Deep Brain Stimulation: Mechanisms, Cost-Effectiveness, and Precision Applications Across Neurology and Psychiatry.

Area of Science:

• Neuroscience
• Neurosurgery
• Neuromodulation

Background:

• Deep Brain Stimulation (DBS) has evolved from a Parkinson's disease intervention.
• Current applications are expanding beyond movement disorders.

Purpose of the Study:

• To review the current state and future directions of DBS.
• To explore advancements in eligibility, cost-effectiveness, targets, mechanisms, indications, safety, and future technologies.

Main Methods:

• Systematic review of evidence across seven key areas of DBS research.
• Analysis of cost-effectiveness models, anatomical targets, mechanistic theories, psychiatric/metabolic indications, safety data, and future technologies.

Main Results:

• DBS shows positive cost-effectiveness for Parkinson's disease and treatment-resistant conditions.
• New anatomical targets and psychiatric/metabolic indications are emerging.
• Safety risks are generally low (e.g., infection ~4%, hemorrhage ~2%).
• Future directions include connectomics, closed-loop systems, and AI.

Conclusions:

• DBS is entering a 'third wave' focused on neural circuits, AI integration, and cost-effectiveness.
• The goal is to extend DBS benefits beyond movement disorders sustainably.
• Personalized, adaptive, and enhancement-focused interventions are key future developments.