Advances in Technical Aspects of Deep Brain Stimulation Surgery

Area of Science:

• Neurosurgery
• Neurology
• Biomedical Engineering

Background:

• Deep brain stimulation (DBS) is an established treatment for movement disorders, psychiatric conditions, epilepsy, and pain.
• Surgical implantation of DBS devices has advanced human physiology understanding and DBS technology.
• Previous work has detailed DBS advances, future developments, and expanding indications.

Purpose of the Study:

• To review the critical role of advanced imaging in DBS procedures.
• To survey current and emerging technologies for DBS electrode targeting and implantation.
• To discuss surgical techniques and device innovations in DBS.

Main Methods:

• Review of structural, functional, and connectivity MRI techniques for target visualization.
• Survey of frame-based, frameless, and robot-assisted surgical systems.
• Analysis of microelectrode recording, local field potentials, and intraoperative stimulation.
• Comparison of novel electrode and implantable pulse generator designs.

Main Results:

• Advanced MRI enables direct visualization of brain targets, improving accuracy.
• Various targeting and implantation tools offer distinct advantages and disadvantages.
• Intraoperative monitoring and novel device designs enhance procedural success and therapeutic potential.

Conclusions:

• Continuous technological advancements in imaging, targeting, and hardware are refining DBS procedures.
• Optimized surgical planning and execution through these innovations are crucial for effective DBS therapy.
• Further development promises expanded applications and improved outcomes for patients undergoing DBS.