Method of Electrostimulation of the Deep Brain Structures in Treatment of Some Chronic Diseases

Bechtereva, N.P.; Bondartchuk, A.N.; Smirnov, V. M.; Meliutcheva, L A; Shandurina, A.N.

doi:10.1159/000102727

Cited by 82 publications

(32 citation statements)

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“…7 Bechtereva 8 coined the term "therapeutic electrostimulation" to describe this technique. Since the Union of Soviet Socialist Republics did not have access to implantable neurostimulators at that time, the last steps of the treatment were ultimately small lesions performed through the electrodes yielding the best stimulation responses 7 (Nathalia Bechtereva [July 7, 1925-June 22, 2008, personal communication to Patric Blomstedt, April 6, 2008).…”

Section: 106mentioning

confidence: 99%

“…In 1969, Blaine Nashold and his colleagues 73 stimulated various subcortical structures including the ventrolateral thalamus, the subthalamic nucleus, and the zona incerta and reported that tremor suppression occurred at frequencies of 120-300 Hz. In 1973, Bechtereva et al 7 advocated the use of "electric stimulation with high-rate pulses" of subcortical structures, however, without specifying what she meant by high-rate pulses. In 1979, Laitinen 58 studied emotional responses to subcortical electrical stimulation in 135 psychiatric patients.…”

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confidence: 99%

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Deep brain stimulation between 1947 and 1987: the untold story

Hariz

Blomstedt

Zrinzo

2010

FOC

199

120

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Deep brain stimulation (DBS) is the most rapidly expanding field in neurosurgery. Movement disorders are well-established indications for DBS, and a number of other neurological and psychiatric indications are currently being investigated. Numerous contemporary opinions, reviews, and viewpoints on DBS fail to provide a comprehensive account of how this method came into being. Misconceptions in the narrative history of DBS conveyed by the wealth of literature published over the last 2 decades can be summarized as follows: Deep brain stimulation was invented in 1987. The utility of high-frequency stimulation was also discovered in 1987. Lesional surgery preceded DBS. Deep brain stimulation was first used in the treatment of movement disorders and was subsequently used in the treatment of psychiatric and behavioral disorders. Reports of nonmotor effects of subthalamic nucleus DBS prompted its use in psychiatric illness. Early surgical interventions for psychiatric illness failed to adopt a multidisciplinary approach; neurosurgeons often worked “in isolation” from other medical specialists. The involvement of neuro-ethicists and multidisciplinary teams are novel standards introduced in the modern practice of DBS for mental illness that are essential in avoiding the unethical behavior of bygone eras. In this paper, the authors examined each of these messages in the light of literature published since 1947 and formed the following conclusions. Chronic stimulation of subcortical structures was first used in the early 1950s, very soon after the introduction of human stereotaxy. Studies and debate on the stimulation frequency most likely to achieve desirable results and avoid side effects date back to the early days of DBS; several authors advocated the use of “high” frequency, although the exact frequency was not always specified. Ablative surgery and electrical stimulation developed in parallel, practically since the introduction of human stereotactic surgery. The first applications of both ablative surgery and chronic subcortical stimulation were in psychiatry, not in movement disorders. The renaissance of DBS in surgical treatment of psychiatric illness in 1999 had little to do with nonmotor effects of subthalamic nucleus DBS but involved high-frequency stimulation of the very same brain targets previously used in ablative surgery. Pioneers in functional neurosurgery mostly worked in multidisciplinary groups, including when treating psychiatric illness; those “acting in isolation” were not neurosurgeons. Ethical concerns have indeed been addressed in the past, by neurosurgeons and others. Some of the questionable behavior in surgery for psychiatric illness, including the bygone era of DBS, was at the hands of nonneurosurgeons. These practices have been deemed as “dubious and precarious by yesterday's standards.”

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Section: 106mentioning

confidence: 99%

mentioning

confidence: 99%

Deep brain stimulation between 1947 and 1987: the untold story

Hariz

Blomstedt

Zrinzo

2010

FOC

199

120

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“…Natalia Petrovna Bekthereva first applied DBS chronically in 1963. Because she published in Russian, her works were not well known until 1975 [200][201][202]. McLellan soon followed in the 1970s [196,201,203] but some had so employed DBS dating back to the 1960s [181,185,[204][205][206].…”

Section: Gabriel and Nashold Statementioning

confidence: 99%

“…Because she published in Russian, her works were not well known until 1975 [200][201][202]. McLellan soon followed in the 1970s [196,201,203] but some had so employed DBS dating back to the 1960s [181,185,[204][205][206]. Starting in 1975, Mundinger used deep brain stimulation of the ventrolateral thalamus for the treatment of movement disorders and reported successfully treated cases in 1982 [207].…”

Section: Gabriel and Nashold Statementioning

confidence: 99%

The Development of Deep Brain Stimulation for Movement Disorders

Greek¹

2012

J Clinic Res Bioeth

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The development of deep brain stimulation has revolutionized care for patients with movement disorders like Parkinson's disease. Many areas of science contributed to this technology but one area, the use of animal models, has been cited as vital. We review these claims as well as the history of the discoveries that eventually led to deep brain stimulation in an attempt to ascertain: 1) the contributions of animal models; 2) the contributions from humanbased research and observation; and the role of advances in the engineering, physics, and computer science. We distinguish between advances and discoveries that were, or at least appear to be, dependent on animal models and those where animals were involved but that could have occurred, and/or were occurring simultaneously, with humanbased research. We conclude that animal-based research played a role in defining gross anatomy in the 19 th and early 20 th centuries, but that essentially all subsequent advances were human-based or secondary to advances in the physical and applied sciences. This has historical, funding, and ethical implications as the development of deep brain stimulation is cited as an example of the importance of animal-based research and a reason for continued social and financial support of animal models in general as opposed to clinical research, other human-based research modalities, and the various disciplines of the physical and applied sciences.

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“…The art of "sharpshooting into the brain" continued to be advanced through the efforts of multiple neurosurgeons and scientists worldwide including Hecaen et al 16 and Guiot et al 13 28 in Spain, and Bechtereva et al 4 in Russia, among others. 11 The leaders in the field of stereotaxy created the International Society for Research in Stereoencephalotomy during an international symposium in Philadelphia in 1961.…”

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confidence: 99%

Early history of the stereotactic apparatus in neurosurgery

Rahman¹,

Murad²,

Mocco³

2009

FOC

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Stereotactic neurosurgery has a rich history, beginning with the first stereotactic frame described by Horsley and Clarke in 1908. It is now widely used for delivery of radiation, surgical targeting of electrodes, and resection to treat tumors, epilepsy, vascular malformations, and pain syndromes. These treatments are now available due to the pioneering efforts of neurosurgeons and scientists in the beginning of the 20th century. Their efforts focused on the development of stereotactic instruments for accurate lesion targeting. In this paper, the authors review the history of the stereotactic apparatus in the early 20th century, with a focus on the fascinating people key to its development.

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Method of Electrostimulation of the Deep Brain Structures in Treatment of Some Chronic Diseases

Cited by 82 publications

References 2 publications

Deep brain stimulation between 1947 and 1987: the untold story

Deep brain stimulation between 1947 and 1987: the untold story

The Development of Deep Brain Stimulation for Movement Disorders

Early history of the stereotactic apparatus in neurosurgery

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