Neurotherapeutics

, Volume 11, Issue 3, pp 465–474 | Cite as

Deep Brain Stimulation for Movement Disorders

Review

Abstract

Deep brain stimulation (DBS) is an implanted electrical device that modulates specific targets in the brain resulting in symptomatic improvement in a particular neurologic disease, most commonly a movement disorder. It is preferred over previously used lesioning procedures due to its reversibility, adjustability, and ability to be used bilaterally with a good safety profile. Risks of DBS include intracranial bleeding, infection, malposition, and hardware issues, such migration, disconnection, or malfunction, but the risk of each of these complications is low—generally ≤ 5% at experienced, large-volume centers. It has been used widely in essential tremor, Parkinson’s disease, and dystonia when medical treatment becomes ineffective, intolerable owing to side effects, or causes motor complications. Brain targets implanted include the thalamus (most commonly for essential tremor), subthalamic nucleus (most commonly for Parkinson’s disease), and globus pallidus (Parkinson’s disease and dystonia), although new targets are currently being explored. Future developments include brain electrodes that can steer current directionally and systems capable of “closed loop” stimulation, with systems that can record and interpret regional brain activity and modify stimulation parameters in a clinically meaningful way. New, image-guided implantation techniques may have advantages over traditional DBS surgery.

Keywords

Deep brain stimulation Movement disorders Essential tremor Parkinson’s disease Dystonia 

Supplementary material

13311_2014_274_MOESM1_ESM.pdf (1.2 mb)
ESM 1(PDF 1224 kb)

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Copyright information

© The American Society for Experimental NeuroTherapeutics, Inc. 2014

Authors and Affiliations

  1. 1.Department of Neurological SurgeryUniversity of California, San FranciscoSan FranciscoUSA

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