Single Cases Promote Knowledge Transfer in the Field of DBS

The development and clinical application of deep brain stimulation (DBS) is based on the cooperation of various disciplines in order to address its neuroscientific, neurological, psychological, technological, and ethical challenges (Benabid et al., 2009). Safeguarding the quality of this interdisciplinary cooperation requires that novel issues (e.g., on adverse events) are raised timely in the scientific community and are communicated across disciplinary borders. In this opinion, we describe the development of the complexity of DBS research and assess knowledge transfer in terms of citations that transcend disciplinary borders. Our argument is based on an extended, ongoing meta-analysis of scientific journal papers on DBS in the nucleus subthalamicus (STN); a literature body that comprises more than 550 case reports, outcome studies, and review papers (Müller and Christen, 2011). Because STN–DBS, beginning in the early 1990s, is the most common DBS application, lessons learned in STN–DBS are important for evaluating clinical, societal, and ethical issues of novel DBS applications that emerge in psychiatry and other fields. The complexity of DBS research is illustrated by the various issues that are discussed in the DBS literature. Our metaanalysis revealed a broad range of issues that can be grouped into four classes (see Figure 1A):