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Using Multinodal Deep Brain Stimulation for Treatment of Complex Movement Disorders: Initial Case Series
Benjamin C Sherman1,2, Mahad A Ahmed2, Lior Lev-Tov3
1Department of Neurosurgery, Geisinger Health System, Danville , Pennsylvania, USA.
Operative Neurosurgery (Hagerstown, Md.)
|July 15, 2026
Summary
Multinodal deep brain stimulation (DBS) offers a safe and effective treatment for complex movement disorders. This approach simultaneously stimulates multiple brain targets, improving symptoms in Parkinson disease and tremor patients.
Area of Science:
- Neurosurgery
- Neurology
- Medical Devices
Background:
- Mixed and complex movement disorders pose significant surgical challenges.
- Current deep brain stimulation (DBS) often targets a single pathway.
- Multinodal stimulation offers a novel approach for complex neurological conditions.
Purpose of the Study:
- To evaluate the safety and efficacy of a multinodal stimulation approach for mixed and complex movement disorders.
- To present the initial case series of this innovative DBS strategy.
Main Methods:
- A cohort of 14 patients with mixed and complex movement disorders received multinodal DBS.
- Multiple deep targets (>2) were implanted via 2 burr holes, connected to a single pulse generator.
- Six patients had prior ineffective single-target DBS; 9 received de novo therapy.
Main Results:
- No intraoperative or postoperative complications were observed.
- Patients with complex Parkinson disease showed significant improvement on the Unified Parkinson Disease Rating Scale (P = .0078).
- Complex tremor patients demonstrated significant improvement on the Clinical Rating Scale for Tremor (P = .0312).
Conclusions:
- This is the largest case series demonstrating the safety, feasibility, and efficacy of single-system multinodal DBS for complex movement disorders.
- The multinodal DBS approach provides added benefit and warrants further investigation.
- This strategy shows promise for treating challenging mixed and complex movement disorders.
