Investigation of the therapeutic applications, neuroanatomical targets and emerging technologies in deep brain stimulation surgery

Background First developed in France in 1987, Deep Brain Stimulation (DBS) is a neurosurgical intervention that involves the implantation of a brain pacemaker, which electrically stimulates specific brain nuclei.1 The FDA approved DBS for treatment for Essential Tremor in 1997, Parkinson’s Disease in 2002 and Dystonia in 2003.1 More recently, DBS has been indicated in management of neuropsychiatric disorders such as: Chronic Pain, Major Depression, Obsessive Compulsive Disorder and Anorexia Nervosa. Although effective, the exact mode of function of DBS remains poorly understood. Up to 2012, literature search yielded 84 peer-reviewed DBS studies that included over 296 psychiatric patients.2 The Canadian United Health Network (UHN) Krembil Neuroscience Centre is pioneering DBS research. Current neuroimaging, intra-operative electrophysiology and emerging DBS electrode and targeting technologies have improved DBS accuracy, effectiveness and acceptability. Objective: To examine the role of DBS in the management of motor and neuropsychiatric disorders and to provide, for the first time, a review of all anatomical DBS targets to date. To evaluate the accuracy of emerging DBS targeting and electrode technologies.