Deep Brain Stimulation-Emerging Indications and Newer Techniques: A Current Perspective
Fayrouz Moidu
James Parkinson’s Movement Disorder Research Centre, Kannur Medical College, Kerala, India.
Sujith Ovallath *
James Parkinson’s Movement Disorder Research Centre, Kannur Medical College, Kerala, India and BMH Gimcare Hospital and Aster Group, Kerala, India.
*Author to whom correspondence should be addressed.
Abstract
Deep brain stimulation (DBS) is in clinical use for more than three decades and its indications are ever expanding. Conventionally DBS is used in the treatment of Parkinson’s disease (PD), tremor and dystonia, and has been approved by FDA. It has been tried in several other indications with encouraging results. Recently a DBS device has been approved for use in intractable epilepsy. DBS is giving promising results for use in obesity, trigeminal vascular cephalalgias, and Tourette syndrome and post stroke rehabilitation. Many psychiatric conditions like depression, obsessive compulsive disorder, anorexia nervosa and substance abuse can be controlled with DBS when conventional medical treatment fails to relieve the symptoms. Newer techniques in DBS like directional leads, variable frequency stimulation, newer target identifications, Newer MRI compatible devices, remote programming, newer DBS recording electrodes that can be used in finding out the pathophysiology of disease is also discussed.
Keywords: Deep brain stimulation, dystonia, tremor, tourette