The History and Future of Deep Brain Stimulation

Abstract

Summary:The advancement of electrical stimulation of the central nervous system has been a story of fits and bursts with numerous setbacks. In many ways, this history has paralleled the history of medicine and physics. We have moved from anecdotal observation to double-blinded, prospective randomized trials. We have moved from faradic stimulation to systems that lie completely under the skin and can deliver complex electrical currents to discrete areas of the brain while controlled through a device that is not much bigger than a PDA. This review will discuss how deep brain stimulation has developed into its current form, where we see the field going and the potential pitfalls along the way.

Neuromodulation in Psychiatric disorders: recent findings and clinical implications

“…The electrical ray was named Torpedo nobiliana by the Romans and narke by the Greeks for its ability to subdue its preys and defend itself against predators numbing them with a 220v electrical discharge. In 46 BC this fish was used to improve severe headache, and due to its remarkable efficacy in pain relief, it was widely used until the 18th century in several diseases as gout, depression and epilepsy [1].…”

“…In fact, the results of their research showed different types of responses, from small arm movements to seizures, depending on the intensity of electrical current applied to the brain cortex [2]. However, only 80 years later, the development of stereotaxy in 1947 by Spiegel et al led to a true revolution in neurosurgical techniques, and conditions for brain placement of electrodes emerged [1]. With this new tool and brain mapping, mortality drops to 1%.…”

“…In the middle of the 20 th century, the first reports of temporary electrode placement in different brain regions for pain control are published, and in the early 1970s chronic deep brain stimulation (DBS) begins with electrode placement in the thalamus for the treatment of chronic pain [1]. Good results that this new therapeutic strategy accomplished in the field of chronic pain, but also in movement disorders led to its application in several other clinical conditions, namely psychiatric disorders.…”

The Potential Transformation of Our Species by Neural Enhancement

“…This kind of scenario needs thinking about as we continue to move toward more technologically complex and integrated prosthetics such as brain machine interface or implanted stimulators. The concept that direct action in the nervous system could be had by electrically stimulating the brain has been with us for a very long time but was clearly established by Fritsch and Hitzig in 1864 (see for review Mussa-Ivaldi & Miller, 2003;Schwalb & Hamani, 2008). Until recently applications of brain stimulation have been largely in the realm of neuroscience research and some clinical diagnostic applications.…”

Surgical Experimental Neurotherapeutics

“…2 There are well-established therapies, such as DBS for specific movement disorders, 3 spinal cord stimulation, 4 intrathecal drug delivery, 5 sacral nerve stimulation, 6 and vagal nerve stimulation for epilepsy. 7 Other therapies have FDA approval but are only now becoming more well known, such as peripheral nerve stimulation.…”