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Brain Sciences
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New Advances in Functional Neurosurgery
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New Advances in Functional Neurosurgery

A special issue of Brain Sciences (ISSN 2076-3425). This special issue belongs to the section "Neurosurgery and Neuroanatomy".

Deadline for manuscript submissions: closed (30 September 2024) | Viewed by 8742

Special Issue Editor

Dr. Nicola Montano

E-Mail Website
Guest Editor
Department of Neuroscience, Neurosurgery Section, Catholic University of the Sacred Heart, Rome, Italy
Interests: functional neurosurgery; trigeminal neuralgia; neuropathic pain; hemifacial spasm; neurovascular conflict; microvascular decompression; deep brain stimulation; epilepsy surgery; posterior fossa surgery; neuro-oncology; spine surgery
Special Issues, Collections and Topics in MDPI journals

Special Issue Information

Dear Colleagues,

There is a wide spectrum of pathologies, such as movement disorders, epilepsy, trigeminal neuralgia, hemifacial spasm and other neurovascular conflict syndromes, spasticity, chronic neuropathic pain, and psychiatric disorders, that can be treated by functional neurosurgeons. Functional neurosurgeons modify the functioning of the nervous system to improve the quality of life of patients affected by neurological disorders. They strictly collaborate with other professional figures, such as neurologists, neuropsychologists, psychiatrists, anesthesiologists, and bioengineers, to develop the best therapeutic strategy for each specific patient in order to personalize and customize therapies. They can target different brain regions in order to obtain an improvement in a patient’s neurological functioning via neuromodulating complex brain or spine pathways. Furthermore, they can treat excruciating conditions, such as trigeminal neuralgia or hemifacial spasm, by removing an arterial compression, or they can remove an epileptogenic zone in the brain, resulting in the disappearance of seizures. The field of functional neurosurgery has gained renewed interest in the last few years due to different technological advances. The improvement of neuromodulation paradigms, the possibility to record brain and spine potentials that can be integrated into so-called closed loop stimulation, the development of directional leads in deep brain stimulation, and the wide spread of intraoperative neuro-monitoring techniques that have also implemented a “functional approach” in brain tumor surgery, spine surgery, and vascular surgery are only some examples of these advances. Artificial intelligence, machine learning, and connectomics approaches have recently increased our understanding of neural network functioning. The aim of this Special Issue is to collect outstanding papers in order to focus on advances in all fields of functional neurosurgery.

Dr. Nicola Montano
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Brain Sciences is an international peer-reviewed open access monthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2200 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • movement disorders
  • Parkinson’s disease
  • deep brain stimulation
  • epilepsy surgery
  • vagal nerve stimulation
  • trigeminal neuralgia
  • hemifacial spasm
  • neurovascular conflict syndromes
  • spasticity
  • chronic neuropathic pain
  • psychiatric disorders
  • spinal cord stimulation
  • microvascular decompression
  • intraoperative neuro-monitoring

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Related Special Issue

Published Papers (3 papers)

