Deep brain stimulation programming in Parkinson's disease: Introduction of current issues and perspectives.

Area of Science:

• Neurology
• Neurosurgery
• Biomedical Engineering

Background:

• Deep brain stimulation (DBS) effectively manages Parkinson's disease (PD) motor and non-motor symptoms.
• Patient selection, lead placement, and programming are key factors for successful DBS outcomes.
• DBS programming is the only modifiable parameter post-implantation, underscoring its critical role.

Purpose of the Study:

• To review current issues and perspectives in DBS programming for Parkinson's disease.
• To identify limitations in existing DBS programming algorithms and guidelines.
• To explore recent advancements in optimizing DBS programming techniques.

Main Methods:

• Comprehensive literature review of DBS programming in Parkinson's disease.
• Analysis of current challenges, including complex lead designs and lack of standardized guidelines.
• Identification of emerging optimization techniques for DBS programming.

Main Results:

• Limited expert-proposed algorithms exist for initial DBS programming and adverse effect management.
• Absence of established guidelines for programming sessions and medical management during DBS follow-up.
• Increasing complexity of lead designs complicates the programming process.
• Recent emergence of novel techniques for optimizing DBS programming in PD.

Conclusions:

• DBS programming remains a critical yet complex aspect of Parkinson's disease management.
• There is a significant need for standardized guidelines and advanced algorithms for DBS programming.
• Emerging techniques offer promising avenues for improving clinical outcomes through optimized DBS programming.