Neuromodulation Approaches in Parkinson’s Disease Using Deep Brain Stimulation and Transcranial Magnetic Stimulation

Abstract

Parkinson’s Disease (PD) is the second most common neurodegenerative disease, characterized by progressive motor (such as resting tremor, hypokinesia, postural instability) and non-motor symptoms (such as neuropsychiatric decline and autonomic dysfunction). Since its introduction in the late 1980s, deep brain stimulation (DBS) has revolutionized the treatment of PD. Initially used in patients’ with advanced PD with either medically refractory motor symptoms or medication intolerance, DBS typically provides excellent improvement in motor symptoms. Indications for DBS have continued to expand, with demonstrated efficacy in early PD and essential tremor, and promising preliminary results in the treatment of epilepsy, psychiatric disease, and depression. Advancements in DBS hardware, programming, neuroimaging, and surgical techniques have led to progressive improvement in efficacy and safety profiles. Thanks to ongoing research into remote programming, adaptive DBS, new targets, and alternative interventions, such as transcranial magnetic stimulation, the opportunities for further improvements in DBS and neuromodulation are bright.

Identification of Parkinson’s disease-associated chromatin regulators

“…The drugs represented by levodopa are widely used in the treatment of PD 18 , 19 . Deep brain electrode stimulation, as a mainstream surgical method, also has a good curative effect 20 , 21 . Exercise rehabilitation therapy can be regarded as a convenient and low-cost method 22 .…”

On‐Demand Chemomagnetic Modulation of Striatal Neurons Facilitated by Hybrid Magnetic Nanoparticles

“…[9] Regardless of the high therapeutic efficacy, DBS remains to be highly invasive and has a number of risks associated with surgery complications [10] and hardware difficulties. [11,12] Other technologies have been developed to mitigate the invasiveness of electrode-based DBS, as are transcranial repetitive magnetic stimulation (rTMS), [13] transcranial direct current stimulation (tDCS), [14] and transcranial focused ultrasound stimulation (tFUS). [15] Regardless of the nature of the current or pulses applied, these minimally invasive therapies suffer from a broad radius of action on the order of millimeters to centimeters [10,16,17] High spatial resolution is offered by cell-type specific neuromodulation technologies such as optogenetics, [18] designer receptors exclusively activated by designer drugs (DREADDs), [19] and emerging nanotechnologybased neuromodulation.…”