Pediatric Brain Stimulation: Mapping and Modulating the Developing Brain presents the latest on this rapidly expanding field that has seen an exponential growth in publications over the past 10 years. Non-invasive modalities like TMS can painlessly map and measure complex neurophysiology in real patients. Neuromodulatory applications like rTMS and tDCS carry increasingly proven therapeutic applications. Rapidly advancing technological methodologies are increasing opportunities and indications. Despite all these benefits, applications in the more plastic developing brains of children are only just emerging.
This book provides a comprehensive overview of brain stimulation in children. Chapters include Transcranial Magnetic Stimulation (TMS) fundamentals, brain stimulation in pediatric neurological conditions, and invasive brain stimulation. The main audience for this research will be those interested in applying brain stimulation technologies to advance clinical research and patient care, although a wide variety of clinicians and scientist will find this to be a valuable reference on brain stimulation with specific chapters on a variety of conditions.
- Provides an overview of recent findings and knowledge of pediatric brain stimulation and the developing brain
- Edited by renowned leaders in the field of pediatric brain stimulation
- Presents a great resource for basic and clinical scientists and practitioners in neuroscience, neurology, neurosurgery, and psychiatry
Table of Contents:Section I. Fundamentals of Nibs in Children
Chapter 1. TMS Basics: Single and Paired Pulse Neurophysiology
Introduction
How Does TMS Work?
Neuronal Structures Activated by TMS
TMS Neurophysiology
TMS Reliability
TMS Safety
Chapter 2. Assessing Normal Developmental Neurobiology With Brain Stimulation
Introduction
Normal Developmental Neurobiology
TMS-Evoked Parameters That Reflect Neuromotor Maturation
Assessing Neurophysiologic Functioning With Brain Stimulation in Development and Developmental Disorders
Outlook
Chapter 3. Neuroplasticity Protocols: Inducing and Measuring Change
Background (In Vitro and Animal Work)
Overview of Repetitive Transcranial Magnetic Stimulation (rTMS)
Types of rTMS
Study Design Considerations
Conclusion
Chapter 4. Therapeutic rTMS in Children
Introduction: From Biomarker of Plasticity and Excitability to Inducer of Therapeutic Changes?
Methods: Types of Repetitive Transcranial Magnetic Stimulation (rTMS)
Most Common Repetitive TMS Methods
Brief Overview of Clinical Trials and Indications in Young Adults
Brief Overview of Registered Clinical Trials Involving Children
Brief Overview of Published Clinical Trials Involving Children
Where to Next With rTMS Treatment in Children?
Chapter 5. Transcranial Direct-Current Stimulation (tDCS): Principles and Emerging Applications in Children
Introduction
Principles and Cortical Effects of Transcranial Direct-Current Stimulation
tDCS Methodology: Electrodes, Current, and Protocols
tDCS Dosage: Computational Modeling Evidence
tDCS Dosage: Neurophysiology Evidence
tDCS in Healthy Children to Enhance Motor Learning
Safety, Adverse Events, and Tolerability
Clinical Application of tDCS
Summary
Chapter 6. Insights Into Pediatric Brain Stimulation Protocols From Preclinical Research
Stimulating the Immature Brain
The Immature Brain Is Hyperexcitable
Inhibitory Control Develops With Age
GABAergic Dysmaturity in Neurodevelopmental Disease
Synaptic Plasticity Considerations in the Developing Brain
Relevance to Translational Brain Stimulation
Conclusion
Chapter 7. Pediatric Issues in Neuromodulation: Safety, Tolerability and Ethical Considerations
Brain Stimulation Techniques Used in Children
Direct Effects of Brain Stimulation in Children
Developmental Neuroplasticity
Side Effects of Stimulation
Ethical Application of Neuromodulation in Children
Neuro-Enhancement in Healthy Individuals
Advisements for Safe Administration of NIBS in Children
Conclusions
Section II. Nibs in Pediatric Neurological Conditions
Chapter 8. TMS Applications in ADHD and Developmental Disorders
Introduction
Key Considerations for TMS Research in Children With Developmental Disorders
TMS in Developmental Disorders: Practical Considerations and Representative Results
Chapter 9. TMS Mapping of Motor Development After Perinatal Brain Injury
Introduction
Developmental Aspects
Functional Aspects
Functional Imaging
MR Tractography
Clinical Relevance I: Functional Therapy
Clinical Relevance II: Epilepsy Surgery
Perspective: Brain Stimulation
Chapter 10. The Right Stimulation of the Right Circuits: Merging Understanding of Brain Stimulation Mechanisms and Systems Neuroscience for Effective Neuromodulation in Children
Introduction
Focal Stimulation to Known Circuits: Lessons From Deep Brain Stimulation for Parkinson’s Disease
Brain Stimulation in Pediatric Hemiparesis: Which Circuits?
