Author:
Groppa Sergiu,Gonzalez-Escamilla Gabriel,Tinkhauser Gerd,Baqapuri Halim Ibrahim,Sajonz Bastian,Wiest Christoph,Pereira Joana,Herz Damian M.,Dold Matthias R.,Bange Manuel,Ciolac Dumitru,Almeida Viviane,Neuber John,Mirzac Daniela,Martín-Rodríguez Juan Francisco,Dresel Christian,Muthuraman Muthuraman,Adarmes Gomez Astrid D.,Navas Marta,Temiz Gizem,Gunduz Aysegul,Rotaru Lilia,Winter Yaroslav,Schuurman Rick,Contarino Maria F.,Glaser Martin,Tangermann Michael,Leentjens Albert F.G.,Mir Pablo,Torres Diaz Cristina V.,Karachi Carine,Linden David E.J.,Tan Huiling,Coenen Volker A.,
Abstract
<b><i>Background:</i></b> Deep brain stimulation (DBS) is a highly efficient, evidence-based therapy to alleviate symptoms and improve quality of life in movement disorders such as Parkinson’s disease, essential tremor, and dystonia, which is also being applied in several psychiatric disorders, such as obsessive-compulsive disorder and depression, when they are otherwise resistant to therapy. <b><i>Summary:</i></b> At present, DBS is clinically applied in the so-called open-loop approach, with fixed stimulation parameters, irrespective of the patients’ clinical state(s). This approach ignores the brain states or feedback from the central nervous system or peripheral recordings, thus potentially limiting its efficacy and inducing side effects by stimulation of the targeted networks below or above the therapeutic level. <b><i>Key Messages:</i></b> The currently emerging closed-loop (CL) approaches are designed to adapt stimulation parameters to the electrophysiological surrogates of disease symptoms and states. CL-DBS paves the way for adaptive personalized DBS protocols. This review elaborates on the perspectives of the CL technology and discusses its opportunities as well as its potential pitfalls for both clinical and research use in neuropsychiatric disorders.
Subject
Neurology (clinical),Surgery