The Development of Deep Brain Stimulation for Movement Disorders

Abstract

The development of deep brain stimulation has revolutionized care for patients with movement disorders like Parkinson's disease. Many areas of science contributed to this technology but one area, the use of animal models, has been cited as vital. We review these claims as well as the history of the discoveries that eventually led to deep brain stimulation in an attempt to ascertain: 1) the contributions of animal models; 2) the contributions from humanbased research and observation; and the role of advances in the engineering, physics, and computer science. We distinguish between advances and discoveries that were, or at least appear to be, dependent on animal models and those where animals were involved but that could have occurred, and/or were occurring simultaneously, with humanbased research. We conclude that animal-based research played a role in defining gross anatomy in the 19 th and early 20 th centuries, but that essentially all subsequent advances were human-based or secondary to advances in the physical and applied sciences. This has historical, funding, and ethical implications as the development of deep brain stimulation is cited as an example of the importance of animal-based research and a reason for continued social and financial support of animal models in general as opposed to clinical research, other human-based research modalities, and the various disciplines of the physical and applied sciences.

Human Stakeholders and the Use of Animals in Drug Development

“…5. See Greek (2012), Greek (2014a,b,c), Greek and Greek (2010), Greek and Hansen (2012, 2013a, 2013b, Greek et al (2011Greek et al ( , 2012aGreek et al ( , 2012b, Greek and Menache (2013), Greek and Pound (2002), Greek and Rice (2012), Shanks (2009), Jones andGreek (2013), Shanks and Greek (2008), and 6. The reader might wonder, if the animal model is so poor at predicting birth defects in humans, then why have we not seen another thalidomide-like disaster?…”

“… See Greek (), Greek (), Greek and Greek (), Greek and Hansen (), Greek et al (), Greek and Menache (), Greek and Pound (), Greek and Rice (), Greek and Shanks (), Jones and Greek (), Shanks and Greek (), and Shanks et al ().…”

Non-human Primates in Neuroscience Research: The Case against its Scientific Necessity

“…Anecdotal evidence, citing NHP experiments in which STN-DBS has been investigated, is not sufficient; the mere use of NHPs in DBS research/investigation of the STN is no measure of their crucial nature or of their contribution to the field. Indeed, a critical and comprehensive review of the literature that includes all methods of investigation, alongside other summaries of evidence, provides a compelling case against the necessity of NHP research in the development of STN-DBS, and in support of human observation and neurosurgical investigation alone as the foundation of DBS treatment of PD (93,94), and these accounts should be consulted for an in-depth argument against it. These arguments are summarised in a recent 'Letter to the Editor' published in ATLA, dedicated to the issue (95).…”

A Discussion of the Role of Complex Evolved Systems in the Development of Invasive Cardiovascular Interventions as Illustrated by the Blalock- Taussig Shunt and Intra-Arterial Stents

“…In light of the fact that animal models are subject to Complexity Theory and the Theory of Evolution, I have developed a theory regarding the problem of using one evolved CAS as a model in order to predict responses of a second: Trans-Species Modeling Theory (TSMT) [67,[105][106][107][108][109][110][111][112][113][114][115][116][117][118][176][177][178]. TSMT can be summarized thusly: While transspecies extrapolation is possible when perturbations concern lower levels of organization or when studying morphology and function on the gross level, one evolved complex system will not be of predictive value for another when the perturbation affects higher levels of organization" [116].…”

“…I have addressed the problems with using one CAS to model another for perturbations that affect higher levels of organization and refer the reader to the following references for more on this particular aspect of CASs: [67,[105][106][107][108][109][110][111][112][113][114][115][116][117][118]]. …”