We estimate that 208,000 deep brain stimulation (DBS) devices have been implanted to address neurological and neuropsychiatric disorders worldwide. DBS Think Tank presenters pooled data and determined that DBS expanded in its scope and has been applied to multiple brain disorders in an effort to modulate neural circuitry. The DBS Think Tank was founded in 2012 providing a space where clinicians, engineers, researchers from industry and academia discuss current and emerging DBS technologies and logistical and ethical issues facing the field. (...) The emphasis is on cutting edge research and collaboration aimed to advance the DBS field. The Eighth Annual DBS Think Tank was held virtually on September 1 and 2, 2020 (Zoom Video Communications) due to restrictions related to the COVID-19 pandemic. The meeting focused on advances in: (1) optogenetics as a tool for comprehending neurobiology of diseases and on optogenetically-inspired DBS, (2) cutting edge of emerging DBS technologies, (3) ethical issues affecting DBS research and access to care, (4) neuromodulatory approaches for depression, (5) advancing novel hardware, software and imaging methodologies, (6) use of neurophysiological signals in adaptive neurostimulation, and (7) use of more advanced technologies to improve DBS clinical outcomes. There were 178 attendees who participated in a DBS Think Tank survey, which revealed the expansion of DBS into several indications such as obesity, post-traumatic stress disorder, addiction and Alzheimer’s disease. This proceedings summarizes the advances discussed at the Eighth Annual DBS Think Tank. (shrink)

Deep brain stimulation of the subthalamic nucleus or the globus pallidus is an established treatment for Parkinson’s disease that yields a marked and lasting improvement of motor symptoms. Yet, DBS benefit on gait disturbances in PD is still debated and can be a source of dissatisfaction and poor quality of life. Gait disturbances in PD encompass a variety of clinical manifestations and rely on different pathophysiological bases. While gait disturbances arising years after DBS surgery can be related to disease progression, (...) early impairment of gait may be secondary to treatable causes and benefits from DBS reprogramming. In this review, we tackle the issue of gait disturbances in PD patients with DBS by discussing their neurophysiological basis, providing a detailed clinical characterization, and proposing a pragmatic programming approach to support their management. (shrink)

Die Tiefe Hirnstimulation hat sich in den vergangenen Jahren bei der Behandlung schwer ausgepragter neurologischer Storungen wie dem Morbus Parkinson bewahrt. WEgen dieses Erfolges werden neue therapeutische Anwendungsmoglichkeiten intensiv erforscht. AUssichtsreiche Ergebnisse liefern dabei auch die ersten Studien an Patienten mit verschiedenen psychiatrischen Erkrankungen, bei denen alle anderen Therapieansatze erfolglos geblieben sind. DIe Tiefe Hirnstimulation weckt jedoch auch Angste. DIese beziehen sich zum Teil auf den fur ihre Anwendung erforderlichen neurochirurgischen Eingriff, bei dem Elektroden dauerhaft in das Gehirn implantiert werden, (...) die uber eine ebenfalls implantierte Stimulatoreinheit mit Strom versorgt werden. ALlerdings wirft insbesondere die Moglichkeit, mit einer neurotechnischen Intervention Einfluss auf das Verhalten bzw. Die Psyche von Menschen nehmen zu konnen, neben medizinethischen auch viele Fragen grundsatzlicher philosophischer Natur auf. IN diesem Sachstandsbericht wird der Stand der medizinischen Anwendung und Erforschung der Tiefen Hirnstimulation in einem neurologischen und einem psychiatrischen Teil zusammengefasst, gefolgt von einer ausfuhrlichen Auswertung der philosophischen Literatur zum Thema. (shrink)