive-compulsive
disorder, and some forms of depression and behavioral addiction. Does this mean
that everyone with a treatable "illness" will be given a DBS implant?
Or that DBS surgery will be used to enforce "normal" behavior? Not
very likely, given the extreme difficulty of deep electrode implantation
surgery, which requires accuracy an order of magnitude better than
"routine" brain surgery.
Biosketch: Dr. Sabelman is the founder of
Pro-Zooics Research, which has been engaged in biomedical design and consulting
since 1979. Eric has been on the core staff of the VA Palo Alto Rehabilitation
R&D Center, where he investigated wearable computers for human body motion
analysis, acute spinal cord injury patient care, and tissue engineering for
nerve repair and reconstructive surgery. He is an Adjunct Lecturer in
Mechanical Engineering at Santa Clara University, and affiliated with the
Biodesign Program at Stanford. He will discuss his current work at Kaiser
Permanente on Deep Brain Stimulation for treatment of Parkinson's
Disease.
- Contact information:
- Eric E. Sabelman, PhD
- Functional Neurosurgery Bioengineer
- Kaiser Permanente Medical Center
- Department of Neurosurgery
- 1150 Veterans Blvd.
- Redwood City, CA 94063
- 650/299-4146
- 650/299-3693 fax
- eric.sabelman -at- kp.org
- Lecture Material:
- Handout - 1.6 Mb pdf
file
- Slides - 6.0 Mb
pdf file
- Audio - 1:16:32 - 17.5
mp3 file
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