Functional Neurosurgery : Current Status and the Future

Abstract

  Functional neurosurgery, including deep-brain stimulation (DBS), stereotactic surgery, and epilepsy surgery, have entered a new era in the 21st-century following the development of technology and investigation in neuroscience. In particular, advances in surgical techniques and devices are essential for the evolution of functional neurosurgery. In this century, magnetic resonance imaging (MRI) -guided targeting for stereotactic surgery has become a common method. The implantable stimulation device (IPG) and stimulus electrode for DBS and spinal cord stimulation have greatly progressed. A rechargeable IPG and directional electrodes have already been used. MRI-guided focused ultrasonography is one of the minimally invasive methods to visualize brain lesions and has been applied to control essential tremor. In addition, implantable drug delivery pump has been used as an intrathecal baclofen therapy for spasticity, and vagus nerve stimulation has become a possible therapy for epilepsy. The advancement and introduction of these devices contribute not only to better therapeutic effect but also to the expansion of indication. The development of computational technology leads to progression in neuroscience. With this progression, the evolution of functional neurosurgery is expected to contribute to a wide range of patients with dementia and mental illness.