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Brain Topography

, Volume 27, Issue 1, pp 55–62 | Cite as

Deep Brain Stimulation, Brain Maps and Personalized Medicine: Lessons from the Human Genome Project

  • Joseph J. Fins
  • Zachary E. Shapiro
Original Paper

Abstract

Although the appellation of personalized medicine is generally attributed to advanced therapeutics in molecular medicine, deep brain stimulation (DBS) can also be so categorized. Like its medical counterpart, DBS is a highly personalized intervention that needs to be tailored to a patient’s individual anatomy. And because of this, DBS like more conventional personalized medicine, can be highly specific where the object of care is an N = 1. But that is where the similarities end. Besides their differing medical and surgical provenances, these two varieties of personalized medicine have had strikingly different impacts. The molecular variant, though of a more recent vintage has thrived and is experiencing explosive growth, while DBS still struggles to find a sustainable therapeutic niche. Despite its promise, and success as a vetted treatment for drug resistant Parkinson’s Disease, DBS has lagged in broadening its development, often encountering regulatory hurdles and financial barriers necessary to mount an adequate number of quality trials. In this paper we will consider why DBS—or better yet neuromodulation—has encountered these challenges and contrast this experience with the more successful advance of personalized medicine. We will suggest that personalized medicine and DBS’s differential performance can be explained as a matter of timing and complexity. We believe that DBS has struggled because it has been a journey of scientific exploration conducted without a map. In contrast to molecular personalized medicine which followed the mapping of the human genome and the Human Genome Project, DBS preceded plans for the mapping of the human brain. We believe that this sequence has given personalized medicine a distinct advantage and that the fullest potential of DBS will be realized both as a cartographical or electrophysiological probe and as a modality of personalized medicine.

Keywords

Personalized medicine Deep brain stimulation DBS Neuromodulation Brain mapping project Genome project Humanitarian device exemption Neuroethics 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Division of Medical EthicsNew York Presbyterian Hospital-Weill Cornell Medical Center, Weill Medical College of Cornell UniversityNew YorkUSA

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