Deep brain stimulation for movement and other neurologic disorders

• Type of Material: Article
• Authors: Thomas Wichmann, Emory University; Mahlon DeLong, Emory University
• Language: English
• Date: 2012-01-01
• Publisher: Blackwell Publishing
• Publication Version: Author Accepted Manuscript (After Peer Review)
• Copyright Statement: © 2012 New York Academy of Sciences.
• Final Published Version (URL): http://dx.doi.org/10.1111/j.1749-6632.2012.06608.x
• Title of Journal or Parent Work: Brain stimulation in neurology and psychiatry
• Volume: 1265
• Issue: 1
• Start Page: 1
• End Page: 8
• Grant/Funding Information: The preparation of this article was supported through grants from the NIH/NINDS (R01-NS054976, R01-NS071074 and P50-NS071669 (TW)), and by NIH/NCRR grant RR-000165 (Yerkes National Primate Center).
• Keywords: CEREBELLUM; Neurosciences & Neurology; internal pallidal segment; CIRCUITS; BETA OSCILLATIONS; Multidisciplinary Sciences; Parkinson's disease; segregated circuits; MOTOR CORTEX EXCITABILITY; Life Sciences & Biomedicine; Science & Technology; PARKINSONS-DISEASE; pedunculopontine nucleus; SUBTHALAMIC NUCLEUS STIMULATION; AREA; subthalamic nucleus; PEDUNCULOPONTINE NUCLEUS; dystonia; DYSTONIA; BASAL GANGLIA; Science & Technology - Other Topics; Neurosciences
• Research Categories: Engineering, Biomedical; Biology, Neuroscience; Health Sciences, Medicine and Surgery

Abstract

Deep brain stimulation (DBS) was introduced as a treatment for patients with parkinsonism and other movement disorders in the early 1990s. The technique rapidly became the treatment of choice for these conditions, and is now also being explored for other diseases, including Tourette syndrome, gait disorders, epilepsy, obsessive-compulsive disorder, and depression. Although the mechanism of action of DBS remains unclear, it is recognized that DBS works through focal modulation of functionally specific circuits. The fact that the same DBS parameters and targets can be used in multiple diseases suggests that DBS does not counteract the pathophysiology of any specific disorder, but acts to replace pathologic activities in disease-affected brain circuits with activity that is more easily tolerated. Despite the progress made in the use of DBS, much remains to be done to fully realize the potential of this therapy. We describe some of the most active areas of research in this field, both in terms of exploration of new targets and stimulation parameters, and in terms of new electrode or stimulator designs.