Directional Deep Brain Stimulation in the Treatment of Parkinson's Disease

Abstract

Deep brain stimulation (DBS) is a treatment modality that has been shown to improve the clinical outcomes of individuals with movement disorders, including Parkinson's disease. Directional DBS represents an advance in the field that allows clinicians to better modulate the electrical stimulation to increase therapeutic gains while minimizing side effects. In this review, we summarize the principles of directional DBS, including available technologies and stimulation paradigms, and examine the growing clinical study data with respect to its use in Parkinson's disease.

Why are clinical trials of deep brain stimulation terminated? An analysis of clinicaltrials.gov

“…Due to the design and focal function of the electrodes, including with directional DBS electrodes, only specific and precise areas can be stimulated rather than diffuse circuits. 14 , 37 This may explain the success in Parkinson's Disease and other movement disorders where dysfunction in a single subcortical structure or network leads to clinical symptoms such as tremor. Although the concept of minimally invasive, non-pharmaceutical, adjustable, and reversibly ablative treatment is appealing, the lack of a defined, precise target will limit the applicability of DBS in these conditions characterized by circuit dysfunction.…”

Advances in Technical Aspects of Deep Brain Stimulation Surgery

“…Here, we will discuss significant innovations in DBS lead technology, with a focus on efficacy and complication avoidance. Lead directionality, as noted above, has significant potential benefits for increasing the therapeutic window in patients with PD or ET who are having DBS systems implanted [125][126][127][128].…”

Advancements in the Clinical Outcomes of Functional Neurosurgery With Deep Brain Stimulation for Movement Disorders: A Literature Review

“…Additionally, optogenetics, a technique utilizing light to control neural activity, has provided a more targeted approach to DBS by focusing on specific neural circuits involved in movement disorders [ 9 , 10 ]. While DBS has demonstrated positive clinical outcomes, including improvements in motor function, tremor severity, and overall quality of life for patients with movement disorders [ 3 , 11 ], potential complications and their impact on cognitive function in Parkinson's disease require further investigation [ 5 ]. Therefore, it is important to carefully assess individual patient considerations before considering DBS as a treatment option [ 3 , 4 ].…”

“…Therefore, it is important to carefully assess individual patient considerations before considering DBS as a treatment option [ 3 , 4 ]. Future developments in DBS surgery aim to improve technology, techniques, and research in the field [ 2 , 5 ].…”

“…Deep brain stimulation (DBS) is a well-established and effective treatment option for patients with movement disorders [1][2][3][4]. It involves the implantation of electrodes in specific brain regions to modulate neural activity and alleviate symptoms [5]. Over the years, advancements in surgical techniques and technology have led to improved outcomes and expanded applications of DBS [6].…”