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Research

11 pages, 570 KiB  
Article
Long-Term Outcome in Adult Patients with Drug-Resistant Epilepsy Submitted to Vagus Nerve Stimulation
by Samuele Santi, Filomena Fuggetta, Gabriella Colicchio, Manuela D’Ercole, Alessandro Izzo, Quintino Giorgio D’Alessandris, Benedetta Burattini, Renata Martinelli and Nicola Montano
Brain Sci. 2024, 14(7), 639; https://doi.org/10.3390/brainsci14070639 - 26 Jun 2024
Viewed by 1751
Abstract
Epilepsy treatment primarily involves antiseizure medications (ASMs) to eliminate seizures and improve the quality of life, but many patients develop drug-resistant epilepsy (DRE), necessitating alternative interventions. This study aimed to evaluate the long-term efficacy and safety of vagus nerve stimulation (VNS) in managing [...] Read more.
Epilepsy treatment primarily involves antiseizure medications (ASMs) to eliminate seizures and improve the quality of life, but many patients develop drug-resistant epilepsy (DRE), necessitating alternative interventions. This study aimed to evaluate the long-term efficacy and safety of vagus nerve stimulation (VNS) in managing DRE. We retrospectively analyzed data from 105 adult patients treated at Agostino Gemelli Hospital from 1994 to 2022. Among the 73 patients with follow-up data, 80.8% were responders, experiencing significant reductions in seizure frequency over an average follow-up period of 9.4 years. Although 19.2% were non-responders, many of these patients still opted for generator replacements due to improvements in quality of life, such as fewer falls and shorter post-ictal periods. The overall complication rate was 12.3%, with most complications being mild and manageable. These findings suggest that VNS offers substantial long-term benefits for patients with DRE, improving seizure control and quality of life. This study underscores the importance of VNS as a viable long-term treatment option for DRE, highlighting its potential to significantly enhance patient outcomes and quality of life. Full article
(This article belongs to the Special Issue New Advances in Functional Neurosurgery)
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9 pages, 1473 KiB  
Article
Selective Vestibular Neurectomy through the Presigmoid Retrolabyrinthine Approach in the Treatment of Meniere’s Disease
by Fabrizio Salvinelli, Francesca Bonifacio, Mara Capece, Denis Aiudi, Alessio Iacoangeli, Fabio Greco, Maurizio Gladi and Maurizio Iacoangeli
Brain Sci. 2024, 14(4), 369; https://doi.org/10.3390/brainsci14040369 - 11 Apr 2024
Cited by 1 | Viewed by 3955
Abstract
Background: Meniere’s disease (MD) is a disabling disease, especially in patients who are refractory to medical therapy. Moreover, selective vestibular neurectomy (VN), in these selected cases, can be considered a surgical alternative which preserves hearing function and facial nerve. Methods: We retrospectively studied [...] Read more.
Background: Meniere’s disease (MD) is a disabling disease, especially in patients who are refractory to medical therapy. Moreover, selective vestibular neurectomy (VN), in these selected cases, can be considered a surgical alternative which preserves hearing function and facial nerve. Methods: We retrospectively studied 23 patients with MD diagnosis and history of failed extradural endolymphatic sac surgery (ELSS) who underwent combined micro-endoscopic selective VN, between January 2019 and August 2023, via a presigmoid retrolabyrinthine approach. All patients were stratified according to clinical features, assessing preoperative and postoperative hearing levels and quality of life. Results: At the maximum present follow-up of 2 years, this procedure is characterized by a low rate of complications and about 90% vertigo control after surgery. No definitive facial palsy or hearing loss was described in this series. One patient required reintervention for a CSF fistula. Statistically significant (p = 0.001) difference was found between the preoperative and the postoperative performance in terms of physical, functional, and emotive scales assessed via the DHI questionnaire. Conclusions: Selective VN via a presigmoid retrolabyrinthine approach is a safe procedure for intractable vertigo associated with MD, when residual hearing function still exists. The use of the endoscope and intraoperative neuromonitoring guaranteed a precise result, saving the cochlear fibers and facial nerve. The approach for VN is a familiar procedure to the otolaryngologist, as is lateral skull base anatomy to the neurosurgeon; therefore, the best results are obtained with multidisciplinary teamwork. Full article
(This article belongs to the Special Issue New Advances in Functional Neurosurgery)
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13 pages, 5778 KiB  
Article
Rescuing Infected Deep Brain Stimulation Therapies in Severely Affected Patients
by Thomas Fortmann, Samer Zawy Alsofy, Marc Lewitz, Antonio Santacroce, Heinz Welzel Saravia, Ioanna Sakellaropoulou, Eike Wilbers, Steffen Grabowski, Ralf Stroop, Zafer Cinibulak, Makoto Nakamura and Ralph Lehrke
Brain Sci. 2023, 13(12), 1650; https://doi.org/10.3390/brainsci13121650 - 28 Nov 2023
Cited by 1 | Viewed by 1927
Abstract
(1) Background: Infections in deep brain stimulation (DBS) hardware, while an undesired complication of DBS surgeries, can be effectively addressed. Minor infections are typically treated with wound revision and IV antibiotics. However, when visible hardware infection occurs, most centers opt for complete removal, [...] Read more.
(1) Background: Infections in deep brain stimulation (DBS) hardware, while an undesired complication of DBS surgeries, can be effectively addressed. Minor infections are typically treated with wound revision and IV antibiotics. However, when visible hardware infection occurs, most centers opt for complete removal, leaving the patient in a preoperative state and necessitating post-removal care. To avoid the need for such care, a novel technique was developed. (2) Methods: The electrodes are placed at the exact same spot and then led to the contralateral side. new extensions and a new generator contralateral to the infection as well. Subsequently, the infected system is removed. This case series includes six patients. (3) Results: The average duration of DBS system implantation before the second surgery was 272 days. Only one system had to be removed after 18 months due to reoccurring infection; the others remained unaffected. Laboratory alterations and pathogens were identified in only half of the patients. (4) Conclusions: The described surgical technique proves to be safe, well tolerated, and serves as a viable alternative to complete system removal. Importantly, it effectively prevents the need of post-removal care for patients. Full article
(This article belongs to the Special Issue New Advances in Functional Neurosurgery)
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