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Topics in Neuromodulation Treatment TOPICS IN NEUROMODULATION TREATMENT Edited by José D. Carrillo-Ruiz Topics in Neuromodulation Treatment Edited by José D. Carrillo-Ruiz Published by InTech Janeza Trdine 9, 51000 Rijeka, Croatia Copyright © 2012 InTech All chapters are Open Access distributed under the Creative Commons Attribution 3.0 license, which allows users to download, copy and build upon published articles even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. After this work has been published by InTech, authors have the right to republish it, in whole or part, in any publication of which they are the author, and to make other personal use of the work. Any republication, referencing or personal use of the work must explicitly identify the original source. As for readers, this license allows users to download, copy and build upon published chapters even for commercial purposes, as long as the author and publisher are properly credited, which ensures maximum dissemination and a wider impact of our publications. Notice Statements and opinions expressed in the chapters are these of the individual contributors and not necessarily those of the editors or publisher. No responsibility is accepted for the accuracy of information contained in the published chapters. The publisher assumes no responsibility for any damage or injury to persons or property arising out of the use of any materials, instructions, methods or ideas contained in the book. Publishing Process Manager Vedran Greblo Technical Editor Teodora Smiljanic Cover Designer InTech Design Team First published March, 2012 Printed in Croatia A free online edition of this book is available at www.intechopen.com Additional hard copies can be obtained from [email protected] Topics in Neuromodulation Treatment, Edited by José D. Carrillo-Ruiz p. cm. ISBN 978-953-51-0395-0 Contents Preface VII Part 1 Neuromodulation Acting in Motor System 1 Chapter 1 Neuromodulation Advances for Seizure Control 3 Ana Luisa Velasco, José María Núñez, Daruni Vázquez, José Damián Carrillo-Ruiz, Manola Cuéllar-Herrera, Rubén Conde and Francisco Velasco Chapter 2 Neuromodulation in Management of Overactive Bladder 21 Hitoshi Oh-Oka Chapter 3 Challenges in Sacral Neuromodulation 35 Mai Banakhar, Tariq Al-Shaiji and Magdy Hassouna Chapter 4 Prelemniscal Radiations Neuromodulation in Parkinson Disease´s Treatment 63 José D. Carrillo-Ruiz, Francisco Velasco, Fiacro Jiménez, Ana Luisa Velasco, Guillermo Castro, Julián Soto, Victor Salcido Part 2 Neuromodulation Acting in Sensitive and Vascular System 87 Chapter 5 Mechanisms of Spinal Cord Stimulation in Neuropathic Pain 89 Imre P. Krabbenbos, E.P.A. van Dongen, H.J.A. Nijhuis and A.L. Liem Chapter 6 Intrathecal Drug Administration for the Treatment of Cancer and Non-Cancer Chronic Pain 111 William Raffaeli, Francesco Magnani, Jessica Andruccioli and Donatella Sarti Chapter 7 Electrical Neuromodulation and the Heart with Special Emphasis on Myocardial Ischemia 143 Mike J.L. DeJongste Chapter 8 Use of Non-Invasive Brain Stimulation in Stroke 167 Sultan Tarlaci and Bulent Turman Preface Neuromodulation is today an issue that has caused a great interest in recent years within the area of neuroscience and science in general. It has been defined as the application of electricity or chemicals in the central or peripheral nervous system for therapeutic purposes, i.e, is the procedure used in the nervous system to use the same way as neurons communicate among them to modify their anatomy and physiology, and therefore can change the pathophysiology of the disease. The reason for doing this is to modify the environment and improving neural function caused by cellular alterations in different diseases. The ancient Chinese, Egyptians and Greeks used the electricity for therapeutic option, and it was followed in the Middle Age by some authors, but is taken up by Guillaume Duchenne in Paris, to treat some diseases such as facial paralysis and neurosis. During the eighteenth century to the sixties of the twentieth century there was great progress until a neurosurgery resident at the time, Dr. Norman Shealy, based on original work in dogs with the use of a pacemaker for conduction problems in the heart is proposed in the treatment of pain using neuromodulation in adapting this device for emitting a power source to the surface of the spinal cord to relieve pain. It was initially used to treat patients with malignancies (in other organs) and a short life expectancy, but it took nearly twenty years to gain experience and demonstrate that treatment was effective with the change of indications also. This experience showed incipient success so early attempts were made to treat others as epilepsy and Parkinson's disease