Brain stimulation: history, current clinical application, and future prospects

The dramatic effects of chronic brain stimulation in the treatment of movement disorders have spurred a renewed interest in this technique for treating a variety of other conditions. This technique has only recently begun to reach its vast clinical potential, due to a number of significant advances in basic and clinical neurosciences. Current image-guided navigation systems and intraoperative physiological mapping techniques offer more efficient, consistent, and precise targeting. Advances in neurophysiology have helped elucidate the pathophysiology of a number of disease states and thus provided for rational target selection for therapy. The latest generation of stimulation equipment allows for precise tailoring of stimulation parameters to maximize clinical benefit. These techniques are now being applied to a variety of other conditions including chronic pain, epilepsy, and psychiatric disorders.