The modulation of neural and mind circuits

ايلالخا نم بيكرتلا ةدقعلما رئاودلا نم ةفلتخم تاعومجم دجوي تايكولسلا ميظنت ىلع لمعت يتلا ةيبصعلا ةيئايميكلاو ةيبصعلا تابارطضا رئاودلا هذه يف للاتخا يأ دلويو .غامدلا فئاظوو تابارطضلااو ،ةركاذلاو ،ةكرلحا تابارطضا لثم ةيفيظو ةيبصع مللأا ضارمأو عرصلا ضرم ثودح ىلإ يدؤي دق امك ،ةيسفنلا فئاظولا ةداعتسا يف ةيفيظولا باصعلأا ةحارج مهاست .نمزلما ليدعت وأ ةيعيبط ريغلا ةيبصعلا ايلالخا ةلازإ قيرط نع ةيعيبطلا ليدعت ةحارج دعت .ةيبصعلا تابارطضلال ةببسلما رئاودلا ةفيظو يف ةلئاه تاروطت هبحصي روطتلا عيرس لًاقح ةيبصعلا فئاظولا يف شقانن فوس .ةثيدلحا ايجولونكتلاو يبصعلا ريوصتلا لاجم ةيبصعلا ةحارلجا لاجم يف ةديدلجا قافلآاو تاروطتلا ثحبلا اذه .ةيفيظولا Different complex neuroanatomical and neurochemical circuits regulate a variety of neuronal behaviors and brain functions. Any disturbance in these circuits can generate functional disorders such as movement disorders, epilepsy, pain, memory disorders, and psychiatric disorders. Functional neurosurgery aims to restore these functions, either by removing or isolating the abnormally behaving neurons or by modulating the disturbed circuits. Neuromodulation is a fast-growing field, powered by the recent advances in neuroimaging and technology. Here, we discuss recent advances and new horizons in functional neurosurgery. Neurosciences 2012; Vol. 17 (1): 16-31 From the Division of Neurosurgery, Neurosciences Department, King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia. Address correspondence and reprint request to: Dr. Faisal Al-Otaibi, Division of Neurosurgery, Neurosciences Department, King Faisal Specialist Hospital and Research Centre, PO Box 3354, Riyadh 11211, Saudi Arabia. Tel. +966 (1) 44237665. Fax. +966 (1) 4424763. E-mail: [email protected] Functional neurosurgery The modulation of neural and mind circuits Faisal Al-Otaibi, MD, Thamer Al-Khairallah, MD. 16 S may be used to treat functional neurological disorders by altering and modulating abnormally functioning neuronal circuits and physiological activities. There are many clinical indications for functional neurosurgery, including movement disorders, epilepsy, pain, psychiatric disorders, addiction, memory disorders, and other conditions.1 Many brain circuits are accessible to functional surgery. Over the evolution of functional neurosurgery, techniques for interrogating and modulating brain circuits have become preferable to ablative or resective surgery. Basic neuroscience research has both motivated and benefited from several functional surgery techniques that allow the exploration of targets deep within the brain. On the other hand, advances in functional neuroimaging, technology, and neurosciences have had a significant impact on the rapid growth of functional neurosurgery. Here, we review the evolution and clinical applications of this field. Historical overview. Functional neurosurgical procedures for the management of neurological and behavioral disorders were developed prior to the introduction of stereotactic frames and surgery. At the end of the 19th century, Horsely and colleagues2,3 performed the first resective procedure to treat hyperkinetic movement disorder. Their procedure involved the resection of the motor cortex to treat athetotic movement. In 1912, the French surgeon, Lirche,4 performed cervical rhizotomy to treat Parkinsonian tremor. Subsequently, several resection procedures have been used to control certain types of movement disorders.5,6 Russell Meyers7,8 pioneered procedures that target the basal ganglia to treat movement disorders. In 1939, he excised part of the caudate nucleus to treat Parkinsonism. By the end of the 1940s, he had operated on 58 patients with different movement disorders and observed improvement in 60% Disclosure. The authors declare no conflicting interests.