Evolution of Deep Brain Stimulation Techniques for Complication Mitigation

Area of Science:

• Neurosurgery
• Neuromodulation
• Medical Device Technology

Background:

• Deep brain stimulation (DBS) is a crucial neuromodulatory technique.
• Complications such as infection, lead fracture, and migration have historically impacted DBS outcomes.
• Continuous refinement of surgical techniques is essential for patient safety and efficacy.

Purpose of the Study:

• To review the evolution of complication mitigation strategies in deep brain stimulation.
• To analyze how neurosurgical practices have adapted to improve acute and long-term outcomes.
• To provide a historical guide on surgical innovations in DBS for current and future practitioners.

Main Methods:

• A comprehensive MEDLINE search was conducted for human studies from 1987 to June 2023.
• Two reviewers screened 776 articles using the Rayyan platform for title and abstract review.
• Full-text evaluation of 124 publications was performed for the scoping review.

Main Results:

• Early deep brain stimulation procedures faced significant inefficiencies and complications.
• Surgical modifications have demonstrably reduced the incidence of infection, lead issues, and suboptimal outcomes.
• Trends show a consistent effort to improve both short-term and long-term results through practice adaptation.

Conclusions:

• Neurosurgical techniques for deep brain stimulation have significantly advanced, enhancing safety and efficacy.
• Understanding historical adaptations is crucial for navigating future innovations in neuromodulation.
• This review serves as a valuable resource for neurosurgeons managing deep brain stimulation complications.