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

Deep brain stimulation (DBS) is a well-established treatment for Parkinson's disease (PD) leading to a significant reduction in motor and non-motor symptoms. Numerous factors contribute to positive outcomes for DBS including careful patient selection, lead placement and effective programming. Only DBS programming can be modified after patient implantation, therefore DBS programming plays a crucial role in improving clinical outcomes. In this paper, we review the literature to present current issues and perspectives for DBS programming in PD. Only a few algorithms proposed by experts for the initial programming and management of some adverse effects are available. No guidelines are available for programming sessions and medical treatment management during DBS follow-up. Moreover, emergence of increasingly complex lead designs makes programming more and more complex. Fortunately, in the last few years numerous techniques have emerged for optimization of DBS programming in PD.