[Networkmodulation through deep brain stimulation].

BACKGROUND

Deep brain stimulation (DBS) is widely performed since 1987, mainly in the realm of movement disorders.

AIM: To provide an overview of the current state of DBS in various neuropsychiatric disorders and to provide an overview of new developments.

METHOD: Narrative review of recent literature.

RESULTS

Several studies have shown the potential of DBS for carefully selected patients suffering from refractory neuropsychiatic indications such as Tourette syndrome, obsessive-compulsive disorder, depression, and Alzheimer’s disease. Applying for a CE or FDA approval by the implant manufacturer by means of double-blinded controlled trials has become highly cumbersome because of the new stricter European medical device regulation. For these RCTs to be successful, a sufficiently long follow-up time and the neurosurgeon’s knowledge of the most optimal stimulation point are required. The latest technical advances focussing on network stimulation have greatly added to defining this optimal stimulation point per disease.

CONCLUSION

DBS is a safe technique with a proven effect on more than 200,000 patients with movement disorders. Trials into the application of DBS for the most important psychiatric and cognitive indications are important.