Evolution of Deep Brain Stimulation: Human Electrometer and Smart Devices Supporting the Next Generation of Therapy.

Abstract

Deep Brain Stimulation (DBS) provides therapeutic benefit for several neuropathologies including Parkinson's disease (PD), epilepsy, chronic pain, and depression. Despite well established clinical efficacy, the mechanism(s) of DBS remains poorly understood. In this review we begin by summarizing the current understanding of the DBS mechanism. Using this knowledge as a framework, we then explore a specific hypothesis regarding DBS of the subthalamic nucleus (STN) for the treatment of PD. This hypothesis states that therapeutic benefit is provided, at least in part, by activation of surviving nigrostriatal dopaminergic neurons, subsequent striatal dopamine release, and resumption of striatal target cell control by dopamine. While highly controversial, we present preliminary data that are consistent with specific predications testing this hypothesis. We additionally propose that developing new technologies, e.g., human electrometer and closed-loop smart devices, for monitoring dopaminergic neurotransmission during STN DBS will further advance this treatment approach.

DOI: 10.1111/j.1525-1403.2009.00199.x
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@article{Lee2009EvolutionOD, title={Evolution of Deep Brain Stimulation: Human Electrometer and Smart Devices Supporting the Next Generation of Therapy.}, author={Kendall H Lee and Charles D Blaha and Paul A Garris and Pedram Mohseni and April E Horne and Kevin E Bennet and Filippo Agnesi and Jonathan M Bledsoe and Deranda B Lester and Chris Kimble and Hoon-Ki Min and Young-Bo Kim and Zang-Hee Cho}, journal={Neuromodulation : journal of the International Neuromodulation Society}, year={2009}, volume={12 2}, pages={85-103} }