Functional Neurosurgery Advances

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Deep Brain Stimulation and Parkinson's Disease

Peter Konrad, MD, PhD
New England Journal of Medicine Reports Superior Benefits Of Deep Brain Stimulation For Advanced Parkinson's Disease
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Deep Brain Stimulation (DBS):

KonradAs performed by Dr. Peter Konrad at Vanderbilt, surgery for the treatment of neurodegenerative symptoms such as rigidity, tremor and dyskinesia of Parkinson's disease is advancing. The use of deep brain stimulation (DBS) provides patients with an implanted system that delivers controlled electric stimulation to the brain to reduce the impulse toward involuntary movements. Depending on the patient, one or two electrodes (one for each side of the brain) may be needed to provide the proper stimulation. Because patients' own responses are essential for properly placing the electrodes, Dr. Konrad performs DBS while they are awake. In addition, advances in preoperative brain mapping techniques at Vanderbilt have made electrode placement more accurate. This is significant because of the small size of the targets being treated, and the need for precise placement of the electrode implant. Reducing the operating time makes the surgical procedure easier on patients.

DBS surgery at Vanderbilt is a team effort, combining surgical and imaging skills as well as constant research. Central to this success is the close collaboration of not only the neurosurgeon (Dr. Konrad), but a multidisciplinary treatment team and a research team. The treatment team includes specialists in movement disorders neurology (Drs. Charles, Cooper, Davis, Fang, and Hedera), a neuropsychologist (Dr. Tramontana), and a clinical neurophysiologist (Dr. Kao). Together they work to provide state-of-the-art diagnosis and treatment for all types of movement disorders, such as Parkinson's disease, essential tremor and dystonia. In addition, members of this group are actively engaged in advancing the latest technology and treatment options for surgical treatment through the use of DBS therapy. Additional members of the research team include engineers and computer scientists (Drs. Dawant, Fitzpatrick, Galloway, Jansen and Mahadevan-Jansen, and Miga). Research into the use of sophisticated computer-guided targeting and placement of electrodes has recently been awarded an NIH grant, under the direction of Drs. Dawant and Konrad. Research into the safety and possible neuroprotective benefits of DBS in early Parkinson's disease has also been awarded an industry sponsored grant, under the direction of Dr. Charles (Neurology).

To refer patients to the Surgical Movement Disorders Program for consideration of DBS or other treatment, please call 615-322-7417.

Epilepsy Surgery:
Presently, over 250 patients have undergone definitive epilepsy surgery to treat their seizures since1998. Procedures such as standard temporal lobectomy, selective amygdalo-hippocampectomy, and extra-temporal lobectomies are routinely performed at Vanderbilt University. In addition, more rare procedures such as corpus callosotomies and hemispherectomies are performed when indicated. Furthermore, vagus nerve stimulator implants are considered when resective surgery is not an option. Dr. Konrad is part of the Comprehensive Epilepsy Surgery Program at Vanderbilt, including more than 10 dedicated epilepsy neurologists, 2 clinical psychologists, and an 8 bed in-patient epilepsy monitoring unit. The Vanderbilt Comprehensive Epilepsy Program welcomes patients for consideration for definitive surgical treatment. For a referral, please call 615-322-3964.

Surgery for Pain:
Sometimes pain cannot be relieved by medications or minor procedures alone. Surgery is considered when medical and alternative therapy fails. Dr. Konrad accepts referrals for patients with medically refractory pain due to the following conditions: trigeminal neuralgia, atypical face pain, glossopharyngeal neuralgia, herpetic neuralgia, reflex sympathetic dystrophy (Complex Regional Pain Syndrome), central neuropathic pain, and pain related to cancer. Referrals should come from either a pain specialist, a neurologist or other physician who has exhausted non-surgical options. Physicians interested in referring patients for consideration should call 615-322-7417.

Procedures that Dr. Konrad can offer for complex pain problems include, but are not limited to: microvascular decompression, radiofrequency lesioning, motor cortex stimulation, peripheral and spinal stimulation (DCS), dorsal-root entry zone (DREZ) lesioning, cordotomy, deep brain stimulation (DBS), and cingulotomy.

Best Doctor Award
For his achievements in the field of functional neurosurgery, Dr. Peter Konrad has been chosen as one of the Best Doctors in America for 2005-2006. The Best Doctors organization provides evaluation services to employers and insurance companies for people seeking the best care choices for themselves and their loved ones.

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Department of Neurological Surgery
Vanderbilt University Medical Center
T-4224 Medical Center North
Nashville, TN 37232-2380