Deep brain stimulation: current and future clinical applications.

Area of Science:

• Neuromodulation
• Neurosurgery
• Neurology

Background:

• Deep brain stimulation (DBS) has emerged as a significant therapeutic advancement over the last two decades.
• Technological and surgical progress has largely superseded ablative techniques for numerous neurological disorders.
• DBS has demonstrated efficacy in managing movement disorders and is being explored for broader applications.

Purpose of the Study:

• To review the current and potential future clinical applications of deep brain stimulation.
• To summarize the established benefits of DBS in treating specific neurological conditions.
• To highlight the expanding scope of DBS therapy.

Main Methods:

• A literature analysis was conducted using MEDLINE.
• Search terms included "deep brain stimulation" from 1980 to 2010.
• Inclusion criteria focused on double-blind studies and large case series.

Main Results:

• Thalamic DBS (ventralis intermedius nucleus) markedly improves tremor in essential tremor and Parkinson disease.
• DBS of the globus pallidus internus is effective for primary dystonia.
• Significant improvements are observed in Parkinson disease symptoms like bradykinesia, rigidity, and gait disturbance, potentially reducing medication-induced dyskinesias.

Conclusions:

• Deep brain stimulation is a highly effective treatment for specific movement disorders, offering symptomatic relief and improved quality of life.
• The success in movement disorders has spurred the investigation of DBS for a wide range of other debilitating conditions.
• While the precise mechanisms of DBS action require further elucidation, its clinical utility is well-established and growing.