Targeting Motor Cortex: Which Stimulation Modality?
Focal Stimulation Versus General Plasticity and Task-Specific Training
Challenges and Opportunities
Chapter 11. Therapeutic Brain Stimulation Trials in Children With Cerebral Palsy
Introduction
Scientific Evidence in Therapeutic Brain Stimulation in Children With CP: Summary of Current Interventional Trials
Trial Design
Conclusions
Chapter 12. Brain Stimulation in Children Born Preterm—Promises and Pitfalls
Introduction
The Motor Threshold
Short-Interval Intracortical Inhibition and Facilitation
Long-Interval Intracortical Inhibition and the Cortical Silent Period
Transcallosal Inhibition
Neuroplasticity Induced With Non-Invasive Brain Stimulation
Other Considerations
Where to Now?
Chapter 13. Brain Stimulation to Understand and Modulate the Autism Spectrum
Introduction
TMS Measures of ASD Pathophysiology
TMS as a Therapeutic Intervention in ASD
Conclusion
Chapter 14. Non-Invasive Brain Stimulation in Pediatric Epilepsy: Diagnostic and Therapeutic Uses
Introduction
Diagnostic Uses of TMS
Therapeutic Uses of TMS
Therapeutic Uses of Transcranial Direct-Current Stimulation
Conclusion
Chapter 15. Brain Stimulation in Pediatric Depression: Biological Mechanisms
Introduction
Preclinical
Neurophysiology
Neuroimaging
Peripheral Biomarkers
Neurocognition
Conclusion
Chapter 16. Brain Stimulation in Childhood Mental Health: Therapeutic Applications
Introduction
Applications
Discussion
Where Do We Stand and Where Do We Need to Go?
Conclusion
Chapter 17. Transcranial Magnetic Stimulation Neurophysiology of Pediatric Traumatic Brain Injury
Epidemiology and Clinical Spectrum of Traumatic Brain Injury
Outcome
Pathophysiology of Traumatic Brain Injury
Insights About TBI Using TMS: A Literature Review
Mild Traumatic Brain Injury
Severe Traumatic Brain Injury
Treatment Studies Using rTMS
TMS in Pediatric Mild Traumatic Brain Injury
Safety and Tolerability
Results
Summary
Chapter 18. Brain Stimulation Applications in Pediatric Headache and Pain Disorders
History of Neurostimulation in Headache and Pain
Pediatric Headache
Safety and Tolerability of Neurostimulation in Children
Pathophysiology of Head Pain and Migraine
Pediatric Data
Therapeutics
Future Avenues in Pediatric Brain Stimulation for Pain
Section III. Invasive Brain Stimulation in Children
Chapter 19. Deep Brain Stimulation in Children: Clinical Considerations
Historical Background
Primary Dystonias and DBS
Physiology of DBS Effect in Primary Dystonias
Efficacy of DBS on DYT-1-Positive and DYT-1-Negative Dystonias
Segmental Versus Generalized Dystonia and DBS
Effects of Switching DBS “Off”
DBS for Secondary Dystonias
DBS for Neurodegeneration With Brain Iron Accumulation (NBIA)
Primary and Secondary Dystonia Responses to DBS
Secondary Dystonias and Functional Imaging Before and After DBS
Patient Selection for DBS
Pooled Cohorts of DBS Data
Children With Dystonia and DBS
Technical Issues Influencing DBS Efficacy
Chapter 20. Deep Brain Stimulation Children – Surgical Considerations
Background
Technical Aspects of DBS
Clinical Indications
Treatment Efficacy
Physiology of Neuromodulation, Neuroplasticity, and Pediatric Considerations
Future Developments and Innovation
Chapter 21. Invasive Neuromodulation in Pediatric Epilepsy: VNS and Emerging Technologies
Introduction
Epilepsy in Children
Surgical Treatments for Epilepsy
Vagus Nerve Stimulation (VNS)
Trigeminal Nerve Stimulation
Intracranial Neurostimulation for Epilepsy
Conclusion
Chapter 22. Emerging Applications and Future Directions in Pediatric Neurostimulation
Transcranial MRI-Guided Focused Ultrasound
Robotics
Brain–Computer Interfaces (BCI)
Future Directions for Single- and Paired-Pulse TMS Studies
Brain Stimulation Biomarkers
Functional TMS
TMS for Biofeedback
Non-Invasive Low-Current Electrical Stimulation
Shifting Membrane Potentials With Transcranial Direct-Current Stimulation
Entraining or Disrupting Intrinsic Brain Oscillations With Transcranial Alternating-Current Stimulation
Conclusion
Index
