Deep Brain Stimulation for the Management of Refractory Neurological Disorders: A Comprehensive Review

Abstract

In recent decades, deep brain stimulation (DBS) has been extensively studied due to its reversibility and significantly fewer side effects. DBS is mainly a symptomatic therapy, but the stimulation of subcortical areas by DBS is believed to affect the cytoarchitecture of the brain, leading to adaptability and neurogenesis. The neurological disorders most commonly studied with DBS were Parkinson’s disease, essential tremor, obsessive-compulsive disorder, and major depressive disorder. The most precise approach to evaluating the location of the leads still relies on the stimulus-induced side effects reported by the patients. Moreover, the adequate voltage and DBS current field could correlate with the patient’s symptoms. Implantable pulse generators are the main parts of the DBS, and their main characteristics, such as rechargeable capability, magnetic resonance imaging (MRI) safety, and device size, should always be discussed with patients. The safety of MRI will depend on several parameters: the part of the body where the device is implanted, the part of the body scanned, and the MRI-tesla magnetic field. It is worth mentioning that drug-resistant individuals may have different pathophysiological explanations for their resistance to medications, which could affect the efficacy of DBS therapy. Therefore, this could explain the significant difference in the outcomes of studies with DBS in individuals with drug-resistant neurological conditions.

Understanding Drug-Induced Movement Disorders: Causes, Symptoms, and Treatment

“…DBS is a surgical procedure that involves implanting electrodes in the brain to deliver electrical stimulation to targeted areas. DBS can be an effective treatment for dystonia in some cases, mainly when other treatments have been unsuccessful [19]. These therapies can help improve muscle strength, flexibility, and coordination, enhancing functional abilities and reducing disability associated with dystonia.…”

A Literature Review of Movement Disorder Associated with Medications and Systemic Diseases

“…Deep brain stimulation (DBS) is a surgical procedure involving the implantation of a device that delivers electrical stimulation to specific brain areas. While DBS is more commonly used to treat movement disorders such as Parkinson's disease, essential tremor, and dystonia, its role in addressing drug-induced movement disorders is less established [200]. DBS is typically considered for individuals with movement disorders that are not adequately controlled by medications or when medication side effects become problematic.…”

Flapping Tremor: Unraveling Asterixis—A Narrative Review

“…Improving both movement disorders can suggest a common pathologic mechanism for these two pathologic movements [ 141 ]. The globus pallidus stimulation and significant asterixis improvement suggest that the postural stability and tonic control may be partially modulated by the globus pallidus [ 142 ]. Interestingly, thalamic lesions can lead to the development of asterixis, so patients undergoing thalamic targets for the management of refractory neurological conditions should be cautiously assessed in the follow-up for asterixis because this abnormal movement can affect the procedure’s efficacy.…”