to control seizures and tremor, respectively. The goodness of the use of neuromodulation clinched the next ten-years of experience in these three areas. It was significantly increasing the extension use for different symptoms of the disease and especially of different neurosurgical brain targets. The nineties and the dawn of the new millennium triggered an explosion of information in neurological and psychiatric illness which have been increasing over time. The application of electrodes in the brain, spinal cord or nerves has led to improve the signs or symptoms of pathological conditions such as dystonia, depression, obsessive-compulsive disorder, spasticity, including some of the most important. However this has been extended to other areas such as urinary and fecal incontinence, angina and vascular pain disease and every day there are other indications such as stroke that is very new. In the case of substance use, within the nervous system have been confined mainly to pain with the application of intrathecal morphine and implementation of various VIII Preface analgesics for reducing the symptoms. The discovery of baclofen in the mid-eighties lessened spasticity in patients with spinal trauma or stroke. To date both drugs with their indications are valid. At present new substances have been used to improve pain and spasticity with limited results. A new chapter has been opened to the treatment of these diseases by the magneto- therapy in which surgery is not necessary in the brain or spinal cord with results that still have to be proven whether they are comparable to those used in more invasive way . The idea of this book is to give the reader a clear idea about these issues picking up the basics, indications for the use of neuromodulation in neurological, urological and vascular disease, expose complications and demonstrate the extensive experience of the clinical groups writing the book´s chapters. This book "Topics in Neuromodulation therapy," aims to provide elements for the non- expert, but also to delve into some of these aspects of the diseases, mentioned above. The book has been divided into two sections: the first one, neuromodulation treatment that acts on the motor system which included epilepsy, urinary and fecal incontinence, and Parkinson's disease. In addition, a section that involves a sensitive part for the treatment of pain, and some in turn involving ischemia in the heart and brain. The desire of the authors is that the readers will enjoy this text especially in helping to treat their patients. Sincerely, José D. Carrillo-Ruiz, M.D., M.Sc., Ph.D, Associate Professor of Functional and Stereotactical Neurosurgery and Radiosurgery, Faculty of Medicine, UNAM and Faculty of Health Science and Psychology, Universidad Anahuac Mexico Norte, México Part 1 Neuromodulation Acting in Motor System 1 Neuromodulation Advances for Seizure Control Ana Luisa Velasco1, José María Núñez1, Daruni Vázquez1, José Damián Carrillo-Ruiz1, Manola Cuéllar-Herrera1, Rubén Conde2 and Francisco Velasco1 1Epilepsy Clinic, Neurology and Neurosurgery Service of the General Hospital of Mexico, 2Azteca Laboratories, Mexico City Mexico 1. Introduction Epilepsy surgery has had an impressive development over the years, becoming a first option for many patients who have refractory seizures. The results of conventional surgery are Fig. 1. Patients that are rejected from conventional epilepsy surgery This flow diagram shows the usual route a patient follows to undergo a surgical procedure. In red are shown those patients who are rejected from surgery. Almost all patients who have none lesional MRI (magnetic resonance imaging) are almost always rejected (dropouts) since the diagnostic procedure is complicated and the outcome is not very reassuring. Patients who have lesions are sometimes rejected too. This is due to an involvement of primary functions with high risk of postsurgical neurologic deficit. 4 Topics in Neuromodulation Treatment excellent thanks to experience, and better diagnostic and surgical techniques. Nevertheless, there are a number of patients who are rejected due to several reasons, for example bilateral or multiple epileptic foci, focus involving primary functional areas of the brain, generalized seizures or non lesional imaging studies. It has been calculated that there is a 30% of patients who need surgery that have to be rejected. These patients need a surgical alternative, and neuromodulation might be the answer to many of them. (Figure 1). Even though neuromodulation has been proposed as an ideal surgical alternative for a number of neurological disorders, it’s application for the control of epileptic seizures would seem to be the most appropriate therapeutic indication
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