History, Applications, and Mechanisms of Deep Brain Stimulation

Miocinovic, Svjetlana; Somayajula, Suvarchala; Chitnis, Shilpa; Vitek, Jerrold L.

doi:10.1001/2013.jamaneurol.45

Cited by 439 publications

(301 citation statements)

References 92 publications

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“…Proposed mechanisms of DBS can be grouped into 4 main categories: 1) inhibition of the target, the classic reversible functional lesioning paradigm; 2) activation of the target; 3) combined inhibition and activation; and 4) disruption of pathological oscillations to restore rhythmic activity and synchronization, the "noisy signal hypothesis." 134,141 Recent findings have mostly supported the view that therapeutic effects are related to alterations in ongoing oscillations. In PD, subthalamic nucleus (STN) field potentials have been found to exhibit abnormal phase-amplitude coupling and spike-local field potential (LFP) coupling to primary motor cortex.…”

Section: Mechanisms Of Dbsmentioning

confidence: 97%

Deep brain stimulation: a mechanistic and clinical update

Karas

Mikell

Christian

et al. 2013

FOC

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Deep brain stimulation (DBS), the practice of placing electrodes deep into the brain to stimulate subcortical structures with electrical current, has been increasing as a neurosurgical procedure over the past 15 years. Originally a treatment for essential tremor, DBS is now used and under investigation across a wide spectrum of neurological and psychiatric disorders. In addition to applying electrical stimulation for clinical symptomatic relief, the electrodes implanted can also be used to record local electrical activity in the brain, making DBS a useful research tool. Human single-neuron recordings and local field potentials are now often recorded intraoperatively as electrodes are implanted. Thus, the increasing scope of DBS clinical applications is being matched by an increase in investigational use, leading to a rapidly evolving understanding of cortical and subcortical neurocircuitry. In this review, the authors discuss recent innovations in the clinical use of DBS, both in approved indications as well as in indications under investigation. Deep brain stimulation as an investigational tool is also reviewed, paying special attention to evolving models of basal ganglia and cortical function in health and disease. Finally, the authors look to the future across several indications, highlighting gaps in knowledge and possible future directions of DBS treatment.

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Section: Mechanisms Of Dbsmentioning

confidence: 97%

Deep brain stimulation: a mechanistic and clinical update

Karas

Mikell

Christian

et al. 2013

FOC

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“…In brief, the DBS technique involves stereotactically guided implantation of one or more electrodes into targeted brain region, and the electric pulses which are generated by a pacemaker implanted in infraclavicular area will be sent through wires and then electrode into brain to influence neural activities [114,115] (see Figure 2). [116]. DBS can also be used in research studies of major depression [117,118] and other affective disorders [119], as well as in treatment of chronic pain [120,121], though none of these newer indications have been approved by FDA till now, which may probably due to high complication rates and side effects.…”

Section: Clinical Studies Of Deep Brain Stimulationmentioning

confidence: 99%

Chemical and Physical Approaches for the Treatment of Alzheimer's Disease

Li¹,

Zhou²,

Wu³

et al. 2015

ADMET DMPK

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“…DBS is primarily used to address motor symptoms in the treatment of movement disorders or emotional and behavioral symptoms in the treatment of intractable mental disorders (1,2). The clinical efficacy of DBS in movement disorders disease is well established, whereas its implementation in mental disorders has produced mixed results (3,4).…”

Section: Introductionmentioning

confidence: 99%

Target-specific deep brain stimulation of the ventral capsule/ventral striatum for the treatment of neuropsychiatric disease

Zhang

Jin

et al. 2017

Annals of Translational Medicine

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Deep brain stimulation (DBS) is a well-established therapy for Parkinson's disease and other movement disorders. An accumulating body of evidence supports the extension of DBS application for the treatment of refractory psychiatric disorders. The ventral capsule/ventral striatum (VC/VS) is the most common anatomical target for obsessive-compulsive disorder (OCD), addiction, and depression. However, no specific electrode is available for the clinical targeting of these areas for DBS. According to the anatomical features of the VC/VS, a novel electrode was developed for simultaneous and independently programmed stimulation of the nucleus accumbens (NAc) and the anterior limb of the internal capsule (ALIC). This VC/VS-specific electrode has the potential to enhance stimulus intensity, provide independent and flexible target stimulation.

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History, Applications, and Mechanisms of Deep Brain Stimulation

Cited by 439 publications

References 92 publications

Deep brain stimulation: a mechanistic and clinical update

Deep brain stimulation: a mechanistic and clinical update

Chemical and Physical Approaches for the Treatment of Alzheimer's Disease

Target-specific deep brain stimulation of the ventral capsule/ventral striatum for the treatment of neuropsychiatric disease

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