IMR Press / FBL / Volume 23 / Issue 1 / DOI: 10.2741/4586

Frontiers in Bioscience-Landmark (FBL) is published by IMR Press from Volume 26 Issue 5 (2021). Previous articles were published by another publisher on a subscription basis, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with Frontiers in Bioscience.

Open Access Review

Deep brain stimulation: foundations and future trends

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1 University of South Florida Morsani College of Medicine, 12901 Bruce B Downs Blvd, Tampa, FL 33612, USA
2 Department of Neurosurgery, Nicklaus Children’s Hospital, 3100 SW 62nd Avenue, Miami, FL 33155, USA
Front. Biosci. (Landmark Ed) 2018, 23(1), 162–182; https://doi.org/10.2741/4586
Published: 1 January 2018
(This article belongs to the Special Issue Cellular and molecular neuroscience)
Abstract

Deep brain stimulation (DBS) has emerged as a revolutionary treatment option for essential tremor (ET), Parkinson’s disease (PD), idiopathic dystonia, and severe obsessive-compulsive disorder (OCD). This article reviews the historical foundations of DBS including basal ganglia pathophysiological models, classic principles of electrical stimulation, technical components of the DBS system, treatment risks, and future directions for DBS. Chronic high frequency stimulation induces a number of functional changes from fast physiological to slower metabolic effects and ultimately leads to structural reorganization of the brain, so-called neuroplasticity. Examples of each of these fast, slow, and long-term changes are given in the context of Parkinson’s disease where these mechanisms have perhaps been the most intensely investigated. In particular, details of striatal dopamine release, expression of trophic factors, and a possible neuroprotective mechanism of DBS are highlighted. We close with a brief discussion of technical and clinical considerations for improvement. Deep brain stimulation will continue to offer a reversible and safe therapeutic option for a host of neurological conditions and remains one of the best windows into human brain physiology.

Keywords
Basal ganglia
Biophysics
Neuromodulation
Parkinson’s disease
Stereotaxy
Review
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