Current and Expected Advances in Deep Brain Stimulation for Movement Disorders.
Authors: Bari AA, Thum J, Babayan D, Lozano AM
Deep brain stimulation (DBS) has become an established treatment for medically refractory movement disorders including Parkinson's disease, essential tremor, and dystonia. The field of DBS continues to evolve with advances in patient selection, target identification, electrode and pulse generator technology, and the development of more effective stimulation paradigms such as closed-loop stimulation. Furthermore, as the safety and efficacy of DBS improves through better hardware design and deeper understanding of its mechanisms of action, the indications for DBS will continue to expand to cover a wider range of disorders. Finally, the recent approval of MR-guided focused ultrasound for the treatment of essential tremor and potentially other movement disorders heralds a resurgence in lesion creation as a viable alternative to DBS for selected patients.
Introduction
Outcomes and Safety
Summary of Outcomes
This review summarizes advances in deep brain stimulation for movement disorders (Parkinson's disease, essential tremor, dystonia), including patient selection, target identification (GPi, STN, VIM), imaging (3T MRI, diffusion tensor imaging, 7T MRI), hardware (segmented directional leads, rechargeable IPGs), and closed-loop adaptive stimulation. MR-guided focused ultrasound (MRgFUS) is briefly mentioned as a recently FDA-approved noninvasive alternative for essential tremor and under investigation for Parkinson's disease, but no FUS parameters or detailed outcomes are provided.
Brain Region
Targeted brain region(s)
Not specified
Ultrasound Parameters
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