The clinical use of deep brain stimulation (DBS) is among the most important advances in the clinical neurosciences in the past two decades. As a surgical tool, DBS can directly measure pathological brain activity and can deliver adjustable stimulation for therapeutic effect in neurological and psychiatric disorders correlated with dysfunctional circuitry. The development of DBS has opened new opportunities to access and interrogate malfunctioning brain circuits and to test the therapeutic potential of regulating the output of these circuits in a broad range of disorders. Despite the success and rapid adoption of DBS, crucial questions remain, including which brain areas should be targeted and in which patients. This Review considers how DBS has facilitated advances in our understanding of how circuit malfunction can lead to brain disorders and outlines the key unmet challenges and future directions in the DBS field. Determining the next steps in DBS science will help to define the future role of this technology in the development of novel therapeutics for the most challenging disorders affecting the human brain.
Bibliographical noteFunding Information:
A.M.L. is a consultant to Medtronic, Abbott (formerly St. Jude) and Boston Scientific and is Scientific Director of Functional Neuromodulation. H.B. has received honoraria for speaking from AlphaOmega, Medtronic and Boston Scientific and research support from the Magnet Program of the Israel Ministry of Economics. P.B. has received honoraria for speaking from Medtronic and Boston Scientific. S.C. is a consultant for Boston Scientific and for Medtronic and has received financial support from Medtronic for preclinical research purposes in the field of deep brain stimulation (DBS). K.M. has chaired advisory boards for studies of DBS for obsessive– compulsive disorder sponsored by Medtronic and has received travel and accommodation support to attend meetings from Medtronic and Abbott. C.C.M. is a paid consultant for Boston Scientific Neuromodulation and Kernel as well as a shareholder in the following companies: Surgical Information Sciences, Inc.; Autonomic Technologies, Inc.; Cardionomic, Inc.; Enspire DBS, Inc.; and Neuros Medical, Inc. T.S. has received limited research support for three investigator-initiated studies from Medtronic. M.S. owns stock in General Electric. J.V. receives grants and personal fees from Boston Scientific and is a consultant and paid speaker for Medtronic. J.K.K. is a consultant to Medtronic and Boston Scientific; has received fees for speaking from Abbott; is a past and honorary president of the European Society for Stereotactic and Functional Neurosurgery; and is a past president of the World Society for Stereotactic and Functional Neurosurgery. The other authors have no competing interests.
This work was supported by a grant from the World Society for Stereotactic and Functional Neurosurgery. It was coordinated together with the Research Committee of the World Society for Stereotactic and Functional Neurosurgery.
© 2019, Springer Nature Limited.
All Science Journal Classification (ASJC) codes
- Clinical Neurology
- Cellular and Molecular Neuroscience